Question:

I read in your column about a dog with Cushing's disease. We have a 14-year-old golden retriever with this illness.

His name is Max, he weighs 62 pounds and he's on 60 milligrams of trilostane, which controls his drinking and urinating very well. He has blood work every so often to make sure the dosage is right. He has been on this for the last three years and is doing well.

J.S., Owings, Md Nov 22, 2011

Answer:

There is no simple cure for the all-too-common canine curse of Cushing's disease, which is an overactivity of the vital adrenal glands that most often is caused by a tumor in the region of the brain (the pituitary) that regulates their function. It may also be brought on by prolonged use of steroids for skin problems and other inflammatory conditions.

It is good to hear that the trilostane (Vetoryl) medication is helping your dog. This drug has some harmful side effects when used long-term, so it is advisable to have the veterinarian administer the ACTH stimulation test and adjust the dosage as needed -- ideally toward a lower dose -- in 20- to 30-milligram increments.

Considering your dog's age (which is remarkable for a golden retriever), you should continue with the present dosage, which I presume is correct because you say your veterinarian has been doing "blood work" to ensure the right dosage. Too high a dose can actually destroy the adrenal glands and create a new disease called adrenal insufficiency, which is the opposite of Cushing's.

Question:

I have a 14-year-old spayed mostly Maine coon cat, Molly, who has been suffering some sort of intestinal problem for about three months. It started with diarrhea that came on frequently and unexpectedly. She has never before had a problem with using the litter box, but in this case, she went wherever she happened to be.

I took her to the vet for a complete exam, stool sample and full blood workup. The only minor problem was that her red blood cell count was slightly below normal. She was treated for two weeks with antibiotics and steroids. The diarrhea went away, but within 10 days she began vomiting frequently and, in most cases, the material thrown up looked and smelled like excrement, not vomit.

I took her back to the vet and it was suggested she might have IBS (irritable bowel syndrome). She was put back on steroids and Pepcid was added, as was a tablet that was dissolved in water in a syringe and given to her by mouth to act as a coating agent for her stomach. She seemed better for about two weeks. Then the vomiting resumed and, once again, seemed more like excrement than vomit.

This time I took her to the emergency vet hospital. The vets did another exam, X-rays and another complete blood workup. They suggested that I might want to have an ultrasound done, although they weren't sure it would provide any more information than we already had. And, to be honest, by this time I had spent almost $1,000 and my cat was still in the same shape as when we started. They gave me more Pepcid and prednisone. For another two weeks, no vomiting; then, in the past couple of days, the vomiting has started again, same details.

She has had no change in diet at any point. Although I have offered EVO canned food, she will not touch it. She normally eats Friskies and/or Fancy Feast canned, and EVO dry food is available in a dispenser.

I know that steroids are not good for animals, especially for long-term use, but the vets seem to think that if the steroids calm the inflammation, she can take them forever. Can you offer any suggestions on what the problem might be and what I can do about it that will not harm my cat? She has a bad tooth that needs to come out, but nobody wants to do the dental work until the current situation is resolved.

K.B., Owings, Md Sep 26, 2011

Answer:

You and Molly have my sympathy, as do the veterinarians treating her, because this not-uncommon malady is difficult to diagnose and therefore is not easy to treat.

A food ingredient allergy is most likely, but other factors affecting the gut bacterial population, including genetically modified food ingredients, may also be involved. (For details, see my website.) Although you never changed her diet, remember: Different batches of the same brand may contain different ingredients. EVO was taken over last year by a big company, and concerns about quality and content have been voiced, although I have not yet heard of any problems. Either way, ad-lib feeding from a dry food dispenser is not advisable since cats may overeat and become obese.

Her stinky vomit may indicate a bacterial infection, and the veterinarian might consider treating this as chronic colitis and try sulfasalazine, tylosin or metronidazole.

She probably needs additional supportive treatment for dehydration and may benefit from fish oil, glutamine and probiotics supplements. Catnip or peppermint tea, given to Molly in a dropper, may give some temporary relief. With such treatment, wean her off the prednisone gradually and perk up her appetite with Gerber's chicken, beef and turkey baby-food formulas.

Do let me know how Molly progresses. I always appreciate hearing back from readers whose letters are published.