Elderly Dog with Cushings-please help

[joanm]

Hello :)
My Bodhi is 18 years old. He is blind and deaf. He was diagnosed with Cushings (Pituitary) a few years ago. He was put on Trilostane and it was not bringing down his numbers, so the vet said to double the dose. After awhile of that, along with expensive blood tests, his levels were still not coming down and the vet sent me to an internal medicine/cancer specialsit vet. I stopped giving him the Trilostane (since it wasn't working and it just seemed like such a high dosage.) The internist said that we could try Lysodrene (a chemotherapy drug that would destroy some cells in the Pancreas. I was made to understand that this could make him feel ill.

I just did not see any reason to put an 18-year old dog through the side effects of chemotherapy. It seems like he has been managing ok, definitely voracious appetite and water, water, water. But lately his panting is getting so extreme and that I worry how much distress he is in. I do not want him to suffer, and don't know what to do. Should I help him to cross the rainbow bridge or try another treatment?

Thanks so much for any help. I love him so dearly...

[DoxieMama]

Hello and welcome to you and Bodhi (what a great name!). You have provided such a great home for him - 18 years old - WOW! We certainly understand the dilemma you face. I'm going to share the response of one of our admins to another member, as she is much more eloquent than I:


Dear Lisa,

Welcome to you and Pepper, and WOW you've done a great job of keeping your girl healthy and happy up to age 17! First off, even though folks here do give various supplements to support healthy body functioning, there are no nonprescription drugs that will address the root cause of Cushing's and lower cortisol sufficiently to control the disease. So it really will take treatment with either trilostane (or Lysodren, the other Rx option) to control the Cushing's, assuming it truly is the cause of her symptoms. Having said that, at age 17, you may want to consider pluses-and-minuses of Cushing's treatment before rushing in to treat Pepper.

Cushing's is typically a slowly progressive disease but it does have the potential to cause systemic damage over time (from high blood pressure, vulnerability to pancreatitis and infections, high cholesterol, kidney damage, liver inflammation, etc.). So for a younger dog, I'd certainly recommend effective treatment so as to eliminate some of these risks, improve longterm quality of life, and allow the dog to live out his/her normal lifespan. However, for a dog of Pepper's age, immediate quality of life issues seem of paramount importance to me. And there are some trade-offs to treatment, especially for an arthritic dog since the arthritis may actually worsen as the cortisol level drops, necessitating the introduction of additional drugs to better manage the discomfort. Also, especially at the beginning, there can be numerous vet visits and blood draws which can be less than pleasant for a dog who's nervous at the vet (and also hard on the owner's pocketbook :o).

I don't tell you any of this to dissuade you from treating if you and your vet agree this is the best path forward for Pepper. But I do think you are the best judge as to how uncomfortable her current symptoms are to you both, and if they are not bothering Pepper all that much -- as I say, you may want to hold off on treating for the time being.

First things first, though -- as Lori says, it'll be great if we can take a look at those test results.

Marianne

I'm sure others will be along to welcome you, as well. Please do post if you have any additional questions, and keep us updated on how Bodhi is doing!

Hugs, Shana

[joanm]

So glad to have a place to talk about this. This board is an angel network ☀️

[Tam]

I agree , I am so sorry for you to be having to go through this.

[lulusmom]

Hi and welcome to you and your precious Bodhi.

First let me just say that the fact that Bodhi is 18 years young is quite a testament to what a great job you have done in making the right decisions for him so far. Of course, his great genetics have played a role as well. The fact that you are here seeking support is yet another great decision on your part. :D Cushing's is a frustrating and difficult disease to wrap your head around so I can certainly understand your reaching out for help. Believe me, we've all been there. Speaking of which, if I were in your shoes now, I'd probably be arriving at the same decision you have. It's not pleasant for any dog to go through the trauma of vet visits and all the poking and prodding but for a deaf and blind 18 year old, it is much worse. I had an 18+ deaf and blind toy Poodle and she was tremendously traumatized by vet visits so I understand only too well.

Cushing's progresses at a snail's pace and unless Bodhi has uncontrolled blood pressure, I believe he will probably pass away of old age before complications of cushing's takes his life. Did your vet check his blood pressure? Dogs with cushing's pant for a number of reasons. Muscle wasting, redeposition of fat to the thoracic area, an enlarged liver and sensitivity to heat are all contributing factors. If Bodhi is overweight, that can put even more pressure on the diaphragm and make the panting worse. The goal of treatment is to remedy the problematic symptoms. Dogs with cushing's aren't sick and generally don't feel ill at all so the symptoms are usually more problematic for the pet owner than the dog. Sooooo, if Bodhi's constant hunger and excessive peeing are not a problem for you, then let's try to help you rule out those things that may be contributing to Bodhi's panting. Blood pressure and excess weight are definitely two culprits that can make it worse. The vet can check the BP and if it's high, he can put Bodhi on medication for that. Unfortunately, I'm not sure a deaf and blind dog is going to have anything close to normal BP at the vet's office. If Bodhi's weight is contributing to the problem, you can work on getting his weight down with appropriate diet. Fluid in the lungs or around the heart can definitely contribute to panting so if the vet doesn't hear a murmur or chest congestion, you can rule those out. Dogs with cushing's are very sensitive to heat so a fan or a cooling pad might help him be more comfortable.

