12 yr old chihuahua mix

[notagain]

My dog Chili is a female chihuahua mix. She is 12.5 yrs old and weighs 17.2 lbs (overweight as she should weight 13 lbs). I took her to the vet last week because she viciously attacked my other chihuahua (weighs only 6.5 lbs) over food. She won't let him eat his dog food and wants all the food. For the last 3 months she has been panting a lot. Granted we don't have air conditioning in our apartment here in California but our other dog isn't panting. Occassionally, I have to get up in the middle of the night to give her a cold shower to cool her down and that seems to work and stop the panting. She will not go for a walk and has lost interest in most activities except for going for a car ride. When we take her for a walk she tires easily, her tongue turns purple and she wheezes. And she has been pooping for no reason in the middle of the kitchen and when she's walking. She is not excessively thirsty. She is not incontinent of urine or urinating frequently. She has gained weight. She still greets me at the door. I took her to the vet and they said her heart and lungs are excellent. They want to rule out Cushings. All of her lab work, including glucose was within normal range except for Alk Phos was 421 (normal 5-150), ALT 291 (normal 5-110) and GGT 11 (normal 0-10). Her Monocytes were 9 (normal 0-8) and her creatinine was low 0.6 (normal 0.7-1.7). The vet wants her to have a urine test (cost $150) and if positive for cortisol then she will recommend further tests....either the ACTH stimulation test and/or the low-dose dexamethasone suppression test (cost $350). An Ultrasound would be even more money. So I'm probably looking at around $1000 for testing alone only to find out she may not have Cushings. I have read online that the life expectancy for a dog with Cushings is 2 to 3 years (I'm not sure if that is treated or untreated). My question for this forum is, based on my dog's age of 12.5 years, the lab work already done (cost $185) and the cost of additional testing and the life expectancy predicted would you proceed with the testing and treatment? I have read that the medication can also have serious side effects. If she was a young dog I would go ahead with everything but based on her age I am quite hesitant to proceed. I appreciate any help.

[judymaggie]

Hi and welcome to you and Chili! I have approved your post so that others can now see it. I am sorry that you have reason to worry about Chili but am glad that you have found us -- you are now part of our family!

We appreciate all the details that you have provided us as, the more information we have, the better we can guide you and offer relevant suggestions. Please don't tire of our questions! :D Here are a few of mine: Does Chili have any underlying illness that she is taking medication for? And if so, what is it and what is the medication? Is she taking any supplements, medications or herbs? You mention that the vet wants to do a urine test (for $150.00). Did he mention that this was a urine cortisol:creatinine ratio (UCCR) test? $150.00 seems awfully expensive for that -- I haven't had one done on my pup in a long time so maybe the price has gone up. The UCCR can rule out Cushing's with a negative result but a positive result does not mean that Cushing's is definitely present. You would have to proceed with additional testing to confirm the diagnosis. Was a "regular" urinalysis done and, if so, could you post those findings too?

I am a bit concerned about Chili's aggression over food -- has she ever shown aggression about anything before? I am also concerned about the symptoms of exercise intolerance. Has the vet pursued any possible heart issues? I can totally relate to the inability to hold poop. My Abbie, who is now 13, can barely hold it until she reaches grass and, nine times out of 10, poops on someone's driveway or in the middle of the street. My neighbors are getting used to me going out with hot water and a scrub brush to clean up after her. Abbie's issue is not Cushing's related but, rather, related to age and doggy dementia.

With regard to whether I would pursue testing in light of your dog's age, Chili still has quite a few years left in her life. When properly diagnosed and treated, dogs can live out their normal life span. It is often other issues that cut short an older dog's life.

We have a wealth of information regarding Cushing's in our Resource forum -- the medications used, and treatment protocols as well as articles written by some of the most renown veterinarians that specialize in endocrinology such as David Bruyette, Mark Peterson, and Edward Feldman. So please utilize it to educate yourself and if you have any questions do not hesitate to ask them. We all eventually figured out that safe and effective treatment is much easier facilitated if the vet is experienced and the pet owner is educated. Here's a link to our Resource thread:

http://www.k9cushings.com/forum/forumdisplay.php?f=10

Others will be along (probably with more questions ...) so stay tuned! Cushing's is a disease that progresses very slowly -- it is much better to be thorough up front, and rule out other possibilities, than rush into anything.

[Harley PoMMom]

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

Aggression and weight gain are symptoms of Hypothyroidism, this is usually checked on the chemistry/CBC blood panel and it's abbreviated as T4. Could you check and see if this is listed?

