Newby here, Corey with Tuki (11.5 y/o Boston Terrier) Tuki has crossed the Bridge

[CoreyW]

Hi all! So glad I found this forum. I know I will have a lot to ask and say in the future. I am Mom to a 11 1/2 year old Boston Terrier girl named Tuki. (Say Tookie). She has developed symptoms of Cushing's about a year and half ago. All the signs are there now. Panting, thirsty, peeing, hungry, weak back legs. I am going to find out how much the testing is and get it done. The vet didn't push for it at our last visit, but I want it now. Any how, I wish we could just start the meds now. But I understand we need to know the numbers before dosing. I welcome any info or questions. Anybody else here in Northern Illinois?

[mytil]

Hi Corey, and welcome to our site; we are glad you found us too. I am sorry your Tuki is having these troubles.

Yep, you are right the test results do need to point to a definite diagnosis of Cushing's.

I wanted to pass on this link that has some great reading on Cushing's, the diagnosis process and treatment - http://www.k9cushings.com/forum/showthread.php?t=180.

It is very important to get a confirmed diagnosis before starting any medical treatment.

Keep us posted.
Terry

[jxeno13]

Hi Corey and Tuki! Welcome to the site! I'm just here to say hi. I'm just learning and researching all this Cushing's stuff myself. My Eli was recently diagnosed in March with a pituitary dependant Cushing's. ...and we've already had our problems with medication, etc. We're learning fast.

The others will be along soon and help you. The REAL authorities on this horrid thing called Cushing's disease.

Things might be a little slow today it being Mother's Day..and one of our favorite babies crossed the bridge the other day.....and many are still really sad over losing her.

But, good luck....and know there are many wonderful people here that will help you! :D

[Harley PoMMom]

Hi Corey,

Welcome to you and Tuki from me as well!! I am so glad you found us and we will help in any way we can.

Cushing's is one of the most difficult diseases to diagnose and unfortunately, it is also one of the most misdiagnosed. There isn't just one test that is conclusive, so a vet has to rely on more than one diagnostic and validation test.

Strong symptoms, as Tuki is displaying, do play a huge part in a Cushing's diagnosis, but a lot of these same symptoms are shared by other non-adrenal health issues such as diabetes and hypothyroidism, have these been ruled out? How much does Tuki weigh? Is she taking any other medicines/herbs/supplements?

The LDDS, ACTH, UC:CR, and/or an ultrasound are the diagnostic tests used to help diagnose Cushing's. If Tuki has no other health issues, if this were me, I would start with the low-dose dexamethasone suppression (LDDS) test, the LDDS test is commonly used as a screening test for canine Cushing's and, in some cases, the results can be used to distinguish pituitary-dependent hyperadrenocorticism (PDH) from adrenal-dependent hyperadrenocorticism (ADH).

Cushing's can be expensive to start with because the initial expense is during the diagnostic phase, the cost of treating for Cushing's usually goes down significantly after you've got the diagnosis confirmed and the treatment underway.

Please feel free to ask all the questions you want and know we are here for you both. ;)

Hugs, Lori

[Spencersmom]

Hi Corey! You've found a great place for support and advice! Everyone here becomes family! I recently received Cushings diagnosis for my Spencer and had it not been for all the great advice and links provided that explained what is going on, I really don't know if I would have been the informed advocate my baby needed!

You are in great hands!

[molly muffin]

Hello and welcome to you and Tuki. What a cute name.

Once you start testing, make sure you get copies of all your test results. One we'll be asking for them constantly, and second, you'll want to start your own file of test and results on Tuki, so you can refer back to it when making decisions during treatment etc.

Has the vet done any cbc's yet? Urinalysis? If so do you have those results by any chance?

Welcome to the forum. We'll be right here with you every step of the way.

Sharlene and Molly muffin

[goldengirl88]

Hi Corey and welcome to you and Tuki, the others have already gone through all the questions to get you started, so I won't continue with that. I hope to see Tuki's numbers posted so we can help you thru this journey. This is one big family with lots of knowledge and support. Blessings
Patti

[CoreyW]

Good morning. Tuki is my little chunk, she weighs in around 30 lbs. We checked urine for UTI and diabetes and is all clear for those. Oh, I do not have any of her numbers for those tests. I have not tried any other suppliments. What would help at this point? Need to get ready for work, but she gets to stay home with my hubby who is retired. She has quite the life of laying around all day. Thanks all!

