12 y/o Boston terrier just diagnosed; reservations about treating

[wehadog]

Hi - Just received a "cushings" diagnosis for my 12 year old Boston Terrier. Not wanting to treat him - afraid of the medicines - the strength, the cost, etc. Not sure how the quality of life will really change. He is only 12 pounds ... Can anyone else please let me know how you came to your decision to NOT treat.

[judymaggie]

Hi! We are glad you found us as a Cushing's diagnosis can be scary. I have had two Cushing's pups -- I am treating my current one, 13 year old Abbie, with trilostane and have seen a significant improvement in symptoms which has made her more comfortable and definitely made my life easier. The two commonly used medications to treat Cushing's can be used safely if the manufacturer's protocols are followed and are used by a knowledgeable vet (or at least one who is willing to learn). We all know how expensive these meds can be and we do try to offer cost-saving suggestions to members. We do have other members who have opted not to treat -- the most frequent reason given is the advanced age of their dog. Please know that we are not going to judge you regardless of the route you decide to take.

However, with some more information from you, we can certainly try to help sort things out. Can you please tell us what symptoms led you and/or your vet to test for Cushing's? Also, please provide us with the highs and lows (along with the stated range) of any recent chemistry panels. What specific tests were conducted to diagnose Cushing's? Please provide those results. Does your pup have any other medical issues? Is he taking any meds or supplements?

More folks will be along to address your concerns.

[DoxieMama]

Hello and welcome to you and your dog. I completely understand your reservations to treat as I had them myself.

After discussing things with people here, doing some of my own research and talking it over with my family and vet, I made the decision to treat. I compared the guaranteed effects of non-treated Cushing's (continued symptoms and the 'invisible' damage to his internal organs) to the possibility of negative reactions from treatment and couldn't justify NOT treating. Then again, if my dog were in declining health with other conditions and/or older... I may have decided otherwise.

Of course, treatment is not cheap, especially at the beginning. Sometimes that makes it impossible for people, which is understandable.

Whatever you decide, we are here to support you.

Hugs,
Shana

[wehadog]

I will have to get the test results from the vet so I can post. My Boston has been exhibiting a lot of the symptoms and his diagnosis is not "definite" but the vet seems to think probable. Thirsty, low energy, can't hold his pee (after not having an accident in the house in 12 years!), hungry (even eating his poo - again, he never did that!), skin is thinning and his hair is getting sparse. Also, if he gets scratched outside, his skin stays irritated. So sad. He has cataracts too ... vet didn't think it would be good to have them repaired in his condition. Again, a huge investment - was quoted $4500 for the eye surgery.

[molly muffin]

It's harder for them to heal and of course they like to have the blood work looking good before they consider surgery for anything.

My vet isn't even keen on doing a dental on my dog because of her liver enzymes and possible clotting issues that would go along with surgery.

I do sympathize as my molly has both retinal bleed scaring and cataracts and surgery isn't in the cards for her either. She gets around very well for not being able to see much. Shes very attuned to sound and smells and of course we don't change a thing in the house so she goes running through like a wild thing when the mood takes her.

[wehadog]

HI again ... my Boston is stable ... no energy ... still goes to the door to go outside ... still eating. Can't seem to get a clear diagnosis from my vet. Before he wanted to put him on a regular dose of lysodren. Now he is suggesting a half pill every three days ...? Lysodren is very strong from what I have read online. Any thoughts from the community as to whether it is worth treating? My dog just spends his days on his bed ... it is very sad to see. But he is almost 13.

[tank&kat]

The medications to treat Cushing's can be safe if used properly and correct protocol is followed by an experienced vet and an educated, observant pet owner. The decision to treat is based on a case by case basis. Here is some basic information about making that decision. This is directly from my textbook, Canine & Feline Endocrinology 4th edition:

To Treat or Not to Treat

The “urban legend” exists that survival is the same whether or not a dog with HAC is treated. That statement has never been scientifically evaluated. It may be true for some dogs, but likely not all. Importantly, treatment typically greatly improves quality of life for both the owner and dog.

On the other hand, not all dogs with positive tests for HAC need to be treated and the decision should be made on a case-by-case basis. In deciding when to treat, consideration should be given to the dog, quality of life, the owner, and clinical signs. None of the drugs are cheap and neither mitotane nor trilostane are benign; therefore, treatment is not to be taken lightly. If the only clinical sign is a benign clinicopathologic finding (e.g. elevated serum ALP activity) treatment is not warranted (neither is testing). If the issue is only cosmetic (e.g., poor hair) or very mild (e.g., slight increase in thirst and urination), a frank discussion should be had with the owner of the risks and benefits. In making the decision, further questioning of the owner on issues that might relate to clinical signs (e.g., the dog has stopped jumping on furniture –a sign of possible muscle weakness) can be helpful, as well as seeking evidence of clinical signs that the owner might not note (e.g., serial evaluation of urine samples collected at home for consistent suggestion of polyuria/polysipsia). It is also important to test for proteinuria by measurement of a UPCR and for hypertension by measurement of blood pressure. Both can damage the body; so if either or both are present and due to HAC, treatment may be more imperative. On the other hand, clinical signs may be recognized in retrospect; for example, an owner attributes decreased playing to old age, but when HAC is treated, the activity increases. Treatment of HAC can unmask diseases that may be inapparent due to the anti-inflammatory effects of hypercortisolemia. For example, clinical signs of atopy or degenerative joint disease may develop with treatment of HAC as cortisol concentrations decrease.

[Nina Fancy]

I just wanted to tell you that my 13 1/2 year old golden retriever was recently diagnosed and has been on vetoryl for a little over a month. His symptoms have improved with no ill effects. My understanding that vetoryl is a newer, improved drug and lysodren isn't prescribed as often now. It is expensive but is cheaper if you are able to order it online. Please consider discussing this medication with your vet or get a second opinion. I would think a small dog could possibly live for several more years if the disease is managed with medication. Good luck with your decision.