Supraglan: Empty Promises, Not Medicine

I came across an especially egregious example of veterinary quackery recently which I wanted to warn people about., a subsidiary of the Canadian company Natural Wellbeing Distribution sells a product call Supraglan, which it advertises as a treatment for Cushing’s disease (hyperadrenocorticism). Cushing’s disease is a serious, chronic disease in which the body produces excessive steroid hormones, which have a variety of deleterious effects on many different body systems. It is usually caused by a benign tumor in the pituitary gland in the brain, which tells the adrenal glands to make too much of their normal steroid products. Some cases are caused by a tumor of the adrenal glands, which is almost always an aggressive, highly malignant cancer. The symptoms of Cushing’s disease can be created by chronic use of steroids given to treat other diseases, but this is a different condition in that if the patient stops getting the drugs then the symptoms will resolve.

The PetWellbeing website offers a brief, and inaccurate, description of the disease and then claims their product:

is gentle yet effective, safe for long-term use without adverse side effects…Supraglan is designed to restore your pet’s quality lifestyle and to increase life expectancy by reducing thirst and regulating elimination (liver/kidney and digestive); balancing blood sugar levels (endocrine); increasing muscle use and ability (anti-inflammatory); protecting against infection (immune); and by promoting a healthy skin and coat (natural herbs)

Of course, to cover their behinds legally, the company includes the Quack Miranda Warning on their page acknowledging that the FDA has not approved the product for what they are selling it for, but this is intended to apply only to products that are making so-called “structure and function” claims, meaningless and unscientific statements that the product “supports” some body system, not that it treats or prevents an actual disease. So the treatment claims are illegal to begin with since the drug is not FDA approved as a treatment for Cushing’s disease.

Unfortunately, even the minimal restraint showed by the actual manufacturer is not found on other web sites promoting this snake oil. One site states, “There are many similarities between the symptoms of Cushing’s Disease and Addison’s Disease in dogs–both considered fatal in canines. There are many rumors in regard to the miraculous healing of the natural supplement Supraglan, reported to cure both diseases.” Addison’s disease is a lack of adrenal steroid hormones produces by destruction of the adrenal glands. It is, essentially, the opposite of Cushing’s disease, and yet Supraglan is reported to cure both! How does it accomplish this miracle? Apparently, it uses, “natural ingredients to decrease the adrenal system in dogs from a completely hyperactive state, the product slows the overproduction of the corticosteroid hormones which have become overloaded in the dog’s system.  Side effects have not been seen yet in the usage of Supraglan.”

So a natural, side-effect free cure for Cushing’s disease and it’s opposite. See any warning signs of quackery yet? So what’s in this miracle elixir?

  • Borage: contains natural precursors of adrenal glands hormones; supports endocrine system functions; helps with detoxification; supports adrenal cortex.   
  • Astragalus: tonic; nutritive; supports liver function; helps maintain immune system.
  • Bistorte: astringent, soothing, anti-inflammatory, has a tonic effect on liver and kidneys.
  • Eleutherococus Senticosus: helps maintain normal hormonal actions (ACTH and cortisone) on adrenal glands; supports the immune system.
  • Wild Yam: natural inflammation management; contains steroidal saponins (dioscin, dioscorin) used as sources of saponins in the preparation of steroid hormones.
  • Licorice: adrenal supporting (contains glycyrrhizin, a compound similar to corticosteroids); immune support; anti-inflammatory.
  • Dandelion: highly nutritious food; supports liver function, digestion and appetite.

Ok, now here’s the tough part. What’s the evidence to support these dramatic claims? You guessed it–reams of testimonials from “satisfied customers” and not one single research study of any kind. Some of the claims for the specific ingredients are found in reference guides to herbal therapy, usually based only on tradition or limited suggestive in vitro or lab animal studies. A search of the usual source, including Pubmed, Cochrane Reviews, even the National Center for Complementary and Alternative Medicine, which is quite friendly to herbal medicine in general, turned up not a single study that lent any support at all to the idea that these ingredients, individually or in combination, are a safe and effective treatment for Cushing’s disease.

I did find a few studies suggesting why some of the ingredients might be a bad idea to use in these patients. Licorice is known to cause pseudohyperaldosteronism, a hormonal imbalance which messes up the levels of sodium in the blood and can cause high blood pressure and even interfere with proper diagnosis of adrenal disease. Wild yams have been thought to increase some steroid hormones, and so have been used as a treatment for menopausal symptoms, but in reality it does not actually increase steroids, and its apparent effects on symptoms was likely due to adulteration of commercial yam products with synthetic hormones

There probably are some in vitro or lab animal studies, maybe even a small human clinical trial or two, that might have some suggestion of some potential effects on the adrenal hormone system. After all, herbs are essentially drugs, though usually unpurified and inadequately standardized and tested, so they likely do have some effect. I would be interested in any such studies any of you are aware of, but I can promise you there is nothing that would justify selling pet owners whose dogs have a serious, life-threatening disease, this concoction with claims that it will cure them or even meaningfully improve their quality of life. Testimonials, tradition, and blind guesswork based on in vitro studies are not sufficient to make such claims or profit from people with sick animal companions.

I expect I will now receive the usual angry comments of the following sort:  “Who do you think you are?! I used it and my dog got better so you’re stupid! You’ve just been bought by Big Pharma to push their toxic drugs!” I have received such comments following previous posts on similar nostrums such as Neoplasene, Yunan-Paiyao, and so on. I don’t expect to be able to head these off, but I will try to save myself some time later and make a few points:

1. For reasons discussed at length here and anywhere critical thinking is respected, anecdotes are not proof, only suggestions of areas to study more formally. A million people are capable of being wrong as easily as one, so if you believe my assessment of this product is incorrect, show me real evidence, not testimonials. The hierarchy of evidence is the best guide to what is real evidence and what isn’t, if there is any doubt.

2. I make my living practicing medicine, and that includes treating Cushing’s disease. This has nothing to do with my objections to this product. If there were proof it worked, I would use it just like I use conventional treatments now. And don’t forget the folks making and selling this have a financial incentive to promote its use the lack of evidence it works that is far greater than any incentive I have to discourage its use. I am motivated by a belief that evidence and the truth serve my patients and clients better than false hope and misleading marketing.

3. I am not closed-minded, dogmatic, and I am happy to change my mind if the evidence warrants it. Being skeptical doesn’t mean disbelieving things automatically. It means withholding judgment until the facts are in. There are almost no facts to base a judgment on here, so the burden of proof is on those making wild claims (and a profit) on the product, not on those of us pointing out there is no good reason to think it works.

