Cushings Disease :(

Well, our boy was just diagnosed with Cushings Disease (see thread below for his past saga)
http://www.basenjiforum.com/showthread.php?t=837

Mom just called last night to let me know and discuss what the vet recommended. Apparently if we decided to treat the Cushings, it would mean an 8 hour visit to the vet, then 2 hour visits once per month following that. Our vet recommended that we did not take this route, as Pongo is really neurotic and its traumatic for everyone for the vet visit. Last time he went to the vets, she came out with him and described the day as a "rodeo". Oh dear. I agree with the vet, and really think it would be harder on him to go through with the treatment, based on what she described. She recommended that we treat symptoms as they come…he is 11 years old now, so he is getting up there as it is.

Does anyone have any experience with Cushings? What did you do when you found out/how old was your dog? Any info would be great (I'm pretty versed now on the actual disease, I'm really wanting personal experiences).

Thanks everyone!

I'm so sorry to hear that your boy is sick. I can understand how & why you came to the decision to treat his symptoms as they come. I'll keep you and him in my thoughts and prayers…

Sorry to hear about your diagnosis. At least now you know what your dealing with. I have some experience with Cushing's so maybe I can help. I used to work at a vet so I am constantly "rehoming" dogs to my family and friends. About four years ago I rehomed an older, I think she was eight, Lhaso Apsa with my aunt and her family. Susie wasn't in the best condition medically and after doing bloodwork and other tests she was diagnosed with Cushing's. At first, it is alot of work to get the medication dosage correct. Basically, their is a feedback mechanism between the hypothalmus, pituitary,and adrenal gland. If either the hypothalmus or the pituitary become damged in any way they do not produce the hormones that are needed to induce the adrenal gland to function. After that the adrenal gland fails to produce the amount of corticosteroids the body needs to function properly. In order to manage this they follow a protocol that starts by killing the cells of the adrenal gland, usually done with lysodren (this way the adrenal gland produces zero corticosteroids). After that, you will give him a corticosteroid to replace the corticosteroids not being prouced by the adrenal glands. Then they go through a sort of trial and error period where they may change the dosage of medication he recieves based on his bloodwork results over that time. Once you get the dosage correct he should only need periodic bloodwork done to make sure the dosage is still correct, probably every six months or once a year.

Sorry this is so long and I know it seems daunting! Ecspecially, since your option is not a cure only management. The initial part is time consuming but after that the maintenance is not so bad. You might want to ask if he could have a mild sedative to help his anxiety before the office visit, I'm not sure if that would affect his blood work or not.

To make a long story short…Susie is now on maintenance for her cushing's and doing well. She isn't perfect but she is comfortable. In the long term, if you don't treat the disease you can expect to see more symptoms develop and the quality of life continue to go down. On the other hand, many dogs treated for the disease continue to live comfortable lives over the course of the next several years.

Good luck! Hope this info helped.

That is great infomation on cushings… thanks for posting it....

@achandl2:

Sorry this is so long and I know it seems daunting! Ecspecially, since your option is not a cure only management. The initial part is time consuming but after that the maintenance is not so bad. You might want to ask if he could have a mild sedative to help his anxiety before the office visit, I'm not sure if that would affect his blood work or not.

Thanks so much for the information! I do understand that his symptoms will get worse if not treated…but the vet thinks its best not to go through the with treatment as well. A mild sedative would not be enough for him...he is beyond nuts when he is taken out of his comfort zone, and we just feel like it is such a strain on him to take him to the vet any more than necessary. The vet told us he would need monthly visits for the treatment...that really doesn't sound like maintenance to me, not for Pongo anyway. I'm feeling torn now; I really don't know what the best choice is for him. Do you think we should get a second opinion from another vet? We really like and trust the one we have now.

A second opinion never hurts but that said, if you are comfortable with your current Vet, I don't think that I would…. In the end, you have to go with your heart and what you think is best for your boy....

Thanks Tanza…it really is hard and sad to think about all this...he is doing so well; in fact the vet said that his kidneys are BETTER than the last time he was tested, which is very strange. He is gaining weight and shine since he was having his seizures. The vet said not to tell him he is sick, and he will never know. 🙂 We just have to take this one step at a time I guess and see what happens. He is 11 years old, so it's not a huge surprise, although our 13 year old girl is healthy as a horse and thriving off the new "lifestyle" of cooked veggies, rice, fish oil, and wet food with their normal kibble...:rolleyes:

@PongoGirl:

Thanks Tanza…it really is hard and sad to think about all this...he is doing so well; in fact the vet said that his kidneys are BETTER than the last time he was tested, which is very strange. He is gaining weight and shine since he was having his seizures. The vet said not to tell him he is sick, and he will never know. 🙂 We just have to take this one step at a time I guess and see what happens. He is 11 years old, so it's not a huge surprise, although our 13 year old girl is healthy as a horse and thriving off the new "lifestyle" of cooked veggies, rice, fish oil, and wet food with their normal kibble...:rolleyes:

My kids are 2-soon to be 16 (Aug and Sept)… one in renal failure but doing well on supportive SubQ fluids 2 to 3 times a week (given by us at home)... a 14 1/2 yr old and a 12 1/2 yr old... so I know all about them getting old....

