Wwyd

[fankino04]

All signs point to noodle having Cushing's, each vet days that's most likely but ACTH and low dose dex test were inconclusive. Previous vet thinks she's not far enough along to trigger a result so pretty much wait and see. She has a cracked tooth which isn't bothering her but I booked her in to have it taken out however when they ran blood tests her Alp (1 of the things making them think Cushing's) had shot up so given her age and that one of her liver markers is raised we opted to not go ahead as the risks of a GA were higher. Have changed vets now and they want to ultrasound her adrenals to see if they can confirm Cushing's, took her in today for that and they said they would try without GA but would most likely need to put her under to get a good image. Given previous concerns I have said not to take it that far. She has been on Hilton herbs cush X for the last month and in the lady week I think she has started to improve.... Should I risk a GA on a dog that the previous vet says hasn't got bad symptoms and I think is improving on herbal treatment, I can always revisit if she gets worse???

 

[Roxylola]

What will you do if you get a confirmed diagnosis? Will your approach be any different. If not, I wouldnt bother

 

[fankino04]

If there was a confirmed diagnosis then she would go on veterol, whether the image would be enough to confirm is unclear, it's one of those "try this it might give us more information to diagnose when the Cushing's tests don't" so even under GA there might not be any enlargement of the adrenals which leaves us in the same position.

 

[Roxylola]

I probably wouldnt for now if you feel shes doing ok as it might be inconclusive anyway

 

[fankino04]

I probably wouldnt for now if you feel shes doing ok as it might be inconclusive anyway

Thanks, that's how I'm feeling but new vet seemed to think GA would be fine, old vet didn't say it was dangerous but did say I needed to think hard about it as it was much riskier and although I want an answer I don't want to take any unnecessary risks. She's an old girl and realistically with or without Cushing's I'm unlikely to get more than another 12 months with her, her symptoms have only been very slowly increasing on the last 10 months and although I may be imagining it I think the cush X has started to help her in the last week or so. I may follow Fls example and get very scientific about her drinking and peeing lol

 

[Pearlsacarolsinger]

I wouldn't want an elderly dog have a GA unless it was absolutely necessary. Would your vet agree to a meds trial without a positive diagnosis if the symptoms don't improve on the herbs?

 

[fankino04]

I wouldn't want an elderly dog have a GA unless it was absolutely necessary. Would your vet agree to a meds trial without a positive diagnosis if the symptoms don't improve on the herbs?

Doubtful, the risk of her getting Addisons if we got it wrong would be too high.

 

[fankino04]

Well the vet called and whilst they have to wait on the full report from the specialist they didn't see anything untoward on her adrenals, they said the liver looked a bit patchy in places but would need more investigation. She is having a full blood panel done again and I'm going to keep her on the cush X then repeat bloods in 6 weeks to see if the herbs are helping ( unless these lot of bloods point to anything else). If she has tumours in her liver then I doubt there would be a suitable treatment plan for a girl of her age so...

 

[FinnishLapphund]

I had written a long reply, refreshed the page, saw post #8, so erased most of it.

A short version of my reply to your first post, is that sometimes another veterinarian can have different/more advanced equipment, which sometimes means they can do something quicker. So I would have wanted to ask more questions, because perhaps your old veterinarian would have needed to keep her under GA for a longer time, than what your new veterinarian was planning on doing. I was also wondering if her liver values are the same today, as they where when your old veterinarian tested her.

Anyhow, I presume that they where able to do the tests they wanted without GA, so big credits to you, and her, for her being so well-behaved that they could do it without GA.

From what I know, it seems the biggest problem with Cushings in dogs, is that they can get to a point where they drink so much, that they can't hold themselves, without starts to have involuntarily accidents indoors. I presume it isn't ideal for the kidneys to be so flushed through either, but as long as it is on a level where you can manage it without indoors accidents, it seems a good idea to wait with Cushings medication until you have more, clearer answers.

Sorry to hear that you didn't get any clear, 'found a fixable problem' answers. And not fun at all that you might have to worry about liver tumours.

The only thing I can say about that, is that if isn't cancer, then my mum have had a so and so liver for over 20 years, and her doctors have always told her that if you have to have problems with an organ, the liver is actually a good option.
There is of course exceptions, we had a cat whose liver just shut down when she was only around 5, 6 years old. But in general, (according to my mum's doctors) at stages where other organs stops working, a liver often keeps on working as good as it can.

Fingers crossed the full panel blood test doesn't show anything bad, and fingers crossed again for that the new food might actually help improve things a bit.

 

[fankino04]

Thanks FL, other half seems pretty adamant that we are not investigating liver anymore at this stage, as much as I want an answer if the answer doesn't have a viable treatment then what's the point, the only thing I'm aware of for the liver is milk thistle which is in the supplement she is on anyway. Really I just want her to stop panting as being too hot all the time isn't fun and to not have too much muscle wastage but not sure if the current muscle wastage is general old age, a symptom of an undiagnosed disease or me being too soft on her when she turns for the shortcut home. I have recently started increasing her evening walks and she's marching along better than I've seen her do for a while, so I think just support and monitor for now ....

 

[FinnishLapphund]

Something my veterinarian usually seems to suggests for dogs with liver values over normal, is to feed smaller portions 4 times per day, so that the liver gets 4 smaller workloads to deal with, rather than 1 or 2 larger workloads from getting fed 1 or 2 times per day.
Preferably in combination with trying to switch to a food with more vegetable protein than meat protein, to make it easier for the liver.

Don't know if that is the type of food you've already switched to, but since you hope it will help with the Cushings, I presume switching to another food isn't currently an option. However, if you're feeding her 1 or 2 times per day, then switching to feed her 4 smaller meals per day, is perhaps something worth trying.

 

[fankino04]

Something my veterinarian usually seems to suggests for dogs with liver values over normal, is to feed smaller portions 4 times per day, so that the liver gets 4 smaller workloads to deal with, rather than 1 or 2 larger workloads from getting fed 1 or 2 times per day.
Preferably in combination with trying to switch to a food with more vegetable protein than meat protein, to make it easier for the liver.

Don't know if that is the type of food you've already switched to, but since you hope it will help with the Cushings, I presume switching to another food isn't currently an option. However, if you're feeding her 1 or 2 times per day, then switching to feed her 4 smaller meals per day, is perhaps something worth trying.

She's on 3 meals a day, will look at feed that uses veg protein instead of meat, the cush X is a supplement, the main ingredients are milk thistle and chaste berry so focused on liver and pituitary but some other things too, she has added salmon oil for easily digested protein to help her muscles.