Hi everyone, I've never posted, but I used to lurk last year when I was figuring everything out for my cat Petra. Certain threads even led me to reach out directly to another member whose cat had Cushing's, so I really appreciate this resource. My beautiful tabby was put to rest at 5 1/2 years old, nearly a year after her Cushing's diagnosis. I wanted to help anyone out in the future who may stumble upon this thread. I'd be happy to respond to any questions and offer whatever support I can. Her Cushing's was the form caused by an adrenal tumor, on the right adrenal gland to be specific. It was around 2cm at the time of her diagnosis, but had grown to 3cm by the time she passed. We first took her to the vet in January of 2019 because she had rapidly gained weight and was excessively drinking and urinating. After a basic blood test, she was first diagnosed with diabetes. We spent that first month attempting to regulate her blood glucose, shuttling her back and forth to the vet weekly for rechecks. Increasing the dosages of insulin seemed to do nothing and we scheduled her to spend a day at the vet for a BG curve. Meanwhile, in mid-February I noticed a fresh wound on her upper back that she likely sustained from grooming. It looked like the classic Cushing's skin tear, though when I took her back to the vet they weren't aware of what it might be and considered that she might have burned herself or that it was a reaction to a too-high dose of insulin. A week later, she had another tear on her arm around the same spot. She also had a bout of diarrhea and needed to be cleaned and, not realizing quite yet how thin her skin was, I scruffed her while putting her in the sink. Doing that caused a pretty significant tear in her skin, and it was at that point that I realized that something was really wrong with her. We were referred to see a specialist in mid-March and they conducted a dexamethasone suppression test to test her cortisol levels, and an ultrasound. They were able to confirm Cushing's due to her adrenal tumor. Her vet and a surgeon discussed the surgery with us and the possible complications and risks involved, especially because of the fact that her tumor was already quite large. The surgery quote was pretty expensive, and we elected to treat her with Trilostane and wait for her insurance period to roll over again the following January while we put some money aside. We knew at this point that Trilostane could possibly not work and that the only cure would be to remove the tumor. She thankfully responded well to Trilostane 10mg, and her skin wounds, which had been open since she sustained them, quickly began to scab over and heal. Curiously, she never grew hair back in the areas where she was shaved while the vets were treating the wounds, but she DID grow hair in the exact places where the wounds healed. From April until October, she did quite well. She lived in a onesie and soft cone that we ordered off of Amazon. She had basic bloodwork and repeat dexamethasone suppression test every 3 months, which showed that her cortisol levels were controlled. We tried to control her difficult diabetes as best as we could, but it was difficult to get her any lower than the 200-300 range, because a higher dosage sometimes made her blood sugar TOO low. I think it all depended on how active the tumor was being. In October she developed a suspected neuropathy in her tail, and she began to attack it. We took her for an ER visit the first time it happened and her bloodwork showed that her potassium and liver values were going bad. She had another ER visit a few weeks later after spending a night unable to eat or drink without vomiting. We started giving her Gabapentin for the tail neuropathy to mixed results. From this point on, it became a delicate balance of keeping her in her small soft cone (for comfort and ability to drink and eat), to switching her to a large hard cone to prevent her from biting herself. She could go weeks at a time without biting herself, and then would suddenly start again. At this point, we decided to consult the surgeon again and plan to have her surgery in January 2020. She had a CT scan at the beginning of December, which showed that the tumor had not metastasized to any other organs, but that it had grown to about 3cm. It was very close to the vena cava, a major artery that made the surgery particularly risky. Her surgeon said that there was a very significant chance that she would die during surgery, and that if she survived she may have needed to spend a week in recovery. We decided not to go forward with surgery and instead try to make her as comfortable as possible while she was still with us. I had made a follow-up appointment with her vet for this past weekend (February) to discuss her future and see if any anti-anxiety medications could be useful for the tail issues, since her bouts did seem to be triggered by environmental stressors, being hungry, etc. I had noticed that her skin began to look red and very thin in the areas where she had previously had wounds months ago. Unfortunately, when I took her out of the carrier case, I noticed she had sustained some pretty massive skin tears on her lower back, most likely from handling her and placing her in the case as I had done many times before. It was clear that the Trilostane had suddenly become less effective. We agreed with the vet that the most humane thing to do at this point would be to put her to sleep, and she died peacefully in our arms that evening. I am always open to discussing anything further or answering any questions to the best of my ability based on my own experiences. To anyone reading this in the future, I will just say - my heart goes out to you for having to deal with this. It's such an awful rare / under-diagnosed disease to see your cat go through. And you are a great person for taking care of your cat as best as you are able to. As you might have heard others say, this disease, specifically the adrenal type, is very difficult to manage with medicine alone. If you have the means to, and if surgery is viable, definitely look into having that done as early as you can. EDIT- I had originally put that she had “ACTH suppression test(s)”, but meant to say “dexamethasone suppression test”. This is the gold standard for diagnosing Cushing’s. She did have an ACTH test prior to this.