Dog with Cushings

[SonnysMom]

My foxhound who will be 12 in September was diagnosed with Cushings this spring. Who has had a dog with Cushings? Did you treat it? Did the treatment help with symptoms?

Kerplunk is a retired foxhound and was a kennel dog until she was 9 years old. She is marginally housebroken at best. She would mostly find the outside world if the weather wasn’t awful. We have a dog door and fenced yard. However if the weather isn’t to her liking or if she gets stressed she will pee on the vinyl floor in the “office”. She has no concept of holding it and no concept of asking to go out.

Since the Cushing’s diagnosis she drinks a lot and pees a lot. She has also been choosing the hardwood hallway sometimes as a good bathroom spot and any throw rug anywhere in the house. I forgot to pick up the bathroom mat after I showered and she got it. She ruined a particular puppy bed peeing on it. If the dog door is open she is sometimes choosing to not go outside even in good weather.

My vet did not recommend to treat her as the testing and meds are very expensive and he feels that it does not actually prolong their life expectancy. We live 35 minutes each way from the vet. She has gotten car sick a few times so the trip to the vet is obviously stressful for her. She did fine in the hound truck but car rides especially by herself are not her thing.

I am starting to wonder if I should look into the treatment again. Maybe even switch her to a much closer vet for that treatment. I would hate to just lock her in the “office” all the time. We leave her there when we aren’t home. It is 16’ x 18’ and has 2 dog beds. The lab puppy’s ex-pen is in there. It is air conditioned. But I hate to do it when I am home.

It is all complicated by the fact that my husband is disabled so he is home the most. He is severely immunocompromised. Low hemoglobin, low white blood cell counts, low platelets, the whole deal. He is on peritoneal dialysis. He really should not be cleaning up dog pee on a regular basis.

Any words of wisdom? Is is worth trying the testing and drugs to see if they help with the excessive drinking and peeing?

ETA: She had a mass on her abdomen that we had removed about 18 months ago. It was mast cell tumor and has no signs of regrowth. She was not spayed until we got her. She had 1 litter when she was 2 years old.
ETA- we lost her today. I must have subconsciously realized something wasn’t right with her. We had tge Cushings diagnosis since late March. Almost 2 weeks ago she started being picky about her biscuits then went on food strike. She is normally a great eater. She then would only eat wet food. Took her to my normal vet abdominal xray didn’t show anything. Scheduled her with a different vet for August 1st to treat Cushing’s.
Sunday night she had a seizure. Monday morning back to vet only additional symptom was maybe a little weak in hind end. She stopped eating Monday night. By Tuesday evening couldn’t walk.

Took her in this morning for her final visit. Different vet in practice men’s heart failure.

During one of the visits I realized what I remembered as mast cell was hemangiosarcoma. I suspect that came back but internally.
Poor Kerplunk. If I had realized she was going to crash so hard and so fast I would have let her go Monday.
We were there Monday to send the 16 year old hyperthyroid, kidney disease foster across the bridge. Not a good week.

[Kyrabee]

I had an old cocker spaniel with Cushing’s. I did test and treat. This was in the 80’s. Then, it was not that expensive and I am a pharmacist so was able to customize his doses (mitotane). I was about ready to stop as he quit eating AND drinking well but I had one more test done and his cortisol was back down so I went to twice weekly dosing and his food and water intake rebounded. He had 3 very good months then went into status epilepticus (intractable seizures) and I had him euthanized. I don’t know if the seizures were due to a brain process or electrolyte issues?

At the time, I had no problem treating. Now days…$$ do matter and testing and treatment is much more expensive. He was very ‘normal’ and comfortable for those 3 months then he wasn’t. So that is my story.

Hugs to you. It is a difficult desicion.

Susan

[freshman]

I had a Cushing’s dog that presented rather acutely with excessive drinking/peeing and also generalized muscle wasting/weakness and panting. She was diagnosed and started on trilostone, even though it was expensive and I really couldn’t afford it at the time. She didn’t respond clinically or as measured by many repeat ACTH at the initial dose, so her dose was increased multiple times. This meant a huge increase in trilostane costs and ton of vet visits to repeat ACTH testing, over and over and over again. She did respond, but not enough to bring her ACTH numbers into an acceptable range or control her clinical signs to an acceptable level. And I had already spent thousands of dollars on drugs, vet visits, and labwork. And she was still drinking/peeing very excessively, panting, and weak.

