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.

Oh, no, DD :grouphug:

Is she symptomatic? What kinds of treatment can they offer?

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.

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.

I found this page that discusses a lot of the different tests and what they're used for:

[URL="http://www.2ndchance.info/cushings.htm"]http://www.2ndchance.info/cushings.htm[/URL]

It also mentions this about the tests:
[QUOTE][B]Do I really Have To Have All These Tests Run?[/B]

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. [/QUOTE]

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 :grouphug:

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.

[url]http://endocrinevet.blogspot.com/2014/01/seizures-and-bilateral-adrenal.html[/url]

[/QUOTE]


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 :o )

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.

Interesting thoughts MaxaLisa. Will talk to the vet about it. Tks

Give Halo a hug from me :grouphug:

Thanks, I will. She's such a champ.

I am very sorry to hear Halo is sick , I hope she will feel better soon , poor doggie. Give her a hug for me too.

I will Barkingdog. Nothing much new on the Cushings front just yet. Have not done the next blood test to "confirm" the disease. That will cost $220. Which is fine, but I do need to find out what the treatment costs are going to be. The vet agree's that the monthly $250 per month in blood work is out of line for most people, so we would just watch clinical signs, but I do want to know the cost of the drugs. If it's prohibitive I may have to look at alternative treatments. The stilbesterol she is taking is costing $100/month now (it used to be so much cheaper...), and they just brought me in a bottle of the Proin for better muscle control, and that is $95.00 for a four day supply - well yeah, that's not working for me either!!! Seriously vet costs are a little out of control. What good does it do to have all this available if the average pet owner can't afford it. Rant over. Sorta.

The price for the Proin seems really high. A year and a half ago I paid $25 for a months supply, I realize prices have gone up a lot, but that still seems really high for only a four day supply.

I know, it's ridiculous! The vet said he would give me a prescription and I could take it to a pharmacy, so I will see what the cost is that way. Diapers at night may be our next course of action at this rate. She will not be a happy girl if that happens. And hubby will not be a happy boy either.

[QUOTE=Dog Dancer;1064742]I will Barkingdog. Nothing much new on the Cushings front just yet. Have not done the next blood test to "confirm" the disease. That will cost $220. Which is fine, but I do need to find out what the treatment costs are going to be. The vet agree's that the monthly $250 per month in blood work is out of line for most people, so we would just watch clinical signs, but I do want to know the cost of the drugs. If it's prohibitive I may have to look at alternative treatments. The stilbesterol she is taking is costing $100/month now (it used to be so much cheaper...), and they just brought me in a bottle of the Proin for better muscle control, and that is $95.00 for a four day supply - well yeah, that's not working for me either!!! Seriously vet costs are a little out of control. What good does it do to have all this available if the average pet owner can't afford it. Rant over. Sorta.[/QUOTE]

I agree and feel the same about vets bills being too high for the average pet owners . Poor Halo how is she feeling right now?

We get a prescription from the vet and order through a reputable online pharmacy--much cheaper than going through the vet! But even so, some pharmaceuticals have shot up in price. We used to be able to get 500 Doxycycline for less than $80--recently, due to manufacturing problems, the price for 500 went up to about $1500! :eek:

Yikes Hazel that is crazy! Barkingdog, Halo is doing okay. She is still a happy girl and just finished chowing down on some roast chicken for lunch at work. Have not picked up the Proin yet, the vet was supposed to call me but was in surgery and I never heard back from him. Will have to talk to him soon though and get a plan going.

That is great she eating good , it was so horrible when my last dog was not to keep any food down because of his cancer . It's so hard seeing a beloved pet get sick. :2huggers: for you and Halo.

Oh, yum! Wish I'd had roast chicken for lunch! :D Glad she's got an appetite! Good girl, Halo! :thumbs up

Well, apparently the Proin isn't used for humans anymore so it's gone way up in price. They did find me a supply for $200 for 52 days. Haven't got it yet. Did the $220 Cushing's test instead. Figure if it's confirmed as Cushing's and we treat it then her thirst should diminish and maybe the pee issue will as well. The Cushing's treatment costs $165 per month, so if I don't spend $100 a month on Proin it's not so bad.

