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Ask Roger L. Welton, DVM Your Own Question

Roger L. Welton, DVM
Roger L. Welton, DVM, Veterinarian
Category: Dog
Satisfied Customers: 1403
Experience:  Licensed Veterinarian, Practice Owner, and Book Author
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In the last stages of Cushings Disease, will my dog die a ...

Customer Question

My dog had some symtoms( mainly frequent urination-but other than that she seemed in good health) of Cushings disease, so we took her(she is a 13 year old Field Spaniel-55 pounds)to the Vet. They tested her urine and did blood work and all they could say was she has a higher than normal amount of protein in her urine.They could do other tests which may not be conclusive, therefore we may need to keep doing more tests with no set number of tests, meaning this could go almost infinitely. Is there a specific test for Cushings disease? Also, the same day we took her to the Vet she went down hill rapidly, at this point she is not eating, not moving very much, urinating very little, drinking a little, she can't really stand up-esp. her hind legs.All she does is rest. She doesn't seem to be in pain, but I really don't know. I really don't know what to do. Is she to far gone to help? Should I let her die a natural death at home. Or should I put her down? I don't want her to suffer.
Submitted: 6 years ago.
Category: Dog
Expert:  Roger L. Welton, DVM replied 6 years ago.
Cushings disease itself does not really reach an "end stage" scenario. Cushings is caused by a functional but benign (not cancerous) tumor of the pituitary gland in the brain. While the tumor does not cause cancer, it causes the pituitary gland to over secrete the hormone ACTH, which in turn over stimulates the adrenal glands to over secrete the hormone cortisol into the bloodstream.

The subsequent chronic excess of cortisol in the body, a hormone normally utilized by the body for the "fight or flight" response, is what leads to problems. Specifically, it causes chronic spikes in blood sugar that causes excess drinking and urination, and can predispose the patient to diabetes. Excess cortisol also overtaxes the heart, kidneys, and liver, as well as causing obesity and chronic skin problems.

Over time, cushings beats up on the body, predisposing to various health problems, but there really is no end stage cushings scenario. Once diagnosed, cushings responed quite favorably to treatment.

There exists a couple different specific bloodtests for cushings. However, if the patient is not showing typical signs of cushings disease (which your dog does not seem to be), and if no evidence is found on general bloodwork (the main evidence would be a significant rise in the liver enzyme ALP), then there really is no reason pursue a specific blood test for cushings.

You dog could have adissons disease, hypothyroidism, or cancer, so diagnostic imaging would be a good idea. I would start by taking x-rays of the chest and abdomen. If x-rays do not uncover any obvious lesions, then consider an ultrasound of the abdomen for more detailed imaging of the organs. If imaging does not offer any clues, then consider ruling out hypothyroidism with thyroid blood panel, as well as addissons disease with a blood test called an ACTH stimulation test.

Testing does not typically go on indefinately - most of the time, we acheive a diagnopsis, but not always. I understand that this can eventually end up getting rather costly, but testing is the only way to shed light on your dog's disease process. It is no different in human medicine. Therefore, I advise you to do the best you can within your means. If because of financial reasons or because of other more philosophical reasons, you decide to halt further diagnostics, you should not be hard on yourself, you obviously love the dog. However, I strongly advise not to let nature just take its course and die a natural death at home. This can lead to days of unnecessary suffering. If you decide against further diagnostics, then you should have the dog put to sleep humanely.

I wish you the very best!

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