Hello!

[Jwerner]

Sweetz, my 12 yo hound mix (we've always called her a beagle but don't know her exact mix) was diagnosed with Cushings last week. She also has some form of kidney disease where her protein is high and the urine is highly concentrated. Our vet had assured us that further testing and treatment would substantially lower her quality of life. We have chosen to take the holistic route, hospicing her when the time comes. I'm overwhelmed by the amount of info online and yet somehow underwhelmed by the quality of the information. I can't seem to find best practices from those who have been faced head on with this disease. Having just lost my 13 yo pittie (and spirit animal) to cancer less than 3 months ago, I'm so not ready for this challenge. I'm looking for suggestions on dietary changes and natural supplements that will help make what little time we have left with her more comfortable. She's gained 6 lbs in 7 weeks despite no dietary changes. Please, if you have any advice or warnings, I would be grateful if you share them. I'm so distraught to be facing the hospicing of a second furry family member in such a short period of time. Thanks.

[judymaggie]

Hi and welcome to you and Sweetz!

I have manually approved your post so that members can start responding to you. Please check your email, possibly your spam / junk folder, for a message from k9cushings. You will need to reply to that email so that your post go directly to the board and are not delayed waiting for approval. If you have already received and responded to the confirmatory email, please be patient. Your registration will be finalized shortly.

I am so sorry for the loss of your pittie and can certainly understand why Sweetz' diagnosis is so upsetting. Please know that many of us are treating our senior pups with Cushing's. My Abbie is my second Cushing's beagle. I started treatment with her a year ago when she was 12; she just turned 13 and she has been doing great with her treatment. I would be interested to know why your vet believes that testing and treatment lowers a Cushing's dog's quality of life.

In order to be able to provide you with our best possible guidance and feedback, we do ask lots of questions so bear with us.

Could you get copies of all tests that were done on Sweetz 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. What test/s for Cushing's were performed and could you post those results too? Does Sweetz have any underlying illness that she is taking medication for? And if so, what is it and what is the medication for? What symptoms did Sweetz display that led you or the vet to test her for Cushing's in the first place?

I know you came here looking for guidance on dietary changes and supplements. Our goal is not to dissuade you from the course you have decided on but we do want to provide you with accurate information to help you make your decisions.

[DoxieMama]

Welcome to you and Sweetz from me, too! I am sorry to hear of the loss of your pittie, and the diagnosis of Sweetz so soon afterward must be difficult. I too would be interested in your vet's explanation as to why treatment reduces quality of life, as I'd think it would be the other way around. Yes, there are lots of visits to the vet at the beginning, with lots of testing... but since you have a diagnosis, I'd bet she has already been through the worst of it.

We can help answer your questions, and give you the best info we have available. Like Judy said, the more information we have about Sweetz, the better we can help!

I look forward to learning more about your girl.

Shana

[Jwerner]

Thanks for the quick responses. It's not just the Cushings that has my vet thinking that Sweetz is nearing her final days. It's the kidney issues in addition to the Cushings. Her urine is highly concentrated despite the ever increasing water intake. She tested high for protein in her urine as well. There is no infection, no diabetes, no thyroid disorder. Sweetz also has a subdermal tumor under one armpit that is increasing in size. The vet isn't sure if it is cancerous, but it is squishy and moves a bit, which is supposedly a good sign. There are just a lot of factors at play here. What I don't want to do is poke and prod her the rest of her remaining days.

Her increasing belly size from the Cuhings is very concerning. She has a very long body, more like a basset than a beagle. Two years ago she was diagnosed with spinal degeneration. The sway in her back has gotten really low and I'm terrified the nerves are going to become damaged, leaving her immobile. The liver disease lead to me having to take her off of NSAIDS for the arthritis (also in her front paws) and start her on Tramadol, otherwise she sometimes can't get up without a lot of discomfort and hobbling. All of these factors added together are the reasons the vet thinks treatment would be invasive, full of negative side effects, incredibly costly, and possibly in vein.

I am all for utilizing science and chemistry to improve quality of life. I also feel I need to be realistic in my expectations. Sweetz came to me as a rescue 11 years ago. She was beaten, emaciated and had a broken spirit. She's had a lot of health problems along the way. But this, this is different. She just is not herself anymore. Her old ornery, sneaky, trash seeking, neighborhood running self is gone. The downward spiral she has been on since my Pittie died has been unmistakeable. They were inseparable for 9 years. Her heart is broken, if that's possible. I don't even know that she has the will to fight through yet another illness. Honestly, I don't know that I do either.

I will stop by the animal hospital and get a printout of her test results so I can answer your questions with specifics. All I know from our review is that 3 different liver enzymes were elevated and her kidneys are compromised. Hopefully I will have more info to offer tomorrow.

[kanga]

So sorry for your loss.

[DoxieMama]

Oh how I wish I could reach through this screen and give you a great big hug, and Sweetz some belly rubs or scritches behind her ears! You are wonderful for having rescued her and given her such a loving home.