Hugs, Lori

[notagain]

Thank-you very much Lori for your reply!! Much appreciated. No Chili has no other underlying illnesses and is not on any medications. No she is not taking any supplements or herbs. Yes, the urine test is a urine cortisol test. Is $150 for this test high as it seems to be to me. The doctor ruled out any heart and lung condition (none). She said her heart sounds were normal and her lungs were healthy. No a regular urinalysis was not done. However in her blood work her creatinine was slightly lower than normal (0.6) whereas normal range is 0.7 to 1.7 mg/dl. Her BUN/creatinine ratio was normal (26.7) whereas normal range is 9 -33. Her BUN was normal (16) whereas normal range is 7-31. Her glucose was normal (97) whereas normal range is 70-125. Her T4 is normal (1.3) - normal range 0.8-5.0 ug/dl.

Chili has not showed aggression about anything else except food. Concerning the dogs lifespan, I read online that a dog with Cushings that the prognosis is 2 to 3 years. Do you know if that is with medication or without treatment/medication? Thanks again for your help.

[Squirt's Mom]

Hi and welcome to you and Chili! :)

I want first to take away some of the angst about what you've read concerning that 2 year life span of cush pups. In large part, that is myth based on old medical records and incomplete info. Over time, our companion pets have become more members of our families vs possessions and as such we pay much more attention to them so we notice small changes more quickly and seek help more quickly; we then demand better medical care for them. I believe that some of the best pet parents in the world are moms and dads of cush pups. ;) Time has also offered better testing and treatment options, more knowledge about some of the complications and how to handle them, resulting in better care. A few years ago one of our members wrote about her take on this and it is still very valid. Here is the link to that from our Helpful Resource section - http://www.k9cushings.com/forum/showthread.php?t=186

My greatest concern about Chili is not Cushing's but that her tongue turns purple with exercise. To me, that says there is something going on with either the respiratory or cardiac system. I assume the vet who checked her heart and lungs is a GP vet? If so, I strongly urge you to take Chili to an IMS asap. Let me share a story with you - I have a teeny Pom mix who started coughing. Her GP vet diagnosed her with heart disease. Xrays at his office showed her heart to be 6x larger than normal. We started treating her for heart disease and she steadily grew worse. He sent us to a vet who has extensive training in heart disease (but is not a cardiologist) and she found my baby's heart was normal BUT she has COPD. Her GP vet did not hear her abnormal breathing because he doesn't have the equipment to do so nor the training her new vet has, and his xray machine and film are not the same quality so her new films are much more accurate. The GP vet didn't have the equipment to actually look at her heart and lungs but the vet he sent us to does because she is part of a specialty clinic. If we hadn't gone to the new vet my baby would have died of pneumonia because by the time we saw the new vet, she had a pretty bad case of it and was not being treated for it but instead being treated for severe heart disease. Our GP vet is a good vet, he did the best he could with the equipment and training he has but it was not sufficient in this case. It took someone who has pursued extra education and training in cardio-pulmonary veterinary care and who has the machines needed to see and hear those systems in detail. So while some of what you describe could certainly be from Cushing's, the purple tongue and shortness of breath take a much higher precedence in my book and require more in depth exploration before testing for Cushing's. ;)

I work in rescue and had a baby, a little Chi, who had a tumor between her heart and trachea. Her tongue would also turn purple, she coughed and wheezed, and really struggled to breath. The GP vet the rescue used had diagnosed her with heart disease and if we had not decided to take her to a clinic that could take a deeper look, she would have suffered longer than she did while we tried to treat heart disease, not knowing she had an inoperable tumor.

These stories aren't meant to scare you but to let you know that sometimes GP vets simply are not what our babies need - they need a specialist. I think Chili needs to see a specialist asap to rule out any serious issues that would cause the purple tongue. ;)

Chihuahuas typically have a pretty long life expectancy so at 12.5 yrs old, I would certainly take steps to find the problem(s) and treat if at all possible. My little male Chi had hydrocephalus and he passed in Ap. of this year at the ripe old age of 17+. ;)

Let us know what you decide to do and what you learn. I'm glad you found us and want you to know we will be with you and Chili all the way. Anytime you have questions please ask - we aren't vets but we have an astounding amount of experience and knowledge here and are happy to share.