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164 Responses to Supraglan: Empty Promises, Not Medicine

  1. cynthia martin says:

    hello , my 10yr old pom has classic cushings symptoms , they do not wax& wane / come & go they stay steady day to day unlike my multiple sclerosis symptoms

    she has gained alot of weight went from 13 pds to 17.9 i was shocked , very weak back end cant walk far , even b4 wt gain ,i have to carry her top potty ect , she has a pot

    belly appearance even b4 the wt gain , she pants constantly with few rest periods

    she drinks bowls full of water several x aday i keep a closed bopwl of water bedside & offer water thru the nite , she has odd hair , lot of graying , she pants , drinks & pee’s excessively , she was trained to go on pads from 6 weeks old did great she refuses to use a pad now must go out side , * word of causion if your pet suddenly starts peeing inside or in places that she dont normally do not scold dog could be a medical problem , like a bladder – uti infection or kidney infection , she has done thios b4 2x in life once because uti infection people its painful & caues frequent urination bladder spasms * ,must be treated asap 2nd time was wen she had a pyometria infected uterus had to have emergencey spay , fyi $ 12oo spay b4 this happens , back to cushings
    she sleeps all the time unless panting , pants thru nite i cant sleep wants to be under the bed instead of with me now very irritable with others ^ other pets , she is miserable & it breaks my heart k9 parents please get pet insurance early on my vet said kizzy wldnt be covered because of genetic diseases ? collapsing trachea & luxating bk patelas knees & she also has severe arthritis head to tail

    she has never jumped or climed on furniture never , i went to a vet for 4yrs & she ignored kizzys symptoms ect opnce i mentioned cushings she said we alreadfy did test i didnt argue but knew we didnt because of the damn cost , ignored her weight she got so bad with breathing & panting ./rinking & us getting no sleep i went to a new vet & he said he felt cushings was most likely the cause oh she does not have diabetes or heart worms , had kenel cough 1 yr ago , he said test cost $ 200 an 8 hour appt
    i said id save up the $ i am on disability due to multiple sclerosis & im a single mother of 4 & 3 k9 kids my mother died 9 months ago today & i inherited her 2 making me # 3 k9 kids i wish id never listen to 1st vet ingnoring every thing even misdiagnoed pyometria 2x out of 3 visits , 1st a resp , 2nd x bladder infec , 3rd time i was waiting at office doors for them to open at 730 am with blood soaked towels under her she was bleeding out they took her straight to surgery out of my arms cost $ 12oo & next day i sat at vets for 8 hours holding her vet said take her home you can take better care of her than we can at this pont , so i did she was 8 1/2 yrs old if diagnosed correctly it wld not of been an emergencey thankfully the bleeding didnt start heavy till 645 am , any how she used to be on metacam for arthritis new vet wants remidel only i preffered the liquid & metacam really worked old vet never did blood work on her , & i had aceamethazine for severe respritory distress from trachea , i only gave her a tiny chipped off piece wen needed new vet dont like that but wen vet is not open & you need it & you dont use much maybe 1x a year for emergencey & you dont have a 1000 for vet er , also she used to get many skin infections cost alot to treat & lots of earinfections till gave grain free food , she dont have many teeth she loves evo small bite crumbles easily so in short i want to try the supraglan because i cant afford the cushings treatment & i think its dangerous , & if you ened up with adisons & had to give steroids steroids cause many problems & cause wt gain so its a horrible place to be too many dog have cushings apparently , i wish youd do a study on it even other sites besides supraglan promote danilion & burdock ect fot tx of cushings ????

    herbs have ben used for centries for illnesses ? & in cases these is it not worth a chance , if you give one of the pharmacurical drugs it could harm your dog or heelp him ? its a gamble with life ?
    i wish supraglan was not $ 45 dollars but 45 is better than 1000 to try & its worth a try rather than her suffering & comteplating having her put down just so she dont suffer no more ? she is not happy rt now , i love her enough to let her go as that will be for me , some x that is our last loving kindness we can give o our k9 fur baby kids we will be with them once again some day ! cynthia martin

  2. My name is Cynthia says:

    I just received the Supraglan on Friday April 20, 2012. I gave my dog who is standard snhauzer 3 years old the recommended dose which was one drop for every 2lbs (1kg) of body weight. I gave him that only one time the Friday and One time the next day which was Saturday. He had seem . to be more active before I gave it to him. That Saturday night he threw up. He threw up two times yesterday and two times today which is Monday. He is now not eating his dog food nor snacks but is drinking plenty of water. He is losing weight rapidly. What suggestions do you have? I need to know asap because I am getting scared and do not want to lose my baby.”
    April 16th My dog was diagnosed with diabetes after taking the suphraglan. He constantly threw up and his blood sugar was high, liver enzymes high and more bodily functions was harmed. I tool him to his regular vet, specialists, and my baby died May, 1, 2012. I am very distraught. can somebody help me please. My baby is gone!!!! These people need to pay for my loss!!!!!! Please Help me Please. Today is May 3, 2012 and I am totally out of it. My heart aches bad! My baby is Gone!!!!

  3. skeptvet says:

    I’m so sorry that you’ve had to experience this loss. While nothing can take away the sadness of losing a beloved companion, there are some groups of people who’ve had similar experiences and who can offer you some understanding and support. Please don’t be hesitant to reach out for the support you need to heal.

    UC Davis Pet Loss Support

    Cornell University pet loss support hotline

    University of Illinois pet loss helpline

    Michigan State University pet loss support hotline

    Tufts University pet loss support hotline

    Washington State University pet loss hotline


    Pet Partners–counselors, groups, websites, memorials, articles
    Pet Loss and Bereavement Directory

    Association for Pet Loss and Bereavement

  4. Luella R. Tonkin says:

    My cocker spaniel is 15 yrs. old. He was diagnosed with Cushings about a year ago. He has undergone expensive surgery to remove 2 anoil tumors. He has all the classic symptoms, i.e. panting, excessive drinking, weakness in his hind leg, sleeps a lot. I started him on Supraglan right after his diagnoses thinking that it could not possibly hurt. I have not noticed any adverse side effects and he is still with us and does not seem to be suffering in general. He even exhibits moments of playful energy. I figure it is worth the $45 about every other month if it helps him at all and does not harm.

  5. skeptvet says:

    if it helps him at all and does not harm.

