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  #1  
Old 04-25-2009, 04:08 PM
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Kakesie Kakesie is offline
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Default Newly diagnosed, our beloved Buddy

Hi Everyone!

I'm Karen. We live in Nebraska. My 15 yr. old daughter and I have Buddy, who was diagnosed 04-22-09 with Cushing's Disease. Buddy is 8 yrs old, 80 lbs, mixed breed.

He doesn't seem sick, (yet), but he does drink a lot of water. Our veterinarian has explained the various treatment options, but we've decided that as long as he's not suffering yet, to wait before we start giving him medications that could push him into Addison's or cause him to yo-yo. But we just found this out so I'm very open to any and all ideas & suggestions.

Buddy is the sweetest, most loving dog I've ever known and he's my daughter's absolute best friend in the world! We want to do whatever we can to help him.

Our other dog, also 8 yrs old, part cocker, dauchshund, chihuahua mixed breed, 23 lbs. has MegaEsopahgus Disease. We belong to a Mega E support group for her and they have been very helpful.

Vets are wonderful, but owners of a dog with a disease have the passion and drive to do the research on that one disease and try every option and come up with creative solutions, that Vets who have to know about a lot of different diseases simply don't have the time to do. Plus no one understands like one we do, how hard it is when our beloved doggie is sick or passes on.

Bless you for being here and wishing the best for your doggies.
Karen, Saralisa, Buddy & Dolly
  #2  
Old 04-25-2009, 04:49 PM
frijole frijole is offline
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Default Re: Newly diagnosed, our beloved Buddy

Hi Karen! Guess what - I'm from Columbus NE! You sound like you have a house full of critters. How wonderful. I can't wait to learn more about Buddy.

My dog Haley is now over 15 and was diagnosed 3 yrs ago and has been on lysodren the entire time. I understand your hesitancy to use what might seem like harsh drugs. I assure you that unfortuneately there is no herbal cure or I would certainly have gone that route and the drugs are not nearly as nasty as what I read early on.

You came to a fantastic site for information. That's how I landed with this group as well. We are simply cush parents that have been down the same path and want to share our many and varied experiences with others.

As you will learn, cushings is a serious disease if not treated. Do you know if it is pituitary, adrenal or atypical cushings? It might help if you tell us more about the testing that was done to diagnose. Believe it or not there are times we see misdiagnosis so we never assume. Atypical cushings can be treated with flax, lignons and melatonin. Adrenal can sometimes be "cured" with surgery and pituitary requires treatment, typically with either lysodren or trilostane.

While you might just be dealing with abnormal thirst now - at some point that thirst will end up as urine all over your house. Sorry but thats what happens. And it isn't Buddy's fault... what is happening is that his body is over producing cortisol and it is causing him to be very thirsty - he needs to hydrate his body. Don't limit his water intake as that can hurt him as he needs it.

Probably when you did the tests you found that his liver enzymes (alk phos) were elevated. Most of have this. Liver is the gateway to all major organs and when cushings goes untreated organs can and will eventually fail. It varies but it can be that they go blind, develop diabetes, or have kidney or heart failure. This isn't a decision you have to make immediately and you are wise to read as much as you can about the disease and ask us as many questions as you want.

So tell us about Buddy, his symptoms, the tests that were done. That will help us help you and him. I am so glad you found us.

Hugs from Haley and I
Kim (frijole)
  #3  
Old 04-25-2009, 05:43 PM
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Kakesie Kakesie is offline
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Default Re: Newly diagnosed, our beloved Buddy

Hi Kim & Haley,

Thanks so much for your reply!!! We just talked to our vet yesterday, (Friday) and now I wish I had asked more questions. The first thing we noticed about Buddy is that he is losing his sight.

The vet did a general check-up on him and said his liver, kidneys, heart, lungs, bloodwork, urinalysis, etc. all looked good, but that something was elevated, (cortisol?), and they wanted to test for Cushing's disease. So we had to bring him back after he had fasted and they did a "Low Dose Dex Supp Test" - took blood samples first thing in the morning, at noon and late afternoon.

Our vet didn't say if it was pituitary, adrenal or atypical cushings. She just said in dogs 75% are pituitary & 25% adrenal and that it's exact the opposite in ferrets. So I think she just assumed it was pituitary.

She consulted with vets in Kansas City who said life expectancy once diagnosed is 2-3 years with treatment OR without treatment. She explained that the problems with trying to reduce the cortisol production with lysodren or trilostane is that it needs to be closely monitored and can easily go too far, pushing the dog into Addison's. Her mentor in Kansas City said if they keep yo-yoing, they sometimes purposely destroy the pituitary gland putting them permanently into Addison's and then treat them with steroids. She also said the treatment and the monitoring is extremely expensive.

Although I'm want to do whatever I can to help our baby, I just lost my job and we're having a hard time making ends meet as it is.