I don't know how I missed it, but your mention of kidney disease and concentrated urine didn't sink in from your first post. I truly understand not wanting to put her through more testing and treatment. It seems to be a fine balancing act, weighing the pros and cons of additional testing, trips to the vet, etc against the potential outcome of that testing and treatment. Will it improve her quality of life, or just make her miserable? You know your girl best, so your decision is paramount.

I am at a similar stage with my mini doxie, and my heart just reaches out to you.

Hugs,
Shana

[lulusmom]

Hi and welcome to you and Sweetz.

I am sorry that Sweetz seems to have a whole lot of stuff going on, some of which is a bit confusing. For instance, a dog with kidney disease, and the vast majority of dogs with cushing's, do not have concentrated urine. Both diseases affect what is called the glomerulus filtration rate. The simple way to explain it is that the kidneys lose the stuff (glomeruli) it needs to concentrate the urine. A urinalysis will often show protein in the urine and urine specific gravity will be low. If Sweetz' urine is concentrated, her urine specific gravity would be normal or high, which is not common in cushings or kidney disease. Both protein in the urine and low USG are very common in cushing's. By the way, dogs with this problem drink to keep up with the tremendous amount of urine being lost. If they don't drink tons of water, they can dehydrate rather quickly which can be life threatening. That is why we tell members to always keep fresh water available.

Dogs with cushing's almost always have liver enzyme abnormalities. The ALKP is usually moderately to severely elevated, ALT can be normal or mildly elevated and GGT can also be mildly abnormal so I will be very interested to see if the abnormalities are the usual pattern we see in cushdogs.

If Sweetz has both primary liver and kidney disease, it would be very, very difficult to diagnose cushing's as all of the diagnostic tests are very prone to yield false positive results in the face of nonadrenal illness. Were the kidney and liver diseases diagnosed before cushing's or were the kidney and liver abnormalities just now seen on the tests that were done for cushing's?

If Sweetz has cushing's, her cortisol would be highly elevated. Since cortisol is our body's most excellent anti-inflammatory, Sweetz probably isn't feeling any aches and pains of arthritis because she is self medicating. A lot of pet owners have no idea their dogs have arthritis or disk disease until cushing's treatment reduces cortisol and unmasks those very painful problems. If joint or disk problems have been formally diagnosed via imaging, that should be huge consideration when deciding whether to treat a very senior dog with degenerative joint or disk disease. Does Sweetz have an adrenal tumor or pituitary dependent cushing's?

I will be very anxious to see the results of all of the testing that was done to confirm the cushing's diagnosis. With respect to the blood labs, you need only post the highs and lows and please include the normal reference ranges.

I'm terribly sorry for the reasons you have to reach out to us but I'm very glad you found us. We're here to help in any way we can. The more information you can provide, the better able we can put all the pieces of the puzzle together and help you become the best advocate you can be for Sweetz

Glynda

[molly muffin]

Hello and welcome to the forum.

With a host of issues going on, making the correct dietary changes, will be a challenge in itself. So, for protein in the urine, the main thing is low phosphorus. When it comes to cushings, you want a good quality protein with lower fat levels, as cushing dogs are prone to getting pancreatis.

With any older dog, I usually like to use a good joint supplement like dasuquin, etc. An Omega 3 that contains vitamin e has also been shown to be beneficial and was a recommendation from my specialist.

Those are some ideas to get your started. I'd go good quality protein, low phosphorus and lower fat for food.

[Jwerner]

That's a good start. Thanks! She was on Fromm's Senior Food, then we switched her to Acana, which is what my Weimaraner has been on for years. We initially made the switch in response to the rapid weight gain. The Acana has a higher protein content and the Pacifica formula is high in omega 3s. We feed her twice a day to the amount recommended by her vet for kcals. The problem is that her beagle nose doesn't miss the opportunity to seek and destroy all things disgusting. We have 3 acres, a portion of which is wooded. From decomposing carcasses to the excrement of dozens of different animals (including my other dogs) she supplements her diet. It has always made me crazy. I wished she would stop. Now she's stopping and I would give anything to have to bathe her because she rolled in dead worms after a rain shower.

She's been on both Fortiflora and DasuquinDasuquin (sp?) for about a year. She also was getting tumeric, msm, glucosamine & condroitin in a single supplement. The vet told me to hold tight on that because of the urine concentration. She doesn't want me loading her up on things she may not be able to process. She gets a serving of sea meal daily as well. We began that when her skin started flaking and she began to shed a lot. It helped slow the process and helped clear the flakes. But again, until I have confirmation from the vet I have been abstaining from that. The Tramadol has helped her with the limping and some of the lethargy.

[Joan2517]

Hi and welcome to you and Sweetz. I love the name.

Reading your post brought back memories for me. My Lena, who was a teacup poodle, used to roll around in everything...totally disgusting, but I would love to be washing goose poop off of her now. She would roll around in it until she was completely green and then want me to pick her up! Yuck!!

We weren't on the Cushing's journey long, so when it comes to clinical knowledge I don't have much to give, but there are many others who do and they have already given you a good start.

[lulusmom]

I'm just checking in and it looks as though you may not have seen my post from yesterday so wanted to make sure you did. I'll be looking forward to your responses.

Glynda