    Well, that’s the question, i sn’t it? There’s no reason to think it helps, but no studies have been done so no one really knows. And you can find anecdotes from people who think it helped, people who think it did nothing, and people who think it killed their pets. Again, no one really knows since anecdotes like these can be found for every medical therapy every tried. The bottom line is using this product is a roll of the dice, nothing more.

  6. The outrageous claims made by Supraglan and others make my blood boil. These people prey on pet owners, especially those who have recently gotten the dreaded diagnosis and are desperate to find anything but conventional meds to treat. I have written to every one of these companies and asked them if they have anything to support their bogus claims about their products. At least Pet Well Being, manufacturer of Supraglan, was honest with their answer. My question to them was very direct: “Can you please tell me if your company has conducted scientific clinical trials or studies that show by way of acth stimulation test, low dose dexamethasone suppression test and/or urine cortisol:creatinine ratio that supports your claims regarding Supraglan’s efficacy in treating cushing’s?” Their answer: “Unfortunately no scientific tests or trials have been conducted on this product to support the claims you inquired below about. The items we offer on are not drugs or medicines, but rather all natural herbal alternatives. Please be aware that these products are not guaranteed to cure or treat all animals, as each individual animal and their situation’s are different.”
    PetWellbeing Customer Service

    Wouldn’t it be nice if these snake oil companies were honest?

  7. skeptvet says:

    Yes, technically they are not allowed to claim any preventative or treatment benefit without FDA approval, which involves lengthy and expensive scientific evaluation. Since the law allows them to sell their products without evidence so long as they only imply a benefit, and since most people (especially when desperate) are more convinced by testimonials than clinical trials anyway, there is no motivation to test these products fairly. Even saying “these products are not guaranteed to cure or treat all animals” is trechnically against the law since it suggests they treat or cue some, but the FDA really doesn’t have the staff or the interest to enforce such rules. It makes it very difficult for even dedicated pet owners to make truly informed decisions about how best to treat their pets, and it clearly takes advantage of people’s fear and depseration in order to make a profit. A shame.

  8. My name is Cynthia says:

    I talked to to one of the customer service Reps. Diane from pet well being. She blamed everything else that might have killed my dog but the Suphraglan. I cry every day about my Snoopy. My Birthday was this month and I could’nt even celebrate because my heart aches. My best friend is gone in a instant and I still can’t believe it. If anybody else pet die from this product, please contact me so that we can do a class action lawsuit against this quackery company at

  9. v.t. says:

    To ‘My name is Cynthia’,

    I am very sorry about the loss of your Snoopy, my heart truly goes out to you.

    What are your vet’s comments/opinions? (you don’t have to, nor should you, per the circumstances) post that information here or elsewhere on the net), it’s a question to address with your vet. Unfortunately, only a necropsy and/or combined toxicology testing could have given indication that Snoopy died solely from the administration of the Supraglan. While it is a coincidence with timing of the administration with signs of illness, it does not prove that Supraglan was the cause. I’m not saying it wasn’t, I’m saying that these are circumstances where the client and the vet have to decide how far to go to even hint at a correlation (outside laboratory services, expense, etc.). Even then, the results may be inconclusive for Supraglan toxicity, and filing suit would involve presenting some pretty convincing evidence.

    I’m not saying this is right, but it unfortunately is the way it works. That said, if your vet has a strong suspicion or even evidence that Supraglan caused Snoopy’s illness and his death was attributed to that, you and your vet could work together to at least report your findings to the FDA for review. It’s not much, and as Skeptvet has stated on many occasions, the FDA is underfunded and understaffed to address many complaints, companies (especially those under the DSHEA-Act), but it’s at least something consumers can do.

    I just want to point these few things out, because many times, owners assume filing suit is the answer when there are many other things to take into consideration (prior or underlying illness unrelated or untreated, reaction to other medications, etc – this is where your vet can help – and the emotional stress and expense of filing suit is not an easy or quick solution sometimes, especially when other evidence might be found to counter).

    If there were any substantial evidence to prove that Supraglan attributed to illness or death, of course you should investigate how to take action.

    Again, I am deeply sorry about Snoopy, it is never easy losing a special pet.

  10. S. Rose says:

    To: “My name is Cynthia”

    Cynthia, I am sorry for your loss, first of all! But I have to say your story doesn’t jive. You wrote that you received the Supraglan on April 20, 20112 and then wrote your dog was diagnosed with diabetes on April 16, 2012, AFTER taking Supraglan! How could that be? Furthermore, you do not explain why you gave the Supraglan to your dog in the first place. Then you say, “These people need to pay for my loss!!!!!!” which is followed by your next post of wanting people to contact you for a class action lawsuit! What is really going on here? I have a Cairn/Poodle mix and the little guy has Cushings and I am looking for a more natural way to help him. In my search, I came across this page and was fascinated by what the Skeptvet had to say (one has to to really check out as much info as possible before administering anything to their pets). Also, suing will not bring your best friend back! I could NEVER put a monetary value on the love and joy given to me by my dogs!

    Again, I am VERY sorry for your loss but I am skeptical of anyone’s motives when they start mentioning “getting paid”…I hope you focus more on the joy he brought you and the time you shared with Snoopy instead of revenge!

    May God Bless You

  11. Patricia StClair says:

    Hello, all I can do is say that I must disagree with you, Dr. Skeptvet! I have an 11 yr old Basset Hound that I adore, he saved my life! I won’t get into the specifics of that story, but, needless to say, the thought of losing him brings me great distress. Last year he began to lose hair, had rashes, etc. I thought he had allergies and I was able to manage his symptoms. This year he began drinking gallons of water and peeing everywhere. I took him in for blood work and they ruled out any kidney disorder (I was terrified he was in renal failure) and a few other ailments. I couldn’t afford to have him tested for Cushings but he has all the symptoms. Rather than put him thru more testing and/or surgery or put him on the medication currently available thru veterinarians (which has side effects akin to chemotherapy) I decided to go with the natural medications. I ordered Supraglan and gave it to him as directed. After 1 month of use I didn’t see any improvement so I sent it back & they refunded me all my money. A couple days later I got him some Cushex and the first time I gave it to him he started to drink & pee less. Now, I’m not stupid enough to think that the Cushex did that, it had to be the Supraglan! Being a natural product I know it had to build up in his system before it would do anything to help him, I just didn’t wait long enough for it to kick in! Luckily I was able to get another bottle of Supraglan and have since been giving him 2 droppers of it per day. I am happy to say that he has improved 100%!! No more drinking gallons of water, no more sea of pee, and a lot more energy!!! So I beg to differ with you, my dog got the help it promised and I’m glad that I didn’t buy into your theory the first time I read it (before I ordered the Supraglan). I figured, at least I’d try it, it couldn’t hurt and I am sooooo glad I did!!!
    Being a veterinarian I would hope that you wouldn’t crush the hope of the owners of dogs with Cushings and say, “It may help your dog and I hope it does”! It sure helped mine so it’s possible, and, if not, they’re great about giving your money back!! So, please, bury your pride and curb your ego because you are wrong!!!