I agree with you taking it one day at a time

I'm not familiar with how that first all day treatment is administered–but is there any possibility of you staying with him at the vets while they treat him? When Max was having SubQ fluids done the last month of his life when he was in kidney failure, I would sit in the exam room at the vets with him in my lap while a technician administered the fluids. Of course--that was a lot shorter than all day....I had the same vet for many years, and he knew how stressed Max would get whenever I had to leave him there. For his dental, he would come out and meet me in the reception area, take Max and immediately shoot him up with a preanesthetic before he had a chance to get stressed.

@PongoGirl:

Thanks so much for the information! I do understand that his symptoms will get worse if not treated…but the vet thinks its best not to go through the with treatment as well. A mild sedative would not be enough for him...he is beyond nuts when he is taken out of his comfort zone, and we just feel like it is such a strain on him to take him to the vet any more than necessary. The vet told us he would need monthly visits for the treatment...that really doesn't sound like maintenance to me, not for Pongo anyway. I'm feeling torn now; I really don't know what the best choice is for him. Do you think we should get a second opinion from another vet? We really like and trust the one we have now.

Tough choices…they sure do stink! I agree that it never hurts to get a second opinion. Just like in human medicine, veterinarians will have different experiences that makes them approach treatment options differently. Some will want to treat aggressively while others will treat more conservatively. After working in a busy veterinary clinic I tend to be more skeptical about the care I recieve. Vets are just people and will make mistakes (even experienced ones). I know I sound pessimistic but I promise I'm not trying to scare you. It's okay to doubt your vet. If you trust your vet maybe you just need to ask him/her to be very specific about treatment options and why he/she is suggesting one treatment versus another. It sounds like you might feel more comfortable about the treatment if you had more detailed information. Most vets will appreciate you asking questions in order to be more informed. Once you get to the maintenance stage you should not have to make visits once a month. In fact, once on maintanence, I never saw a cushing's dog in our clinic that often for tests. Maybe there is a good reason why your vet says that would be necessary but I would question why. Without seeing how your dog acts at the clinic it wouldn't be fair to make a judgement about how often he should or shouldn't go for treatment. When you say he is beyond nuts...in what way? Is he aggressive...does he bite you or other people? Can you muzzle him or will he bite? I had a rescue dog we were trying to rehabilitate one time that would go beserk out of fear. He would fear bite us and anyone who came near him. He wouldn't even let me muzzle him. We would have to restrain him and literally knock him out to do routine stuff. So I understand how frustrating that can be and in that type of case you really are limited on treatment options. It does suck because you feel kind of helpless.

@MaxBooBooBear:

I'm not familiar with how that first all day treatment is administered–but is there any possibility of you staying with him at the vets while they treat him? When Max was having SubQ fluids done the last month of his life when he was in kidney failure, I would sit in the exam room at the vets with him in my lap while a technician administered the fluids. Of course--that was a lot shorter than all day....I had the same vet for many years, and he knew how stressed Max would get whenever I had to leave him there. For his dental, he would come out and meet me in the reception area, take Max and immediately shoot him up with a preanesthetic before he had a chance to get stressed.

One thing about SubQ fluids, it is very easy to do and certainly any Vet Tech can show a lay person how to do it at home… Like I said, I do it for Maggii (also in renal failure) 2 to 3 times a week and it takes maybe 10 minutes tops....

@tanza:

One thing about SubQ fluids, it is very easy to do and certainly any Vet Tech can show a lay person how to do it at home… Like I said, I do it for Maggii (also in renal failure) 2 to 3 times a week and it takes maybe 10 minutes tops....

Yes–I was trained how to do it--and did do it at home a couple of times, but it was really a struggle for me. Both my dogs reacted very, very poorly to the procedure--and it really took two people to do it comfortably. Since I live alone, it was best for me to go have it done at my vets who is only about 5 minutes from me. They also got a special contraption for the bag of fluids that expressed the fluid out so it went much more quickly. But I know many people who are able to do it at home because their dogs or cats are more tolerant than mine were. It's much cheaper that way 🙂

@MaxBooBooBear:

Yes–I was trained how to do it--and did do it at home a couple of times, but it was really a struggle for me. Both my dogs reacted very, very poorly to the procedure--and it really took two people to do it comfortably. Since I live alone, it was best for me to go have it done at my vets who is only about 5 minutes from me. They also got a special contraption for the bag of fluids that expressed the fluid out so it went much more quickly. But I know many people who are able to do it at home because their dogs or cats are more tolerant than mine were. It's much cheaper that way 🙂

One of the best ways is to have a grooming table that comes complete with a "noose"…. It supports the head and keeps them standing.... you can fairly easily hang the IV bag off the same support.... while I agree the first couple of times it helps to have two, one to hold the dog, one to "stick" the needle in.... but once you get the hang of it.. it usually works.... But whatever works... and that is great that you could just run down to your Vet...

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