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Old February 7th, 2014, 04:23 PM
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Halo and Cushing's Disease

Okay, so just had a call from my vet that it seems Halo has cushing's disease. She had an ultrasound done today to rule out any cancers in her bladder/kidneys, etc., but it showed enlarged adrenal glands, likely caused by a tumour in the brain he said.

He has recommended some expensive drug tests to confirm this, and options of a couple of treatments that can be very costly also. I'm still sort of in overload situation here.

Any info or advice you can offer me on this would be appreciated. For the next week I have to just let it all sink in before I decide what to do. Extreme treatment is not going to be an option. Halo is old, and while I love her to bits, I do have limits of what I can offer. What I have read tells me that most treatments offer improved quality of life but not extended life. Yes I know quality is important. Maybe more important than longevity.

Thanks for any input and experience you have in this area. For those who may not know Halo she is a 13 and a half year old black lab cross.
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Old February 7th, 2014, 05:45 PM
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hazelrunpack hazelrunpack is offline
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Oh, no, DD

Is she symptomatic? What kinds of treatment can they offer?
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Old February 7th, 2014, 07:04 PM
lindapalm lindapalm is offline
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My only advice is to make sure you have a vet that knows Cushings and the different types of meds offered. Ours didn't, it seemed like he was learning as he went along, which wasn't good for our dog.
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Old February 8th, 2014, 09:15 AM
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Well right now she is showing some symptoms such as weight gain, increased thirst and urination (which may be part of her incontinence issue) and extreme panting. Her coat has deteriorated over the last while, but we had really put that down to old age.

My vet does seem to have a good grip on the treatment options. Now as Hazel can relate with her pack, spending tons of money is not a great plan. I have to be able to take care of all of them not just Halo. So extreme measures we won't do anyhow just due to her age, but we are going to talk next week after I've had a chance to assimilate some of this information, and decide on a go forward plan. He assures me she's not in pain anyhow.

It's really something I have no experience with, but I do have a friend here in town who had a dog years ago who had cushing's so I'll talk with her this weekend I hope.
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Old February 8th, 2014, 11:26 AM
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hazelrunpack hazelrunpack is offline
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I found this page that discusses a lot of the different tests and what they're used for:

http://www.2ndchance.info/cushings.htm

It also mentions this about the tests:
Quote:
Do I really Have To Have All These Tests Run?

If a low dose dexamethasone test result is strongly suggestive of Cushing's disease (and your pet is ill) , it is acceptable to have your vet place your pet on appropriate medications and see how it does - we already know that about 85% of these dogs have a tumor in their pituitary gland.

Here is the risk in doing that: If your pet is one of the other 15% that have the tumor in their adrenal glands, there may be an option to remove it surgically, curing the dog. The other problem is that those 15% which are in the adrenal glands are occasionally malignant and by the time you get around to doing further tests, such a tumor might be inoperable. Also, dogs in this 15% often need a much higher dose of medication than dogs with pituitary gland tumors.
I'm looking at that surgical 'cure' thing. If we thought that might be an option, then we'd go for at least a few of those tests that can distinguish between an adrenal and a pituitary tumor. But if, after weighing pros and cons ('chances of a cure' vs. 'recovery time in an older dog can seriously impact the quality of the time they have left', for example), we realized we wouldn't opt for the surgery anyway, we'd probably decide to just go with the meds and tinker with the dosage till we got something that worked.

It's a tough decision...I'm so sorry you're faced with this whole thing
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Old February 8th, 2014, 08:31 PM
MaxaLisa MaxaLisa is offline
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It may not be Cushing's....is the Alk Phosphate elevated too?

Here's a note from an endocrine vet:

Quote:
"However, bilateral adrenal enlargement was noted, and the radiologist recommended a workup for Cushing's disease"

Response...
Hyperadrenocorticism (Cushing's disease) is a clinical diagnosis and is based primarily on the finding of compatible signs (e.g., polydipsia, polyphagia hepatomegaly, hair loss, pot-belly). In a dog suspected of suffering from Cushing's syndrome, we confirm the diagnosis by using one or more of the adrenal function tests (e.g, ACTH stimulation or low-dose dexamethasone suppression tests) (5-7).

One should never make a diagnosis of hyperadrenocorticism based on the finding of large adrenal gland size alone. Remember that the stress of any nonadrenal illness commonly leads to an overactive hypothalmic-pituitary-adrenal axis. Therefore, any dog with chronic stress or illness can develop bilateral adrenocortical hyperplasia as a physiological response. I know that some radiologists like to diagnose Cushing's disease based on adrenal gland size, but this just cannot be done using this criteria alone (5,6). Dogs with Cushing's disease certainly tend to have larger adrenal glands, but large adrenal glands alone are not diagnostic for this disease.

http://endocrinevet.blogspot.com/201...l-adrenal.html

Cushings can also be treated with things like ketoconazole, which is noted from the link above. Has your dog been on prednisone at all? Are there any skin issues?

The Cushing's test is expensive - it's similar to the one for Addison's. I paid $400 (U.S.) for Jazz's addision test (she had to have two )

Some dogs do better without treatment from what I read, but if there are symptoms, I think I might consult a holistic type vet, and see if there are any herbal preparations that block cortisol.
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