  12. skeptvet says:

    As always, I’m glad your personal experience has been a good one, but that says nothing about whether or not the product works. Thousands of individuals swore by the benefit they had received from bloodletting, ritual sacrifice, leeches, and plenty of other medical treatments that we now know or useless or even harmful.

    I always find it odd that people think defering to science rather than accepting the value of my own experience is a sign of arrogance. Humility means acknowledging our limitations. I know that my personal experiences can’t tell me with certainty what is true or false and that I need formal scientific research to help compensate for my own limitations. you seem to think you don’t because your own experience is proof enough. yet you don’t see the irony in accusing me of being driven by ego?! Strange…

  13. Patricia StClair says:

    You have a wonderful way with words, sir, very impressive, and a bit twisted. You’re right, I am going by my own experience, I do not need so-called experts to tell me what to do. And thank goodness those who came before us learned by their own experience or you would have no ‘scientific proof’ to try to force others to believe you. Isn’t it odd that with all the science & technology out there, telling us what to do to get fixed (especially regarding medications), and taking all that time to get a medication approved with the FDA, and, yet, every time I turn of the TV or LT I see blurbs about, “If you took _______for whatever, please be aware the drug _______has been linked to heart failure & death”. Just a made up version of what is seen & heard constantly, stemming from ‘proven’ scientific evidence that now says “don’t take this medication because it can hurt you”! But at one time said, “take it, it will cure your problem”! So much for trusting science over experience!!
    So I will take my good, proven experience over your “scientific proof” every time! You can call that “Strange” if you want, I call it smart! And if you aren’t a big enough man to say, “yes, this natural substance may work for your pet, I was too hasty in my judgement, good luck!” then your heart isn’t nearly as big as your head!!

    Sincerely, Very Proud to be ‘Strange”

  14. skeptvet says:

    Yes, thank goodness those who came before us learned by their own experience that bloodletting and mercury and electroshock therapy and ritual sacrifice were effective ways to treat disease, and that they didn’t need any scientific evidence to support their beliefs. If you can claim to be proud of self-righteously preferring your own experience of scientific evidence despite the evidence of history and still call others arrogant for accepting the limitations of individual human judgment, you have a truly strange way of looking at things indeed. Sadly, it’s the same view that has always supported superstition and blind faith in oneself over reason, and the suffering such a view causes will undoubtedly always be with us.

    “Nothing is worse than active ignorance… Nothing hurts a new truth more than an old error… Everyone hears only what he understands… The phrases men are accustomed to repeat incessantly, end by becoming convictions and ossify the organs of intelligence… We know accurately only when we know little. With knowledge doubt increases”

    Johann Wolfgang von Goethe

  15. v.t. says:

    Patricia StClair , it really is sad that you believe whatever nonsense is before you, but rather than choose to evaluate what evidence there may or may not be, you choose instead to attack someone who has a bigger heart than you could ever hope to imagine. That someone also has a bigger arsenal of evidence than your so-called anecdotes.

    Even more sad, is that your dog can’t speak and tell you that what you’re doing is doing nothing effective for him.

  16. Tanja says:

    Good to read a current review from someone who has utilized both of the competing natural Cushings therapies. I have a 13yr old male cocker who has a diminished response to his trilostane therapy. After over 15mos of differing dosage amounts I have yet to see an alleviation in his symptoms, frequent drinking and urination, restless circling/pacing and increasing hind quarter weakness. I am considering these options as the “traditional” route is more costly, less certain with irreversible side effects. I was only hoping to understand the main differences in natural therapies to make sure the one I chose wouold be the most effective choice. I want a happy, comfortable dog and am hoping to find a good alternative to the trilostane, meloxicam, and pain killers he’s been bombarded with without great results.

  17. Dianne says:

    I have a 10 year old Shih Tzu a beautiful dog who has never in his lifetime done anything wrong. It was suggested that he has Cushings by our Vet.
    I say suggested because she would not commit without several 100 dollars of tests.
    Since we have already had $500 plus in blood tests plus surgery charges. This is a result of a miss DX of dental problems and a need for a tooth to be pulled. As it turns out the abscess on the dog’s cheek was the result of a fox tail in his cheek. The vet discovered this after the dog was asleep in the surgery. Needless to say, I no longer had the funds to pay for additional lab. The vet also said it could be hypothyroid but would have to test for that too. But can’t treat for hypothyroid without knowing for sure about the cushings So I would need to have the cushings tests done to rule that out before they can treat for hypothyroid if in fact he has that.
    Pepsi, appeared to be gaining weight and drink large amounts of water last January. I noticed his belly was getting bigger and he was loosing hair. He could no longer climb the stairs. His skin was flaking off and seemed to be turning white. Actually I think it just looked white because of his thinning hair. Sometimes at night he was leaking urine as he slept.
    When the Vet suggested Cushings, we searched online for any information we could discover. There is not a lot of help but many people in the same boat so to speak.
    We started to give the dog different combinations of herbs and vitamins. I purchased a product called Cushex from the net. We gave milk thistle but have now changed it to Sam-E.
    It has been since March that we have been treating him for the cushings.
    The lab work done a month ago, before the so called “tooth extraction” showed no visible difference in his liver function tests. So I felt like I had wasted months on a treatment that didn’t work. Since then I have switched to Sam-E.
    I do not feel the Cushex drops made any difference at all. Except for stomach distress, gas etc.
    The Sam-E has been given with food which is said to lower the effectiveness but it appears his stomach is getting smaller. So perhaps the Sam-E is helping with the liver distention.
    So to sum it all up. There is nothing you can do for Cushings that does not cost a fortune. The medical route calls for many dollars in repeated blood tests and drugs that can harm your dog. This may or may not prolong his life.
    The herbal route is also a crap shoot with or without results. False hopes and disappointment when they don’t work. So, It’s a personal decision as to how long you as a pet owner can manage the disease.
    I want to know the cause. How come no one has asked “what caused this”.
    We fed those Chinese jerky strips because the dogs loved them. We also had a mini Schnauzer. He died of liver failure. Maybe we should have suspected the jerky strips sooner.

