# 10yr old dog suddenly thirsty and urinating excessively, looking for ideas...



## MuGGzy

10yr old Pit/Lab mix, never had any health or behavioral issues. People are usually shocked that he is 10-11 years old because he has always been so healthy and energetic.

About 2 months ago, over the span of about 1-2 weeks he started having accidents in the house, I noticed that he had been getting into the toilets (we don't encourage this but they are clean and we don't use chemicals so this has never concerned me) and drinking them down after draining all his water dishes. 

He acts very frantic about getting water and will drink until he is very bloated and can hold no more. Like if we go to a park he runs to the stream or any puddle and drinks until we pull him away. The only real logistical issue here is that we have to take him out to pee every hour or so and I have to limit his water intake in the evenings before we go to bed so he doesn't have accidents or wake me up at night.

This has slowly escalated into various small behavioral issues, he gets into the trash on occasion, when he hasn't done that in YEARS, I assume looking for anything with water or moisture in it.
He seems very restless and any time I move he is RIGHT on my heels, which isn't a problem per se but get's annoying. Sometimes just when at rest he whines or whimpers but otherwise he just sleeps like he always has. He is not sleeping any MORE than in the past and seems to have a normal energy level, always up to run outside with other dogs and generally do "dog stuff".

His diet has not changed, when this started I tried 3-4 different brands and types of very expensive food, like a bag a week to see if it made any difference and nothing changed. He does seem more food aggressive towards other dogs than he has in the past and I presume that is because he is generally grouchy and uncomfortable.

The vet found a minor bladder infection early on and after a series of antibiotics she said the urine was clean. Next visit they x rayed him and checked for tumors etc and couldn't see anything. They did a urine culture for bacteria and found nothing.
They said they found nothing indicating Diabetes in his blood work.

The next thing they want to try is some kind of test for his adrenal glands or some glands that produce cortisone that may be producing too much which makes him thirsty more than normal...

I just can't endlessly throw $$$ at this with no idea or suggestion of what may be going on and it makes us sad to see such a good dog uncomfortable.

I am just posting this here to see if anyone else has had this happen or has any ideas what else it could be?


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## WheatenDaneMom

Might want to have a diabetic screen done.


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## dantero

I would ask them about his kidneys, since it sounds like they ruled out Diabetes. Kidney issues can also cause the drinking/urinating, and discomfort.


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## spotted nikes

CUSHINGS! Excessive thirst, accidents in the house, ravenous appetite, and pot bellied appearance are CLASSIC Cushings signs. Google it.

Left untreated Cushings can cause blindness, heart problems, and immune system problems. Your dog needs to see a vet and be tested for it.


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## MuGGzy

Oh my god... this sounds like him almost exactly except the hair loss.....
Cushings

http://www.peteducation.com/article.cfm?c=2+1597&aid=416

I am caling my vet and asking if that is what they were testing him for... Thank you so much for the lead!


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## spotted nikes

MuGGzy said:


> Oh my god... this sounds like him almost exactly except the hair loss.....
> Cushings
> 
> http://www.peteducation.com/article.cfm?c=2+1597&aid=416
> 
> I am caling my vet and asking if that is what they were testing him for... Thank you so much for the lead!


Good luck. Please update us when you can. Treatment is usually just giving a pill (Lysodren) a day for the rest of their life. I had a dog that was diagnosed with it at age 14 and he lived to be 17. I finally had to have him put down due to spinal degeneration that could no longer be controlled with pain meds. (We couldn't give him steroids due to the Cushings. Steroids make Cushings worse. (Note- The vet did give us some Prednisone pills to have on hand when he first started on the Lysodren. The dosing can take a little adjusting to find the correct dose. He started on it on a Fri, and the vet wanted to make sure that if the dose was too high, then the prednisone would correct it. Being a weekend, he didn't want me to have a problem and not have a vet open. Something to keep in mind, if he is diagnosed, and you start the treatment near a weekend or holiday).


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## MuGGzy

Any idea how expensive that kind of thing is?

My Vet said something like $200 for the test for it, then an initial treatment via medication to sort of kill the adrenal gland, then a different medication for maintenance that he will take every day. Plus periodic check ups to do his blood work and make sure he isn't getting worse or having other issues. 
I just don't want him to have a poor "quality of life" while also going broke.


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## WheatenDaneMom

dantero said:


> I would ask them about his kidneys, since it sounds like they ruled out Diabetes. Kidney issues can also cause the drinking/urinating, and discomfort.


