A Crash Course in Canine Cushing’s Disease

This is one way to deal with the excessive urination experienced by Cushing's patients. I just thought this was cute, please don't actually do this. I'm sure the puppy was quickly removed from the potty pre-flushing.

This is one way to deal with the excessive urination experienced by Cushing’s patients. I just thought this was cute, please don’t actually do this. I’m sure the puppy was quickly removed from the potty pre-flushing.

One of the diseases that struck fear into my heart when I was a newbie vet was hyperadrenocorticism. AKA Cushing’s disease. I barely understood it, could hardly explain it to clients and dreaded diagnosing and treating it.

I’m still not too thrilled about diagnosing and treating it, it’s complicated and messy and requires some diligence, vigilance and more than a little financial output on the part of the clients. However, I have a fairly decent handle on the understanding and explaining of the disease.

I got to thinking about Cushing’s because I had to euthanize a sweet little Chihuahua stricken with it yesterday. She had developed diabetes mellitus as a complication (on top of the Cushing’s). That just opens up a Pandora’s Box of additional requirements for diligence, vigilance, and financial output for this client which proved insurmountable. Euthanasia was the best outcome under these circumstances because her quality of life was poor.

So I haven’t done a particularly educational blog in awhile so I decided to tackle this topic since it’s a bit slow at work today, and who doesn’t like to write about complicated endocrine maladies when they have some free time!

And yes, “Old Broad” (frequent Cone of Uncertainty commenter and confessed crazy cat lady), cats do get Cushing’s disease, but I’ve never seen one so don’t have enough comfort level with the topic to talk about it at the moment 
The major players in Cushing’s disease are the adrenal glands and the pituitary gland. The pituitary is this vaguely testicular looking little gland that sits up in your dog’s brain, nestled in there behind the eyeballs. It is kind of like the remote control gland for all the other glands in the body. It secretes hormones that tell the other glands to secrete their hormones.

In about 90% of the cases, a little benign tumor pops up inside the pituitary gland that shoots out a bunch of ACTH (adrenocorticotropic hormone, for those of you playing along at home). This hormone tells the adrenal glands down by the kidneys to secrete cortisol. And secrete cortisol it does, in huge amounts. Way more than the body needs. (Under normal conditions, you need cortisol to deal with the stresses of every day life. Too much cortisol though, and you have problems.) This is “pituitary dependent hyperadrenocorticism”; I’m throwing in the big words for those who need reassurance that I am, indeed, a medical professional.

Cortisol is a steroid hormone (cortico-steroid not anabolic-steroid. It’s not going to, in the words of Hans and Franz of 90’s SNL fame, “pump you up”). Pretty much the natural version of Prednisone and some of the other anti-inflammatory steroids we use in practice every day. You know, the ones that make your dog pant like crazy, drink tons of water, pee everywhere and want to eat everything in sight.

These steroid side effects, incidentally, are the reasons people bring their dogs to the vet when they develop Cushing’s syndrome. The eating, the panting, the drinking and the peeing.

Especially the peeing.

There are myriad other symptoms, skin issues, hair loss, hypertension, abdominal distention, muscle weakness, etc. But the one that brings them to the vet is usually the peeing.

I imagine I’m losing people here, are you bored?

If you are still with me, I’ll mention that 10% of Cushing’s cases actually don’t have the little pituitary brain tumor, they instead have tumors in the adrenal gland. Symptoms are the same, but if not diagnosed properly (generally via ultrasound) the tumors are malignant will grow and invade things in that region (Like the vena cava, which is this giant vein that carries lots and lots of blood. Things do not go well when this vein gets eaten up by cancer). This is “adrenal dependent hyperadrenocorticism”, best treated with surgery, if caught early enough. I don’t know if any DVM’s read this blog, with different experiences, but in our practice, the dogs that go to surgery for this (and we refer this out to boarded surgeons); have about a 50:50 chance of surviving. Somehow there seems to be a high risk of complications involved with getting these tumors out. Sorry to be all gloom and doom. My “Bible” of endocrinology (Feldman and Nelson’s Canine and Feline Endocrinology and Reproduction) says that “Dogs diagnosed as having ATH have an excellent prognosis…if they survive the first two weeks after surgery”. So there’s that.