  18. skeptvet says:

    Your situation is an example of the real difficulties people face whent heir pets develop serious and complicated diseases. There is inevitably a lot of uncertainty, and a lot of expense involved. I don’t have the solution to that problem, unfortunately. My purpose in talking about products like Supraglan is only to point out that they don’t have the solution either, but they will claim to and take your money without good evidence that it will help and not hurt your dog.

    As far as the cause of Cushing’s disease, it is well understood how it happens: a tumor arises either in the pituitary gland or an adrenal gland that produces extra hormone and doesn’t respond to the normal mechanisms that should control levels of steroids in the body. Obviously, the details are far more involved, but the basic cause isn’t in question. And why some individuals get these tumors and others don’t is a complicated combination of factors involving genetics and environment, which means we cannot as of yet control or predict very accurately if a particular pet will do so. Again, this is a frustrating reality, but not a justification for people claiming they have the answer and can effectively prevent or treat this awful disease without providing any proof other than their opinion, anecdotes and testimonials, and other unreliable support for such claims.

    It would be a much better world if everyone could afford the diagnostic tests and the treatments we do have evidence to support, but sadly this is not possible for everyone. I fully understand why people in your position are driven to try unlikely and unproven remedies, I just wish it weren’t the case since I don’t see any good reason to believe the hope they are offering is real. I hope you find a way to get the care your pet needs or that you are lucky in your “crap shoot.”

  19. LM says:

    I’m a vet tech of 15+ years and have become increasingly more interested in homeopathy in the past few years after becoming of the opinion that there are sometimes better ways than conventional medicine, too. I want to do the very best for my dogs, and I have access to whatever I need. That being the case, I have decided to treat my 12 YO English Springer’s Cushings naturally, through better nutrition and yes, I am using the Supraglan. I am working toward going grain free with all my dogs (but boy is it expensive!), I also feed Springtime Joint Health, Fresh Factors and Spirulina to this old gal, and the Supraglan. Adding the Springtime products did make a big difference in energy levels and activity, but I do have to say – the shaking hind legs, the excessive drinking, the having to go out every other hour, it all stopped after a week on the Supraglan. The pot belly has disappeared as well. The panting is up and down, but mostly it’s greatly improved.

    So, for whatever it’s worth, for THIS dog, thus far I am pleased with the Supraglan, but I also look at it from the point of view that an herbal treatment might not work for every pet, and a lot has to do with other things you are doing as well. I’m sure the Springtime products are helping some, although the Cushings symptoms did not dissipate until adding Supraglan. I did not want to do too much at once, wanted to see if I did get results, but it’s been 5 months at this point so I am about to add Flax oil and milk thistle as well. So far, so good.

    I suppose my main reason for posting in here having come across this thread is simply to provide one of those ‘testimonials’, though I also don’t expect miracles. As I said, it’s working for us right now – I think in the end it’s a pet owner’s choice as long as they are fully educated on the choices and understand the ups and downs. Actually, too, I wish I could find it but in the research that I did, I did come across a rather extensive paper on treating Cushings homeopathically, but of course I can’t find it now to link here. If I find it in the future I’ll try and remember to link it.

    Anyway, I like your blog a lot. I don’t personally agree with some of your opinions, professionally, but I like the fact that you do present the facts and give people things to think about, and you point out when there is no actual basis behind certain things such as some homeopathic remedies. I don’t feel as though you necessarily discourage homeopathy as much as you just want to encourage good medicine – whatever that may be. As far as homeopathy is concerned though, I think a lot of the reason why results vary so much is because of the fact that every patient is, indeed, different and reacts different ways. There is still piles of proof, however, that the Chinese herbalists practiced much better medicine than we do today, even with synthetic drugs. I agree that we do not have a good enough grasp on the how and why of these remedies, but feel very strongly that they should not be considered quackery, especially when they work for some.

    Thank you. 🙂

  20. v.t. says:

    LM, please provide proof that homeopathy works and why it shouldn’t be considered quackery.

    That’s a pretty big claim you made that chinese herbalists practiced much better medicine than we do today. Got proof for that as well?

  21. fluidtherapy says:

    LM may better appreciate the realities of TCM by partaking of a recent entry over at SBM, replete with a litany of references:

  22. v.t. says:

    Not to mention the continuing use of animal parts from critically endangered and threatened animal species, reduced habitats, poaching, and illegal trade market. All in the name of “medicine” that is not real medicine at all but rather a culture.

  23. ForJigs says:

    My dog Jigs is about 8-9 yrs old – Retriever Mix. He has been diabetic for about a year. That was under control until a couple months ago when he was diagnosed with Cushing’s. His blood sugar was going way high and I had to keep increasing his insulin. He of course was always hungry with diabetes but he became even more so along with drinking a lot more water.

    I had another mixed breed (husky/shep) with Cushings 10 yrs ago. That dog I went the traditional meds with. She had liver failure within a few months and was very ill from the meds. To me it appeared those meds killed her but it is most likely she also had liver cancer.

    So I didn’t want to put this dog Jigs through that terrible med treatment if I didn’t have to. Not to mention the treatment is a fortune. I began Supraglan 3 weeks ago (there is a new formula now Adrenal Harmony Gold). Within 2 weeks Jigs was lasting 2 hours vs. 1 hour during the night without waking me to have to urinate. He no longer urinated right in front of me after eating… there were no more accidents at any time if I didn’t wake up the split second he whined at night. He is drinking far less water than he was before. It’s been over 4 weeks and he is about the same however, the biggest change now is that his blood sugar has drastically dropped down to where it was prior to diagnosis. This could also be why he is drinking less water.

    Now I have just started the new formula so it’s too early to tell if it’s going to be better or not. I am still hopeful that this treatment will get all of his symptoms in check. I should also mention that although his coat was dry and flaky prior to his diagnosis, it is now the most soft, shiny and healthy looking than it’s EVER been. He also does not lack energy what-so-ever – a retriever still wanting to retrieve without end.

    So I’m sticking with it.

