Cushing's disease in old dog...getting desparate...

[chicknmania]

Our German Shepherd/ Chow/ Rottweiler mix breed dog is 14 years old and was diagnosed with Cushing's at a very young age. She has dealt with it ok all these years, but now it's catching up to her. A few years ago we had to take her off Proin,(PPA) which she was taking for incontinence, because the Proin was making her nauseous. The vet didn't really have any other suggestions. WE tried the herbal stuff but it does nothing.
She goes through a dog diaper in a matter of a few hours, so she's often wet with pee, and the environmental repercussions of using disposables make me gag. She is beginning to have serious deterioration in her hind quarters, We have had to move her to the garage at night, and she has to stay outside most of the day because of the incontinence. Lately, she's made it her life's mission to get inside, come Hell or high water, even on nice days. When in the garage she refuses most of the time to sleep on her good bed, even though we try to make sure she has dry bedding for the night. Instead, she sleeps on the hard floor. She suffers from restlessness at night and howls almost all night long most nights. She drinks non stop. She's driving us crazy. We love her, but we can't stand much more of this, and neither can she. She stands around staring at us with big sad eyes most of the time, but she DOES have some good days where she likes to take walks, and she still eats well and tries to be the good guard dog she's always been. We had pretty much made up our minds that we are going to have to put her down when the weather turns cold, which it will soon. But then someone suggested that we try DES for the incontinence. I'm not sure how that will work, in light of the Cushing's being tied into hormones. Or I believe it is, from what I've read. WE have been giving her 5 Flower at night, which helps some. I also think she might be getting into some senility type issues. She's almost stone deaf, but everything else works ok...

Has anyone had luck with DES? I will call the vet tomorrow but depending on what he says, time is running out, and I'm just curious to see if others have experienced this and if anything worked well. I think if we could get the incontinence and probable UTI stopped, she might have a few more years. I'm pretty sure the vet will recommend that we put her down. Or, anyone else who can compare notes with Cushing's disease in dogs, I'd be interested to hear from.

 

[Peaches Lee]

This is always the hardest part of owning animals. Did the vet try putting her on Pepcid while on the Proin? That may help with the nausea. Anyway, sorry about what you are going through, hopefully someone with Cushings experience in dogs can chime in for you.

 

[chicknmania]

No, he didn't, but the Proin wasn't really working for her very well anymore anyway. I had started her just one once in a while, then up to every day, then twice a day, and that's when it started to upset her. And she was still incontinent, so....

the vet just has a sort of well, this is what you can expect, and see it's happening, I told you so attitude. So the implication is there's not much we can do.

Thanks for the kind words.

 

[mamawolf544]

My chihuahua Sandi aka Mama Puppy (she was never a mama) had Cushing's for many years. She had many surgery's to try and keep her bladder in place and at some point the Vet would not put anymore mesh in her. She took meds to make sure she could poo easy, was active and happy. Could not hold her bladder and from the shape of her hind end could not wear diapers.
We finally let her cross the Rainbow Bridge when she was 15 years old. I still miss her terribly, but it is such a terrible disease to manage.
Prayer's sent to you and your Furbaby.

 

[chicknmania]

Thank you. :s Your situation sounded horrible too. Sorry for your loss.

 

[SunnySkies]

My own dog had Cushing's. Trilostane was a miracle for us for about 18 months, and then it was time. Have you talked to your vet about that medication?

It sounds like most of the symptoms are secondary to Cushing's now, not just incontinence. Treating the Cushings will likely help.

If that medication is too expensive, ask about ketoconazole. I have one patient in that now as the owner cannot afford the better option, but the symptoms were really getting to her and it was try something or euthanize.

 

[chicknmania]

Thanks, I will see if I can ask his staff and maybe they can get a prescription for her. The vet himself is on vacation for two weeks, on a cruise, left yesterday morning,
so I can't consult with him at all! His backup has never seen our dog. I saw something on line about Adrenal Gold, an herbal based remedy for dogs with Cushings,
but it is expensive and no guarantees, of course. Yes, I'm sure all her symptoms tie in to the Cushings. I'm kind of surprised that the vet hasn't suggested anything,
but really all her symptoms seem to have escalated in the past couple of months, so she really hasn't seen him re the Cushings for quite a while. It was never a huge
issue for her when she was younger....

 

[SunnySkies]

I work as a relief vet myself, and often I read the chart and prescribe or suggest they come in for an office consult and we start meds while the regular doctor is out of town. And I'll be honest...sometimes I give better care as a relief vet than an older vet who might not be as up on some conditions as they might be, some vets don't keep up, and others think well, that client won't be interested in this expensive treatment and don't even offer it. Many relief vets don't have those hang ups, so it might be worth talking to the relief vet, lettin them peruse your chart and maybe even going in for a consult.

However, if she has not had a diagnosis of Cushing's for sure, I would suggest starting there. Some vets do the diagnostics in their hospital, others refer to a specialist. I have done both. What I like about the dogs seeing a specialist is we cn determine if it is adrenal based or pituitary based. Adrenal based is a surgical treatment...remove it, and it's fixed. If it isn't adrenal, then we use trilostane or ketoconazole to induce remission for an unknown period of time.

IME, the herbal medications are merely supportive. They do not treat on their own.

 

[chicknmania]

I know she was positively diagnosed....when she was very young. I don't remember that he ever said what kind she has. Maybe he doesn't know, because I do know it was never referred
to a specialist. I talked to the vet staff this morning. They didn't recognize either med you mentioned, though she did say they have other patients with Cushings on meds, but she didn't know what.
Naturally, they cannot get me a prescription and have no contact with him. The relief vet is not even working out of their office. I might try to call him. I'm not sure that my husband will go for another consult....we have put so much money into this dog...personally I think it might be worth it..we are having cool weather right now which she loves, and this morning after she went out she came running back to the house...she has been feeling better since her bath a couple of days ago, too. The vet staff member did mention that she didn't know what kind of Cushings our dog has, so that would make a difference, it sounds like, from what you're saying, as to how we treated her.

Anyway, thank you SO much for your advice! I may see if I can talk to the relief vet on the phone, and see what he suggests. We do have a backup vet also, but she has not seen our dog at all so I know she would need a consult and would need to see her records. I wish I had started researching this months ago, but like I said, it's never really been a serious problem for her...that we recognized.

 

[SunnySkies]

It is HIGHLY unusual for a dog to be diagnosed with Cushing's young. It is generally a disease of middle aged to older female dogs. And they become sick and have a poor quality of life if not treated, with survival without treatment usually ranging from a few months to just a couple years, as it is a progressive disease secondary to a tumor, either an adrenal tumor or a pituitary tumor. I am slightly concerned you either were not offered correct treatment or the diagnosis you have is incorrect.

IMO, you need to seek a second opinion. No, it will not be cheap. If you came to my office, I would run bloodwork, unless you had bloodwork from within the last month, a urinalysis with maybe some other tests on the urine, and go from there. Going from there would involve either a specialist referral or an ACTH stimulation test in hospital.

Average lifespan post Cushing's diagnosis is two years, before the symptoms become unmanageable, the dog becomes terribly sick with a secondary infection (the excess steroids in the system lead to recurrent infections), or the symptoms become problematic for the owner. If it is secondary to an adrenal tumor, then it is often completely treatable.

I am not surprised the staff was unaware of medications. Many veterinarians do not teach their staff much, or the staff doesn't learn on their own about what drugs are often prescribed for what conditions. I once worked in a clinic where the staff didn't even know how to set up for surgery, what drugs they had in the shelf or even what the prescription diets that place pushed hard were for.