To treat or not to treat

[Pamela J]

My dog went to the vet for a small lump on his stomach which turned out was an insect bite. However the vet opted to do a scan before draining the abscess and came back with hefty bill and a diagnoses that my dog has cushings disease.

Besides a pot-belly (he is a cross Basset/Daschund so not sure if that is just his shape) he shows no other signs of the disease besides what the vet says that he has enlarged adrenal glands (no tumors). I've looked up all the sypmtoms and had he not had the lump this would most likely would never have been diagnosed.

After an emotional roller-coaster treatment of my last dog with chemotherapy i am loathe to put my dog on medication that he may not need and feel the vet may just be using my paranoia as a money making scheme... Financially i am more than able to pay for treatment but my gut feeling is that i should not be giving chemical treatment to an animal showing no signs whatsoever of this disease and think the vet may be playing on my emotions...

[Renee]

I am sure some of the experts will be along to chime in, but I wanted to welcome you, and tell you that I think you are absolutely correct in questioning cushings treatment at the moment. Good for you for not jumping right into treatment before getting educated!

[Trixie]

Welcome to the board. I'm sure the more expert posters will be on and they will ask you what other tests were done to diagnose Cushings which is a complicated disease and often difficult to diagnose.
Most dogs will have some symptoms--loss of fur, drinking copious amounts of water and then urinating so much that they begin to have accidents in the house, excessive panting, excessive hunger. Your dog has not even one of these symptoms?
You mentioned the dog having a scan, was that a ultrasound? Was a blood test performed which could show some increased liver levels-a possible red flag for Cushings or an LDDS test which would show the cortisol levels and be more exacting in diagnosing Cushings--neither of these tests and the vet still thinks Cushings? That's a pretty big assumption in my opinion.
At this point being that your dog has no symptoms I wouldn't dream of treating, so you are correct in feeling the same. If I were you I would want much more proof that the dog actually has the disease which right now doesn't seem to be the case.
Barbara

[labblab]

Welcome from me, too! Unfortunately, I have only a moment to post. But like the others, I would be very reluctant to start treatment in this situation. Over and over again, we are told by the specialists that the a dog's history and symptom profile are the two most important pieces of the Cushing's diagnostic puzzle. In their absence, blood test results are always questionable. And in the case of an abdominal ultrasound, other physical conditions that stress the body could also result in adrenal enlargement. Here's a quote from a noted endocrinologist, Dr. Mark Peterson, who explains the diagnostic dilemma well.

Unfortunately, none of the diagnostic tests used in dogs with suspected hyperadrenocorticism are totally reliable, and both false-positive and false-negative results are common. Because there are inherent problems with these diagnostic tests, the veterinarian is frequently challenged when attempting to properly interpret the dog’s tests results. It is important to remember, however, that the predictive value of a positive screening test result for hyperadrenocorticism increases in direct proportion to the number and severity of clinical signs and biochemical changes that develop in this disease. Therefore, one must always remember the importance of the dog’s signalment, history, and physical examination findings when interpreting the disgnostic test results for all pituitary-adrenal function tests.

http://www.k9cushings.com/forum/atta...1&d=1242114382

Marianne

[molly muffin]

Hello and welcome from me too. I can tell you that my molly has enlarged adrenal glands, has an enlarged liver from excessive cortisol production and no symptoms of cushings. That I am not treating her currently for cushings, but that I am monitoring her liver values, because as Marianne said, if there is another reason that they are producing cortisol, then the adrenal glands will be enlarged. This could be anything going on in their body.
I would want an LDDS test And an ACTH test to verify whether or not it really is cushings. (full blood work, urinalysis to check urine specific gravity) If all of that comes back positive and consistent with the cushings, then it is worth considering early treatment as a possible option, but otherwise, there is a risk of treating for cushings, when it is in fact Not cushings and that holds alot of risks.

Welcome to the forum!
Sharlene and Molly Muffin

[Heatherdo]

Hi Pamela,
I am new to this forum too. I have just seen a cushings specialist this week and even though my dogs diagnosis is a little different thatn yours, they both have cushings. The specialist I went to said he would absolutely not medicate symptoms that weren't there. My dog, Gabby, exhibits none of the normal cushing symptoms and he said until she does (if she ever does) he would not put her on meds for cushings symptoms.
It might be a good idea to find out what is causing the cushings.
Wishing you and your pup all the best.

Heather

heather

[Meg_Elizabeth]

Hi Pamela and welcome to the site! We are so glad you found us. Most of the moderators and administrators on this forum have done more research than many specialists and really know what they're talking about!
I have to agree with them at this point, I would definitely not start any type of Cushings treatment until your pup is symptomatic. The medications used to treat the disease (Lysodren and Trilostane) are prescribed to reduce symptoms, not cure it. So it would essentially be a waste of money at this point, IMO

Best wishes!

- Meg & Abby

[doxiesrock912]

Ditto from Connecticut :-)
Monitor the effect of Cortisol on the organs, be sure that it is Cushings and not something else, and don't treat until you have to.

Find a small animal internal medicine vet (IMS specialist) if you're not confident in your vet's abilities. Many of us have changed vets several times because of their lack of knowledge. Learn as much as you can from our helpful resources link and welcome.

[goldengirl88]

From my experience with Tipper I think if my vet had listened to me and tested her earlier when the symptoms first started I could have prevented a lot of the damage done to her from high cortisol. That is just my opinion right or wrong that is how I feel on the subject, but I would want a firm diagnosis. Blessings
Patti