Hugs,
Leslie and the gang

[notagain]

Hi and welcome to you and Chili! :)

I want first to take away some of the angst about what you've read concerning that 2 year life span of cush pups. In large part, that is myth based on old medical records and incomplete info. Over time, our companion pets have become more members of our families vs possessions and as such we pay much more attention to them so we notice small changes more quickly and seek help more quickly; we then demand better medical care for them. I believe that some of the best pet parents in the world are moms and dads of cush pups. ;) Time has also offered better testing and treatment options, more knowledge about some of the complications and how to handle them, resulting in better care. A few years ago one of our members wrote about her take on this and it is still very valid. Here is the link to that from our Helpful Resource section - http://www.k9cushings.com/forum/showthread.php?t=186

My greatest concern about Chili is not Cushing's but that her tongue turns purple with exercise. To me, that says there is something going on with either the respiratory or cardiac system. I assume the vet who checked her heart and lungs is a GP vet? If so, I strongly urge you to take Chili to an IMS asap. Let me share a story with you - I have a teeny Pom mix who started coughing. Her GP vet diagnosed her with heart disease. Xrays at his office showed her heart to be 6x larger than normal. We started treating her for heart disease and she steadily grew worse. He sent us to a vet who has extensive training in heart disease (but is not a cardiologist) and she found my baby's heart was normal BUT she has COPD. Her GP vet did not hear her abnormal breathing because he doesn't have the equipment to do so nor the training her new vet has, and his xray machine and film are not the same quality so her new films are much more accurate. The GP vet didn't have the equipment to actually look at her heart and lungs but the vet he sent us to does because she is part of a specialty clinic. If we hadn't gone to the new vet my baby would have died of pneumonia because by the time we saw the new vet, she had a pretty bad case of it and was not being treated for it but instead being treated for severe heart disease. Our GP vet is a good vet, he did the best he could with the equipment and training he has but it was not sufficient in this case. It took someone who has pursued extra education and training in cardio-pulmonary veterinary care and who has the machines needed to see and hear those systems in detail. So while some of what you describe could certainly be from Cushing's, the purple tongue and shortness of breath take a much higher precedence in my book and require more in depth exploration before testing for Cushing's. ;)

I work in rescue and had a baby, a little Chi, who had a tumor between her heart and trachea. Her tongue would also turn purple, she coughed and wheezed, and really struggled to breath. The GP vet the rescue used had diagnosed her with heart disease and if we had not decided to take her to a clinic that could take a deeper look, she would have suffered longer than she did while we tried to treat heart disease, not knowing she had an inoperable tumor.

These stories aren't meant to scare you but to let you know that sometimes GP vets simply are not what our babies need - they need a specialist. I think Chili needs to see a specialist asap to rule out any serious issues that would cause the purple tongue. ;)

Chihuahuas typically have a pretty long life expectancy so at 12.5 yrs old, I would certainly take steps to find the problem(s) and treat if at all possible. My little male Chi had hydrocephalus and he passed in Ap. of this year at the ripe old age of 17+. ;)

Let us know what you decide to do and what you learn. I'm glad you found us and want you to know we will be with you and Chili all the way. Anytime you have questions please ask - we aren't vets but we have an astounding amount of experience and knowledge here and are happy to share.

Hugs,
Leslie and the gang

Thank you Leslie, I was looking through some of the articles posted on this board and one titled "Diagnosis of canine hyperadrencorticims" says "the disease is frequently not life threatening even thought the clinical signs may be debilitating to the dog and of considerable concern to the owner"..."if the owner cannot afford any treatment or the associated monitoring, the money would be better spent treating the complications (e.g. recurrent cystitis) of the suspected underlying disease".

So I'm gathering from this that Cushings is not a disease that requires treatment? Meaning they aren't going to die from it if left untreated? Another artictle "Evaluation of twice daily lower dose trilostane treatment administered orally in dogs with NOH" states "with rare exceptsins, NOH in dogs is nether a rapildy progressive nor a life threatening condition that requires a rapid response to treatment. Typically NOH is a chronic progressive disease that ultimately causes unacceptably bothersome clinical signs (eg polyuria, polyphagia, weakness and panting) in affected dogs. A primary goal in treating dogs with NOH is to achieve resolution of signs of PDH as perceived by the owners. Treatment may cause adverse effects that are more worrisome that signs of the disease, including death or severe illness requiring hospitalization."

Perhaps its better to not treat if this is Cushings as the drugs could be worse than the drug itsef. And instead pursue why her tongue is turning purple and she is wheezing, as you say above. Thanks for your time and help, so very much appreciated.

[Harley PoMMom]

So I'm gathering from this that Cushings is not a disease that requires treatment? Meaning they aren't going to die from it if left untreated?

Cushing's is a slow progressing disease so the dog does not die from Cushing's per se, but if left untreated the damage internally is life threatening.

When my Harley started treatment it unmasked kidney issues so his vet and I decided to stop the treatment for Cushing's and instead focus on his kidneys. Eventually that high cortisol was detrimental to his liver, heart, and kidneys.

I don't share Harley's story to scare you, I just thought you should be aware of what could happen.

Hugs, Lori

[judymaggie]

Hi! As a follow-up to Lori's post, here is a link to information on our Resources forum that describes complications of not treating Cushing's:

http://www.k9cushings.com/forum/showthread.php?t=195

Again, not meant to scare you but to provide you with as much information as possible in order for you to proceed in a well-informed way.