[CoreyW]

Good morning all. The copy below came from this website. Why would you NOT treat the dog?

http://www.kateconnick.com/library/cushingsdisease.html

Treatment: Treatment depends on the type of Cushing's disease, as well as on the overall health of the canine patient. As many dogs with Cushing's are elderly and may have concurrent health problems, treatment can be complicated. The comfort of the patient should be the ultimate goal. In a dog with severe arthritis, for example, it may be more humane to allow him to remain Cushingoid than to treat the disorder. In general, surgery may be indicated for adrenal tumors. Chemotherapy in the form of Lysodren or Ketaconazole may be used to treat pituitary-dependent or adrenal-based Cushing's. And Anipryl may be tried to combat pituitary-dependent Cushing's. Treatment is best viewed as a means to improve quality of life, rather than increase lifespan, per se.

[CoreyW]

Ok, I read the rest of the article. Makes sense I guess. Does anybody hold back a little bit on the water? And why are the evening times so much worse. She is like a different dog after 6 pm. Can't hold her urine very well in the evening. But she can go all day and lay around and only pee every couple of hours. After 6 or so I have to make sure to let her out every HOUR. Then we are ok, and the house stays dry.

[Harley PoMMom]

Restricting water can be life threatening to a dog with Cushing's. Cushing's is when a dog's system produces excessive amounts of cortisol. This over abundance of cortisol makes the kidneys work more than usual and thus a dog's urination is increased greatly, so to compensate for all that urine output a dog must drink buckets of water and has to have water available at all times.

Cortisol fluctuates in a dog's body so it may be that Tuki's cortisol increases more at night.

Hugs, Lori

[CoreyW]

I have been having a heart attack over the fact that we may not be able to treat Tuki. But the following info I found today does make me feel better. We are seeing the vet this Saturday to discuss what might be done for her.

from a couple of threads I saw today:
The goal of treatment is to remedy problematic symptoms of Cushing's, which are usually a bigger problem for the owner than the dog. Cushing's is not a painful disease. Dogs are usually quite okay with it, especially dogs with arthritis. Excess cortisol is a strong anti-inflammatory so these dogs are self medicating, masking signs of arthritis. If Max were to actually have Cushing's, lowering his cortisol with treatment could be quite painful for him so this is something to consider. Aside from the excessive panting, the two most problematic symptoms are excessive drinking and peeing which causes a once housebroken dog to start to have accidents in the house and a voracious appetite......(which she is not so bad)

And:::::: I do agree with Glynda that, even if your dog does suffer from Cushing's, there are several factors to balance in terms of treatment decisions. With a dog of that age, comfort and quality of life become the paramount issues in my own mind. So in the absence of many classic overt symptoms, it would be a hard call for me to put a senior dog through the stress of the diagnostics and monitoring tests associated with treatment. I would be more concerned about immediate comfort than risks of long-term damage caused by chronic effects of untreated disease.

[CoreyW]

No other comments to my post? Figures, if I decide not to treat, I will probably not hear from you guys again.

[labblab]

Gosh Corey, I was not intentionally ignoring you, but from what you had written, I thought it would not be until after your Saturday conversation with your vet that we would have any more details to talk over with you. At this point, I am uncertain as to whether or not you will be proceeding with any testing that would be the prelude to starting treatment. Have you already made up your mind about that? Do you have any specific questions that you want to ask us before Saturday?

Marianne

[Harley PoMMom]

No other comments to my post? Figures, if I decide not to treat, I will probably not hear from you guys again.

Oh Corey,

I am sorry that I didn't respond to your post until now, it's been hectic for me lately. Let me make one thing clear, we are not here to judge any one and we will always be here for you whether you decide to treat or not, ok?

Every dog is different so I truly believe that there are many things that will influence a person to decide to treat or not. A dog's health is a huge factor when deciding and if it is suspected that the dog's quality of life would be worse from treatment then I would agree that no treatment should be pursued. Every dog is an individual, there is no "one size fits all" when dealing with Cushing's.

Hugs, Lori

[molly muffin]

Hi Corey, Sorry that no one posted after your last comment. I can certainly say that just because one decides not to treat, or not treat yet, or to wait and monitor doesn't mean that we stop talking. If so I wouldn't have been here all these years. We are in a wait and monitor stage and have been for years, just seeing where things go.

