New diagnosis and treatment fears

[Spartacus]

Hello all, i'm posting here because my dog, a Boxer/pointer mix of about 8 years, was recently diagnosed with Cushings after we noticed him peeing and drinking far more than usual. Initially the vet recommended Lysodren, but it seems to have been discontinued. My friend is a vet in Mexico and recommended Vetoryl, which turned out to be the next thing my vet recommended as well, but they mentioned that there is a small chance of death when starting. Naturally, this is a cause of great concern for me. I know treating my dogs condition seems the right thing to do and i want to give him the best quality of life, but it seems such a big risk to take when his symptoms seem relatively mild. Any advice would be appreciated. I feel bad for not treating him but if my treatment killed him i could never forgive myself.

[labblab]

Hello, and welcome to you and your boy! We’re really glad you’ve found us and we’ll do our best to answer your questions. First off, Cushing’s is typically a slowly-developing disease so you can go ahead and take whatever time you need to feel comfortable with making a treatment decision. In order to assist you, it’ll help us a lot if we can find out more specifics about your dog’s overall health history and also the specific numbers for the blood test that was used to actually diagnose the Cushing’s (usually either an ACTH stimulation test, and/or a LDDS test). Additionally, Cushing’s typically causes certain abnormalities on other routine blood and urine tests such as elevated liver markers, high cholesterol, dilute urine, etc. So if you can get copies of any recent lab tests, please post any of the values that are either abnormally high or low. Finally, does your boy suffer from any other typical Cushing’s symptoms such as excessive hunger, hair loss, pot belly, hind-end muscle weakness, exercise intolerance, seeking out cool spots when resting?

The reason why we’re interested in all this info is because Cushing’s can be a difficult disease to accurately diagnose. There can be other causes for excessive thirst and urination, for instance, and both of the diagnostic blood tests can give “false positives” in the presence of other illnesses. So the first step in a treatment decision would be determining your confidence that the diagnosis is correct. If Cushing’s does indeed seem likely, then these can be additional considerations. If the dog suffers from either high blood pressure or protein loss in the urine, there may be greater urgency to start treatment. Those abnormalities can cause/herald other significant problems such as kidney damage or blindness, so treating the root cause if it’s Cushing’s can be very important. Also, there’s a particular skin condition that can be caused by Cushing’s and it seems to manifest fairly frequently in boxers. It’s called Calcinosis Cutis, and appears as raw eruptions or lesions on the skin. From a quality of life standpoint, these lesions can make a dog miserable. So any evidence of CC can definitely motivate quick and effective treatment decisions so that the problem may be nipped in the bud before it’s allowed to become a full-blown problem.

But going back to your boy, if his only symptoms right now are excessive thirst and urination that are not that problematic for either you or him, then you may indeed wish to hold off on jumping into treatment for the time being. As it turns out, Lysodren is still being made, but there is now only one single distributor of the brand name product in the U.S. and we understand the cost has become quite expensive. One alternative is to obtain a compounded version of the medication — we can tell you more about that in another post. Vetoryl is now more commonly prescribed, as you’ve already learned. Both of these medications do carry the potential for serious side effects, including even death. These risks can never be removed entirely, but careful monitoring of these medications via periodic blood testing serve to reduce the risks significantly. Due to the risks, though, you do want to establish a clear clinical reason for beginning treatment.

So that brings us back full circle, as we seek to learn more about your boy! Thanks in advance for any additional info. And once again, we’re really glad you’ve joined us.

Marianne

[Squirt's Mom]

Hi and welcome to you and your baby boy! :)

Boy, do I understand the fear part of your title! When my 7 year old Squirt was first diagnosed in 2007 I started to panic almost immediately. For hours on end every day I sat at my computer trying to learn all I could about this disease I had never heard of and how to address it. The more I read the more terrified I became until I could barely function. Not only was I scared I was angry, frustrated, felt so very guilty and confused. I found several groups and what were called "lists" back then and started talking to people who were supposed to be experienced in Cushing's. Only one group seemed supportive and positive but they overwhelmed me with links that seemed to be written in Greek and a long, long list of questions I couldn't answer....which added to my guilt. The other places I found are best described as cruel - one lady told me I might as well put a bullet in Squirt's head if I followed what her vet prescribed. That was the tipping point for me, mentally and emotionally - I fell off the edge of sanity and into a dark world of intense loss and sadness because I felt so hopeless and helpless. I was going to lose my Sweet Bebe, who was my heart and soul, and there was nothing I nor her vet could do to help her.

Then I found the people here. I had given up on all the other places I had found and really didn't want to go thru all of that again but because she was my world I had to try one more time. By the time I got here I was a complete basket case. But they saved my sanity and my baby. Thru their gentle support and guidance I began to breath again and started learning how to help Squirt have the best life possible. Their questions were plenty but kindly put and came with explanations I could understand. If I didn't have the answer they told me how to get it. I started to learn and by learning my fear left.

Now, 12 years later, my beloved Squirt has gone ahead but she lived to be a little over 16 years old, passing from old age and not Cushing's. She lived a good life and was treated with Lysodren when the time came to treat. Her story is not the typical cush dog story but her story contains some important lessons that I will share with you one day soon. But for today I simply want you to know that we DO understand being afraid at this point and we are here not only to help you learn about Cushing's but to hold your hand when needed, to offer a shoulder to cry on when needed, to always have an ear to listen to anything you want to share, and to walk every step of this journey with you - you and your precious boy will never be alone. So take a deep breath and try to relax; you are in the best hands possible. :)

Hugs,
Leslie