Our 7 year old Boston Terrier, Hammer is being tested for Cushing's

[Hammer7]

Hello, I am new here. I have a 7 year old Boston Terrier named Hammer who has been showing all the symptoms of Cushing's disease. We took him to the vet last week after I looked up his symptoms and Cushing's disease came up. He is also having problems with being unsteady on his feet and has a head tilt. He had blood tests done which showed things to be conclusive with Cushing's so tomorrow he is spending the day at the vets to have some kind of test done that takes all day. I can't remember the name but it is supposed to confirm if he has Cushing's or not. I'm very scared as I know this is a lifetime illness. We love our dog but we are very afraid of what it will cost to treat him and will the treatment be worse than the disease. Any advice is much appreciated.

[Harley PoMMom]

Hi and welcome to you and Hammer!

With the head tilting and wobbliness it sounds like Hammer might have a vestibular issue, did this come on all of a sudden? Can you tell us exactly what symptoms Hammer is displaying? Does he have any other health issues that he is taking medications for? Could you post the results of the tests he has had done, we only need to see the abnormal values along with the reference ranges and reporting units.....ALT 150 U/L (5-50)...thanks! Was an urinalysis done and if so could you post those findings too?

If the test that Hammer is going to have is going to take all day than it's probably the low-dose dexamethasone suppression (LDDS). Although this is the "gold standard" test for Cushing's it can show a false positive result if other non-adrenal illnesses are present or even if the dog is really stressed. If Hammer does have a form of vestibular disease and if this did happen pretty recently, if this were me, I would hold off getting the LDDS test performed.

I have only a moment to post, sorry, but I will try to make it back later...hang in there, ok ;)

Hugs, Lori

[Hammer7]

Hammer has been showing symptoms for quite some time now, maybe 9 months. We thought it was just him getting older at first. His symptoms are excessive hunger, (he raided our garbage a few times), excessive thirst, peeing a lot with some nighttime accidents, big pot belly, thinning hair on hind legs, and bum, lethargy, sleeping on cold floor (he always would cuddle under blankets before), no interest in playing with his toys anymore. He can't jump up on our bed anymore.
The head tilt and wobbliness only started about two weeks ago.
I don't have the results of his blood tests. They are at the vets. They did not do a urine test on him.
The vet said she would be very surprised if he did not have Cushing's as he has every clinical symptom. Oh and he's not on any medications. We haven't even started him on his heart worm preventative yet this year. Holding off until we know what's happening.
Thanks for replying to my post.

[Harley PoMMom]

Could you get copies of Hammer's test/s from the vet and post those results here? We will be especially interested in those LDDS test results. We can help you understand the tests that are being done and while we're not vets, we know how to interpret these tests. Hammer does have the clinical symptoms of Cushing's, however, many other conditions can have blood abnormalities and symptoms that overlap with Cushing's such as a thyroid issue or diabetes.

Cushing's is very difficult to diagnose, and unfortunately it is often misdiagnosed as there is not a test that can accurately identify it. Also it is a slow progressing disease, some dogs go undiagnosed for years and since the majority of dog's with Cushing's are senior the symptoms associated with it usually are attributed to old age.

The key to successful treatment is an experienced vet and an educated pet owner. Adverse side effects are usually only seen when the proper protocols are not being followed. Both Vetoryl (Trilostane) or Lysodren (Mitotane) are very effective in the treatment of Ccushing's. Both are serious drugs so it would benefit you to learn everything you can about which treatment you ultimately opt for. There's scads of information regarding Cushing's in our Helpful Resource section. I've included a link below to a great thread for members who are new to the disease.

http://www.k9cushings.com/forum/showthread.php?t=180

The ACTH stimulating test is used to monitor a dog on treatment for Cushing's, and these tests are expensive because of the stimulating agent used, which is usually Cortrosyn. Depending on how much Hammer weighs you can save money on the ACTH stimulation tests if your vet knows how to dilute and store Cortrosyn. There is no reason why s/he shouldn't so make sure you talk to him/her about splitting the vial of Cortrosyn. You and your vet can read about this on Dr. Mark Peterson's blog found here: http://endocrinevet.blogspot.com/2011/03/how-to-extend-your-supply-of-cortrosyn.html

Cushing's can be hard to wrap one's head around and it can be confusing at times but we are here to help you and Hammer in any way we can. ;)

Hugs, Lori

[Hammer7]

Thank you very much. Hammer had his LDDS test done today. I do not have the results yet. The vet said to me that she would be shocked if he didn't have Cushing's disease. She is trying to figure out what is causing his head tilt. She keeps talking about putting him on a broad spectrum antibiotic in case it's an inner ear infection. He doesn't act like his ear is bothering him. My husband and I love this dog very much but we have spent $1000 so far just figuring out what is wrong with him and haven't even started the treatment yet. We are getting concerned that we won't ge able to afford to treat him. We are feeling quite overwhelmed at the moment.

[Harley PoMMom]

With Cushing's the initial expense is during the diagnostic phase, once a dog is on treatment and the dose is stabilized the cost does go down significantly. Having the medication for Cushing's compounded will also save some money, but you need to purchase through a trusted compounding pharmacy. Many of our members use Diamondback pharmacy, here's a link to their website: http://www.diamondbackdrugs.com/home-mobile/

One of the ways that helped me with the expense was applying for Care Credit. It's a revolving credit line that allows you to pay large bills same as cash for a year. And don't forget that money saving tip on how to extend the supply of Cortrosyn, that can be a big cost savings!

Will be checking back for Hammer's LDDS test results. ;)

Hugs, Lori

[Hammer7]

Hammer tested positive for Cushing's. They don't know what type he has yet and they want to do more tests. What test needs to be done to determine if it's adrenal or pituitary? I read that most cushingoid dogs have the pituitary type. The head tilt seems to have gone away on its own. We meet with the vet on Tuesday to discuss further action and/or options.

[Harley PoMMom]

The low-dose dexamethasone suppression test may be able to determine if the Cushing's is adrenal or pituitary based. An ultrasound is another option if the adrenal glands are seen.

What test was used that diagnosed Hammer's Cushing's, and could you post those results?

Hugs, Lori