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Questions for Dr. Shawn - Cushing's Disease

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"Dear Dr. Shawn:
”My 13 ½ year old dalmation was diagnosed with Cushing’s disease last year. He was treated with Lysodren but got sick, and now takes prednisone every day. Current blood tests are normal. Can I give him glucosamine without hurting him, as his arthritis is worsening?”

Answer:
”Cushing’s disease is a common disease of the adrenal glands in older dogs, but usally smaller breeds are more likely to be affected. Lysodren is a potent medication that can treat this problem but care must be taken to prevent side effects like those that have affected your dog. A new drug, Trilostane, can also be used. While a safer alternative to Lysodren, there have been reports of side effects similar to what has happened to your dog. In general, I prefer to treat this disease naturally with supplements before clinical signs appear (there are no conventional medications to treat the disease at this early stage.)

In my practice, only 2 dogs treated naturally at this early stage went on to develop true Cushing’s disease, and both had adrenal cancer. Glucosamine can be safely given to any pet. For severe arthritis I prefer hyaluronic acid (even given with glucosamine,) the active ingredient in Cholodin Flex. Weight loss is also important to reduce stress on the damaged joints. Finally, I would recommend a good adrenal glandular product for your dog in an attempt to wean him off of prednisone.”


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"Dear Dr. Shawn:
”I have an 11 year old maltese-poodle mix. In April he was diagnosed with Cushing’s disease. He has been on Lysodren and it has successfully decreased his excessive thirst and hunger and has also stopped his frequent urination. He is currently on 1 tablet weekly and his blood tests are within normal ranges. I have noticed however that he seems more tired and withdrawn than usual so have decreased him to 3/4 tablets believing it may be the Lysodrene. So far this has not changed his behavior at all. Are there other treatment options for Cushing’s? What can I do with adding supplements to his diet? I should also add that there is something wrong with his knee where he is not applying any pressure and the doctor is not sure if it is a torn cruciate ligament. I have been carrying him up and down stairs to not aggravate his injury. I know that I don’t want to put him on prednisone, and I’m not so sure that he should undergo surgery at his age. In the past, Rimadyl and Deramaxx have given him neurological side effects so he is currently on a baby aspirin for the pain.”

Answer:
”Cushing’s disease is caused when the adrenal glands produce too much steroid, causing the clinical signs your have noted. The chemotherapy drug Lysodren works well for these pets but does have side effects that require careful monitoring. At the dose you’re using I’m doubtful that his lack of energy is related to this drug however. I would certainly have him checked again to make sure the Lysodren dose is not too high or that other problems have not developed.

In my practice I use a variety of herbal products such as Cushing’s formula and Hepatosupport to decrease steroid levels and support the liver (which is usually secondarily involved.) A homeopathic detoxification protocol is also helpful for any pet with a chronic disease such as this. A health maintenance formula is also good to perk up the immune system and relieve stress.
Natural therapies for joint problems such as a torn cruciate ligament are preferred to aspirin or the other NSAIDS you mentioned. Cholodin Flex, NutriFlex, Glycoflex, Zeel, and Traumeel are a few I’ve used with great success.

Personally, I can’t understand why any person or pet with joint problems like arthritis would ever rely on these potent drugs for long term pain relief when natural therapies work as well or better with little or no side effects! Finally, keep in mind that the cruciate injury can certainly be secondary to undiagnosed or improperly treated Cushing’s disease, and may even be the first sign of Cushing’s disease in some dogs. Surgery is really only needed if your dog can’t use the leg at all. I would recommend trying the natural approach first for 1-2 months to see if your dog improves; surgery can be done then if the lameness persists.”

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