clovermw
02-12-2010, 06:02 PM
Hi, I've never used a discussion board/forum before...so hope I'm doing this right. My bottom line question is: Should I get my dog tested now for Cushing's, or do I wait until his symptoms become worse (or "clinical", as one of the vets suggested)?
The background: I have a roughly 13-year old poodle mix (seems mostly poodle) named Clooney who seems to have mildy excessive thirst and urination (more later on this). He is in good general health, especially for a dog his age. I noticed about 9 months ago that he seemed to be drinking more water than is usual for him - drinking much longer, sometimes getting up at night to drink. He started having occasional accidents (urinating) but also seemed to have stool accidents. Both were usually in the morning if we didn't let him out right away. Usually he is excited about food being around too (especially with pooping accidents). I figured both were due to his age, maybe old-age incontinence. He pretty much lost his hearing around 18 months ago, and also seems to have an on and off fungal/bacterial skin infection - the vet said this probably is the same infection never fully cleared.
November 2009: Clooney had his routine check-up and his urine specific gravity was low - 1.010. (In May 2009, it was 1.035) I mentioned his increased thirst to the vet, who ran routine bloodwork and said we should consider kidney failure, Cushings, and diabetes insipidus. Everything was within normal range (BUN, creatinine, glucose, alk phos, LFTs, etc). He was diagnosed with mildly elevated BP, which is under control with BP medication. Originally, we were worried about early kidney failure. His BUN remained normal/improved 2 weeks after starting BP meds. He recently had all labs rechecked prior to dental cleaning/cyst removal, and everything is still normal. I did a 48-hour measure of his water intake, which was 32 ozs - on the high end of normal, so his intake is not technically excessive. I've been meaning to check it again. When I took away his water before his surgery, he acted really really thirsty - paced around the kitchen for over an hour looking for it that night. I finally gave him a tablespoon which was enough he settled down for the night.
Yesterday (2/11/10), his urine was rechecked. All was normal except the urine specific gravity was still 1.010. Since we were still worried about early kidney failure, they sent it out to check protein/creatinine ratio - and THAT is also normal. So, it does not look like kidney failure, which is a good thing...
So, I usually talk to an older, very thorough but conservative (given Clooney's age, cost of tests, general life expectancy, quality of life, etc) vet who is on vacation right now. Instead I talked to another vet, who essentially told me that Clooney is probably in the early stages of Cushing's disease. But since his symptoms are not very severe, I should wait on the testing until he is waking us up in the night to go out (which he does not seem to do in his older age - wake us up, that is). I asked if diagnosis and treatment early vs. later would prolong his life, and he said not really. I asked what the treatment would be, and it sounds like they use Lysodren. We've dropped close to $2000 in the last year with all his tests and visits ($1000 for the dental/cyst removal alone), so the idea of holding off on more expensive testing is appealing. But not at the expense of Clooney's health/life span.
A few other things: I do notice that Clooney is having more frequent urination accidents, but I'm not clear that it's always because his bladder is really full - sometimes maybe, but other times it seems like we might not let him out RIGHT when he wants to go (I have a distracting and active 18-month old) so he decides to just go wherever. It's always during the day once he's up, I don't find he's had accidents anywhere overnight. The older vet said it might be a little "senility" too, which could be the case too since he doesn't always act particularly guilty like he used to when he'd have an accident.
Besides getting hard of hearing 18 months ago, I did notice he seemed to have "aged" quickly in terms of agility. He has more problems jumping on the couch, going up and particulary down stairs, getting up from laying down, seemed to "strain" his back and ankles a little more, not interested in long walks like before. He just seemed like an older dog. I started giving him glucosamine/chondroitin supplements in November (per vet suggestion), and he has perked up quite a lot. But I know that muscle weakness can be a sign of Cushings - and also old age.
So, increased thirst, increased urination/accidents, low urine specific gravity, muscle weakness are some of his symptoms. Not sure if the skin infections are related other than maybe weakened immune system. But he just had 3 mini cysts removed, his incisions healed nicely, and his fur is growing back quickly. His weight is on the lower side of where he hovers but within a pound (around 18 lbs). He generally acts normal, not quite as happy as he used to be, but no particularly different behavior. He's always been kind of a couch potato or "energy efficient", as I call him. His labs say he is in excellent health, especially given his age.
I plan to talk with his normal vet when he returns from vacation, but I was wondering your opinions on if I should go ahead with testing/treatment sooner vs later.
Assuming he has Cushings, it seems to me that waiting until he is more symptomatic also means more damage to the rest of his body and organs may be happening. But, I understand treatment with Lysodren is essentially chemotherapy, which makes me kind of nervous too. Do symptoms usually get really bad (not just the drinking and peeing) without treatment?
I also read that average life expectancy after diagnosis is roughly 2 years with or with out treatment. Do you all find this to be accurate? (I do realize that 2 years would make Clooney 15yo, which is a ripe old age for a dog - but I was hoping he'd be a wonder dog and live until more like 17!)
I don't know that he has Cushings, but the only other diagnosis left is diabetes insipidus - which the older vet says is very, very rare.
Sorry to be so long-winded, but I figure I should provide everything I know.