I’m not going to go into how we diagnose Cushing’s because it’s boring and painful and confusing and I hate it. Suffice to say that it can be expensive and there are lots of grey areas involved in the testing. There is not usually a really definitive “yes or no” test. It’s more of a “probably” or “probably not” test. Sometimes one expensive test is negative, so then we have to do another expensive test which may test positive. Plus we have to view all these results in light of the patient and his clinical signs. The art of veterinary medicine comes to play quite a bit when dealing with this syndrome. So bear with us, we really are doing our best and we aren’t just after your money.

Not only is diagnosing Cushing’s disease difficult, treating it is also. First and foremost, there is no cure for Cushing’s disease. (Unless your dog has adrenal dependent, and he survives the surgery, and he doesn’t subsequently develop metastasis, or a pituitary mass.)

You just manage the symptoms. The goal is to get them to not act like they’re starving to death, not drinking gallons of water, and most importantly, not peeing all over your carpet. Ultimately they live an average of three years, give or take. They may succumb to complications like diabetes or pulmonary thromboembolism (blood clot in the lungs). Sometimes the little pituitary tumor gets really big and the pet starts to have seizures that we manage with anticonvulsants.

There are several treatment (or symptom management) options. The two more common ones are Lysodren and Trilostane.

Lysodren has been around forever, it’s actually a derivative of the insecticide DDT (which almost wiped out the pelican population in the 70’s, if I remember correctly from my “Ranger Rick” magazines from elementary school). Used VERY carefully, it basically destroys just enough of the adrenal gland to reduce its cortisol secretion. Used not very carefully and it can wipe out the whole gland and cause HYPO adrenal corticism which, if untreated could result in death. This isn’t better than peeing all over the carpet. Usually. Guess it depends on who’s cleaning up all that urine.

Then there’s Vetoryl (generic name: Trilostane). About, what, 5 or 10 years ago we used to have to buy this stuff on the “grey” market from England and have it shipped over. It all felt very illicit and dicey because the product wasn’t FDA approved in the US, but it was supposed to be fantastic and much safer for managing Cushing’s. It’s available in the US now and we use quite a bit of it. It’s not cheap though. Theoretically it’s safer, but every now and then it randomly can melt down the adrenals and cause death by hypoadrenocorticism (see above). It works by shutting off cortisol production at the molecular level as opposed to randomly killing off adrenal gland cells like Lysodren.

There are many more things I could still tell you about Cushing’s disease, but I’ve got to stop somewhere. If you happen to have a dog (heck, or cat) with the syndrome and want to share your experience, feel free. I’m always open to questions too.

31 Comments (+add yours?)

  1. TheOldBroad
    Aug 22, 2013 @ 22:59:18

    At one time, my Ivy Elizabeth (yes, a cat) was suspected of having Cushing’s Disease. When I adopted her, she had no hair from the “waist” down. (We later determined that she licked so ferociously she licked herself bald.) Depo Medrol gave her a little relief, but only for about a week. Plus, I really wanted her off the steroid injections.

    Anyway, she had huge bald patches and the vet thought her skin was thin so, on the off chance she had Cushing’s, Ivy was tested. I don’t remember what tests were run (seems like there might have been an ACTH level test), but the vet was almost as happy as I that, after many tests and trials and errors, Ivy was just allergic to most everything.

    So my question is this: Have you found that some dogs you suspect of having Cushing’s end up with just having allergies?

    Reply

    • drvivc
      Aug 22, 2013 @ 23:44:03

      Strangely enough, Cushings actually masks allergy signs in dogs. It’s the excess cortisone, it actually treats any underlying allergy or arthritis issue. Sadly, when you treat their Cushing’s signs, their allergy/arthritis signs get worse.

