Duke Has Cushing’s Disease

After Emma’s Cushing’s Disease, I truly hoped it was something we’d never deal with any of our pets having again.  Unfortunately, that hope hasn’t come true. 

We boarded Duke at his vet’s office when we went to Folly Beach in the fall.  We've always loved boarding the dogs there because the vet is very hands-on.  More often than not, it’s the vet himself walking, feeding, and playing with the dogs.  It’s sort of like a week-long vet visit/observation period for the price of boarding. 

They’re also perfectly fine with you calling to check on your pets, and they usually text us updates and pictures.  When I talked to Dr. M. on the third day, he mentioned that Duke’s water consumption was excessive and that he wanted to do some tests. 

I know that excessive water consumption is a sign of Cushing’s Disease.  It happened with Emma and was really the first symptom we saw.  I should have put it together with Duke, but I didn’t.  My first thought was diabetes.  Dr. M. has lectured us for years about Duke’s weight.  I thought we’d finally have to get strict about Duke’s food. 

After the first round of bloodwork, I knew exactly what Dr. M. was looking for.  The results were similar to Emma’s years ago.

Dr. M. did all of the bloodwork necessary to confirm Cushing’s Disease and was able to diagnose Duke.  He just couldn’t tell us, for sure, if it was the pituitary or adrenal kind.  He’d already referred us to the specialist for imaging.  He was just doing everything possible ahead of time since the appointment was months out.  We were waiting for the specialist, Dr. V., who had treated Emma.  We’d had an extremely bad experience with another vet in the practice (she misdiagnosed Emma and cost us time with our girl; you can guess how I feel about her) and wanted to stick with the vet we knew we liked.  Meanwhile, Dr. M. was in contact with Dr. V. about the test results he was getting and was fairly sure Duke had the adrenal Cushing’s, not the pituitary like Emma had. 

Because of Dr. M.’s diligence, we were able to make Duke’s first appointment with Dr. V. for all of the imaging needed to determine whether the Cushing’s was adrenal or pituitary.  We also knew what our options were likely to be, so we had a little more time to plan.  Dr. V. was great with Duke, and they did all of the CT scans and bloodwork they needed. 

Dr. V. was able to determine immediately that Duke’s Cushing’s is the adrenal kind.  He has a mass on the right adrenal gland.  She told us that from what she could see on the CT scan, Duke was a good candidate for the surgery, but she wanted a radiologist to look at to be sure.  That took a few days.  Dr. V. called with the results and told us that Duke is a good candidate for the surgery to remove the adrenal gland and tumor.  The outlook with treating it with medication instead of surgery isn’t good. 

We talked to Dr. M. (because we always talk to our regular vets), and he agreed that surgery is in Duke’s best interest.  He said it’s a highly specialized surgery, and not one he would perform himself, but one he felt confident in the surgeons at the specialist practice doing.  Dr. V. isn’t a surgeon, so she won’t be the one doing Duke’s surgery. 

Duke was scheduled for surgery on Monday, January 17^th, with Dr. A., the surgeon Dr. M. is familiar with.  Unfortunately, because of all of the snow and ice in western NC and upstate SC, the specialist vet’s office was closed on Monday, and Duke’s surgery was canceled.  He’s now scheduled for surgery on Wednesday, January 26^th, with Dr. S.  

Dr. M isn’t familiar with Dr. S. but says he’s confident in any of the specialized surgeons there who do this kind of surgery.  He also said the surgery needs to happen as soon as possible.

I talked to Dr. S. on the phone three times yesterday, and I liked her.  I had some questions about some problems Duke has been having, and she said that Dr. V. was more qualified to address them since Dr. V. treats diseases.  Dr. S. talked to Dr. V. and called me back within 10 minutes.  Dr. V. and Dr. S. wanted us to get an appointment with Dr. M. for Duke to get checked out and have some bloodwork done.  Getting a call back so quickly was huge.  I feel like that means the vet cares when they communicate and work to get answers.  I also liked that she immediately involved Dr. V. when she thought Dr. V. would be better able to help Duke.  The third call made me like her even more.  She called to make sure Dr. M. was able to see Duke since all of the vet’s offices were behind due to the weather.  If Dr. M. couldn’t fit Duke in, she wanted to make sure they got him in at her office.  Dr. M. was able to see Duke, but I really liked that Dr. S. called to make sure.  I always feel better about a vet who seems to see him as Duke, the three-legged dog who loves to catch birds and rabbits and steals lasagna, not chart #12345.   

Oddly enough, Duke will have to go on steroids for a while after the surgery.  Apparently, the adrenal gland that’s left takes some time to start functioning properly, so dogs who have the surgery go from way too much cortisol (Cushing’s) to none/not enough (Addison’s Disease).  Dr. V. will be the one managing Duke’s medication and aftercare, which is good since we know she’s good and very communicative. 

We’re told that Duke will have to stay in the hospital for a few days.  There’s a risk of blood clots and complications in the first week or so after the surgery, but after that, it’s usually all good.  The specialty clinic is part of an emergency clinic, so they have 24-hour staff. 

Of course, we’re nervous.  Duke’s our boy, we love him, and he has already been through so much. 

The silver lining in all of this is that we have a great regular vet.  Dr. M. was able to get things started to get Duke diagnosed much earlier than he might have been otherwise.  We’re also fortunate to be within a reasonable drive of a specialty practice and that we have a vet we really like there.  I’m also so incredibly grateful that the adrenal Cushing’s  Duke has doesn’t suppress his appetite the way the pituitary Cushing’s did with Emma.  Duke has always been a total pig, stealing food every chance he gets.  It would be devastating to go from that to begging him to eat something, anything, the way we did with Emma. 

Assuming all goes well, Duke should be completely back to normal after he recovers.   We just want him to be healthy and happy.