Charlie - 6 y/o Puggle newly diagnosed

[Charlie's Mama]

We rescued our Puggle Charlie at 9 months old. He turned 6 on 2/15 and was diagnosed with Cushings the same day. We went to the vet on 1/26 because Charlie had thrown up several times from the new diet food they put him on. Charlie has been overweight and hungry all the time since we got him 5+ years ago. They decided to run a routine blood panel and his ALP came back at 768. I asked to see his blood from the year before and his alp was 425 and the year prior was 220. At this time the vet suggested due to his weight and hunger (even though it wasn't increased) to do a LDDS test. They set the test up for 2/15/16. In the mean time, I changed Charlie's diet to white meat chicken breast, vegetables, and brown rice and a vitamin supplement each day. His treat has been apple slices for fiber. He has lost 1/2 pounds in a 3 week period on this diet and is playful as usual with no vomiting at all.

We brought him to the vets at 8am, 12pm, and 4pm for blood work on Monday 2/15/16. By 5:30, the vet called and said he was Cushingnoid as his results were: 3.8 (baseline), 0.5 (at 4 hours) and 6.8 (at 8 hours).

They advised us to take him to a hospital 1 hour away from an abdominal ultrasound which is costing $650.00 to decifer if it is adrenal or pituitary.

He does not have any hair loss, excessive thirst, excessive urination, excessive panting, etc. Do I treat a dog that has no symptoms with toxic medications? Do I try homeopathic remedies? We are going for a 2nd opinion on Thursday with another vet.

We are devastated by the news as he means the world to us!! We keep reading horror stories and people stating their dogs only lived like 2 years with treatment?

Any suggestions or insight would be GREATLY appreciated!

[tyry]

Hi Charlie's Mama,

I'm sure one of the experts will be along to help you read the results as I'm still fairly new to this. I will say the best advice I've gotten was to take a very deep breath if it does come back Cushings. I waited and tried homeopathic meds for almost a year as I was so afraid of the meds. We then had no choice but to put our pup on meds a year ago, and it truly saved her life. I was SUPER EXTREMELY freaked out about the dangers that I read about, but what I've learned is if you follow the recommendations and start low and slow (at least with Vetoryl) you run into very few issues.

And I don't know if this helps or not, but after reading these boards for a year now I've learned that the two year rule can go out the window. Many dogs are much older when they are diagnosed so that's why they live just a short time. The younger ones seem to go on and live out their full lives.

Tracy

[Harley PoMMom]

Hi and welcome to you and Charlie!

If increased appetite and an elevated ALP are the only symptoms Charlie has than I would opt to not treat at this time. Charlie's LDDS test results do point to the pituitary form of Cushing's, his 4 hour number is less that 50% of his baseline number which is indicative to PDH. I'm including an excerpt from Dr. Bruyette, who is a renown canine Cushing's expert:
If the eight-hour post-dexamethasone administration cortisol concentration is above the reference range, then evaluate the baseline and four-hour postdexamethasone administration cortisol concentrations to see whether cortisol suppression occurred during the eight hours. If at least 50% cortisol concentration suppression is present at the four- or eight-hour time points, the definitive diagnosis is PDH and additional adrenal function tests are not needed.
Full article can be found here: http://veterinarymedicine.dvm360.com/clinquiz-interpreting-low-dose-dexamethasone-suppression-test-results

Cushing's is one of the most difficult canine diseases to diagnose, and unfortunately it is often misdiagnosed. If any underlying illness is present when the tests for Cushing's are performed the chances of a false positive result is more likely to happen. The sole purpose of treatment is to remedy problematic symptoms as the medications used for Cushing's do not to cure it, so if a dog doesn't have obvious Cushing's symptoms than I do not know how one would judge if treatment is working.

Could you get copies of all tests that were done on Charlie and post any abnormalities that are listed? With respect to the blood chemistry and complete blood count (CBC), you need only post the highs and lows and please include the normal reference ranges. Does your boy have any underlying illness that he is taking medication for? And if so, what is it and what is the medication? Were other non-adrenal illnesses ruled out such as diabetes, UTI, or a thyroid problem? Was an urinalysis done to check his urine specific gravity and does he have diluted urine?

That 2 year rule, it just isn't true, with treatment dogs with Cushing's can have a good quality of life and there is every reason to believe that they can live out their normal life span.

If you have any questions please do not hesitate to ask them and know we are here to help in any way we can.

Hugs, Lori