      Reply

  2. Nancy Kidd
    Aug 24, 2013 @ 03:04:58

    My “Amber” (dog-mixed breed) has been with me for 11yrs -adopted from the SPCA so maybe she was 2-3 yrs old back then. Now has Cushings for at least 2yrs – drinks lots, pees often, always hungry. Has “licked”/chewed hair from her butt cheeks and back legs so first I used tea tree oil mixed w a little aquafor for those areas but that didn’t really work – back to vet -maybe allergy so put her on zyrtec and a cortisone spray for her hairless areas. Currently give her glucosamine/chrond/MSM tabs, deramaxx 37.5, soloxine, tramadol am & pm. Her wt has dropped from 61lbs to 47.5lbs – her back legs are also very weak – any suggestions

    Reply

    • drvivc
      Aug 27, 2013 @ 19:01:40

      Cushings can cause muscle weakness and hair loss. Cortisone spray won’t help anything (she’s already swimming in cortisone). If you’re not doing anything to treat the Cushing’s I’d start there. The hair should grow back. If she’s losing weight, and you haven’t had her blood checked lately, I would. She may have become diabetic.

      Reply

  3. Max
    Sep 17, 2013 @ 08:36:07

    Hi, thanks for the article. My dog has cushings (3 years now). He is a 13 year old border collie. He has been treated with vetoryl. Started on 70mg and stable until early this year. Then ACTH tests showed his levels dropping. Each test he dropped so they lowered his meds and said he was reverting and that this is rare. We have just moved to a rural area and in the last two tests his levels fell again (35). The vet dropped him to 10mg but he has begun to pace again through the night. No other symptoms though. She suggested putting him up to 20mg again but I am worried about potential addisonion crisis if we overdose so made her call the lab that do the testing. They said at his levels we should stop completely and test again in a month. I am completely confused about what the right thing to do is so any advice would be welcome. He weighs 18.5kgs and is insured.
    Thank you for a great blog.
    Max

    Reply

    • drvivc
      Jan 09, 2014 @ 04:05:36

      So sorry, I wrote a long reply to this a while back, and apparently it never posted. Hope things have leveled off???? The cool thing about Cushings is there isn’t any rush to treat and it’s ok to stop the med when necessary to make sure the dose is ok. Pacing without the drinking/peeing/appetite isn’t a good reason to bump the meds. Again, sorry for the very, very late response.

      Reply

  4. Patricia
    Nov 15, 2013 @ 18:28:13

    Thank your for clearing the haze surrounding Cushing’s disease. Our Ginger girl, canine, 15 years, recently went through the testing process and was diagnosed with Cushing’s disease, is now on Vetoryl and Proin. Her symptoms are much improved, for which we are most thankful, but we’re spending more on her medication than our own…which is amazing as my husband and I are in our seventies. We’re obviously on a fixed income and need to find the meds she needs more reasonably priced. I’ve done some searching online, but am unable to find Vetoryl or the generic, Trilostane, any less expensive than our vet’s price. If ANYONE knows of an alternative please share.

    Reply

    • drvivc
      Nov 19, 2013 @ 15:22:52

      That’s a problem with Trilostane. I don’t know of a way to get it cheaper (did you try the human pharmacies? Some carry veterinary drugs at a bit lower cost). The other drug used to treat Cushings, Lysodren is much cheaper, but requires careful administration to avoid side effects. My boss has used Lysodren for 40+ years and is really comfortable with it and considers it an important alternative especially when cost is a concern. Also, I came across this website that lists organizations that help people with their veterinary costs: http://www.warreneckstein.com/g/Groups-Providing-Financial-Assistance-For-Veterinary-Bills/299.html
      Hope that helps…

      Reply

  5. Carole
    Dec 28, 2013 @ 23:46:57

    My old girl, Casey (lab mix rescue) is 15 and has been on Vetroyl for probably two years. She is doing great but still pants and constantly acts like she is starving. We know its the Cushings but at times it drives us crazy. I can afford the meds (she is also on Metacam, Tramadol and one other pill). But wish they would come out with a generic version. I love her to death and will do what I need to keep her pain free and in good shape. As I write this she is licking dirt! Silly girl! Thanks for this. I understand it a little more. Oh and I spent $$$$ on testing for it. But was worth it cos she is doing much better (she developed a pot belly and peed like crazy which got her to the vet and started this).

