Thank you for the reply.
I agree that Cushing disease has to be on the list of rule outs, but that is not the only disease condition that can lead to the symptoms that you are seeing. Even if it is Cushings disease, not every dog with Cushings has to be treated and it depends on the symptoms they are showing and the quality of life they are experiencing as to if treatment should be considered.
The very first thing I would do is to have a urine sample analyzed and cultured to look for possible bacterial infection. Urinary tract infections are very common in dogs with Cushings and if she in fact did have one, it may be contributing to the urinary symptoms and if treated, may improve them. Not all dogs with Cushings show any symptoms and if her symptoms were due to a secondary problem, like a urinary tract infection, she may be able to live with the Cushing untreated once the infection was resolved. I would at least have the testing done to confirm Cushing or not as well. This is best done with the test called a low dose dexamethasone suppression test (LDDS). It really is no ordeal at all to have the test done and requires only 3 blood samples drawn over an 8 hour period. Even if you choose not to treat the Cushings disease if present, it is a good idea to confirm if it is present or not as it does put her at an increased risk of other health conditions, including infections and hypertension. On all of our Cushing patients, we monitor for these conditions twice a year as when they do occur, they usually occur "silently" and with no other outward signs. Here is a like that describes the tests used to diagnose Cushings. LINK HERE
The treatment for Cushings itself is not toxic and many dogs handle it very well. It is true that the initial treatment protocol involves monitoring bloodwork while the treatment drugs are introduced, but that is the reason why the blood is monitored so that the pet being treated does not experience any adverse effects of correcting the increased cortisol levels. Here is a link that better explains treatment options. LINK HERE
One other very possible scenario besides Cushings is that she may have developed early kidney failure to the point that her bloodwork is not yet affected, but that her kidneys are no longer able to concentrate the urine well. The increase in water intake is then more of a compensating mechanism due to the presence of a more watery urine. This is not seen frequently, but it can occur and if so, her Cushings tests will be normal. It would be important to differentiate the two as if it is related to loss of concentrating ability by her kidneys, there really would be no treatment. As long as she is still feeling well, eating and maintaining her weight, I wouldn't see a reason to euthanize, but living with a pet who drinks excessively and thus experiences urine accidents in the house can be a challenge. In any case, better defining her disease would be beneficial and help you in making choices for the future.
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