Undiagnosed, but likely Cushing's in 15yo doxie

[HarleyKin]

My 15 yo dachshund has exhibited signs of pituitary dependent Cushing's for a couple years - primarily stiffness, increased hunger, and panting. My vet wasn't recommending the blood cortisol tests because his symptoms weren't severe and she is reluctant to treat with pharmaceuticals, with the related side effects, while his symptoms are mild.

For the past 18 months, Harley has received acupuncture for stiffness in his rear legs and to regulate his endocrine system. In August, Harley had an episode with disc compression. He had surgery for a ruptured disc when he was 5, so another disc issue wasn't too surprising. His mobility is a bit better after a round of steroids, but in the process, he was diagnosed as hypercalcemic, likely due to a growth on his parathyroid, identified by an ultrasound. He has elevated blood pressure (190mmHg) and a 3-4 level heart murmur. Amlodipine was prescribed for the high blood pressure. In addition to the amlodipine, daily he takes one gabapentin at bedtime, a 150mg CBD treat, two Quiet Moments Calming Aid with Melatonin treats, and he is treated with an Assisi electromagnetic loop 6 times daily for spinal issues as recommended by a physical therapist.

For a dog with several health concerns, outside of limited mobility and some panting episodes, he seems to be a happy, comfortable dog. My question is, what would be the compelling reason for confirming the Cushing's diagnosis?

[Harley PoMMom]

Hi and welcome to you and your boy!

I have manually approved your membership so now all your posts will be seen right away. Also, please just disregard the validation email that was sent to you from k9cushings.

The decision to treat is a very personal one and with an elder dog there are pros and cons to look at. If the dog suffers from arthritis than treatment may make it more painful because that abundance of cortisol acts as an anti-inflammatory. Also, there are the monitoring tests that have to be done to check the level of cortisol which for any dog are not enjoyable but much less so for an older one. I don't tell you this to dissuade from treating your sweet boy, I just want you to have as much information as possible. Now having said that, Cushing's is a treatable disease and with treatment dogs with Cushing's can have a good quality of life and there is every reason to believe that they can live out their normal life span. However, for the treatment to work safely and successfully it requires an educated pet owner along with an experienced vet as adverse side effects are mostly only seen when the proper protocols are not followed.

In my opinion, since your precious boy is not exhibiting strong Cushing's symptoms I would not pursue any testing for Cushing's.

Hugs, Lori

[labblab]

Welcome from me, too, and I agree with Lori’s recommendation. For senior dogs, immediate quality of life is my top priority in terms of making a Cushing’s treatment decision. Given Harley’s age, other known problems, and lack of truly bothersome Cushing’s symptoms, I’d be hesitant to launch into treatment at this time. As Lori has said, elevated cortisol may actually be providing some degree of anti-inflammatory benefit in terms of osteoarthritis.

For the time being, it sounds to me as though you are already addressing Harley’s most pressing issues. But please feel free to ask us any additional questions that come to mind.

Best wishes,
Marianne

[HarleyKin]

Thank you! Really appreciate the feedback from both of you. And yes, thanks for the reminder of what our vet said, which was the benefits of the excess cortisol. I sort of lost track of that aspect.
It's great to hear from experienced dog owners. Vets are great, but can be overwhelming when providing a ton of info, and mostly over the phone now that we're doing curbside.
Thanks again!