    Reply

    • drvivc
      Jan 09, 2014 @ 03:59:35

      Sounds like you’re doing a great job! Two years is a long time for a Cushing’s dog. Generic Trilostane would be dreamy. Keep up the good work, it’s a frustrating disease to manage. Keep up the good work :)

      Reply

  6. Doreen Ahearn
    Jan 20, 2014 @ 20:04:22

    I have a 4 year old female border collie. About 6 mths ago she started gaining wgt, unable to tolerate exercise like usual, dribbling urine. She has two siblings and now is her littermate. Tests include hypothyroid, X-rays, coronary ultrasound, addtl blood work. My vet has tried to rule out as much as possible before turning us to cardiac doc…because her EKG was normal except for a high vagal tone. The cardiologist said heart working great and we should look at cushings….even though she is only 4. Also, she was hit by a van in her front area and shows signs of spinal changes. My vet just found these on X-rays. Our prior vet kept her in the hospital to monitor and said she was fine. Anyway, would appreciate any ideas, comments,etc…we are stumped and I want my girl to be able to play and be active like before. Also, tested for diabetes(neg). My prior border was an insulin dependent diabetic so I am a little familiar. Thanks.

    Reply

    • Doreen Ahearn
      Jan 20, 2014 @ 20:06:40

      Sorry doc…also ruled out spay incontinence.

      Reply

      • drvivc
        Jan 23, 2014 @ 17:11:04

        How did they rule it out? I have an incontinent Westie that I’m seeing and apparently there is a laundry list of exam findings needed to evaluate incontinence. Does she leak in her sleep or while she’s walking around? Does she empty her bladder fully? Is her bladder in the right place within her abdomen? Could there be a bladder stone? Vaginal/vulvar anatomical issue? Ultrasound or contrast x-ray to check bladder/ureter/kidney anatomy? Is she drinking too much? Any other signs of neurological dysfunction? Is she fecally incontinent too? Is the urine culture negative for bacteria? Turns out urinary incontinence is far more complicated than I thought :/ Your GP can rule out some of these things, but she may need an internal med or neuro consult to rule out/assess the rest.

    • drvivc
      Jan 23, 2014 @ 17:06:18

      Hi. Has she been tested for Cushing’s? If not then that’s a good starting place to rule in/out that. Urinalysis to follow up on the urine dribbling (does she have a bladder/kidney issue?) Respiratory issues can cause loss of endurance (your chest films should have helped rule that out, were the films read by a radiologist/I assume the cardiologist looked at them). If everything is normal, then sometimes I put the dog on a trial of pain medication to see if something (her back?) is hurting her and she’s modifying her activity in response to that. I usually do about a week or so of an NSAID and maybe Tramodol so I’m confident any pain should be eliminated. Then I have the client monitor to see if the dogs activity level improves on the meds. It’s called a therapeutic trial. If the dog improves, then we need to figure out where she’s hurting (X-Rays, MRI, Neuro consult if indicated) and what we can do long term to help.

