A friend of mine just called me, in tears. Her dog (female, spayed, if it makes a difference) has been drinking large amounts of water. She isn't bloated, she seems as "lively" as usual - but she has begun to leak urine when she sleeps.

The urinalysis shows traces of blood.

The Vet said there's a possibility that it's a bladder infection but he doubts that. He is more inclined toward Cushings Disease. I am positive I had a dog with Cushings many years ago. The treatment was very expensive but she lived until the age of 12, 3 years after she was diagnosed. I don't have her Vet records any longer so I can't be sure.

I've looked up everything I can on the Internet. Does anyone have any experience or thoughts?

The Vet said the tests alone will be in the Two Thousand Dollar range and the medication is "very expensive." I have no idea what category "very expensive" is or might be. I can only guess!

The Vet said that the good news is that she isn't bloated but that often "comes later."

Is your friend near any university? I know that the ones where they trian vets usually take in cases like your friends and she may not even have to pay anything. A friend of mine years ago went through cancer with their dog and that is how they were able to keep up.

Cornell would be the place to ask that's closest to you. UConn has a school as well but They're not even close to Cornell.

I did take my dog, with hepatitis, to Cornell years ago. I'll suggest it to her - do you need a Vet referral?

Diagnosing and treating Cushings isn't cheap.

Most clinics start with an ACTH stimluation, which will determine if the issue is either Addisons, or Cushings. The test isn't 100% effective however and sometimes an inconclusive result is given. The test takes about 2 hours.
The more accurate test is a Low Dose Dex test. This test takes about 8 hours. If the result is positive, they will often do a high dose dex test, which again takes 8 hours and determines the origin (pituitary or adrenal). It's not cheap, but I don't think it'd be more than $1000 for all three.

We have many dogs that are cushanoid and not treated, and a lot get along fine, but they do go downhill faster than the ones treated.

Off the top of my head I can't remember exact prices, but here Trilostane or Mitotane (the drugs of choice) for a 20lb(ish) dog is about $130 a month, and there are ACTH stim tests that need to be done regularly (price ranges depending on clinic) to ensure the dosage is correct.

Hi Judy, I'm sorry to hear of your friend's dog's problem.. but it might not be Cushing's disease. My female who is spayed suddenly developed started leaking while she was relaxed and sleeping about 2 years ago. She was behaving normally, not bloated, playful, though she seems to drink more than usual to me. I didn't know what was happening at first, but then I was petting her once while she was asleep I saw the urine leaking out onto the floor. Very concerned I took her to the vet. He thought maybe it was a bladder infection, so we collected some urine and it tested negative. He mentioned that it could possibly be spay incontinence and we could try a couple different medicines for it. Both drugs worked. The one I chose to use is a hormone replacement because it seems to have the least effect on her temperament. The other medication seemed to cause her to be hyper-excitable.

Here is a link that can explain more:

Methods for Handling Spay Incontinence in Dogs - Associated Content - associatedcontent.com (http://www.associatedcontent.com/article/275982/methods_for_handling_spay_incontinence.html?cat=53 )

My dog was not very young I had her spayed. I did not get her until after she had had litter of puppies. I think she was about 3 years old then and I had her spayed right away. Later she developed the leaking. At her worse, she rarely had to squat when she went out because she was leaking just about all her urine while at rest.

She doesn't leak at all anymore and she is as healthy as ever.

The meds are cheap, so it might be worth trying it to see if this can fix the problem.

My previous dog had Cushings, never formally diagnosed - strongly suspected by my vet. I did the 2 hour test, didn't agree to the 8 hour test. He was diagnosed at 12 years old. He had severe arthritis in his neck and shoulders and knee problems. Cushings actually provided him great relief from the daily pain and even from his allergies. Something about cortisol, I'm sure Sariss could explain this. Apache passed away four years later at the age of 16. I believe it improved his quality of life due to the pain relief. The last year and a half he used puppy pads on my long days - but he was always a rock star when it came to "holding it".
I did have to become quite diligent in watching for symptoms. I know he had infections and other issues that were probably related, so we saw the vet frequently. :)

The extra cortisol in the system helps with inflammation and general stress response.

It's not incontinence due to spaying - that was checked out. I've had dogs on hormone therapy.

It's my understanding it's either Cushings or Addisons.

I don't know if it is the same given the blood, but my girl has incontinence.
It is not spay incontinence as her leaking was the whole reason she was spayed!

You friend can ask her vet about the drug propalin, that's what my girl is on. I don't think it can hurt for her to try it.
What Propalin does is helps tighten the muscles around the bladder making it less likely for them to leak when relaxed.

The blood could have been coincidence and she may have had a bladder infection at the time of testing ( wouldn't be too hard to do another urine sample) or it could in fact be cushings... just throwing another idea out there.