It's the nature of the beast that is cushings that there is no one thing right for every dog and each one has to be evaluated on their own merits. That is what we are doing, still doing and here we are :)

I think that many people when they are dealing with a 16 year old, have to make choices about whether to treat or not and gauge it against quality of life. There is no right or wrong decision, just what is best for Tuki and you.

Again I too apologize for the lack of communication.

Sharlene and molly muffin

[CoreyW]

Thanks, I guess I am just a bit nervous. but, she is really doing very well. We have not had an evening pee accident in over a week or so and still is my silly girl. I guess I would like to hear more from the folks who have not treated their dogs to see what they were like and how long they lasted. Along with the questions about her Cushing's symptoms......we are also having her butt looked at this visit because she has a strange condition back there that looks awful but doesn't bother her. Almost like 'roids but not really. Anyways, thank you.

[lulusmom]

Hi Corey,

I'm glad the others posted and I wanted to add my own apologies for making you feel like you were being ignored. I assure you that is not the case. I am personally more prone to smothering or confusing people with too many of my opinions so . Sometimes threads disappear on the second page and sometimes they are missed but as Marianne mentioned, I think most of us were anxiously awaiting your update after Saturday's appointment. If this should happen in the future, please repost with just "bumping up" or do like I do and type "AHEM!" :D

Now that you have my undivided attention, I'd be happy to share some comments that I was keeping until you reported back on your vet appointment. With respect the information you posted from the Kate Connick site, you should know that while a lot of that information is still good, Ms. Connick has not kept that page current, and I am talking information that is several years old. Treatment considerations are very much different now. Lysodren and Ketoconazole are listed as the two first treatments for both pituitary (PDH) and adrenal (ADH) cushing's. That is not true today. With respect to PDH, the two most effective treatments are Vetoryl (Trilostane) and Lysodren. With respect to ADH, Vetoryl seems to have become the treatment of choice. The reason for that is that adrenal tumors are highly resistant to Lysodren, requiring massive doses to achieve loading. Side effects at these large doses are almost guaranteed. Vetoryl was only the second veterinary drug to be approved by the FDA for treatment of cushing's. As I recall, it was approved in 2008. Prior to that, Lysodren was definitely the only effective drug, with many cushing's experienced vets prescribing this drug for years and years with good results. Lysodren seems to have fallen out of favor with the veterinary community, primarily due Vetoryl's reputation for having less risk of side effects. Lysodren can kill a dog if a vet is ignorant enough and an owner places blind faith in that vet and Vetoryl can also kill a dog under the same circumstances. Both are serious drugs that need to be respected and most certainly, understood. I am intimately familiar with both drugs as my two cushdogs treated with both, with excellent results. Why I switched is a long story so I'll save that for another day.

Ketoconazole is rarely prescribed anymore because 1) a good number of dogs simply don't absorb into the GI tract and 2) it can have a marked effect on the liver. Anipryl was the first drug approved by the FDA for treatment of cushing's and unfortunately it turned out to be a big disappointment. Depending on the experts you follow, efficacy is anywhere from 0% to 20%. It really is only effective in dogs having a pituitary tumor in the pars intermedia lobe. Only a very small percentage of dogs have a tumor in the pars intermedia an efficacy in those dogs is questionable, depending on the progression of the disease. I can tell you that the 0% comes from renown specialist, Edward C. Feldman. He lectures frequently on treatment options and when he gets to Anipryl, he tells students/audience to get a pen and paper and write this down...."Anipryl does nothing" for cushing's. He then goes on to say that the information submitted by the developers to the FDA proved that it didn't work and that he had no idea why the FDA approved it. However, we have had a few members who reported improvement in symptoms with Anipryl. I just don't remember if those few members continued to see improvement.
Hopefully this information will help you if you ultimately decide to treat Tuki.