      Reply

  7. Missy's mom
    Jan 20, 2014 @ 23:32:40

    Thank you for the information. My black lab is 11, we went through the tests and she has Cushings due to an adrenal tumor. She cannot have surgery because it is too close to her vena cava. She took Lysodren for about 4 months -she lost all of her hair but it grew back in, she had back leg weakness but she was getting her muscle back. She stopped drinking and peeing, she seemed pretty good. But she became lethargic and a blood test revealed her blood O2 was about 11%, she had a transfusion. they took her off the Lysodren. Her drinking and peeing has not come back, i gave her a series of B12 shots, her blood level is finally up to about 30%. The vet told me to give her 6mg melatonin and 50mg plant lignans, this is a new treatment. But her legs are much worse, she was a 60# dog (small lab) but she is in the 40′s now. she can’t get into or out of the car w/o being lifted. She falls down and skins her ‘elbows’ she hits her face, she is not able to get up from most surfaces and she moves her front legs with no results-I wake up through the night and have to help her up and during the day, it is sad to see her struggle. The vet said she has arthritis-she was so active and healthy before the Cushings hit her, now she is so sad. I now take her for cold laser therapy several times a week, I give her glucosamine, and every thing else I can!! she barely eats 1 can of food a day. Everything I read about cushings indicates they live a few more years and get better, this does not seem to be the case for her, I would appreciate your thoughts. I can afford treatment, but I want it for her to feel better-is that truly a possibility. I appreciate any comments you might have. Grateful for your knowledge on this subject.

    Reply

    • drvivc
      Jan 23, 2014 @ 17:17:20

      Well, here’s the difficult thing about Cushings, the ones who have the more common Pituitary form are the ones who can live up to two years. The dogs with the adrenal form, unfortunately don’t share that fate. That terrible tumor is highly malignant and sitting right next to some very important and vascular organs. Eventually the tumor eats its way into something vital and the patients either pass away suddenly at home or have to be euthanized due to decreased quality of life. I wonder if she was bleeding internally from the tumor eating into her vena cava or one of the renal arteries and that’s why she needed the transfusion? Surgery is very often not successful in these cases, I’m afraid. We have managed some adrenal dogs very successfully for a while on Lysodren, but over time, the physical signs from the tumor itself growing impact the dogs quality of life such that euthanasia may be indicated. She sounds like she needs to go to the vet for a quality of life evaluation and to see if her weakness stems from a low blood count/anemia again or if there is evidence of tumor spread. So sorry for your girl. :(

      Reply

  8. Carol
    Jan 21, 2014 @ 11:11:53

    Is Zyrtec safe to use for my dog who is taking Trilostane?”

    Reply

    • drvivc
      Jan 23, 2014 @ 17:19:07

      I believe there is no contra indication for Zyrtec. Best to double check with your vet since I haven’t examined your pet and don’t know what other meds she’s on.

      Reply

  9. doreen
    Jan 24, 2014 @ 06:40:55

    Thanks for the response. She was on a trial of rimadyl which helped with the movement but she was still bottoming out after short periods of activity. The urine problem seems to go hand in hand with the increased activity. I make sure she goes before and after activity…but being a border collie and trying to limit her activity is like trying to put a round peg in a square hole…it won’t go and she won’t stop. I have tried taking her siblings out while my husband distracts her inside and the neighbors thought we had a coyote in the house. She lives for that ball and frisbee and it breaks my heart to see how she struggles to catch her breath after only a few minutes. No urine leaking i her sleep, and no fecal incontinence. The leaking seems to be only after she runs and particularly when she jumps a lot. Radiologist read x-rays and no stones or abnormalities in chest or abdomen. The urinalysis test showed some crystals. Any insight or ideas would be greatly appreciated…

    Reply

    • drvivc
      Feb 13, 2014 @ 16:28:56

      Hard to say without an exam. Maybe it’s something related to the “spinal changes”, the respiratory nerves run through the cervical vertebrae. Maybe a neuro consult/ MRI to look at the spinal cord? Ultrasound to make sure she doesn’t have a hernia secondary to the hit by car incident? (Sometimes diaphragmatic or pericardial hernias become apparent years later). Is there a vet school near you where a team of specialties can take a look at her? Or a referral clinic with multiple disciplines?