  24. Cynthia says:

    It is November 8, 2012 and I am still grieving over my Snoopy. I would never put a price on my beloved friend . My message was to whomever made that statement and to anyone who’s dogs have died from this product to file a class action lawsuit. My vet said that my dog had cushings disease. He he urinated a lot and drank plenty of water and began to drag his back left leg. He was still eating good on a reqular basis. After I gave him the Surpraglan, he immediately started throwing up and never stopped. I took him to his vet and his veterinarian said said that he was dehydrated from the throwing Up!!!! I left him there over night to get fluids . I went back and picked him up the next day, he had stopped eating but still wanted water. My vet ran tests again on him and all of his vital signs of his organs was messed up from the Surpraglan!!!! I am no fool lady whomever trying to justify this killer product. I can’t bring my bestfriend back but I can try to help save more pets lives from this crap!!!! I miss My Snoopy!!!! Do you Understand???? S.Rose???? Patricia S. Clair . You could be part owner in this crap and trying to justify this crap to make more money. Everybody who have ownership in this product probably posted a good post about the product pretending to be a pet owner who purchased the product for their pet. I work for a congress person here in Texas. If I want to proceed further I would. I am still grieving over my best friend. It is not a threat it is a promise! This crap is not FDA approved and should be removed until done so. Thanks for all of those who symphathize with me. It is never about the money its about my pet is dead. Thats almost the same as if a doctor malpractice on a human. So lets see who is really about the money? My dog is dead and you are still selling this shtt to other pet owners making money. Like someone stated in the other post , it is a roll of a dice. My dog lost his life and I lost my best friend!!!! I will soon put this crap on the news since you all think I am just about money. I want the world to know this crap not no good!!! I don’t need the money. But if anybody else dog perish from this product, we should do a class action lawsuit once again!!!!

  25. Rose says:

    First of all, thank you for your message. I just wish I had seen this before purchasing twice the product from Pet Well Being. Unfortunately, I only discovered it is a scam when I tried to purchase more and it is no longer available and they are now offering something new with over 200 reviews. My question is how do they have 200 reviews if they only started selling it? I researched the ingredients and even made up my own and I thought it couldn’t hurt. The fact they stopped selling it tells me something and I feel they at least need to advise all the hundreds of people who purchased it why they stopped selling it.
    Also, what would you recommend instead? Very upet with Pet Well Being. I sent them a message asking these same questions and they have not responded. I guess I shouldn’t be surprised but if they were on the up and up, then they would at least have something to say.
    This has turned me into a skeptic!

  26. Rose says:

    After accusing Pet Wellbeing of caring about money more than animals, I received a response to one of my inquiries about Supraglan. They claim they just renamed the product. Why then when you go to Supraglan does it say no longer available? Also, their “new” product has different ingredients! They won’t address that or mention why Supraglan was discontinued. I don’t know about anyone else, but I don’t plan on doing business with them until they can explain that and then I just am very skeptical!

  27. skeptvet says:

    I agree that his looks like more than just a rebranding. The ingredient list is significantly different for the new product. I will look into the claims and the evidence for the new product as well.

    But clearly, if Supraglan did all the miraculous things that the company and some owners claimed, it is hard to unerstand why they chose to replace it with something else. It also is a reason to be even more suspicious of the claims and testimonials for the new product.

    My recommendation, as always, is to establish a good relationship with a veterinarian you trust, possibly an internal medicine specialist if one is available in your area, and discuss the risks and benefits of treatment. Anyone who promises miracles with no risks is not telling you the truth.

  28. crazycolleen says:

    It all started when my 14 year old yorkie had to have teeth removed along with a small tumor on his skin. The blood and urinalysis work showed possible Cushing’s Syndrome. Pepsi was showing symptoms of CS that I had been attributing to old age, such as distended belly, urinating all over the house, bony spine, pacing, lethargy, and weakness. It was the losing his fur on parts of his torso along with scabs that pushed me back to the vet to have more tests done. The ACTH test showed that he didn’t have CS but instead indicated Addison’s Disease. The test for AD showed negative. The vet suggested biopsies of the skin to figure out what was going on. It suggested that Pepsi had CD but that he to more tests to confirm it, which cost $600 more. After spending over $2,000 to spend more money that I never had in the first place was not possible. The vet did offer to let me give Pepsi the medications without all of the expensive tests, which was very compassionate of him.

    In the end, I decided that I really didn’t want to put my pet through such a harsh chemical because he has had such severe reactions in the past to other medications, that I just didn’t want to chance losing him, so I decided to try Cushex drops, not expecting any results, but as a last crap shoot. It has only been 2 weeks since I started, and he is back to his playful self, has stopped most of his pacing, and stopped urinating on the furniture. It is too soon to tell if it is a “cure” but I am just happy to have my dog happy and running around and able to jump back up on his chair without hesitation and falling. If there are any more improvements in the future, so much the better.

    I do not need trials to tell me if it is working, but I also would not say it will do the same for every dog, just as the all medications for humans don’t work the same.

  29. skeptvet says:

    And di you notice that the company has now stopped making this wonder drug and replaced it with another that has almost entirely different ingredients? Why exactly would they do that if it worked so well? Or have you considered any of the reasons why such stories don’t actually tell us what works and what doesn’t? (Medical Miracles, Why We’re Often Wrong)

  30. LM says:

    skepvet, in response to your comment dated 1/8/2013, and as an update to my comment dated 8/10/2012, just thought I would update and mention that I, too, was sent the new formula with my last order. Within 5 days of switching off Supraglan to the new version, ALL of my dog’s symptoms returned. I used the new formula for 4 weeks with no improvement. I have since returned the order for a refund since it’s obvious it was not helping. Now we are back to Square 1.

    So, for whatever value this adds, this has been my experience. I want the Supraglan back. Whether or not it will work for all, it works for some, and it was working for my dog.

  31. v.t. says:

    So maybe all those with such glowing testimonials for Supraglan can write the company and ask why they no longer make/sell it (Was it truly non-effective? Was it contaminated? Source ingredients too expensive? Toxic findings?). Funny how so many think it worked, and the company made such persuasive claims, but now that it’s no longer made/sold, the testimonials that the “replacement” isn’t working, …tells all.

  32. crazycolleen says:

    It has been over a 6 weeks since I started giving Pepsi the Cushex drops. Since my last post he still continues to improve. There is fur growing back in the spots where it was completely missing. He still has flaky skin, but no longer has bleeding sores and scabs all over his torso.

    I do not know what was in Supra Glans originally or why they changed it. To add to the ideas of others; could it be they were trying to get better results by changing the formula? Just like any medicine, they don’t work the same for everyone. Or maybe there were too many bad reactions.

    I would caution anyone giving herbs that just because it is natural does not mean that it completely safe, after reading about others having bad reactions, but then again, the medicines to treat Cushing’s Syndrome are not perfect either.