With respect to Kate Connick's information on treating elderly dogs, what she doesn't tell people, which I think is completely misguided, is that most dogs are pretty senior at diagnosis. Some people may not know that it is often referred to as old dog's disease. If we all chose not to treat because our dog was old, we'd be mopping up pee 24/7 and going crazy watching our dogs beg and rummage for food. My first dog was only three years old when she was diagnosed so it was a no brainer for me. She lived another 8 years with treatment. My second cushdog was a shelter rescue who was definitely very senior and very debilitated by the disease. He lived another five years with treatment. While the drinking and peeing never resolved, his quality of life was greatly improved with treatment. I'd do it all over in a heartbeat. My advice to you is to ignore the horror stories you might read elsewhere on the internet. Most of the people writing those horror stories write enough for me and other experienced members to know that they are completely clueless about proper diagnose and treatment protocol. It seems you are off to a great start with reading threads. There are lots of case studies right here for you to observe first hand. If you have any questions, we're here to answer them and point you to credible resources to help further your education.

If you've spent a lot of time reading up on canine cushing's, you've probably seen that brachycephalic (short snouted) breeds seem to be predisposed to larger pituitary tumors. Boston Terriers are definitely up there at the top of the list. It is known that treatment with either Lysodren or Vetoryl can facilitate growth of those tumors. That doesn't always happen but if it does, the dog would start to show neuro signs at some point. If I shared my life with a Boston Terrier, the possibility of an expanding tumor would definitely be a consideration for me. Opting for treatment is a very personal decision but that decision should be an educated one. We're here to help you and Tuki in any way we can. We can help educate you but we can also provide an invaluable support system. You are family now and just remember that we may be silent after your post but that doesn't mean we've let go of your hand or Tuki's paw.

Glynda

[CoreyW]

Hi all. Thank you for your post, Glynda. Well, maybe I jinxed Tuki by saying she was doing so well. Her back legs have just gotten so weak she can barely get down the couple of deck stairs to the yard. Really don't know what we want to do for her. Does treating help with the muscle weakness? Wasn't sure if it did. We are getting pretty sad over here. But hubby is not ready to let her go yet.

[goldengirl88]

Since you have not treated Tuki she has high cortisol surging through her body. This high cortisol wastes muscle tissue, immobilizes fat, and weakens ligaments. Unfortunately the truth of the matter is if you do not treat her her muscle wasting etc. will get worse. This also does damage to their organs. If you are thinking of treating her, if it were my dog, I would want to treat her before the situation you describe got worse. It will not get better on it's own. This is all we currently have to manage this disease, trilostane or lysodren. I am sorry you and
your Tuki are are going thru this, but it all comes down to the quality of life the dog has. Blessings
Patti

[Harley PoMMom]

Does treating help with the muscle weakness? Wasn't sure if it did. We are getting pretty sad over here. But hubby is not ready to let her go yet.

Treating does help with the muscle wasting but it may take a while to see improvements in that area. How is her appetite? Is she drinking/urinating normally?

Hugs, Lori

[addy]

Sorry to read this. Are you sure something else is not going on? Weakness in the hind legs can be from something other than Cushings.

What happened with her tush issues?

[labblab]

Just wanted to agree with the others that, with some time, appropriate Cushing's treatment can stop the progression of muscle wasting and allow a dog to rebound and return to more normal activity levels. I know you have been holding off on treatment as you weigh quality of life issues, but it sounds as though the scales may now be tipping toward treatment if Corey is essentially becoming immobolized. Has Corey actually been formally tested for Cushing's yet -- as Addy says, to have confirmation that Cushing's is indeed the source of the problems?

Marianne

[goldengirl88]

just wanted to check in with Tuki and see how things are going and what you decided to do? Blessings
Patti

[CoreyW]

Sad to say but we had to let her go the 3rd of July. It was just time and we are peaceful about it. I stayed with her until the end. Thank you for all your help.

[addy]

I am so sorry to hear about Tuki. My heart goes out to you.

[molly muffin]

My sincerest condolences on the loss of your precious Tuki.

My heart goes out to you.

hugs
Sharlene and molly muffin

[labblab]

Dear Corey,

I am so very sorry about the loss of your sweet girl. Thank you so much, though, for returning to tell us what has happened. This way, we can always join you in remembering and honoring her here.

Sending you many hugs, always in loving memory of your little Tuki.
Marianne

[Renee]

Rest in peace Tuki.

So sorry.

[Harley PoMMom]

Dear Corey,

I am so terribly sorry for the loss of sweet Tuki and my heart goes out to you at this most difficult time. Please know we are here for you and do understand.

With Heartfelt Sympathy,
Lori