10 year old beagle with possible Cushing's (long)

[CCR]

I took my beagle, Colby, to the vet yesterday for his shots and for what I assumed would be a discussion on senior health issues (he's been having accidents in the house). The vet was concerned because he was dehydrated (his blood was thick and his gums were tacky) and because of something they saw in the urine sample (one of the numbers was very low. I don't remember which, sorry). Today I got a call about his blood test results, and it seems that he either has Cushing's or a liver issue, but the vet is leaning toward Cushing's. Right now he's on antibiotics for a bladder infection, and we won't be starting treatment until that clears up.

He has several symptoms, but I didn't realize it and I'd been explaining them away. He's been drinking a lot, but it's winter and it's hot inside, and his appetite has been ravenous, but that coincided with the diet he was put on, and I thought the accidents and frequent trips outside were the result of old age.

He had issues coming out of surgery in the past, so I'm inclined to rule that out as a possible step, even if he does have the type that can be treated with surgery. I've been warned that the side effects of the medication can be rough. He's still active and playful and I'm not sure what to do. The vet is going to be sending me information on the testing and treatment options, but I'm here, hoping to gather as much information as I can.

[DoxieMama]

Welcome to you and Colby! I'm new here as well, just about to get started with treatment for my 13 year old miniature dachshund in the next week or so. Our situation is similar in that I had considered most of the symptoms to be those of the season or to-be-expected for a dog his age.

There's all kinds of information in the Helpful Resources forum (http://www.k9cushings.com/forum/forumdisplay.php?f=10), though I'm sure one of the resident experts will be by shortly to provide more details. Speaking of which, they LOVE details. If you have (or can get) copies of all the test results, posting them here is much appreciated and can aid in providing you better information specific to Colby's condition. You only need to post those results which are out of the ordinary, along with the normal ranges listed for the value.

I've not much time so I'll keep this short. Welcome!

Shana

[CCR]

Hi Shana, and thanks for the welcome. I don't have any of his records, but I will try to get them. I've been looking through the information in the resources forum, but I'm going to stop and take some time to digest everything.

[Harley PoMMom]

Hi and welcome to you and Colby from me as well!

Shana is right, we are all about those details ;):D The more information we know about your boy the better our feedback can be, ok? So, if you could get copies of those tests that were done on Colby and post those results here that would be great. With respect to the blood chemistry and CBC, you need only post the highs and lows and please include the normal reference ranges. Is he taking any other herbs/supplements/medications? Does he have any other underlying illness? How much does Colby weigh? Was an urinalysis done, and if so, could you post those findings too?

The two medications that are usually prescribed for Cushing's are Vetoryl/Trilostane and Lysodren/Mitotane. These are strong drugs and both have some pretty scary side effects, however, adverse effects are usually not seen unless the proper treatment protocols are not followed. We have many members that are treating their cushdog with either Vetoryl/Trilostane or Lysodren/Mitotane and are experiencing success. The key to facilitating safe and effective treatment is an experienced vet and an educated pet owner, so the best advice I can give you is to do your research on Cushing's, the treatment protocols, and how it is diagnosed. 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.

I am providing a link to our Resource forum which has a wealth of information regarding Cushing's and also includes articles written by some of the most renown veterinarians that specialize in endocrinology http://www.k9cushings.com/forum/forumdisplay.php?f=10

Please know we are here to help in any way we can, and do not hesitate to ask all the questions you want.

Hugs, Lori

[CCR]

I gave my beagle 30 mg of trilostane today. He did not get the stimulation test. I was told that the tests might not be conclusive and that they were expensive, and I was given the option to just put him on a low dose of the medication. That's the choice I made, although I'm not fully comfortable with it. I didn't think to ask for copies of the results of his urine samples. If he tolerates the medicine, he's supposed to go back to the vet within 4-6 months for a checkup, although he will be going sooner than that since he has other health issues that need to be addressed.

[DoxieMama]

Hi again, I'm a little worried for Colby since you decided to start medicating him with Trilostane without a confirmed diagnosis. The tests are expensive, no doubt about that, but they're so very important. Trilostane is not a benign treatment and if Colby doesn't have Cushing's, the effects could be bad.

I don't want to alarm you, but ... you really need to watch Colby for signs of overdose. Lethargy, diarrhea.. I can't remember them right now. If you see anything BAD happen to him, get him in to the vet ASAP please.

That said, even if he doesn't have any signs of overdose, he really needs to be tested again much sooner than 4-6 months from now. Trilostane treatment must be monitored regularly, using those expensive tests.

I've got to run but I'm sure others will be along to provide more details. And I'll check back later. I'm worried about Colby.

Shana

[Joan2517]

I didn't like the sound of that either. He really needs to be tested to be sure of the diagnosis, before you give him the Trilostane. You definitely don't want him on it if he doesn't need to be.

[CCR]

I was given paperwork on the signs of overdose to watch out for, so that is definitely covered. Don't worry about not alarming me because I'm already on edge about this, due to concerns about the medication.

