14 year old Maltipoo with Cushing's PDH (Casey)

[Cris]

Hi folks… I'm starting another thread because my 2nd dog, Casey (14 year old maltipoo), has also been diagnosed with Cushing's. Maggie (14 1/2 year old Bichon), was diagnosed last month with Cushing's and we are still monitoring and making adjustments (as necessary) with the medication, Lysodren for her. Casey, my 14 year old maltipoo who was recently diagnosed with Cushing's based on the LDDS test results, had her ultrasound today. It confirms that she does have PDH Cushing's. The consultation was with a internist/oncologist. HOWEVER…. check this out: The internist/oncologist does NOT advise that we start Casey on any medication for Cushing's at this time. Why??? Because Casey does NOT display any behaviors indicative of Cushing's (thinning of hair, panting, excessive appetite or thirst, etc..etc.), she is opting for NO medication….at this time. Apparently, the protocol is to NOT administer medication UNLESS the dog is displaying behaviors. The reason why the initial tests for Cushing's were administered to Casey to begin with…. was based on my request to have them done. I had taken Casey last week to see the vet, because during the night, Casey was crying very loudly, while laying on her side on the floor, sleeping. I thought she was having another FCE episode (fibrocartilaginous embolism which left her completely paralyzed for several weeks). When I tried to wake her.. she urinated on herself. I thought her problem might be neurological because often, I see Casey, while asleep, trembling. And, it is difficult, at times, to wake her from this state. Perhaps they are some kind of seizure. The x-ray (at the vet) didn't show anything wrong with her and so the vet suggested a blood test. The next thing that came out of my mouth was …. "could you check her for Cushing's". I guess I had Cushing's on the mind because Maggie, (my 15 year old Bichon) was ALSO just recently diagnosed with Cushing's and we had started her on Lysodren. So, the doc suggest (for Casey) that we continue to monitor her behavior should it be indicative of Cushing's. Today, while she was having her ultrasound, I did bring these mini seizures-like episodes up to the internist/oncologist. She said that the pituatary tumor isn't causing these episodes…which would be called a "pituitary Macroadenoma" in a Cushing's patient. SO much to learn!

[Dixie'sMom]

I'll let the experts express their thoughts about Casey's medicine or no medicine status because I have no clue what is best. I did want to pop in to give you a hug and say you must be a great Mom for the maker to give you 2 cushbabies to care for. Hang in there and BIG HUGS!

[Cris]

Thanks Suzie
!!!

[Crystal&Zoe]

God bless you, I can't imagine having 2 cush babies. I'm still trying to figure it all out myself. Perhaps your vet is going by a paper written back in 2009 that I found through AAHA. On Page 3 under the heading Treatment it talks about whether to treat or not to treat and when. My own Zoe was atypical or occult HAC for a few years and we treated holistically to support her adrenal glands. Now she's full fledged cushings and she's on Trilostane. I don't know if this was the correct way to go or not. I also don't know if there is more current research or opinions on this since this paper was published I believe in 2009. But I came upon it today in my research and thought I'd share. I'm sure some of the experts will give you fabulous advice soon. Hugs to you.

http://secure.aahanet.org/eweb/images/AAHAnet/phoenix2009proceedings/pdfs/01_scientific/044_CONTROVERSIES%20IN%20CANINE.pdf

[Cris]

Hi Crystal… I just finished reading a couple of articles, each took the position that medication should not be administered unless there is evidence (other than lab work)…behaviors that are indicative of Cushing's. This makes me wonder… is Cushing's considered more of a problem for the owner(s) of a Cushing's pet because of the behavioral issues associated with a Cushing's dog?? I really don't understand this, since sometimes, the behaviors are somewhat "subtle" and are not consistently displayed by all dogs. I understand that the medication administered to a Cushing's pet can have adverse effects and so it is a VERY potent drug. So, are they suggesting.. wait to administer the drug until it presents a lifestyle problem for the dog and the owners. Interesting.

[Renee]

I think your vet is very smart not to jump right into treatment.

A big component of diagnosing cushings is the presence of strong symptoms. In the absence of symptoms, you would not want to start treatment, because treatment is used to control and alleviate symptoms, nothing more (no cure!). If there are no symptoms to treat, then you would simply be administering very strong drugs for no outward reason.

That said, there is some consideration of the fact that excess cortisol can cause internal organ damage and that early treatment could prevent this damage. I'm not sure there is science to back this claim up though, just some food for thought. I would have to wonder what true amount of internal damage could take place, if there were not also a corresponding outward reaction?

My personal opinion is that the onset of cushings symptoms are more bothersome for pet owners than the pets... but, as the disease progresses, I cannot imagine how it must feel for the dog, and I would not ever ask one of my pets to suffer through those symptoms once they had become advanced.

[Cris]

VERY interesting Renee !!! And, thank you for that line of thought…. VERY interesting. I'll need to do some further research (reading) on that. And, yes… it is also an excellent reminder that there is NO cure for this disease; simply an alleviation of symptoms. But, like you, I also wonder if there could be internal damage with such a steady and consistent increase of cortisol… a SLOW progression of damage caused by an over supply of cortisol.

[Cris]

Oh.. one more thing… the internist did mentioned the possibility of "diabetes". I'm now waiting for Casey's regular vet to call and let me know where we proceed from here. Tomorrow, Maggie goes for her ACTH test, to determine how her Cortisol levels are doing..since adjusting her Lysodren.

[Cris]

ooops… Maggie's report should be on another thread.. "her" thread. LOL… sorry about that.:eek: