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Cushings Disease – Rocky’s Story

By Barbara Boettcher
June, 2013

February 2013 – Rocky (FC AFC CFC Lighthouse Rock Star) started consuming tremendous amounts of water. Rocky has always been a water dog, he loves his water! This however was escalating and became quite concerning. He would finish a 5 gallon bucket of water at one time if I would let him in addition to the water he consumed with his food twice a day. Every time he went outside he dove into the water bucket! At first I thought it was because he was back home, in the house more and that the weather was warmer than at the trainer’s.

He ran his first Spring trial February 23 & 24 where he finished and won the Amateur stake. We traveled to CA the beginning of March where he ran two days. It was HOT for us and the dogs. Rocky ran well despite the heat, but was just a little ‘off’. All along he continued to consume as much water as we would offer him along with starting to scavenge for anything he was convinced was edible. I was beginning to really get concerned with Diabetes running through my thoughts.

I decided that since he would be 8 years old in June maybe I should have a full workup done on him. Hadn’t had any blood work done previously, the dog just has not been sick a day in his life! His blood work came back pretty darned normal for a dog his age; however, he did have a Urinary Tract Infection so we put him on antibiotics. He was not diabetic which is what I was really expecting them to find with the water consumption! One of the symptoms of a UTI is excessive water drinking as dogs instinctively try to flush their system so we thought we were on the right track.

We went off to the Utah trial March 22nd, he was loaded with antibiotics but the water consumption continued. While we were at the Utah trial we had a couple of people remark that Rocky looked heavier than he had ever looked but not in a ‘fat dog’ way. These were people who had seen him the beginning of March so the change was pretty remarkable. We looked at him and could see at that point that he was beginning to look pot-bellied. He ran well and hard but the birds won on Saturday so we headed home.

I worked for a veterinarian previously and things just weren’t adding up to me. So while we were driving home I started searching on his symptoms. I landed on Cushing’s  Syndrome (Disease), also known as hyperadrenocorticism, and it all started to make sense to me. His age, the water consumption, the pot belly look, the musculature changes, the UTI that wouldn’t clear up…everything was there with the exception of the baldness that happens between the shoulders and the front of their hip bones. We saw a few Cushings dogs at the clinic, but we wouldn’t see them until the dogs were practically bald.

We are fortunate in that our vet is open 7 days a week and is also the Emergency clinic after hours. So I called on that Saturday as we were driving home to see if I could get Rocky in on Sunday for the 1st follow up Urinalysis A (I’m not sure what UA stands for, so other readers may not either . . .) and to talk to her about what I suspected.

She did the UA in house and sure enough he still had a UTI….Cushing’s dogs have a harder time fighting infections. I asked her about my suspicions and she agreed with what I was thinking so we left him there for the afternoon so that they could do what is called an ATCH Stimulation Test. Cushing’s is caused by the over-production of cortisol by the Adrenal Glands. Cortisol is a stress hormone that the body needs, but can go horribly out of whack generally in older dogs. The cortisol strangeness can go either to overproduction, which is Cushing’s, or underproduction, which is Addison’s. Both conditions happen in people and neither is hereditary.

We got the results and sure enough he was hugely over producing Cortisol! She put him on a stronger antibiotic to try to knock out his UTI and we scheduled an Ultrasound to see if he had an Adrenal Gland Tumor. The overproduction is either caused by an Adrenal Gland Tumor or is Pituitary Dependent. Luckily he doesn’t have an Adrenal Gland Tumor (but he does now have a bald tummy from the ultrasound).

As the weeks were going on we could actually see him aging before our eyes. He was getting depressed and just didn’t have the Rocky spark.
We headed off to Montana for our absolute favorite trial and poor Rocky could hardly finish the first series of the Open and passed a bird in the second. He had no energy at all! (Another symptom, exercise intolerance, plus the second antibiotic killed his nose!) We headed home Sunday and had an appointment Monday for a second diagnostic test, a Low Dose Dexamethasone test. This one came back with the same conclusion, so at that point it was confirmed that he has Cushing’s. The second course of antibiotics also cleared up the UTI.

At the recommendation of our vet we put him on Trilostane, 30mg twice a day. The endocrinologists prefer to split the dosage so that they receive one every 12 hours to keep the medication in the dog’s system consistently. After 3 1/2 days of the medication the change in Rocky was absolutely incredible!!!!!!!! He was drinking a normal amount of water and stopped his foraging for food. He reverted back to his normal bright eyed, happy, energetic self. He was bugging us to throw tennis balls and bumpers for him again. Five days into his medication we camped at a Pheasant preserve over a weekend for a club function. We were there with good friends who have Field Bred English Cockers. There were loose pheasants, especially roosters, all over the 340 acres we had access to. Rocky and the adult cockers went for 3 – 4 mile walks through these fields a couple of times a day flushing pheasants and just generally having a great time. Rocky handled all of the exercise like he normally would. The fact that he flushed no less than 4 or 5 pheasants on each run probably helped but he was definitely on the road to getting back to his former self.

The ATCH Stimulation re-test at 14 days came back with normal cortisol levels. We have chosen to keep Rocky on the same dosage with another test scheduled for 90 days. At that point we will decide what level of meds to keep him on.

We also asked our vet for information on nutritional support for Rocky and she referred us to the Tufts University Veterinary Nutritional Consultation program. I highly recommend this program; it is very thorough and extremely educational (is there a link?). http://vet.tufts.edu/nutrition/I was given 6 foods to try with him, the goal being the absolute best nutrition, the most protein, and the largest quantity of food he could have to meet a strict calorie guideline to keep his body condition at about 4/9 on the Body Condition Chart.

We are now about 44 days into his medication and nutritional plan.This past weekend he ran Master Level in three hunt tests, qualifying two of the three days. His desire and run are there where they normally are and as long as he is feeling good, and shows the desire, we will continue to let him run Field Trials and Hunt Tests.

Lighthouse Rock Star

Photo Credit: Photography by Geeb