      Reply

  10. Jules Fox
    Jan 31, 2014 @ 17:03:18

    My Ziggy, who has been a diabetic solidly for one year after a brief remission in 2012. 13 yr. old tuxedo kitty whose fur has been turning reddish brown for a few years. Saw the fur loss on front legs, flanks, now shoulders. Leg/flank fur has had regrowth but not the same as before. Shoulder fur is getting slight regrowth now. It was the last area to go bare. Tummy considered “pot belly”. Insulin resistance now in play since Dec. 2013 – sub 400 BG on 3.5-4 units Lantus each day, now- up from 1.5 each day. He’s had kidney disease without any problems for 7 years and chronic pancreatitis flare-ups (7.6 as of recent test). Kidney test – good. Urine – good. Blood tests are pretty good but high Triglicerides since last year.

    Specialist is soon to, definitively. call it Cushing’s. Ultrasound in mid-Feb. Otherwise, he’s behaving, eating, eliminating and moving normally. That’s a good thing. I’m happy to see this string of communication as I read Cushing’s is rare in cats and shared experiences seem rather scarce. He is a ‘red caution’ kitty so minimizing exposure to tests thus keep stress down will be at play. Doubt surgery will occur for any tumor. He’s a tough guy to deal with in a clinic setting but a tough guy who always beats the odds. But, given the other issues – we suspect that he might fare well with the meds but the reality of the disease(s) combined is being faced. I’ll be reading how everyone else is doing….

    Any insights are welcome. Thanks for taking the time to post. It helps shed light when one is in the dark.

    Reply

  11. Sharon Sumrall
    Feb 19, 2014 @ 17:27:39

    Spiffy my 14 y.o. Jack Russell was diagnosed w/Diabetes 3 months ago. We started on Lantus and there was no change in his symptoms and his glucose remained in the upper 500′s we changed to Humulin for a month and still no change in glucose, I suspected Cushings and did an ultra sound and the blood work and he is indicated for pituitary Cushings. So today I started him on Trilostane. This is my issue. I am moving across country in a month and will do two follow-up blood tests before I go. So much death in my life at the moment as Spiffy’s old Vet and my dear friend recently passed away from Cancer so I am broken hearted and very upset about Spiff and the new Vet said it I can’t get his blood work correct in a month that I should consider what is best for the dog and the stress of moving across country could be fatal. So there is talk of putting him down.

    Will I see changes in Spiffy’s behavior in a month? or hopefully sooner? Having read so ,much I appreciate this site and information posted. Thank you for the time.

    Reply

    • drvivc
      Feb 25, 2014 @ 16:07:09

      So terribly sorry for your loss. I wouldn’t expect Spiff to be perfect in a month, but I would expect some improvement. (Spiff is a great name, by the way. Any relation to Spaceman Spiff of Calvin and Hobbes fame?) I don’t think the stress of moving is going to be fatal. It will be stressful, and I would do everything possible to mitigate that (hopefully you are driving him, or flying him in the cabin with you). Granted, I guess I’m making assumptions here, I don’t know what Spiffy’s current medical condition or overall quality of life is like. For example, I could see myself gently recommending euthanasia if the dog has Cushing’s, kidney disease, a grade 5 heart murmur, terrible arthritis, and uncontrolled diabetes (the stress of the trip could put the dog into overt kidney failure, or congestive heart failure). Your vet could know something I don’t that makes her think the trip may be too much for Spiff (here’s a blog I wrote about euthanasia and determining a pets quality of life ), in the off chance that helps at all.

