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Dr. John
Dr. John, Texas Veterinarian
Category: Dog
Satisfied Customers: 11930
Experience:  Over 14 years of clinical veterinary experience
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We have a male westie, he will be 13 years old next month,

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We have a male westie, he will be 13 years old next month, he has been diabetic since 2013 on 10units of insulin twice a day, the curves are always showing high, but the blood test that shows over the month must be ok, as they never seem to say anything has to change. Today he has just been diagnosed with cushings, also he has a problem walking due to his back legs. He is quite poorly, and is breathing out his mouth, and sometimes falls over, today he was trying to be sick but it seems like he didn't have the strength, and I was worried he was choking on his own vomit. My question is, is it worth putting him through cushings treatment, obviously our vet says start the treatment, but I wonder if enough is enough already.

Hello. Thanks for writing in. My name is***** and I would be happy to help you. I am not set up to do phone calls but would be happy to answer any questions you do have online. You are definitely left with a difficult decision. I will just say that there really isn't a right or wrong answer to this question. Deciding whether to treat or euthanize are both exceptable. Here are my thoughts on the matter, though. I would be concerned about what else may be going on. With those symptoms, I would worry about some type of cancer. Before deciding to treat, I would get an abdominal ultrasound and a chest x-ray done to look for potential cancer. If the reason behind the Cushing's is an adrenal tumor, I would probably not treat and decide to euthanize. Adrenal tumors do not respond very well to treatment for Cushing's. Usually surgery to remove the adrenal gland is the best way to go. If it is deemed to be a pituitary gland problem, I would give the medical treatment a chance at least. The weakness and abnormal breathing can be due to the Cushing's and may resolve with treatment. If it doesn't, then the decision to euthanize can always be made. With treatment of Cushing's disease, though, you have to be prepared to spend some money for treating and monitoring. Neither the medication or the blood work monitoring is cheap, and blood work monitoring with ACTH stimulation tests may need to be done every couple of weeks until he is regulated, then every 3-6 months. These two diseases are commonly found together, so management can be achieved, but regulating the diabetes may be harder now with concurrent Cushing's disease. Now, with that being said, the worse off they are, the more difficult it is to get them feeling better. If you feel like he has made a quick decline in health, and it will be a big up hill battle to get him better, then humane euthanasia may be the best thing for him. Please let me know if you have any other questions or concerns. Hope this helps.

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