Hmmm, I have calacatta marble in my master bath in 12x12s. I'm not really fussing over them but they don't get much traffic. I can say for sure that if I had a smaller format tile, like a mosaic, I'd fuss over the grout more and the tile less. But the large format marble will show etches more than a smaller, busier one. I have been using a large bathroom rug in front of the vanity and one smaller one for stepping out of the shower. The vanity one catches toothpaste, soap drips, etc. The floors look great and we've been using them for a WHOLE two weeks so I don't think pictures will help. My advice is to go for it but I'm the maniac who did a 4 year old's bathroom in limestone including 16x16 floor tile :) Hopefully, you'll get more practical advice from others. I just think a used and abused marble is still beautiful.

Trilostane is very recently available in the US for treatment of Cushings with less side effects than lysodren. Well, except for the very low risk of sudden death. But other than that, it is a reversible non-cytotoxic drug that doesn't carry the risk of making your dog Addisonian like lysodren can. Some vets use trilostane in conjunction with ketoconazole (an anti-fungal drug) to increase the bioavailability of the trilostane and reduce the dose. As far as behavior changes, most dogs don't have that many except the already mentioned increased hunger, thirst, and perhaps panting and lethargy. I've heard a few people say that their dog got aggressive or had other odd personality changes with Cushings in the untreated stage, but that seems rare. Once treated and stable, it seems all those signs go away. As far as pain and quality of life go, I think it depends on how well the disease is being managed. Most seem like happy dogs, unless they go into a Addisonian crisis. Then they are pretty darn miserable until their cortisol levels are fixed. But that is pretty easy to do. If they are accidently made permanently Addisonian, that is treatable too. I guess it would be a big problem if your dog was hard to medicate for some reason, because treating either Cushings or Addisons is usually a lifelong ordeal. Another issue would be if your dog get stressed at the vets or resented frequent blood draws. I think the biggest issue in treating Cushings is the expense and inconvenience to the owner, because the dog must be pilled, monitored at home carefully, and the drug dose must be monitored closely requiring many blood draws and trips to the vet. This isn't a type of disease where you just give some pills for a couple of weeks and it goes away. It's generally life long. So it requires a lot of committment from the owner. But dogs are well worth the effort IMHO. Their quality of life is much improved with treatment.

60mg of what? Three times a day seems like an unusual dose for any Cushings meds. Huge dog? Lysodren, also known as OPDDD or mitotane, is a medication that targets the adrenal gland and is actually toxic for it, slowly killing certain portions of it. If the balance is right, the idea is to kill the cells producing too much cortisone slowly, but not to wipe out then entire adrenal gland (resulting in a somewhat 'opposite' condition known as Addisons). It is a pretty effective drug, and is usually given far less often (not daily long term) than Trilostane is, but should be taken carefully and with close monitoring. However, for huge dogs, it can pretty costly, too, perhaps even more than Trilostane. TRilostane can be compounded and sometimes the compounded forms (depending on which pharmacy one chooses) can be far less costly than Vetaryl (the drug name for this product in the US).

33% of dogs with Cushings disease have concurrent diabetes. The vet did not neccessarily misdiagnose the diabetes or the Cushings. The typical clinical signs of both diseases are very similar. Sometimes there are signs of Cushings in the labwork when the diabetes is diagnosed, but other times not. Usually the Cushings is discovered because the diabetes cannot be controlled with insulin, just like in your son's dog. You don't necessarily need a specialist to diagnose the type of cushings. If the dog is on steroids, that is obvious- just ask your son if he is giving the dog corticosteroids. Remember that topical steroids can be absorbed systemically too. Dogs with allergies are often given steroid shots to control itching, which can lead to Cushings too. That would be a best-case scenario, because once the steroid administration is tapered off, the disease will go away. Then you are just left with diabetes, which will hopefully stop being refractory to insulin. The bloodwork to determine the type of cushings is usually a low dose dexamethasone suppression test +/- a high dose dexamethasone suppression test. It is important to know which type of Cushings the dog has because the treatment is different for each. But any vet who can draw blood twice can send the samples to a lab for analysis. The trick is in the interpretation of the results, which can get complicated. Sometimes it's obviously an adrenal tumor, other times it's obviously a pituitary hyperplasia, and sometimes it's really hard to tell. That's when a specialist might be needed. Or your son's regular vet may want to consult because of the concurrent diabetes. Cushings can get very complicated in both diagnosis and treatment, and adding diabetes to the mix really throws in a monkeywrench. Some specialty places can run a endogenous ACTH assay, which is more clear-cut in the diagnosis of PDH (pituitary dependent hyperadrenocorticism) or AT (adrenal tumor), but that blood sample requires very specialized handling and shipping to a certain lab, so it isn't done often. It's probably expensive too. The concerning note is the blindness. It could be due to glaucoma secondary to diabetes, which can sometimes be reversed. This is pretty common with diabetes. But in rare cases of pituitary carcinoma (bad cancer) which can be a cause of Cushings, sometimes blindness occurs because of tumor interference with the optic tracts. This would be a bad prognostic factor, because 1) there isn't a way to remove a pituitary tumor and 2) that it interferes with the optic tract means it's large already and getting bigger, soon to invade other brain tissue. Hopefully it's just the common glaucoma-related diabetes though. There is a lot to consider, but really nothing is of any help until the type of cushing's is diagnosed. Once you know whether it is pituitary or adrenal dependent, you have a variety of options for treatment, which either the specialist or your son's vet will discuss. There are pros and cons to every treatment option. Cushings can be managed, but it takes a lot of dedication to the testing, treatment, and monitoring from everyone. And it can get expensive, depending on the type of Cushings and which treatment your son opts for. In any case, good luck, and please keep us posted.