I reread and must have missed that part, good call.


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## spotted nikes

MuGGzy said:


> Any idea how expensive that kind of thing is?
> 
> My Vet said something like $200 for the test for it, then an initial treatment via medication to sort of kill the adrenal gland, then a different medication for maintenance that he will take every day. Plus periodic check ups to do his blood work and make sure he isn't getting worse or having other issues.
> I just don't want him to have a poor "quality of life" while also going broke.


You don't really have to worry too much about the poor quality of life part, really. The symptoms go away very quickly (excessive thirst/peeing, panting, ravenous appetite). They actually have a good quality of life because they go back to being normal. The Lysodren really didn't have any side effects when the correct amount is given.
The monitoring is just initially, as once the dosage is figured out, it's pretty apparent when it is/isn't working.

It can be somewhat costly to start with, but of the old age diseases for a dog to get, the treatment really seems to make the dog "Normal", with no downside, besides a lighter wallet. 

Ask your vet what would be the best way to treat it on a limited budget. Some vets will treat based on their clinical signs, and retest occasionally, but go more by how the dog is doing. Let them know that your budget is limited and ask them what they suggest, knowing that, and them thinking it is Cushings. They usually will try to work with you, regarding number of tests.


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## GottaLuvMutts

Isn't Cushings really common in labs? I thought I remembered reading that somewhere.


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## lulusmom

I agree with Spotted Nikes. Your dog seems to have the major symptoms associated with the disease. I share my life with two dogs with cushing's and I know how expensive it is to get a confirmed diagnosis. The best place to start is a urine cortisol creatinine ratio (UC:CR). It's a simple urine test and you will need to catch a specimen, preferably the first pee of the morning before food and meds. Of course, that may be hard to do if the dog is up all night peeing and drinking. The reasoning behind collecting a specimen at home is that the dog will remain relaxed. Urine specimens are not collected in office because 1) the dog is already nervous about being at the vets and 2) sticking a needle in the abdomen is pretty stressful so a dog will respond by dumping cortisol. This would render the test useless. If the test is within normal range, you can pretty much rule out cushing's but if it is abnormal (high) then additional testing needs to be done. Unfortunately no one test can be relied up to be 100% accurate so additional validating and differentiating tests have to be done. The gold standard in tests is the low dose dexamethasone suppression test (LDDS) so this would be the second test I would opt for if the UC:CR is high. This test can differentiate between the adrenal and pituitary forms of the disease but not always. An abdominal ultrasound would be the third test to validate and give the vet a look at the adrenal glands and surrounding internal organs. 

*Do not restrict water*. Dogs with cushing's lose their ability to concentrate their urine which is why they pee lakes and drink buckets. They do not pee because they are drinking too much. It is the opposite, they drink too much because they are peeing too much. If water is restricted, they can dehydrate quickly and it can become life threatening. 

Cushing's is more common in smaller breeds but bigger breeds like labs and boxers are at the top of the lists of breeds that are over represented. The age of diagnosis is usually over six years old but dogs as young as two have been diagnosed. My own dog, a Pomeranian, was diagnosed at three years old. She is now 10 so that goes to show you that a cushing's diagnosis is not a death sentence. With treatment, a dog can live out their normal life expectancy with a really good quality of life.

Cushing's is not an easy disease to wrap your head around and it's not easy to go through it alone. You can find an amazing support group who are knowledgable and experienced with all forms of cushing's and it's effective treatments at www.k9cushings.com. There is a wealth of information in the resources library and a whole lot of handholders who can you help you understand every aspect of the disease. You will also find ways to save money. Hope to see you there.


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## MuGGzy

TY all!

Currently my fiance is keeping him because she lives on a farm and can let him roam and drink and pee all day long with no issues. I live in an apt and I was being forced to withhold water before I left for work and late in the evening to avoid accidents so having easy access to water and the outdoors should help him until I can get the meds going. 
I have an appt with me vet to get the major Cushings tests done and luckily they take payments so I am feeling better about this whole deal. 
Thanks again for all the feedback and guidance!


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## lulusmom

MuGGzy said:


> Any idea how expensive that kind of thing is?
> 
> My Vet said something like $200 for the test for it, then an initial treatment via medication to sort of kill the adrenal gland, then a different medication for maintenance that he will take every day. Plus periodic check ups to do his blood work and make sure he isn't getting worse or having other issues.
> I just don't want him to have a poor "quality of life" while also going broke.