Anyhow, I mentioned in TJT that it turns out the Cushing's test came back normal. The vet says it's probably still Cushing's must atypical cushing's. He really didn't have anything helpful to offer me at this point. He suggested if I won the lotto I could have $600 worth of blood tests sent to the states to see what imbalance is present but it would be a shot in the dark. I'm at a loss as to what to do now. I feel horrible that I'm disappointed she doesn't have straight on Cushing's as I hoped the treatment would cure so many little issues.

Anyhow, back to the research I guess. Perhaps I will have to search out a holistic vet and see what they recommend.

Atypical Cushing's I believe can be treated using freshground flaxseeds and melatonin.
[url]http://www.vet.utk.edu/diagnostic/endocrinology/pdf/TreatmentInfoAtypicalCushings201107.pdf[/url]
[url]https://groups.yahoo.com/neo/groups/ScottishTerrierForum/conversations/topics/2968[/url]

Woman you are a wealth of knowledge. I didn't even think to search atypical cushing's. Will read your links and see what I can dig out. Thank you! I love this board, so many people with so much experience to share. And willing to share. It's great. Thanks again.

:blush: thank you :)

I, unfortunately, have never had a healthy dog :shrug: Way too many hours spent googling and obsessing! I'm just glad if I can use that info to help others....

Don't blush it's just the truth. I am going to find to melatonin and start her on it after talking to my pharmacist to make sure it won't interact with the pills (that Idon't recall the name of) for the yeast.

My mom's been sick, I haven't been around, have you tried the melatonin? I'm not sure what you might noticed if it's working though.

Sorry to hear about your Mom MaxaLisa, I hope she is doing better now.

I have not tried the Melatonin yet. I wanted to get through the pills the Vet gave her for her yeast infection first. Have to say for $200 they were a total fail. They really haven't helped at all and we're just about done with them.

I'm very disheartened by all of this. My brightest light has been from the help I have received on this board and from friends, not from the vet. I don't really blame him, but I don't feel he's helped much either. I see Halo falling apart in front of my eyes. She's very unsteady on her feet lately as well. Stumbles coming up the few steps we have at the front, and I don't let her take the back stairs very often anymore, there's just too many out there. It is heartbreaking. Will start the melatonin this weekend though and hope for the best. Thanks for checking.

MaxaLisa , I am sorry to hear about your mom too and hope she'll feel better soon.
DD , that is so sad about Halo and it's heartbreaking to see a beloved pet get sick . :goodvibes: for Halo

Well I bought the melatonin last night. 3mg caps, so I'll put one on her dinner tonight. The article says 6 mg for dogs over 30 lbs, but I gave Halo a Benadryl once and I thought she was dead she was so sound asleep. So I think I'll just try one and see what happens to her. If she's okay with one I'll go up to two. I'll give them with dinner because I gather they are supposed to also make you tired. Wish me luck. I bought her a probiotic also to try to help with the yeast. Gave her that this morning.

Good luck, DD! Hope this works for Halo! :fingerscr :goodvibes:

MaxaLisa, I hope your mom is better! :grouphug:

You know Hazel, it can't hurt I guess. I can't believe I spent $200 on the last set of pills for her skin and it hasn't helped at all really. I spent $18 last night for the two bottles of pills that will last about a month. :fingerscr I know it's not going to cure the cushings, but I just want her skin to be better for her sake.

I will keep fingers crossed for Halo.

You know, when my GSD was put on anti-fungals (ketoconazole and fluconazole), with each of them, it made him very wobbly and unstable on his feet. I hope that Halo is better now that the meds are done?

It is very frustrating, because we want our vets to have answers (particularly when we are paying good money!). But so often, these things are so elusive :(