      Reply

  12. Gill
    Mar 11, 2014 @ 20:46:15

    I have a fourteen year old crossbreed who has had Cushings disease for the past two years, he’s is on vertoryl at the present time and has regular blood tests to check his levels, he is now only on 10mg of vertoryl very other day as his levels went dangerously low just before Christmas. He has lost a lot of weight and has a skeletal appearance, he is still very hungry all the time, he has back leg weakness and is licking his hind quarters. We have visited our vet for blood tests today and the vet agrees that his weight loss and muscle loss is now a problem. Along with his normal blood test today he has taken a liver and kidney function blood test (as he was having bloods taken anyway), my vet has said he may need some steroids for his weight loss and muscle loss but he did say this is going to be difficult due to his Cushings. I have come home and read about steroids and really not keen on my old boy having these as I don’t see how they can help, I also have a 3 years old cavalier King Charles and a 15 year old ginger tom cat and on top of all the side effects from steroids it also states they can change the dogs temperament and they may become snappy, I can not afford this to happen due to other animals living in the home. Any adivce welcome and I will be speaking to my vet anyway tomorrow when he rings with the blood test results. Sorry for the long response.

    Reply

  13. Jeremy James
    Mar 17, 2014 @ 18:48:48

    Hi..read your article with interest. my dog was finally diagnosed WIth Cushings after a couple of misdiagnosi. She showed all the classic signs, such as massive thirst, peeing, hair loss and muscle weakness. I resorted to 30 mg a day of Vetoryl, however, sadly, on the second day of her treatment, she became overly affectionate, then started acting drunk, seemed to be blind as she walked into corners and stared vacantly. She then started to defecate uncontrollably and fell into what seemed like total paralysis. After four hours( this was at 3am on a saturday), in which she seemed to be breathing normally, I rushed her to an emergency clinic but she died on the way. Could her death have been an adverse reaction to Vetoryl? Your reply would be massively appreciated as I am asking myself so many painful questions.

    Reply

    • drvivc
      Mar 24, 2014 @ 00:35:29

      I don’t think it was a Vetoryl reaction. Sounds like a thrombotic event, due to a blood clot, which Cushings patients are susceptible to (regardless of whether or not they are on medication).

      Reply

  14. jrtlover
    Mar 20, 2014 @ 13:25:26

    My Jack Russell Terrier was diagnosed with cushings almost 3 years ago. We noticed a major weight gain, 12lb to 17lbs at the time- now almost 3 years later he is 23lbs. eek! But we chalked it up to just having a baby and maybe thought he was depressed, what brought us to the vet was the fact that he was peeing EVERYWHERE and we were refilling his water dish 9x a day. He seemed better with lysodren for quite a while, but now he is peeing everywhere again. We try to watch the water intake, but that deems pretty much impossible – how can you not give a thirsty dog water? He’s also been struggling over the last few weeks with stairs- he can do them, but a lot of times he stumbles. Might have to do with his large belly?
    I’m at a loss right now and don’t know what to do. He is 11 years old and otherwise seems decently happy- definitely “not himself” and looks at me with sad eyes after he has an accident. He typicalliy only has accidents when he’s up and moving. I don’t know if we should try to move our family dog out to live in the garage or what is best? All I know is, we can’t continue having him pee all over the house or my husband my just leave me (kidding, he won’t… but he’s having a much harder time accepting this is part of having a pet) Suggestions? Is there anything I can do to stop the peeing? My husband and I differ on the topic of putting him down. Any help is greatly appreciated. Thank you, thank you, thank you!

    Reply

    • drvivc
      Mar 24, 2014 @ 00:33:16

      He may have become diabetic, he may need a Lysodren dose adjustment, or he may have a urinary tract infarction/stone/etc. Have you been back to your vet for evaluation?

      Reply

  15. k9Cushmom
    Mar 28, 2014 @ 22:53:43

    jrtlover, it is not uncommon for dogs to relapse on Lysodren and you are lucky if you’ve managed to control cortisol so well for three years without a reload or adjustment in maintenance dose. I suspect that your boy’s adrenal tissue has regenerated and cortisol is once again flowing unabated. I’ve treated three dogs with Lysodren so I know the drill only too well. The longest we ever went without an acth stimulation test was six months. All of mine relapsed in the first and second year, two requiring increase in maintenance dose, which was effective, and one requiring a reload.

    Reply

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