Last Friday (March 20), I got the call from the vet telling me that Caesar has Cushing’s Disease. This is something I was preparing myself for. All the things he has been going through, all of the symptoms – they all fit. It’s been about a week now, and due to the coronavirus, I don’t think I’ve really had time to process it all. So I’m gonna take the time now and explain to you what this means for Caesar and I.
What Is Cushing’s Disease?
Cushing’s Disease is caused when the body secretes more cortisol than it needs. Cortisol is the stress hormone.
There are two types of Cushing’s – pituitary-dependent or adrenal-dependent. Most dogs, around 80-90 percent have the pituitary-dependent type. Dogs with pituitary Cushing’s have a tumor on the pituitary gland in brain. According to the FDA, “The pituitary makes a number of hormones, including adrenocorticotropic hormone (ACTH). The pituitary tumor causes overproduction of ACTH, which travels through the bloodstream to the adrenal glands, stimulating them to produce more cortisol than the body needs.” This is what is happening to Caesar.
The other type, which is more rare, is caused by a tumor on the adrenal gland which causes the gland to make more cortisol.
What Symptoms Does Cushing’s Cause?
So, if you have been following this blog for awhile then you may recall last year when Caesar got a kidney infection so bad that he was urinating blood and could not hold his urge to urinate. He had several accidents in the house. It took six weeks of antibiotics to treat. During this time, I noticed his thirst for water became immense. It seemed there was no amount of water in the world that could quench his thirst. When doing a urinalysis, the vet was concerned about this dilute urine and the amount in which he was drinking.
After X-Rays and Ultrasounds, it seemed Caesar looked healthy. There was nothing wrong with his kidney or bladder. There was no blockage or stone. “Sometimes we don’t know what causes these things,” the vet told me in November. The UTI cleared up, but Caesar’s thirst didn’t go away and then he developed a huge appetite! He began throwing his bowl at me. Mind you, this from a dog that for 8 years would pick at his food. For as long as I can remember, I’d have to beg him to eat. I thought, however, this was just a symptom of our long and frequent walks. Understandably, I thought he was just hungerier because he was burning more calories.
Near the end of the year, I also began noticing his abdomen looked different. I asked my boyfriend, my mom, my dad, and my sister, “Does his sides look weird?” I knew I noticed a change, but no one else seemed to, and he had actually lost two pounds, so I decided not to worry further about it. (Always trust your instincts! You know your dog better than anyone!)
Fast forward to March 11. Caesar and I meet my mom and Fozzie at the Van Wert Reservior for a walk. During this walk, Caesar stops to urinate every few steps. “That’s not normal,” my mother says. I agree. The next day I take a urine sample in to the vet and let them know the situation. “I think he has another UTI,” I say. The day after, the vet calls me. The sample is too dilute, which is concerning. She tells me she’d like to get another sample, but wants it to come straight from his bladder. I dropped him off, and while there I told them to go ahead and do an X-Ray on his bladder and a full blood-analysis.
When we get the results, we find out his bladder is enlarged and his liver enzymes are elevated meaning two things: either his liver is failing or he has Cushing’s Disease. Oh, and he did in fact have another UTI.
I tell her about other issues Caesar has had – dry skin that I can’t seem to get rid of, constant diarrhea, the way he looks thicker. With those symptoms, on top of the dire thirst, she suggests the Cushing’s test. We went home with medication for his live and an anti-biotic for his UTI. We set up a test for Cushing’s and then awaited the results.
And now here we are.
To be clear, here are the symptoms of Cushing’s Disease from the FDA.
- increased thirst
- increased urination
- increased appetite
- reduced activity
- excessive panting
- thin or fragile skin
- hair loss
- recurrent skin infections
- enlargement of the abdomen, resulting in a “potbellied” appearance
Caesar has nearly all of these symptoms.
How Is Cushing’s Disease Treated?
Caesar will have to take medication for the rest of his life. He will also have to have regular bloodwork for the rest of this life.
Caesar will be taking Vetoryl (trilostane) which is FDA approved and requires a prescription. According to the FDA, “The drug’s most common side effects are poor or reduced appetite, vomiting, lack of energy, diarrhea, and weakness.” I’m hoping Caesar doesn’t have these effects, but if he does, at least I am home a lot right now to monitor him.
Caesar will have to have bloodwork frequently to see how his body is reacting to the drug. At first, he will have bloodwork every few weeks. Eventually, when the vet thinks everything looks good, he will have it every couple of months.
What Does This Mean For Caesar?
Cushing’s is not a death sentence!
When I asked her about his life-span, my vet reminded me that Caesar is technically an old man (he’s almost 9). She said that while the medication will be hard on his organs over time, he could perfectly well live out a normal, long life and die of age-related matters. In fact, the medication and treatment should help Caesar’s body go back to normal.
According to the vet, Caesar should begin to drink a normal amount of water within a few weeks. His frequent urination should stop. He should not get any more UTIs. His skin should clear up. His appetite should return to normal. Overall, he should feel a lot better.
While the medication and treatment is costly, it’s more than worth making my best friend feel better. He’s been living with this for too long and I’m excited to see what he looks like without all of these symptoms.
More than anything, I am just glad to finally know what is going on. In a world with so much uncertainty right now, it’s nice to finally have answers regarding my best friend.
What I want people to know is that my dog seems perfectly normal. I don’t want people to pity him, and I’m sure he doesn’t feel like he needs pity. If I didn’t tell you about all his symptoms and you looked at him or saw him in public, you’d never now he had anything wrong with him. The week before we got the official diagnosis, we hiked the most we have ever hiked together – 11.5 miles in one day! His energy has never been better. He’s a very active dog, and I suspect he will continue to be well into his senior years.
My dog is not going to die tomorrow. He, hopefully, will be able to live to see many of his teenage years.
Through this blog, I will continue to document how we work through this diagnosis and how Caesar reacts to treatment. Hopefully, if nothing else, someone will find this useful. As in most cases, the quicker something is diagnosed, the more effective treatment is. Thankfully, it appears Caesar has not been living with this for too long. It always pays to be very observant, and as always, trust your gut! You know your dog better than anyone.