$200 is a rather low amount for adequate testing. Cushing's is one of the most difficult canine diseases to diagnose which makes it one of the most misdiagnosed diseases. Symptoms play a huge role in a confirmed diagnosis and I believe your dog has some pretty overt symptoms that are usually seen with cushing's so that's one piece of the puzzle that fits. Has your vet done a complete blood chemistry and urinalysis? If a urinalysis was done, did he do a culture? It is difficult to detect infection via a regular urinalysis as the white blood cells will be diluted out, thus the need for culture. According to what I've read, approximately 40% of dogs with cushing's will have a urinary tract infection at the time of diagnosis so you want to make sure that if your dog has a UTI, it is diagnosed and treated.

The medication your vet is referring to is called Lysodren. The story of how it came to be developed is an interesting one. The short version is it is a derivative of DDT that was discovered while scientists were trying to develop biological warfare back in the early 40's. Dogs were used in the experiments and what they discovered at necropsy is that after giving huge daily doses, the only thing that seemed to be effected was the adrenal cortex. When this was released to the public in the late 40's, the medical community was excited because this was very promising human cushing's. Unfortunately, it didn't work that well for humans but it is very effective in dogs so Lysodren is used off label by the veterinary community. 

Dogs treating with Lysodren have to be loaded, meaning you have to pound the adrenal cortex with large twice daily doses until you observe 1) a change in eating habit and/or 2) reduction in water intake. Your vet should provide you with no more than 8 to 10 days worth of pills and having prednisone is not an option, it is a necessity. If no sign of loading after all pills have been administered, you would take your dog in for a blood test (acth stimulation test) to see where cortisol levels are. Once it is within therapeutic range, the dog can go to a weekly maintenance dosing which should be split over at least three days. Lysodren is a serious drug and protocol must be followed by both the vet and pet owner to minimize, and in most cases, eliminate adverse reactions completely. There is published protocol for this which you can find at k9cushings.com. I have loaded my dogs more than a few times over the years and I have a printed copy of the Lysodren loading instructions in my kitchen drawer for ready reference.

There is an equally effective drug that was approved by the FDA a few years ago. It's called Vetoryl (Trilostane) and is manufactured by Dechra, a British company. It is given once or twice daily so in the long run, this drug would probably be more expensive for you. Cushing's is a very graded disease, progressing at a snail's pace, so you have plenty of time to get a confirmed diagnosis as well as research and shop both drugs. FYI, Costco and Walmart have pretty good prices on Lysodren.


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## MuGGzy

Thanks for the replies...

Tests done so far:
Multiple Urine tests
Urine Culture
Adrenal Gland Stimulation for Cushings
Xray of abdomen, all organs looked normal apparently

All reflect no issue but symptoms persist.
A friend that has 5 dogs and has always had dogs says it looks to her like cancer or something, mostly due to the major personality/behavior change. I am worried that he has a brain tumor or something.

The vet wanted to test him for "one type of diabetes" by giving him some drug that works on humans too. She said that if it worked and the symptoms stayed away, it would mean he had a type of diabetes, however if it worked for a few weeks but the symptoms came back, it was cushings, so in effect we were testing for two things at once. She gave me enough pills for 10 days at 3 times a day, a pharmacist friend said it was the same drug they give humans that wet the bed? I don't recall what it is called though.

The bad news is that the pills did not seem to do anything at all. In fact his behavioral issues are increasing. 
He seems to be "hoarding" food, it's really strange, I can put food in his bowl and he will run around and chase the other dogs off of their bowls and eat all of their food, leaving his for last or totally ignoring his own. Overall VERY food aggressive, when he used to be able to pass that "hand in the bowl" thing they do on the Animal Cops show with no problem.

He has begun to destroy things to get at food, like chewing the lids off of "totes" where food is stored. We have to put garbage cans up or he will knock them over, he will tear open bags of cat food. He will also stand on his back legs to try to take food out of the hands of people which is bad. This weekend he even ran down and chased a HORSE away from her grain so that he could eat horse oats!

What concerns me most is that I am beginning to feel a little unsure of him, last night when I was eating dinner he stood and stared at me and actually started barking like he wanted my food after he had eaten a full bowl of his own food. I REALLY don't want my last memories of my dog to be of him "going cujo" on me and going insane or something.

he has become defiant and not listening when I call him or try to put him in the dog run, and this is a dog with formal obedience training that I at one point was going to try agility comp with, he has NEVER NOT obeyed me.