  33. Terrie says:

    So glad I decided to research this company and came across your post. As a desperate dog owner who has tried everything the specialists have suggested without success, I almost fell for their product. I am so confused, sad that I haven’t been able to get my dog’s hormones under control. I don’t know what else to do but to try a holistic very and acupuncture. But will I be wasting more money and previous time? He is not ” suffering” other than increased hunger and excessive drinking (some days). What do I do? He is otherwise a healthy pup and a happy and spoiled one!

  34. skeptvet says:

    The decision whether or not to treat Cushing’s diseases is complex and has to be made for every individual based on their situation. That said, it is ideal to control the disease before it progresses to the point of severe or irreversible harm, so treatment is often in the best interests of the pet. Unfortunately, treatment with made-up remedies like Supraglan or with unproven and unlikely treatments wastes time and money and puts pets at risk without solving the problem. Cushing’s disease is one of those conditions for which a lot of these remedies are available precisely because we don’t have a simple, completely safe, and universally effective conventional treatment. So the desire to grasp at straws is understandable, but it is at least as likely to do harm as good. All I can suggest is that you try to gather as much reliable, scientific information as possible and be as skeptical as you can of anything “too good to be true” or anything that is backed up primarily by stories and personal experiences rather than real research evidence.

    Good luck!

  35. v.t. says:

    Terrie, why do you feel a holistic vet has anything better than a conventional vet has to offer? Likewise, why acupuncture? There is, to my knowledge, no available evidence suggesting any benefit of acupuncture in pets (the evidence for this in humans is very sketchy at best). Acupuncture really only benefits the practitioner and the pet owner, who are basically already conditioned to “believe” it works when there’s no evidence whatsoever that it does anything for the pet.

  36. Loraine says:

    My 13 year old beagle mix has diagnosed Cushing’s. She was on trilostane (Vetoryl), which for a few months helped with all her symptoms, including skin rashes, hair falling out, skin turning black in spots, increased thirst with potbelly. However,within about 2 months her symptoms would reappear and the trilostane dosage would increase. And within another few months, the cycle would repeat with reemergence of symptoms. Besides the enormous cost of all this (which would have been worth it, if she would have been cured!) the low dose dexamethasone test- used to determine the new trilostane dose- would itself cause problems in my little dog, with immediate and severe worsening of symptoms, including panting and lameness which she never showed prior to the test. This continued until the Vetoryl no longer worked without cortisol levels dropping toward Addison’s crisis!
    So I took her off the vetoryl and started melatonin and flaxseed lignans,based on the university of Tennessee study. My pup had immediate relief from all her skin symptoms, including this terrible odor I could never wash away. My dog weighs 45 pounds and the recommended melatonin dose is 6 mg twice daily. I’m always skeptical, and started her instead on 3 mg twice daily which worked fine to address all her symptoms, with no apparent ill effects. Then, her drinking began to increase again (although no more skin problems) and I decided I would try the recommended 6 mg twice daily dose to see if her drinking would decrease. But I could tell she was miserable when I increased the dose- and it didn’t seem to help her drinking even though she wasn’t at this dose for very long- at one point I could actually feel her head pounding, as if she had a terrible headache. I dropped her down to 3mg in the am and 5 mg in the pm and while her drinking was better it was still more than normal.
    So I decided to try the Supraglan I’d read so much about. By then, Supraglan was not available and what I purchased was Adrenal Gold,which did Not work for her. In fact it brought back her skin problems and made her sick. So, I immediately stopped.
    Today she continues on the melatonin 3mg in the am /5mg in the pm which hasn’t cured her, but at least seems to have somewhat stabilized her symptoms. Occasional skin problems are mild and her drinking is still often excessive. By chance, I noticed when I added pumpkin to her diet (which has vitamin B5 which I understand helps to reduce cortisol levels) her drinking seemed to improve, although still far from perfect. Her energy level is good and she does not appear to be in distress, but I do worry about her, especially potential problems with her heart due to fluid overload. I’m not sure what I’ll try next, if anything. I’ve come to the conclusion there’s no perfect cure out there and plenty of potential side effects from anything else I might try.
    Just thought I’d tell my story in case it should help anyone.

  37. fluidtherapy says:

    interesting unsubstantiated anecdote. first, assessment of trilostane dosing per HAC status is not performed via a LDDS test but an ACTH stim test. and there are no side effects. even if it were the LDDS test, the recommended 0.01 mg/kg injection isn’t going to adversely affect the test subject. and, you “took her off the trilostane”? who put her on? and, you could feel her head pounding? on what? and cure? HAC’s not cured, it’s managed. perhaps you should do yourself and your poor canine friend a huge favor and see a veterinarian. or, at least, get your story straight. or, better yet, stop trolling.

  38. Loraine says:

    Replying to Fluid Therapy:
    My dog’s vet, after diagnosing Cushing’s for my dog, put her on trilostane. And, my mistake, it was the ACTH stimulation test that she had done for dosing that caused the side effects that are not supposed to occur. But they did occur. Twice. And events happened as I said,where she was headed towards Addison’s, as evidenced by bloodwork done by my vet, even while her symptoms were not under control
    Then I- not my vet- stopped the vetoryl and put her on melatonin. The dose recommended by the university of tennessee- 6mg twice a day -did cause my dog’s head to pound, which I could feel when I had my hand on her forehead (she looked miserable at that time and I was petting her.) Melatonin in known to cause headaches as a side effect in people. So I decreased the dose and my dog’s cushing’s symptoms are under control. Not cured, but under control. And I no longer feel her head pound.
    I am not trolling. I am simply offering my story to hopefully benefit others.

  39. JN says:

    To LM

    Supraglan is still available. PetWellBeing did not change the formula they have just replaced it with another product, Adrenal Harmony. JN

  40. crazycolleen says:

    It has been almost 4 months since Pepsi started taking Cushex Drops and he is continuing to show signs of improvement. After grooming him and giving him his short summer hair cut I noticed that his belly is almost back to normal and his spine looks much better, half as bony as it was before. He has so much energy now and continually wants to play his games of stealing my socks and have me chase him around the house. He has also quit drinking large amounts of water and peeing all over the house.

    In Pepsi’s case, the Cushex Drops have had a very positive effect. When he was first diagnosed, I thought he did not have much time left and now there is hope that he will have a few more years to be with us.

  41. April says:

    Thank you for providing this forum. As a concerned pet owner, I would like to share my experience with others. In December 2009, my 9-year old Lhasa Apso was diagnosed with Cushings after the required tests. With money being no object for my beloved dogs, I did not feel comfortable with the regimen of drugs which offered no cure. I put him on Cushex drops which has one visible effect–some hair comes back. I later discovered Supraglan & the dog has been on one or the other since then.