I really appreciate SO much your reply and any one else who writes. It really does help to have other dog lovers who care as much as we do and understand what we're going through!

Thank you very much!!!
Blessings to you and Haley, Kim
Karen & Buddy
  #4  
Old 04-25-2009, 05:55 PM
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Kakesie Kakesie is offline
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Default Re: Newly diagnosed, our beloved Buddy

Quick add-on,

In skimming the other posts, I can see there's a lot of additional information I need to get from my Veterinarian! Does this site have a list of "Cushing's-Knowledgable" Veterinarians? I like our veterinarian, but I have learned so much more about our other dog's disease from the Mega-Esophagus support group. I really do think online support groups can help each other out so much and I'm very glad I found this site!

Thank you for being here!
Karen
  #5  
Old 04-25-2009, 05:59 PM
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BestBuddy BestBuddy is offline
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Default Re: Newly diagnosed, our beloved Buddy

Hi Karen and Buddy.
A lot of us get the test results and keep them in a file. It's good to have the numbers to compare if you have more tests and also in an emergency if you have to see another vet to have all the info on hand. The most expensive part of cushings is the initial testing and monitoring to get the right treatment and dosage. Welcome and keep us up on how it's going.
Jenny
  #6  
Old 04-25-2009, 06:17 PM
frijole frijole is offline
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Default Re: Newly diagnosed, our beloved Buddy

Karen

I can tell you that there are no internal med vets in our entire state - K State sends some folks to Omaha a few times a month. I would ask friends who love their dogs equally for info on their vets OR call the folks at your local animal shelter (animal lovers) and find out what vets they feel have the most experience and explain your situation. Like I said, mine wasn't a seasoned cushings expert but he was caring enough to learn and wanted to help me save my dog.

Whoever your vet is calling in Kansas City is NOT correct. I suspect your vet did what my first one did (the one I fired) She said she was getting advice but she was just speaking with someone at the lab that she sent the tests to. NOT the same.

Get a copy of the LDDS test that was done. This IS the best first test to have done so that is great. There will be 3 numbers. Those 3 numbers are what your vet (or the lab) should read and use to indicate if its adrenal or pituitary OR if more tests should be done.

That comment about 2 to 3 yrs is untrue. Most of our dogs that seek treatment die of OTHER causes - mostly old age.

Yes you have to monitor when giving the drug but heck, any drug should be monitored and it is the job of the vet to help you do so. They have protocols to follow. (and we can give them to you if you want ) The key is for the vet to take the initiative to learn about this and help you. Of course we would be here as a reference and answer questions as well.

Don't worry - all will be fine. Lets start by getting the numbers and make sure your dog has cushings. As Jenny stated the expense is the testing at the beginning - it gets better after that. There are organizations that help out with expenses but I don't have the link. Perhaps someone else has it.

So glad you found us. Hang in there - you aren't alone. Give Buddy a big hug ok?

Kim
  #7  
Old 04-25-2009, 06:20 PM
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Lulusmom Lulusmom is offline
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Default Re: Newly diagnosed, our beloved Buddy

Hi and welcome the forum.

I am so sorry for the reason that brought you here but I'm glad that you found us.

It would help us greatly if you could round up copies of the test that your vet did to diagnose Buddy. It's a very difficult disease to diagnose which makes it the number one disease that is misdiagnosed. As Kim already mentioned, dogs with cushing's usually drink to excess to keep up with the frequent urination. Excess steroids effect the kidneys ability to concentrate the urine so if the dog doesn't drink more fluids that it is getting rid of, it doesn't take long to dehydrate and get very sick. Since your vet said that the urinalysis was fine, I am wondering if he checked the urine specific gravity. This is usually low with cushdogs as the urine is dilute. Increased water intake can be attributable to any number of diseases so I am wondering if Buddy has any other symptoms that are associated with cushing's such as an increased appetite, loss of coat, change of coat, panting, weakness...especially in hindquarters or recurrent infections?

Has Buddy's blindness come on over a long period of time or is this something that you have recently noticed? There is a condition called SARDS (Sudden Acquired Retinal Detachment Syndrome) which comes on quickly and a dog can go blind over night or in a week's time. Researches think there is a connection between Cushing's but they don't know what it is. What they do know is that a lot of SARDS dog are diagnosed with cushing's one to six months of going blind. Those that don't almost always test positive for elevated adrenal hormones within a month to a year after going blind. Excessive thirst and urinations are a symptom of abnormal adrenal hormones/steroids other than cortisol.

Just so you know, a dog can live out their normal life expectancy if the cushing's is controlled with proper treatment. I suspect that a lot of vets tell pet owners that 2 to 3 years after diagnosis is all you can hope for based on the fact that most dogs are pretty senior when diagnosed. One of my cushdogs, however, was only three years old when diagnosed and she is now seven. I have no idea what Buddy's breeding is but 8 years isn't that old for a lot of breeds so I poo-poo that 2 year prognosis bunk.