The vet told me that there was no guarantee that the tests would confirm a diagnosis. But I am leaning toward calling back and scheduling the tests. I'm going to get back in contact with the vet and ask why they don't plan to monitor him more frequently.

[Joan2517]

Good for you....if he has Cushing's you don't need to feel rushed. Take your time and make an informed decision...you may know more than your vet and will need to advocate.

[Renee]

I apologize for this --- but, what the hell is your vet doing? Run, do not walk, to a new vet. And please do not give your dog any more trilostane.

This breaks every single protocol in the book and unfortunately, the only one that will ultimately pay for any negative consequence is your pup.

These medications are powerful, and can be deadly, when used incorrectly. For your vet to nonchalantly put your dog on the medication without following recommended protocols is downright negligent.

[judymaggie]

Hi to a fellow beagle Mom/Dad! I am going to add my strong concern that you are giving Colby a very strong medication that he may well not need. He may also be getting a dose that is not accurate for his weight. My beagle, Abbie, weighs 24 lbs. and is well managed on 25 mg. of trilostane. Curious how much Colby weighs ...

I would honestly be seeking out a vet who has experience with Cushing's diagnostic and treatment protocols. Even if your vet has been a trusted partner with Colby's treatment in the past, he is not providing you or Colby with the veterinary care that you deserve to have in this instance. Successful Cushing's treatment relies on a well-educated owner and a vet who is well versed in the proper protocols and who is willing to work with the owner on every step of the journey.

PLEASE do not give Colby any more trilostane. If he, indeed, has Cushing's, it is a disease that progresses very slowly so you are not causing harm to him in any way.

Since Colby was dehyrated and had a bladder infection when the vet decided he had Cushing's, this only raises more red flags.

As others have asked, please get hard copies of all of Colby's recent tests so that we can help guide you.

[molly muffin]

Oh my goodness. One you can't tell if a dog has cushings or even test for it if they have an infection somewhere and are being treated. The results would be skewered due to the infection. (cortisol will naturally raise when the body needs it to)
So, you don't even want to test till around 30 days or so after any infection is cleared up (re the bladder infection) and there is no way you give a dog cushings meds on a hunch. They are strong and if used inappropriately they can have very bad effects which is why you need a confirmation of cushings and rule out other options prior to starting meds, then you start at the low end, 1mg/1lb.

I'd stop the meds, wait for the infection to be confirmed gone, see how he is doing and then if you still want to pursue testing you can.

That is what I'd do personally.

[CCR]

Thanks for the information. You've given me a lot to think about. I've been very pleased with this vet, so it's startling to hear that this option is something no one else has ever heard of. I'm doing some reading and will be continuing to, and I'm going to get the stimulation test. I do want to answer a couple of questions. My dog is 28 lbs. As for the infection - this thread was started a few months back. He finished his course of antibiotics some time ago and has been free of infections since, based on urine samples. Unfortunately, the last urine sample was still dilute.

[lulusmom]

Hi and a belated welcome to you and your pups.

I am glad you are thinking about things because if your vet truly did not do any diagnostic testing for cushing's and prescribed Vetoryl, that egregious breach would be unconscionable. We have been witness to some ignorant vets but it is extremely rare to be witness to that level of ignorance and arrogance that he would place your dog at high risk of adverse reactions to a very serious drug. This is why you have seen members get very emotional.

If your vet did not do the testing, his decision to prescribe Vetoryl to your dog was never an acceptable option, it was nothing less than a horrifically bad decision that placed your dog at great risk if he does not have cushing's. By the way current Vetoryl dosing recommendations are 1 mg per pound of body weight so 30 mg may be an appropriate dose for a 28 pound dog who has been properly diagnosed but it is not the low dose your vet inferred was safe enough to give your undiagnosed dog to test the waters. :mad:

You mentioned that you are going to have an acth stimulation test done but if I were you, I would look for a vet in your area experienced with diagnosing and treating cushing's and have the proper tests done to diagnose your dog. Finding a gp vet with experience is not an easy feat so if you can afford it, you may want to consider getting a referral to an internal medicine specialist. An internal medicine specialist diagnosed my first cushdog after my ignorant gp vet failed to diagnose her. She could have been the poster dog for cushing's and he was clueless. She went undiagnosed for well over a year which I believe contributed greatly to the severe osteoporosis that eventually robbed her of any quality of life. I thought my vet was the best thing since sliced bread and I now firmly believe that my little dog paid the price for my blind faith. Sadly, my experience is not that uncommon.

You have already been provided with some links to some good reading material that can help you learn about the disease and Vetoryl so read, read, read. The more you learn, the more confident you become and the more relaxed you will be. Cushing's is not an easy thing to wrap your head around and it takes time to sink in. If you see something that you don't understand, ask and we'll do our best to explain. We're here to help you be the best advocate you can be for your pup and we're ready to make the journey with you.

Glynda