MaisyMoo
01-05-2017, 12:47 PM
Hi all.
I'm looking for some guidance and experience. Our nearly 14 year old Chow mix Maisy (affectionately Maisy-Moo, or Moomer) has been diagnosed with adrenal-dependent Cushing's. She started exhibiting symptoms this past spring, when her Alk-phos levels were a bit high. When we re-tested in early summer that level had doubled. Based on this, along with the appearance of some classic symptoms, we decided to schedule a LDDS test for early fall. Apparently there was an error on the clinic's side, so they asked to re-test for free in October. This was done and showed a pattern consistent with ADH.
To confirm, the vet suggested we take our girl to a specialist about 2 hours south for an ultrasound. We did so, and confirmed a tumor 3 cm x 3 cm on one of her adrenal glands, along with slightly enlarged liver. The second gland had atrophied and could not be seen. The specialist could not see invasion into the vena cava, but did not rule that out either.
We have already decided not to pursue surgery. We are most concerned with her quality of life, and are wondering whether it's worth trying trilostane. Her symptoms are not out of control yet - she drinks more than in her younger years, but does not empty the bowl. She acts ravenous, but this is something of a blessing, as she used to be an extremely picky eater. She pees more often, but doesn't wake or wet in the night. Her once-beautiful fluffy tail is now bald. The saddest symptom has been the wasting of her rear leg muscles. She can no longer get in the car unaided; she sometimes trips, and struggles a bit to stand from lying down. She cannot tolerate long walks - about 1 mile of flat terrain is her limit.
From what I've read, the muscle wasting is the last symptom to resolve, if it ever does. So I wonder how worth it it would be to go on trilostane, endure the repeated testing, which terrifies her, possible side effects, possible loss of appetite, etc. She is eating beautifully; I would hate to lose that. We just have to be careful not to keep any table scraps within reach, and bought a locking garbage can. She also has a small amount of arthritis in her lower back. I worry about pain, if/once cortisol is suppressed.
Mostly I'm just very conflicted. When they're young it's so easy; of course you try X, Y, Z medication or treatment. When she shattered her femur, we took her to an orthopedic surgeon for a plate and 8 screws. When she developed bladder stones, we had surgery to remove them. But now? How much is old age, versus the disease? How many trips of her panting and trembling at the veterinarian do we undertake? Trying to find the answer feels like cutting fog - useless, and exhausting.
I'm looking for some guidance and experience. Our nearly 14 year old Chow mix Maisy (affectionately Maisy-Moo, or Moomer) has been diagnosed with adrenal-dependent Cushing's. She started exhibiting symptoms this past spring, when her Alk-phos levels were a bit high. When we re-tested in early summer that level had doubled. Based on this, along with the appearance of some classic symptoms, we decided to schedule a LDDS test for early fall. Apparently there was an error on the clinic's side, so they asked to re-test for free in October. This was done and showed a pattern consistent with ADH.
To confirm, the vet suggested we take our girl to a specialist about 2 hours south for an ultrasound. We did so, and confirmed a tumor 3 cm x 3 cm on one of her adrenal glands, along with slightly enlarged liver. The second gland had atrophied and could not be seen. The specialist could not see invasion into the vena cava, but did not rule that out either.
We have already decided not to pursue surgery. We are most concerned with her quality of life, and are wondering whether it's worth trying trilostane. Her symptoms are not out of control yet - she drinks more than in her younger years, but does not empty the bowl. She acts ravenous, but this is something of a blessing, as she used to be an extremely picky eater. She pees more often, but doesn't wake or wet in the night. Her once-beautiful fluffy tail is now bald. The saddest symptom has been the wasting of her rear leg muscles. She can no longer get in the car unaided; she sometimes trips, and struggles a bit to stand from lying down. She cannot tolerate long walks - about 1 mile of flat terrain is her limit.
From what I've read, the muscle wasting is the last symptom to resolve, if it ever does. So I wonder how worth it it would be to go on trilostane, endure the repeated testing, which terrifies her, possible side effects, possible loss of appetite, etc. She is eating beautifully; I would hate to lose that. We just have to be careful not to keep any table scraps within reach, and bought a locking garbage can. She also has a small amount of arthritis in her lower back. I worry about pain, if/once cortisol is suppressed.
Mostly I'm just very conflicted. When they're young it's so easy; of course you try X, Y, Z medication or treatment. When she shattered her femur, we took her to an orthopedic surgeon for a plate and 8 screws. When she developed bladder stones, we had surgery to remove them. But now? How much is old age, versus the disease? How many trips of her panting and trembling at the veterinarian do we undertake? Trying to find the answer feels like cutting fog - useless, and exhausting.