He pants allot when at rest. In the evening when he is resting it sounds like he is either having trouble breathing or is whining softly. His nose is also warm and dry.

If he is uncomfortable and in pain I don't want him to suffer, but I also don't want to just go have him put down and then worry that it was something that we missed and he would have lived years longer with some pills that we just didn't figure out.


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## lulusmom

Please see my comments in blue within the body of your post. 



MuGGzy said:


> Thanks for the replies...
> 
> Tests done so far:
> Multiple Urine tests
> Urine Culture
> Adrenal Gland Stimulation for Cushings
> Xray of abdomen, all organs looked normal apparently
> 
> All reflect no issue but symptoms persist.
> 
> Was one of the urine tests a urine cortisol:creatinine ratio (UC:CR)? As I mentioned in a prior post, a UC:CR is a great initial screening test for cushing's. If results are normal, you can pretty much rule out cushing's but if it is high, then additional testing should be done.
> 
> Was a complete blood chemistry and count done? If so, were there any abnormalities? With cushing's, the common abnormalities are elevated ALKP and mildly elevated ALT. These are both liver enzymes. High cholesterol and triglycerides are also common. T4 thyroid hormone can be low. Was your dog's T4 low? Hypothyroidism can cause huge appetites, bad skin and behavioral changes.
> 
> Was the adrenal gland simulation test you mentioned the ACTH stimulation test? If so, you should know that a good number of dogs, especially ones with an adrenal tumor will yield false negative results. Unfortunately, none of the diagnostics are great which is why you have to do so dang many of them. Did your vet do an Xray or an abdominal ultrasound? To really visualize the adrenal glands and get a good look at the surrounding organs, an abdominal ultrasound is optimum.
> 
> The vet wanted to test him for "one type of diabetes" by giving him some drug that works on humans too. She said that if it worked and the symptoms stayed away, it would mean he had a type of diabetes, however if it worked for a few weeks but the symptoms came back, it was cushings, so in effect we were testing for two things at once. She gave me enough pills for 10 days at 3 times a day, a pharmacist friend said it was the same drug they give humans that wet the bed? I don't recall what it is called though.
> 
> I believe the pills your vet probably gave you were Desmopressin (DDAVP), which is a synthetic replacement for a hormone called vasopressin. The diabetes your vet suspects is not Diabetes Mellitus but rather Diabetes Insipidus. Most dogs with Diabetes Insipidus don't produce enough vasopressin and if given DDAVP, they usually respond quite nicely within a few days.
> 
> He seems to be "hoarding" food, it's really strange, I can put food in his bowl and he will run around and chase the other dogs off of their bowls and eat all of their food, leaving his for last or totally ignoring his own. Overall VERY food aggressive, when he used to be able to pass that "hand in the bowl" thing they do on the Animal Cops show with no problem.
> 
> He has begun to destroy things to get at food, like chewing the lids off of "totes" where food is stored. We have to put garbage cans up or he will knock them over, he will tear open bags of cat food. He will also stand on his back legs to try to take food out of the hands of people which is bad. This weekend he even ran down and chased a HORSE away from her grain so that he could eat horse oats!
> 
> What concerns me most is that I am beginning to feel a little unsure of him, last night when I was eating dinner he stood and stared at me and actually started barking like he wanted my food after he had eaten a full bowl of his own food. I REALLY don't want my last memories of my dog to be of him "going cujo" on me and going insane or something.
> 
> I'm not convinced that your dog doesn't have cushing's and a voracious appetite is the hallmark of all forms of the disease, whether it be typical or atypical. Dogs with typical cushing's produce an excess of cortisol. This adrenal steroid chews through protein like nobody's business which is why a cushdog is always hungry. I called my two Hoovers before they were diagnosed and yes, they become very food aggressive. This is a common thing with cushing's.
> 
> He pants allot when at rest. In the evening when he is resting it sounds like he is either having trouble breathing or is whining softly. His nose is also warm and dry.
> 
> Panting is a common symptom of cushing's. This is caused by redeposition of fat to the thoracic area as well as muscle wasting caused by the catabolic effects of cortisol.
> 
> If he is uncomfortable and in pain I don't want him to suffer, but I also don't want to just go have him put down and then worry that it was something that we missed and he would have lived years longer with some pills that we just didn't figure out.
> 
> Most dogs with cushing's are not in pain. Cortisol is the best anti-inflammatory in the world and in excess dogs with cushings are self medicating their arthritis or other inflammatory conditions. If you've every known anybody with asthma who has taken prednisone for any length of time, they will tell you that they are tired and hungry all the time.
> 
> If you haven't visited www.k9cushings.com yet, please do. Members can help you understand and interpret the various tests and explain the different forms of the disease and why one acth stimulation test cannot be used as the sole basis of a diagnosis or exclusion of a diagnosis. The good news is that Cushing's is not a death sentence so if your dog has cushing's, with effective treatment, you will be witness to an amazing transformation. It's called getting your old, wonderful, asymptomatic, active, loving dog back.


