Hi Franceen,
I'm sorry you're going thru all of this. Believe me, I know just exactly how you're feeling bc I went thru this period w/ Wylie too. It's very overwhelming and confusing.
Yes, I think you're correct in that Tootsy has very likely had Cushings for a long time, given what you've described below. Generalist Vets misdiagnose (or miss completely!) Cushings when it's staring them in the face ALL the time...bc the symptoms can be so vague, unrelated, and diffuse.
As far as going to a specialist - I went to one bc my vet misdiagnosed Wylie for 1.5 yrs, when I *knew* something was wrong. So I finally went to a dermatologist (bc of all Wylie's skin issues) and she suggested we test for Cushings - sure enough, he had that along w/ hypothyroid (many Cushings dogs are also hypothyroid, btw). We then went to the Internist for add'l testing, the ultrasound, and for med titration....once we started to get meds on track - I then went to a new generalist vet for continuing care.
IF your own vet seems well versed and comfortable w/ Cushings, then I don't know if I'd go to a specialist. How do they feel to you w/ their knowledge?
As far as meds, Wylie is on Lysodren/Mitotane, 100mg, Mon Wed Fri - he's never had a single side effect. These are *very* toxic drugs, without a doubt, but they try to give them as low a dose as possible -- not a chemotherapy dose or anything. Wylie's been taking it for almost 8 years now.
I totally understand your fear with the meds...but the upside is that if your kiddo can tolerate the meds, she'll get her old self back - her energy, her liveliness, her healthier body weight, her fur (if she lost fur), she won't pant/wear out as much at all, she won't drink so much. And yes, drinking more (and peeing more) is a cardinal sign of Cushings.
As far as tests, Wylie had a couple ACTH tests and an ultrasound of his adrenal glands to see what they looked like (they looked totally normal, btw, which I think is often the case -- so this test can be a waste of $$$). We also had to send Wylie's blood to the University of Tennessee for even more specialized ACTH tests bc Wylie ended up having Atypical Cushings, which is even more complicated. So mainly, you just want the ACTH test and possibly the ultrasound if you want them to view the adrenals.
Btw..just so you know, it can take up to 1-1.5 yrs to really get the meds properly titrated. You may get lucky and nail the meds from the start. However, it can really take some time bc you start super low w/ the dose, give for 6 weeks, then do another ACTH to see what's happening w/ the cortisol. If you need to change the med at that point, then you give that new dosage for 6 weeks, and then ACTH test again...and so on and so on, until you get it right.
He is not on any special diet for Cushings. I feed all my kiddos raw by Primal or NV or Know Better Pet Food.
I don't know if any of that was very helpful - but just know you'll get her through all of this, and you'll get to her to a better place eventually
! Don't hesitate to ask more questions if you have them...
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