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Steps to Evaluating Cushing’s Disease

on March 25, 2015
Posted in Cats

Q:

Cappuccino is a Miniature Pinscher that we adopted almost 8 years ago. She is thought to be 11, 12 or 13 – our original veterinarian placed her age at probably 4 when we adopted her. She was a badly abused dog. When we adopted her she had baldness in areas attributed to poor nutrition – we rectified that and her fur is perfect. Due to her abuse we have had to have dental work done on a number of occasions resulting in a few extractions. We have not had to do much else other than normal routine care.

Last year at her annual checkup she had elevated liver enzymes – they were at 1700 when I am told the normal range is about 130. The Vet we visited suggested a course of action that included additional blood testing, x-rays and sonograms that would have required Cappuccino to be sedated. After discussing with the Vet, and Cappuccino showing no signs of any discomfort whatsoever we opted to adopt a wait and see approach.

This year, her blood test shows the same enzymes being elevated to 2000. In addition she is experiencing urinary issues. She is able to urinate but also spends a lot of time straining to urinate. She has changed in a few other ways as well. In all the years we have had Cappuccino she has never urinated in the house. She is now doing so. She appears confused at times. I believe that her hearing has diminished and that her eyesight has as well.

She is not eating more than usual. She is not drinking more than usual. She generally does not exceed more than 1 bowl of water a day and most days doesn’t even consume a full bowl of water.

The current Vet (who we don’t have a history with but was recommended by a friend) has done a blood test, a urine test and an x-ray. The blood test shows that everything is great except for this liver enzyme. She says that Cappuccino’s kidneys are functioning properly. The Urine test shows no bacteria – she did a culture as well and just told us that nothing grew. We were given antibiotics for Cappuccino and she is half done with them – I am continuing to give them to her but I don’t know if I should. The x-ray showed no blockage that would be causing her to strain to urinate. The Vet suggests the following course of action – an extended blood test for Cushing’s – she says that Cappuccino would need to be in the office for about 2 hours or so to perform this test. She also suggests a sonogram of the bladder to see if there is a tumor or some other blockage.

My concerns are this: I read about Cushing’s and the treatment. It seems to me that the treatment might be worse than the disease itself and other than her straining to urinate and sometimes urinating in my home she doesn’t appear to be in any discomfort. She is eating and drinking normally. She is as active as she has ever been – save for the fact that she no longer likes to go up long staircases – she will go up and down the 4 steps in the front and back of my home but not the 14 to the second floor – she will only go down those. I think that is normal for her age. Is it the best course of action to diagnose Cushing’s and treat her if there is a likelihood that the treatment will be worse than just leaving her be? As far as the sonogram – if Cappuccino does have tumor in her bladder – she is an advanced age – I wouldn’t necessarily want to put her through an operation – I am not sure she could withstand it.

I have asked those questions of the current Vet and have not really received any kind of an answer – – mostly she is just silent. I don’t know what to do and would be interested in hearing your thoughts on the matter if you were so inclined. I came across this supplement called Adrenal Harmony Gold – do you have any thoughts on that related to the information in my question?

Any input would be greatly appreciated.
Alicia

A:

HI Alicia
Sorry your Cappuccino is ill. It is difficult to really tell you exactly what is going on without seeing the pet but here are some concepts. I would have the sonogram done as it is not invasive and if you have a good sonographer you will get information on the adrenals, liver and the bladder. If the adrenals are abnormal then have the Cushings test done. If the problem is the liver then you have your answer. I would not start your dog on Adrenal Harmony on speculation because that is never good–you should have a diagnosis. You could safely start on Milk Thistle as you know the liver needs help. This is how I would proceed if it were my patient.

Hope that is helpful
Dr Jan

Read also: Dealing with a Pet that has Cushings Disease

Our Expert

Dr. Janice Huntingford
Janice Huntingford, DVM, has been in veterinary practice for over 30 years and has founded two veterinary clinics since receiving her Doctor of Veterinary Medicine at the Ontario Veterinary College, University of Guelph. She has studied extensively in both conventional and holistic modalities. Ask Dr. Jan

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Adrenal Harmony Gold works to normalize the production of adrenal gland hormones and alleviates suffering from Cushing's in Dogs.

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