Test for Cushings - questions for vet

Hi, My dog, Chewy, is suspected to have Cushings. He is a rescue so I don't have his age but I believe he is probably 12+ years. He is an 18 pound Chihuahua mix. His symptoms are enlarged adrenal glands, increased thirst and urination, increased appetite and elevated ALP (1356).
His ultrasound shows enlarged adrenals, enlarged prostate, mass on liver, heart murmur and possibly beginnings of kidney disease. He also has retinal atrophy and is completly blind in his left eye and about 80% blind in right eye. He is also deaf. Even with all these issues he appears to be happy and enjoys his walks and still is interested in treats and meals and smelling people to see if he knows them.

I just read on this forum that Cushings is a very slow growing disease. He is having test for Cushings on July 10th. What are the questions I should be asking the vet with his prognosis. Does it make sense to put him on medication that may cause side effects?

A friend had a Corgi with Cushings and vet put dog on Selegiline to help with expense of blood tests and medication. Is this an option that I should discuss with the vet? Any comments would be appreciated. thank you

Hello and welcome to you and Chewy — we’re so glad you’ve joined us! From your description of Chewy’s symptoms, it does sound as though Cushing’s may be the cause. So we won’t be surprised if his diagnostic test comes back “positive,” and your decision then will be regarding a treatment path going forward.

It sounds as though you’ve already done a very good job of reviewing other postings here, so you’ve probably already seen what I’ve recently written about my thoughts about the pros and cons. In Chewy’s case, we’re happy to hear that he remains basically happy. But it seems there’s evidence that Cushing’s may be having some negative effects that might worsen his heart and kidney issues. So even though his outward symptoms may not yet be bothering him that much, your vet may feel as though it would be beneficial to go ahead and try to lower his cortisol with treatment.

As far as the selegiline, it does have the benefit of not requiring blood tests for monitoring and I’m guessing it is indeed less expensive than Vetoryl. The downside is that it only seems to work for a small percentage of dogs that have tumors in a very specific area of their pituitary glands. But from the results of Chewy’s ultrasound, it does appear that if he truly has Cushing’s, it is a pituitary tumor that is the cause. So if your vet agrees, then it might be worth it to give selegiline a try. If it works, great. If not, you could go ahead and shift to Vetoryl.

Vetoryl does cause some side effects in some dogs, but we’ve had many members who have done very well with good results. As you’re already aware, the biggest drawbacks are probably the cost and the need for the ongoing lab monitoring. But if Chewy ends up taking Vetoryl and the cost of the medication is more than you can handle, there is an option of having a less expensive version prepared by a custom compounding pharmacy. But we can talk more about that further down the road.

Please feel free to ask any more questions that come to mind in advance of your visit. I guess the one question that I have myself is about the liver mass that was seen on the ultrasound. Cushing’s itself can cause certain liver changes, but I’m just wondering whether your vet thinks that liver mass may present any issue or need any more diagnostics on its own.

OK, I’ll go ahead and close for now. But once again, we’re so glad to meet you and Chewy!

Marianne