The beginning - Diagnosis

 Here we go again.....

Hopefully you will have read the first page of this diary, so will know the back story of my experience with Cushings and reason for this blog.

I couldn't believe it when Dora was diagnosed with Cushings, I should have recognised them, but they're so subtle in the beginning they're not easy to spot. The peeing overnight, sometimes the odd poop as well. I put that down to her age, although she was only 9 then, she celebrated her 10th birthday 22nd September 2024. She was a bit tubby around the middle, she's a Jack Russell cross Dachshund and so they're quite often 'tubular' and tubby, so the pot belly didn't raise the alarm with me either. Then at the beginning of 2024 she had an insatiable appetite. I put that down to the fact the vet had said she was overweight, like they do, so changed her diet to a lean low fat wet food and thought she was hungry because I'm hungry when I'm on a diet. It never occurred to me that she had Cushings for quite a while. 

Mid 2024 I took her to the vet, I had suspicions it could be Cushings, but thought it could be a lot of other things, diabetes for instance, even parasites even though she's regularly wormed. The vet ran a full blood panel, testing for all the obvious things it might be and they all came up negative. The only thing they didn't test for was Cushings. 

When I suggested a Cushings test they said "well you have put her on a low fat diet, so give it a couple of months and see if that hunger settles down, and the overnight urination will probably ease once she's lost some weight." Huh? 

But them being the experts and me being, well me, I accepted their advice and a couple more months passed and she was still the same, in fact the hunger was worse. 

Inbetween she'd had either a blockage or infection in her gut, they weren't sure which and I wasn't happy with them at all. They'd been taken over by a huge international veterinary company and the prices had trebled and the service was not as good. It was all about the money. They couldnt diagnose without a scan of some kind and, well it was just dire. So I left that practice and went to another and boy am I glad I did. 

They are totally brilliant. I explained all about Dora's problems and they did a full blood panel again as they said it was a few months since the last one and something may have developed in the meantime. The results were the same, all negative and didn't show anything untoward. 

I suggested the Cushings test. Now when Bonnie had Cushings there was just the ACTH test. What is an ACTH test? Well it was the first line recommended test to diagnose Cushings. It used to wreck Bonnie. They take bloods to test the level of cortisol in the blood then inject cortisol into the bloodstream. Wait an hour then take more bloods. The dog usually has to stay at the vets for at least 2 or 3 hours. So it wasn't something I really wanted to put Dora through but I thought it was the only test that would determine for sure if she had Cushings. 

So she was booked in for the following Monday 7th December 2024 and was to stay there from 9am until around 7pm when the last blood tests were completed. What happens is they take bloods and test them then inject with Dexamethasone and take bloods 2 hours later and test them, then 6 hours from the Dexamethasone injection and finally 8 hours from the Dexamethasone injection. They can then tell from the results if it's definitely Cushings or not and which type it is. It's not at all stressful on the dog and if the dog gets stressed before the first bloods or during then it can alter the results as it's very sensitive. So Dora was put in their isolation ward on her own and kept quiet all day. Nothing to eat before she went in and nothing to eat all day, so you can imagine how hungry she was when I collected her.  The tests are then sent to an external specialist lab and I'd be told in about 3 or 4 days what the results are.

The vet said the Dexamethasone Suppression test is much more accurate and canteen tell if the dog has Adrenal or Pituitary Cushings. Adrenal Cushings is a tumour on the adrenal glands, near the kidneys. Pituitary Cushings is a tumour on the pituitary gland at the base of the brain. The latter not being operable. Not many vets would remove one or both adrenal glands if the tumour was there but it is an option.

The ACTH test that can't determine which Cushings the dog has, adrenal or pituitary, so the Dexamethasone test is a big improvement from when Bonnie had Cushings. 

I had to wait 3 days and then the vet phoned me in the evening and told me Dora definitely had Cushings, and it was Pituitary, so inoperable and that he would write up a script for me to collect her meds on the Friday. Vetoryl, starting dose 2 x 10mg tablets taken as one dose together in the mornings. So she started her course of Vetorly on Saturday 7th December.

The next appointment is on Monday 16th December when I take her in for a physical examination to check for any adverse reaction to the drug and if she's having or had any side effects. So a quick in and out I think. 

Then she has another appointment in January when she goes in for another Dexamethasone Suppression test so will be staying in all day again. 

The vet has said she may need several of those tests to get the dose right, so it's going to be an expensive time. Thankfully she is insured, but after a claim last year my premium shot up to £135 a month. 

I mentioned to the vet I may cancel the insurance as I couldn't afford to pay that and pay vet/drug costs up front then claim it back. This always seems a stupid idea to me. So the vet said to keep the insurance for the first year, because if she's going to develop secondary conditions such as Diabetes or kidney or liver problems then they will happen within the first year. So to wait and see what the future holds before cancelling anything. 

I bought the first lot of Vetoryl from the vet, it should have been just over £144 for a months supply, I am a member of their pet club where I get free vaccinations/flea treatment, unlimited vet and nurse consults, 20% off dentals and food, tests etc, meds, but they will give me a prescription to buy them online which is a bit cheaper. So the that will be a Godsend. The prescription is £12 for either 3 or 6 months, whichever I prefer. I did some costing online and the cheapest I could find was petdrugsonline.com who sell Vetoryla lot cheaper and the cost would save about £25 a month on the drug so well worth buying from them, less the £4 per month for the prescription.  You need to have your wits about you to find the best place to get the drug and the best option vet or online remembering to take the cost of the prescription into account. Not all vets charge the same for a prescription and some dont like issuing one in the first place. So with my pet club discount from the vet I actually paid just over £115 for the first months supply of drugs. 

I'm not forgetting of course as the dose is adjusted, if it's increased or decreased (I can't see it being decreased as it's not had any effect on Dora yet), then of course the cost of the drug will go up accordingly. 

Now all this is not possible for a lot of owners who's dogs aren't insured so it's something to take into account. This was the problem I had with Bonnie. I couldn't insure her so a lot of my friends on Twitter told me to do a crowd funding page so I did. I didn't want, I felt like I was begging, and my pride took a knock, but I discovered that your online friends rally round and support you if they know your situation and gladly donate a few pounds and in some cases a lot of pounds to help with the cost of tests and treatment. It really shows you that human kindness is not dead and that there are some wonderfully kind and generous folk out there. 

With a disease like Cushings, it is of course a lifelong condition and how long that may be is in the lap of the Gods because all dogs are different, it's never sure when the dog first had Cushings so that makes a difference, and of course the age of the dog when it was first diagnosed. So this expense is something that could last a few months, a year or several years. I have since heard of friends who's Cushings dog lived 5 years after being diagnosed and beginning treatment, and some of them died from old age not from Cushings. So there is always hope. Never give up hope.

There is support out there where you don't expect it and although it's a club we'd rather not be in, we can advise each other and learn the best ways to manage this horrible disease. Just enjoy every day you have with your dog and make it special for them and for you and your family. Live in the moment. Because that moment may be all you have with them. 

I'll write up the second article after Monday's vet visit and let you know how Dora is progressing. In the meantime if you want to know anything about Cushings, SAARDS, or any other related conditions your dog may or may not have, please do check out BonniedaWestie.Blogspot.com. Most of the information is still relevant and when I get time I will edit it to include the Dexamethasone Suppression test and the new Cushings drug that is coming out sometime in 2025 I believe. I'll mention that in this diary too. 

Take care my friends, and remember, live in the moment! 

With much love

Hazel & Dora

xxx