Loving with tears

[execsupport]

My 13 year old dachshund, Maggie, has been diagnosed with Cushings. She has always been a very healthy dog. The only issues she had were allergies. She couldn't wear a nylon collar and almost every spring/summer, I used an OTC hydrocortisone spray once or twice to prevent her hair from falling out.

8 months ago, I notice she was lying around more and losing interest in a lot of things. I knew it was serious when she stopped staring at the parrot hoping he would "join her for dinner". The vet ran some basic blood work and did acupuncture for back issues.

2 months ago, I noticed she had developed a pot belly and it looked like her entire rear end had ballooned out into this huge lumpy ball. I took her to the vet again. Her weight had gone from 9 lb to nearly 17 lbs. Her hair was stiff, coarse and thinning. Her skin was dry. The vet suspected thyroid and drew blood for a full blood workup. She did not send the thyroid test off because she saw some other issues that made her think Cushing's. I took Maggie in a few days later for an all day test. I can't remember the name but they did something every hour for 8 hours. Maggie was then diagnosed with Cushing's.

The vet wanted to put her on Veterol and suggested I search the internet for a better price than she could get it for me which came to $80/month. I can't remember the dosage offhand. I found some at about $55 for the same dosage.

I'm in a serious quandary and I feel horribly guilty. I am an amputee and use a wheelchair at home. I have other health issues. I am in my mid-60's and fairly recently widowed. I have 4 adult Chihuahuas, an elderly Min Pin and Maggie. I also have a parrot and a pigeon. Caring for them was no problem at all when my husband was here. Except for Maggie's new needs, I manage relatively well. I have had to make pretty major financial adjustments trying to fit my life into my new budget restrictions.

I can't see how I can possibly afford treatment for Maggie. I managed to pay for her testing but had to use the money I planned to use for tires. Testing let me know where I am to identify needs.

I am trying to see how it is with just not treating her. I've tried 3 weight control dog foods and the only one she will eat is Hill's Perfect Weight. I am feeding it to her and the Min Pin by locking them in cages while they eat. In the meantime, the Chihuahuas eat an active adult food in the next room. Their bowl is picked up before Maggie gets let out. She doesn't like the Perfect Weight in her bowl and only nibbles. The Min Pin is the same. When I open the doors, she and the Min Pin swap to steal all the food out of each other's cages. Apparently Perfect Weight tastes better out of someone else's bowl. I keep Perfect Weight kibble with me so when she begs for food, I give her a piece. She is happy with that.

The problem I am truly having is the peeing. She has a big bladder any way for a little dog. Thank goodness I have mostly vinyl flooring. The floor in my bedroom is that super thin wood that they call hardwood floor. Underneath it all is concrete. I have puppy pad stations all over the house. I spend most of my day sopping up her pee and mopping the floor in sections. It's hard from a wheelchair. If I fall out of my chair, I have to use my medic alert button for firemen to come put me back in it.

I have had people tell me to just give her away but I have had her since she was 5 weeks old. She has to sleep on floor pillows now because of peeing. I've had surgeries recently that have not allowed me to pick up her weight so I can't take her in and out of the bed all night like I had been doing.

I need to have a sit down with my vet to see what alternatives I have. I hate the thought of euthanizing a pet because I can't afford treatment and I can't mop the floor all day long. I have been telling myself she's just fat, old and incontinent like her mom.

She is back staring at the parrot though. I guess Samson looks tastier than Perfect Weight out of Rhett's bowl.

Nancy

[labblab]

Welcome to our family, and I am so sorry for the many challenges you are facing, and especially for the recent loss of your husband. I have only a moment to post right now, but I sincerely hope you will be able to at least give treatment a try. I have a few suggestions that can make it more affordable. The first is to try using a compounded version of trilostane rather than brandname Vetoryl. This can save you a great deal of money. Current initial dosing recommendations made by many specialists and also the manufacturer of Vetoryl is to start using a formula of no more than 1mg. per pound. So for your dog, that would translate into about 15 mg. as a maximum. Compounding pharmacies can custom make trilostane at virtually any dose other than the exact dose in which Vetoryl capsules are produced. So, for instance, you could have 15 mg. capsules made up. Or, as an alternative that might be even better, you could initially have capsules made up in a smaller increment -- say 5mg. -- so that you can easily add or subtract capsules should the dose need to be raised or lowered. Here is a compounding pharmacy that many of our members use. You can call them directly to check out their pricing for comparison purposes: Diamondbackdrugs.com.

Secondly, the test that is the gold standard for monitoring treatment is the ACTH stimulation test. It is indeed expensive, but there is a way in which your vet can lessen the cost for smaller dogs. I will come back later and add a link with an explanation.

Last but not least, an alternative less expensive testing method that can be substituted at times for a full ACTH test is testing the baseline cortisol alone. The greatest risk to a dog on trilostane comes from overdosing and driving the cortisol too low. A baseline cortisol can give you a fair amount of reassurance that this has not happened, especially in conjunction with starting treatment at low doses of the medication.

So my hope is that by starting out with a low dose of the compounded trilostane, you will avoid unwanted side effects but still see some symptom relief that can improve over time with small, incremental dosing increases. If so, you may be able to limit the frequency of the more expensive monitoring testing.

A final thought is to check to see if your vet accepts "Care Credit." It is a special credit card program that allows you to pay for medical or veterinary bills, sometimes even at no interest whatsoever when the balance is repaid within a certain period of time.

Marianne

[Junior's Mom]

Hi, welcome to the forum. I don't know what blood work you have had done, but I would check the thyroid before moving to a cushings diagnosis. It is also a good idea to have a urine culture done to rule out an infection there. Cushings is slow to progress, so it's better to rule out other things beforehand.
Tracey

[molly muffin]

I just want to welcome you to the forum. Marianne has come up with some excellent suggestions that might help with Maggie's situation. Care Credit is especially helpful, as is going with the compounded trilostane rather the name brand vetroyl. Starting low, is good, you are likely to see improvement without as much risk.

Do you have any help that comes in that can help with Maggie too? or family that might help out with care? Once you get Maggies symptoms under control I think you will be able to manage her care better, without having to cage feed her. She just won't be As interested in the food, more like normal.

Sharlene and molly muffin

[execsupport]

Marianne, thanks so much for the suggestions. I will pass them onto my vet. She has other Cushing's patients and it could help all of us. I have a lady who comes in for half a day once a week. She gives the floors a really good mopping. My nearest family is several states away. The cage feeding actually has worked out great. The Min Pin and my 2 lb male Chihuahua became food aggressive after I had them neutered. I have Maggie, Rhett the Min Pin and Chico the Chihuahua all in separate cages for feeding while the other three Chihuahuas nibble out of their bowl. My rescue Chihuahua won't eat when the others are eating so this way she gets enough food. Maggie, Rhett and Chico nap in their cages after they eat and feeding time is quiet. They also hang out in their own personal cages off and on during the day. Maggie and Rhett are both overweight so this way they can get the Perfect Weight while the Chihuahuas eat their active adult formula. (Since Samson the parrot and Blessing the pigeon are in cages in the same room, I call it my gated community).