    I also give him a 200 m.g. Milk Thistle and one-third of a Sam-e daily. I add yogurt which is supposed to reduce Cortisol, flex seeds powder after reading the University of Tennesse study (would like to hear more from others who tried Melatonin also recommended by the study), whey protein for his weak muscles, a multi-vitamin and fish oil to his diet. He was doing fine till about December last year when he was diagnosed with kidney failure. A month back he started limping in his front leg. I added a glucosamine wafer, which made the limp worse. After 10 days on the wafer, I read the warnings on the label that dogs with metabolic disorders (Cushings) or diabetic should take the product only after consulting with their Vet. Interestingly, it also stated that if lameness worsens to discontinue use. I would never have guessed that glucosamine could be harmful in certain conditions. Curious, I researched this & found that glucosamine affects insulin and dogs with Cushings generally have diabetes and thus the warning. However, my dog does not have diabetes, although he could have developed it since the test in December. Anyway, I discontinued it. He is currently on Tramadol for the limp although there is only slight improvement. Because of his kidneys, I did not want to take chances with Rimadyl.

    So did the Cushex drops & Supraglan help my dog. Frankly, I don’t know. He has lost most of his hair, the pot belly never went away and the hind legs shake from weakness. He now is 12 and a half years & I’ve no way of knowing if he’d have done better with the Vet’s medicines or without the herbal medicine or nothing at all. I still give him the Supraglan drops twice a day cause I don’t know what else to do.

  42. Susan Miller says:

    Thank you so much for this information – it’s just what I needed. If you are monitoring this site, two things: one, my vet said conventional medicine for Cushings can be more toxic than helpful, altho she didn’t recommend herbal rems either. Two, is Cushex any better than Supraglan? At any rate, thanks so much for this posting.

  43. skeptvet says:

    Whether or not to treat Cushing’s disease is a complex decision. Though the medications can have side effects, as any treatment which does anything at all can, the promoters of alternatives dramatically exaggerate how common such effects are. Most dogs treated properly for Cushing’s and monitored appropriately do not have any significant problems with the medications.

    however, Cushing’s disease is usually a very slowly progressive disease, and symptoms can come and go over time. Part of why ineffective nonsense like Cushex and Supraglan can look like they are working is that the symptoms often diminish or go away spontaneously for weeks or months. So it may not always be necessary to treat. However, this is still no reason to subject a pet to untested, probably useless and possibly dangerous snake oil. If it’s worth treating, it’s worth treating with a medication about which we understand the risks and the benefits.

  44. rod says:

    June 13, 2013 ———- Supraglan does work !!!!!! Our ( Redbone Coonhound ) all of a sudden started to have an uncontrollable urine problem . She would urinate while walking across the floor . This went on and on so we took her to the vet . Had all the test and was diagnosed with ” Cushings Disease . With the price this started to cost us I decided to search the Vets on line and found “Supraglan ” . I purchased a bottle and started to give it to her the day I got it in the mail. About a week later the urinating problem stopped . She’s been on it about a year and still has no problems . ( I would definatley recommend it ). Also the only reason I believe that some Vetinarians would disagree with this is because they would be losing ” DOLLARS ” on the cost of the ( extensive and expensive ) treatment of this disease !!!!!!!!!!!! — Our Vet was happy to here that it was working.

  45. rod says:

    Skeptvet , Please tell me what happens to a dog when it’s symptoms get bad enough that a dog owner knows there is something wrong with it that we take it to the Vet and is diagnosed with Cushings Disease . What happens if we do none of the High priced Medications and Expensive Treatments . Does the Disease stop by itself or does it just go away. Do all the physical and visable symptoms stop also. Please explain what happens to the dog if we go this route .

  46. skeptvet says:

    Untreated, Cushing’s Disease will almost never go away on its own. Symptoms will vary in severity, but generally they will worsen over time and eventually be severe enough that the pet’s life will be clearly uncomfortable. Secondary problems, such as infections and diabetes, are also very common in advanced Cushing’s Disease. Unfortunately, one of the main reasons people try nonsense like Supraglan is that they cannot afford appropriate therapy. However, this is unlikely to help and may possibly make things worse, so it’s not the ideal choice.

  47. skeptvet says:

    Anecdotes prove nothing, nor do silly insinuations.

  48. Littlemacc says:

    My dash has been on this produce for a couple of years and is doing great for he is now 15 years old. He has had cushings for about 3 years with all the symptoms until I found supraglan. With in the first month his belly is no longer swelled, no more uncontrolled peeing, no more panting, no more drinking large amount of water. After a couple months on this produce I took him to the vet for a check up, the blood work came back great, The vets advise was I don’t know what you are doing but keep doing it! So with his low fat diet and Supraglan he is a much happier dog and I am a much richer owner, no longer spending thousands at the vet! After two years still no symptoms!

  49. Sarah says:

    For those with concerns about products and customer service, you might want to contact the Better Business Bureau. They have an online list of complaints they’ve received and assisted in resolving to the extent that they are able.

    Here’s the information about the company as stated by the BBB:
    Natural Wellbeing Distribution (Headquarters)
    (800) 536-9353
    438 Westridge Pkwy Bldg 100
    McDonough, GA 30253-3002

  50. gene tinelli says:

    I have a 12 yo Shep/Rott mix who’s had Cushing’s Disease for about a year. Rather than the two very expensive and potentially problematic recommended medications with the risk of producing Addison’s disease or lower her cortisol so much that her arthritis becomes very painful, I followed the basic U. of Tennessee Vet School recommendations of ketoconizol 200 mg 2x/day, melatonin 3 mg 2x/day, and flax lignans 2x/day to gently lower her cortisol so she wasn’t symptomatic either for Cushing’s or chronic pain. My vet agreed with this and added one aspirin 81 mg/day and benazepril 20 mg/day (blood pressure control). I switched her to wet food and 80% ground beef from Blue Mt. dry food (a switch she loved) and added squashed pumpkin (not the pumpkin pie mix) and Crananidin 2x/day to control urinary tract infections (which were common prior to the Crananidin and have not occurred since). I also have her 0n gabapentin for better pain control with an occasional Tramodol if she looks like she’s hurting (2-4x/month). All of this is far less expensive than the major meds and she is doing well, walking with me and our lab daily and, when not sleeping, playing like a puppy again. So long as she remains functional and able to enjoy her life, I don’t have to euthanize her and she remains my cuddly friend.

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