Looking forward to hearing lots more about Buddy.

Glynda
  #8  
Old 04-25-2009, 06:37 PM
stardeb55 stardeb55 is offline
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Default Re: Newly diagnosed, our beloved Buddy

Welcome, Karen!

Please disregard these statements about 2 year survival with or without treatment. It's nothing but hogwash!!! My 1st Cushpup, Barkley, was successfully treated with lysodren for just about 8 years, crossing the bridge at 15.

I think you may have misunderstood some of the things your vet has told you, so my responses to clarify are in blue.

The vet did a general check-up on him and said his liver, kidneys, heart, lungs, bloodwork, urinalysis, etc. all looked good, but that something was elevated, (cortisol?)
On general labwork, the first thing that will usually tip off a vet to look for Cushing's disease is an elevated alk phos which is one of several liver enzymes. Most of the liver enzymes are usually elevated in our pups as the liver takes a beating since it has to process the extra cortisol produced by the adrenals.

Our vet didn't say if it was pituitary, adrenal or atypical cushings. She just said in dogs 75% are pituitary & 25% adrenal
Statistically, your vet is correct. You can't just assume that it's pituitary. Sometimes the low dose test will differentiate between the 2 forms, but not always. It is also extremely important to have any positive result on a low dose test confirmed by a second test such as an abdominal ultrasound or the high dose dex. The LDDS is considered to be the "gold standard" for Cushing's diagnostics as the test can yield a false positive result in the presence of non-adrenal illness. This is what makes Cushing's one of the most frustrating diseases to diagnose as there is no single test that is 100% specific or sensitive. An abdominal US would be the better choice to confirm as not only do you get a look at the adrenals, but you get a look at all of Buddy's internal organs, thus getting a better idea of his overall health.

She explained that the problems with trying to reduce the cortisol production with lysodren or trilostane is that it needs to be closely monitored and can easily go too far, pushing the dog into Addison's.
This is possible, but not likely as long as you are working with a vet who is well-experienced in treating Cushpups, following the standard loading/dosing protocols for either med. Vets who lack the knowledge & experience have a tendency to start guessing, "flying by the seat of their pants', etc., & this is where things can get really bad really fast. The other important job of the experienced vet is to work with you, teaching you what you need to know in using either med, including the signs of a possible low cortisol emergency, provide you with prednisone in case this might happen, & answer all of your questions & concerns.

Her mentor in Kansas City said if they keep yo-yoing, they sometimes purposely destroy the pituitary gland putting them permanently into Addison's and then treat them with steroids. She also said the treatment and the monitoring is extremely expensive.
I think you may have misunderstood this, as the pituitary gland is not affected in an Addisonian crisis, it's the adrenal glands. How badly the adrenal glands are affected is strictly determined by how much drug has been administered, how quickly a problem is caught & treated, with quick treatment in an Addisonian crisis, most dogs recover quite nicely without ever going permanently Addisonian. Just to point out, most vets in Europe prefer to totally destroy the adrenal glands when treating Cushing's, then treat the Addison's, feeling that it is the easier problem to treat. I can't deny that the initial treatment phase is expensive. I had to take out CareCredit to help me cover Harley's expenses when he was diagnosed a year ago, & am still paying on his bills. I use lysodren, so really can't speak to the expenses involved with Trilostane. What I will tell you is, with lysodren, once you have the dose stabilized the treatment costs will decrease substantially, with necessary testing either being done only quarterly or maybe even just twice a year. You can shop around for the either med to try to get the best price you can.

Cushing's is a very slowly progressing disease, so you can take a month or two to thoroughly review everything, educate yourself on the disease, possibly get a second opinion from another vet, then make the best informed decision you can on Buddy's behalf.

Debbie
  #9  
Old 04-25-2009, 06:40 PM
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Kakesie Kakesie is offline
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Default Re: Newly diagnosed, our beloved Buddy

Wow, you guys are AWESOME!

Within minutes of posting I had my first reply and now several more! Bless you Kim, Glynda & Jenny.

I have HOPE - maybe two to three years isn't his "death sentence"!

First thing Monday I will contact my vet and get copies of the test results with the numbers.

His breed - Well, you can see photos of him on my profile. The vet we took him to when we first got him thought he might be a Grosser Munsterlander. She showed me a photo in a book and he does look like that. Otherwise I'd say possibly a cross between pointer and black lab.

Thank you all so very much!!!
Karen & Buddy
  #10  
Old 04-25-2009, 07:08 PM
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Kakesie Kakesie is offline
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Default Re: Newly diagnosed, our beloved Buddy

Yes, I probably did misunderstand many of the things my vet said. It hit me all so fast and I went home without any of the test results or anything on paper. I will try to get better information on Monday.

Thanks so ALL of you, (you too, Debbie). I'm over-whelmed by the support and kindness of all who replied!

Bless you all!
Karen
 

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