At that point I chose to do an adrenal ablation using mitotane. I wouldn’t have been able to afford that, either, but the vet had enough of the mitotane in her good sam stock to allow me to purchase only about half of what was needed. Still expensive. As were vet visits/monitoring throughout and after the process. But once completed, I now had an Addisonian dog that was managed on prednisone (very cheap) and a monthly DOCP injection that cost around $100-150.

She did great for about 6 months. No more excessive drinking/peeing, less anxious aka no more panting, and she also got stronger and could jump on the bed/navigate stairs again. She was so much happier. Then she started drinking more, lost strength, and very anxious again. She would have required another adrenal ablation or attempt to control her disease with trilostane. I chose to euthanize her at that point.

Not trying to discourage you, OP. I know there are many Cushing’s dogs that respond to medication and are stable for very long periods. Mine was not one of them. It was heartbreaking, but I am glad I tried to help her and that she did end up having a good 6 months.

[Lizrd]

Been there, done that. Here is my post from several years ago. I have also linked two educational threads for your review. Keep in mind they are several years old and treatment recommendations may have changed and protocols may have evolved since I last reviewed this information. I still miss my old guy…

Cushings is not a great diagnosis but there is a fairly long period where it develops, which gives you plenty of time to love up your dog. My dog’s first symptoms were a pot belly, scruffy hair coat, and excessive drinking and peeing.

I have been down that road with my Boxer. He lived with Cushings for nearly 18 months and I would do it all over again. We had ACTH stim tests done regularly to make certain the meds were controlling it. We chose to go with Lysodren which is powerful but worked for him. We always knew when he was getting ready for an ACTH stim and an increase in his dosage because his peeing and drinking would ramp up. We got to the point where we were sweet talking him when he would trickle-pee in the house - we didn’t want him to feel naughty about something that was clearly out of his control. Best thing we did was keep him as active as he would tolerate. Cushings can cause muscles in the back end to waste away so maintaining fitness is crucial - within reason of course. He got pretty creaky at the end and we even did acupuncture and chiropractic work on him to keep him comfy. There is a lot I would give right now to be wiping up his pee from the kitchen floor one more time. I relish every day I have with my dogs because our time together is simply too short.

I realize that your husband’s condition throws quite a curveball in here… You do have to think about what is safe, healthy, and appropriate for him to be managing. Would puppy pads help? Or a diaper? I am not one who would use a diaper but all dog families have their own thoughts on where to draw the line. Your travels to the vet may be upsetting for your pup and that adds a factor, too. Generally, you want a specialist to monitor the meds as they have to really be dialed in.

Good luck and keep us posted.

Two threads on Cushings you might find helpful.
https://www.chronofhorse.com/forum/forum/off-topic/the-menagerie/284240-cushings-in-dogs

Chronicle Forums

[Tucker5]

I currently have a 10 y.o., 30lb terrier mix diagnosed with Cushings in December '21. She is being maintained on twice daily dosing of trilostane (30mg x 2). The cost of meds has been $120/month. We did initial testing and then follow-up after I needed to increase her dose to 2x daily. The follow-up test was around $250. Without the meds, I would have to euthanize as the peeing, frantic hunger, panting, and restlessness would be intolerable.

About 7 months into this, she is noticeably weaker in the hind end. When riding in the work truck her haunches tremble something awful. She is also losing her vision and seems less aware. It is sad because she’s always been so active and sharp. Heat intolerance is also apparent. Not much of a pot belly and her coat is okay. She has been presumptively diagnosed with lymphoma as well.

The vet is hoping I have a year with her, although the months are flying by. She had her first noticeably bad day last week so I’m planning some days to take off work and just do fun dog stuff - visit feed stores, the off-leash dog beach, McDonalds for fries and nuggets, etc.