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## MuGGzy

The problem is that I really don't have the money to keep doing tests or start all over again with a different vet... :-( This sucks...


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## lulusmom

I have two cushdogs so I understand how costly it is for diagnostics and ongoing treatment. The most expensive phase is the diagnosis and you already have a good deal of that behind you. You don't necessarily have to start from scratch if you go to another vet or a specialist. I don't know what I would have done without Care Credit. It's basically the same as cash for a year. Have you looked into that?


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## spotted nikes

You should be able to ask your vet for a copy of your dog's records and take them to another vet for a 2nd opinion. They should only charge a standard exam fee, not repeating the tests. 

I honestly think it sounds like cushings.


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## MuGGzy

Sheesh, FINALLY got an answer. According to the second test, it is Cushings, but even then the vet spent more time telling me how 25% of dogs give a false negative on the first test and this second test is only 90% positive etc etc. I GET that it is her "best guess" just like with human docs, sometimes they are not SURE, I am paying them for their experience and their best guess. Anyways, thanks for all the input and kind words!


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## spotted nikes

If you start him on the meds for Cushings, ask your vet if you could have a couple of Prednisone pills, to keep on hand while you are getting the Cushings med dosing figured out. If the dog gets too much Cushings med, and it is at night when no vet is open, Pred is the antidote to an OD of the Cushings med. The vet should be able to tell you what signs to look for in the event of an OD of Cushings med.

If the dog showed OD signs during vet business hrs, you'd want to bring them to the vet, but if it's a weekend/night, the Pred can save his life. But you don't want to give Pred, if there isn't an OD, because Pred will make the Cushings symptoms worse. (Keep this in mind as your dog ages. Many vets will give a steroid to a dog with acute arthritis. You want to avoid steroids with a Cushings dog). Make sure that any vet you ever take him to, knows he has Cushings, and is on meds for it.


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## lulusmom

Unfortunately, no one test used to diagnose cushing's can be relied upon to be 100% accurate. That is why additional validating and differentiating tests must be done and that is also why it is so expensive to get an accurate diagnosis. No vet should ever guess about a dog having cushing's and if your vet actually told you it was guess, you need to find another vet or better yet, an internal medicine specialist. There are only two effective drugs for cushing's and you never, ever want to give them to a dog with normal cortisol levels. Please do check out k9cushings.com. If you do not feel comfortable joining then simply check out the Helpful Resources section and read up on whatever treatment that is ultimately prescribed for your dog. Because these meds are serious, proper treatment dosing and monitoring protocol must be followed in order to minimize adverse reactions.


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## aussiegirl6

My dog had the same thing and her blood work was always normal. Ultrasound of the bladder was normal. However the final diagnoses after I took her to 5 vets over 2 years was cancer. She went into kidney failure from all the meds she was given over the 2 years.How did your dog make out? I am new here and just saw your post when I googled for my own dog. I just put her down last week for the same thing you are posting. My dog was a German shepherd mix I had her for 13 1/2 years. She started with a Chronic rhinitis, a rhinoscopy was negative so they put her on piroxicam which she threw up. Then the UTI's started. 2 years of that and constantly on antibiotics. They were sometimes the wrong antibiotic for the bacteria she had. After 5 vets and almost 3 years of suffering, she began the ravenous thirst and hunger with peeing every hour. The last vet I found was excellent but I only had her for the last 2 months of my babies life. She was diagnosed with degenerative myolopathy and began loosing her footing on the back legs. She refused anymore medicine including her pain pills and her thirst and urination were a sign of kidney failure due to all the meds she had taken. The vet said she had cancer somewhere maybe way down in the ureters, even though an ultrasound of her bladder was negative. She became cachectic, muscle atrophy, and laboured breathing. But to the day before she died, that dog would hobble to the gate to greet me when I got home.


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