I really love my Cloonster and can't imagine life without him. Although it's a lot of money, I would spend it and go through the hassle if it means he would have a better quality of life and/or live longer.
Thanks so much for any help!
Melissa
The background: I have a roughly 13-year old poodle mix (seems mostly poodle) named Clooney who seems to have mildy excessive thirst and urination (more later on this). He is in good general health, especially for a dog his age. I noticed about 9 months ago that he seemed to be drinking more water than is usual for him - drinking much longer, sometimes getting up at night to drink. He started having occasional accidents (urinating) but also seemed to have stool accidents. Both were usually in the morning if we didn't let him out right away. Usually he is excited about food being around too (especially with pooping accidents). I figured both were due to his age, maybe old-age incontinence. He pretty much lost his hearing around 18 months ago, and also seems to have an on and off fungal/bacterial skin infection - the vet said this probably is the same infection never fully cleared.
November 2009: Clooney had his routine check-up and his urine specific gravity was low - 1.010. (In May 2009, it was 1.035) I mentioned his increased thirst to the vet, who ran routine bloodwork and said we should consider kidney failure, Cushings, and diabetes insipidus. Everything was within normal range (BUN, creatinine, glucose, alk phos, LFTs, etc). He was diagnosed with mildly elevated BP, which is under control with BP medication. Originally, we were worried about early kidney failure. His BUN remained normal/improved 2 weeks after starting BP meds. He recently had all labs rechecked prior to dental cleaning/cyst removal, and everything is still normal. I did a 48-hour measure of his water intake, which was 32 ozs - on the high end of normal, so his intake is not technically excessive. I've been meaning to check it again. When I took away his water before his surgery, he acted really really thirsty - paced around the kitchen for over an hour looking for it that night. I finally gave him a tablespoon which was enough he settled down for the night.
Yesterday (2/11/10), his urine was rechecked. All was normal except the urine specific gravity was still 1.010. Since we were still worried about early kidney failure, they sent it out to check protein/creatinine ratio - and THAT is also normal. So, it does not look like kidney failure, which is a good thing...
So, I usually talk to an older, very thorough but conservative (given Clooney's age, cost of tests, general life expectancy, quality of life, etc) vet who is on vacation right now. Instead I talked to another vet, who essentially told me that Clooney is probably in the early stages of Cushing's disease. But since his symptoms are not very severe, I should wait on the testing until he is waking us up in the night to go out (which he does not seem to do in his older age - wake us up, that is). I asked if diagnosis and treatment early vs. later would prolong his life, and he said not really. I asked what the treatment would be, and it sounds like they use Lysodren. We've dropped close to $2000 in the last year with all his tests and visits ($1000 for the dental/cyst removal alone), so the idea of holding off on more expensive testing is appealing. But not at the expense of Clooney's health/life span.
A few other things: I do notice that Clooney is having more frequent urination accidents, but I'm not clear that it's always because his bladder is really full - sometimes maybe, but other times it seems like we might not let him out RIGHT when he wants to go (I have a distracting and active 18-month old) so he decides to just go wherever. It's always during the day once he's up, I don't find he's had accidents anywhere overnight. The older vet said it might be a little "senility" too, which could be the case too since he doesn't always act particularly guilty like he used to when he'd have an accident.
Besides getting hard of hearing 18 months ago, I did notice he seemed to have "aged" quickly in terms of agility. He has more problems jumping on the couch, going up and particulary down stairs, getting up from laying down, seemed to "strain" his back and ankles a little more, not interested in long walks like before. He just seemed like an older dog. I started giving him glucosamine/chondroitin supplements in November (per vet suggestion), and he has perked up quite a lot. But I know that muscle weakness can be a sign of Cushings - and also old age.
So, increased thirst, increased urination/accidents, low urine specific gravity, muscle weakness are some of his symptoms. Not sure if the skin infections are related other than maybe weakened immune system. But he just had 3 mini cysts removed, his incisions healed nicely, and his fur is growing back quickly. His weight is on the lower side of where he hovers but within a pound (around 18 lbs). He generally acts normal, not quite as happy as he used to be, but no particularly different behavior. He's always been kind of a couch potato or "energy efficient", as I call him. His labs say he is in excellent health, especially given his age.
I plan to talk with his normal vet when he returns from vacation, but I was wondering your opinions on if I should go ahead with testing/treatment sooner vs later.
Assuming he has Cushings, it seems to me that waiting until he is more symptomatic also means more damage to the rest of his body and organs may be happening. But, I understand treatment with Lysodren is essentially chemotherapy, which makes me kind of nervous too. Do symptoms usually get really bad (not just the drinking and peeing) without treatment?
I also read that average life expectancy after diagnosis is roughly 2 years with or with out treatment. Do you all find this to be accurate? (I do realize that 2 years would make Clooney 15yo, which is a ripe old age for a dog - but I was hoping he'd be a wonder dog and live until more like 17!)
I don't know that he has Cushings, but the only other diagnosis left is diabetes insipidus - which the older vet says is very, very rare.
Sorry to be so long-winded, but I figure I should provide everything I know.
I really love my Cloonster and can't imagine life without him. Although it's a lot of money, I would spend it and go through the hassle if it means he would have a better quality of life and/or live longer.
Thanks so much for any help!
Melissa