Meet Phoebe 

Phoebe is a 68lb, 7 1/2 year old, spayed female Doberman.  Her owners adopted her from a Doberman rescue organization in Idaho.  Her ears had been cropped too short, she showed signs of possibly being abused and may have been used as a “breeder.”  Phoebe was under 50 lbs and very scared when she arrived at her new home.  She seems to have adapted well to her relocation to Bainbridge Island.

After about 18 months in her new home, her folks noticed that she had started to drink more water, her urine was more dilute and she seemed to have a problem with her hair coat.  She had two incidents of wetting in the house, but was still quite active.  Her folks suspected something was not quite right.

Phoebe first came to CAWC in January ’07.  The concerns above had been previously diagnosed as “Cushing’s Disease”, but her folks wanted more information. Cushing's disease results from an overproduction of the hormone cortisol. Cortisol is produced by the adrenal glands (located next to the kidneys) which are stimulated to produce cortisol by the pituitary gland (at the base of the brain). Disease may be due to overproduction in the adrenal glands by themselves or overstimulation of the adrenal glands by the pituitary gland.

Signs associated with Cushing's disease may include increased thirst and urination, a voracious appetite, an enlarged sagging belly, hair loss, lethargy/weakness, panting and sometimes recurrent infections. Without treatment most dogs will die within one or two years. With treatment your pet's life can be prolonged, at times to a normal life span. Treatment consists of medication to control the overproduction of cortisol by the adrenal gland.

Dr. Lisa examined Phoebe.  In addition to the symptoms of Cushing’s, Phoebe also had a small mass inside her mouth.  Dr. Lisa and Phoebe’s folks discussed the diagnosis and treatment of Cushing’s disease, inherited conditions of Dobermans and concerns with growths in the mouth.  Once they had all elements of the big picture identified, they began to develop a plan specific to Phoebe.

Phoebe wasn’t showing signs of being significantly affected by the Cushings, so it was decided that the mass in her mouth was the priority concern.  Dobermans are predisposed to heart disease so Dr. Lisa suggested an ECG in addition to bloodwork prior to undergoing anesthesia to remove the mass.

Phoebe getting blood pressure taken.

Phoebe’s bloodwork showed elevated liver enzymes and her ECG showed abnormalities that could be indicative of early heart disease or high blood pressure.  Both elevated liver enzymes and high blood pressure can be caused by Cushing’s disease and since Dobermans are predisposed to heart problems, Dr. Lisa recommended taking Phoebe’s blood pressure to help further isolate what was causing what.   Sure enough, her blood pressure was elevated.

Phoebe went under anesthesia to have the mass removed.  Dr. Lisa developed a protocol that considered all of her “issues” and the nurses monitored her very closely.  Phoebe did great!  The mass was removed and later determined to be malignant, so it was a good call to prioritize that piece of her health care.

Team Phoebe also decided that even though she wasn’t showing significant signs of being affected by the Cushing’s disease, the disease was causing her to be hypertensive and it would be best to begin treatment.  The treatment they decided on was to use high doses of Lysodren to supress her adrenal glands from producing excess cortisone.  The treatment required that her folks carefully monitor her food and water intake for subtle changes that would indicate to Dr. Lisa that it was time to lower the dose of medication.  Phoebe’s folks were very in tune with Phoebe’s habits and were able to accurately get the information for Dr. Lisa that she needed.

By early March, Phoebe’s Cushings was in remission and her blood pressure had returned to normal.  She is able to be maintained by a medication regime that only requires two pills weekly.  Her dad says that she is an active, well-behaved, gentle Doberman who shows all the signs of a normal, healthy canine citizen.  She enjoys daily walks and car rides.  She loves tidbits form the “Toast Lady” and her family is looking forward to years of love and affection.

In May, Phoebe gave us all a scare by coming down with severe pneumonia.  Dr. Lisa was concerned that there might be some relationship between the pneumonia and the Cushing's disease.  She consulted with specialists who did not feel that the two diseases were related.  Phoebe is currently recovering from the pneumonia.  Now Team Phoebe is trying to determine what affect the pneumonia has had on their progress in managing the Cushings.  

Phoebe’s story illustrates how observant owners working as a team with their veterinarian can manage significant health problems.  It shows the importance of taking the time to get all of the issues (health concerns, cost, time constraints, schedule conflicts, etc) on the table and prioritize them.  Phoebe's folks were very upfront with their concerns.  Dr. Lisa was very upfront with issues of the disease process, treatment and costs.  Together they worked out a plan that meshed Phoebe's best interests with the practical needs of all of her human advocates.

For additional information on the conditions discussed in this article read these articles in the pet info library.
Cushings Disease.
Symptoms of Cushings Disease.
Hypertension.