When our dogs are at, nearing or are over their expected life span, our focus on quality of life becomes more of a necessity that we are usually comfortable with. I'm 64 years old and have outlived a whole lot of my precious pups and no matter how many times I had to make that decision, it was gut wrenching. It was also hard for me to remain selfless so that my judgment was not clouded by my tremendous need to keep them with me. I am hoping that you have many more months of joy with your precious Bodhi and if at some point in the future you think he may be telling you it's time but you are not sure, I've attached links to two sites that might help guide you. These and similar sites were helpful for me as were my vets who were painfully honest. I've lost count as to how many times I've asked a vet, "what would you do if it were your dog?"

http://www.naturescornermagazine.com/help_companions.html

https://rainbowsbridge.com/Grief_Support_Center/Grief_Support/Making_the_decision_to_put_a_pet_down.htm

I'm very sorry for the reasons that brought you here but I'm glad you found us. You and Bodhi are family now and we're all here to hold your hand, provide you with meaningful feedback and help you in any other way we can. I hope I have been able to help a little with your quandary and also hope that others will be by to share their thoughts with you.

Glynda

[Joan2517]

Hi and welcome from me, too. Glynda has given you a great start in making an informed decision. 18 years! Wow...

My Lena was almost 15 and I think that with what I know now, I would have just let her live out the time she had left without treatment. We were dealing with the peeing and she was on medication for high blood pressure. She was also beginning to show signs of congestive heart failure. The vet visits were stressful on her and she began to spit out her pills.

I think I would rather have enjoyed the time she had left without the stress that treatment put on all of us, especially her. She was pretty much completely deaf and it frightened her to be taken to the vet every couple of weeks.

You and Pepper will be in my thoughts and prayers...we love them so much, don't we?

[joanm]

Thank you for your informative comments and heartwarming understanding. I somehow feel supported and comforted already. I think I will be able to be more comfortable in my decisions. This sharing board is a wonderful example of building a more peaceful and loving world. Blessings to you all 💕

[Squirt's Mom]

Hi and welcome to our little family!

My Squirt was first diagnosed at the age of 9. She did very well with treatment but I chose to stop it when she reached 15 yrs of age due to several factors, her age included. She lived another year+ with no treatment and few meds at all...meaning few vet trips which had come to terrify her.

At 18 yrs old, I would simply enjoy each minute with Bodhi, making him as comfortable as possible and giving him as much joy as I could each day. Whatever he loved, that he would have as much as I could give him without harming him. ;)

You are so blessed to have this much time with your baby boy. What I would give to have had another 2 years or so with Squirt! Rejoice in each day to come that you and Bodhi share.

Hugs,
Leslie and the gang

[kanga]

Hello,

First welcome to the forum! I see you look for some helpful advice and some good information about what happen to your poor dog, cushing is one of the biggest problem for the health of our dog, I know there's a lot of threads here similar issue like yours hope you find some good information there. I want you to know that you and your doggy are always in my thoughts.

[judymaggie]

Hi! I wanted to welcome you and Bodhi. Others have already covered what I could offer in suggestions but wanted you to know that you are both in my prayers and thoughts!

[molly muffin]

Hello. I just want to say hi and welcome to the forum also.

I think that when it comes to an elderly dog, that the main thing to think of is quality of life. He has had very good quality to make it to 18, and that is a testament to your love and devotion to him.

I personally would enjoy the time you have together. I don't know that at 18, if he would tolerate lydoren that well or not and you already said that trilsotane didn't bring his numbers down.

What you have been doing for him seems to have worked just fine. :) That is what i personally would keep doing until quality is not there for him.

[joanm]

I feel much better tonight and enjoying Bodhi more than worrying so much. Thank you all so much ☀️Joan

[joanm]

Bodhi still likes his doggie door to be kept open, even though he is blind and deaf and has arthritis. I worry so when he goes out, and usually I accompany him, but I am accepting that he likes to have the freedom to go out, and somehow (though my heart leaps when I see him) seems to make it back ok. Thanks to all of you for your support and understanding ❤️.

[molly muffin]

Dogs are much more resilient with things than I think us humans are. We worry constantly about them and they just figure out a way to keep doing the things they want to do.
I find keeping an eye on them while letting them figure out, usually will work out better for them.