Questions about Cushings - Charlotte has crossed the Bridge

[LaurieS]

It looks like the only thing out of range at all on the blood work is EOS and LYS (?) is low. Everything else is perfect. Not what we normally see with cushings.

The urine concentration is 1.015, yellow clear and it does say WBC occ and cellular debris. Drinking water, etc, did they rule out Urinary Tract Infection?

I don't see anything about a thyroid test on this. So I would want that checked out next, as this can have many of the same symptoms as cushings. Diabetes is ruled out based on this, kidneys and liver are good, so over all she looks to be a healthy dog, just have to figure out what is causing these symptoms.
I'd do a thyroid panel.

and hello and welcome to the forum

They said no UTI. And yes she looks healthy according to this. I think the vets thought we were doggie hypochondriacs! But there is definitely something going on. I asked about thyroid but the 2nd vet said she didn't feel anything when she palpated that area. I know sometimes they can feel swelling but I know that's often not the case in humans so I will ask for them to test for that next. Thanks!

[LaurieS]

Definitely doesn't look like a Cushpup's bloodwork.

Maybe this can help someone in the know:

LYM—immune cell highly responsive to “stress” and potentially increased during chronic infection.

EOS—inflammatory cell associated with parasitic disease, hypersensitivity and allergy

http://www.animalmedicalcenterofchic...ostic-test.pdf

Thanks! Both vets told me there was no indicator of cushings from this bloodwork but she had so many symptoms I wondered if something went wrong with the test. But thyroid problems have some similar symptoms so maybe that's what we are dealing with. That will be next to test for.

Thanks so much to all of you for your input and I will keep you posted.

[LaurieS]

Update on Charlotte... We saw a new vet and had a senior CBC done as well as some abdominal xrays. We are still waiting on the Thyroid test results but her liver enzymes are up and the xrays showed an enlarged liver and a huge bladder. Although they do ultrasound there they don't have a radiologist on staff so they suggested we take her somewhere else for that. This vet felt like Cushings could definitely be a possibility after examining her so I thought about contacting UC Davis (we live about an hour away) to see if they are still conducting the study there. It sounds like if they accept her it could save us a lot of money. We have already spent $1000 and have no answers. She continues to drink a ton of water, she is trembling all the time and very lethargic. We are running low on money to spend on tests so I need to pick and choose carefully. I will post the CBC here tomorrow when I get it in case anyone might have some suggestions.

[LaurieS]

I've been reading posts on here frantically, trying to learn more and make decisions for my girl Charlotte (7-8 year old Boxer, 75 pounds). We have already spent $1000 on tests and still don't feel like we know much. I have another thread I started a few days ago but wanted to ask about my dog's specific symptoms. Here is what we are witnessing:

Excessive water intake with frequent urination
Lethargy
Lack of interest in exercise/playing with our other dog
Trembling/shaking
Ravenous appetite
Slight pot belly
Loss of muscle

In the past week she has been panting and not wanting to wear her sweater even though it's cold but this is something new (she normally ran cold in the winter). I've also noticed her gait has changed, something seems wrong in her hind end. She almost squats and then turns to look at her as if there may be pain. A couple of times it almost looked like she was constipated (which she hasn't been) because she was squatting and walking strangely. She is reluctant to wag her tail which she always has done in the past. She also stretches her back legs a lot which seems odd but there is obviously something going on back there, not sure if that would have anything to do with cushings.

We were not at all confident in the first vet we saw (I posted the bloodwork in my other thread) so I found another vet I feel good about who did a senior CBC, urinalysis and abdominal xrays. I will post results tomorrow as we didn't have all the results tonight but we do know that the xray showed an enlarged liver and the bloodwork showed elevated liver enzymes. We are waiting on urine culture to rule out UTI and also thyroid levels to rule out hypo or hyperthyroidism. We ruled out diabetes. This new vet said she thinks cushings is a possibility but there may be other things going on as well.

I'm just sick because Charlotte is trembling all the time now. We have given her tramadol the past couple of days in case she is having pain but it doesn't seem to stop the shivering/trembling. Is this something you see in cushings dogs?

[tank&kat]

Hi and welcome! I only have a minute but wanted to share some quick thoughts with you. I will do a search for your other thread later today and take a look at the blood work you mentioned.

Shaking/trembling is not a recognized symptom of Cushing's in my textbook. However, I have heard many pet owners describe this as a symptom. The symptoms you did list are all very common signs that point to Cushing's.

I'm happy to hear diabetes has been ruled out. Keep in mind with the thyroid test that cushingoid dogs can sometimes have a transient low T4 result. Here is a general explanation of what that means:

"Sometimes a Cushing's dog may be truly hypothyroid and need to be taking medication for that condition along with the Cushing's medication they are prescribed. But there is also a form of hypothyroidism called "Sick Euthyroid Syndrome" or "non-thyroidal illness" which may actually only be secondary to (caused by) another condition such as Cushings, and this type of hypothyroid condition will often resolve without need for medication once the excessively high cortisol production caused by the Cushing's is lowered and brought under good control." You can read more about it here http://www.k9cushings.com/forum/showthread.php?t=191

It broke my heart when you mentioned she was reluctant to wag her tail. I will never forget seeing my dog wag his tail for the first time in almost a year. This was after a month of being treated with vetoryl. I felt so horrible because I had dismissed this as a sign of him just getting older (he was 15!).

I hope the tests come back negative. I will check back later today or tomorrow.

~Kat

[labblab]

Hello, and here's an overdue welcome from me! You'll see that I've merged your new thread into your original thread so that we can keep Charlotte's medical history and related information all in one place. This way, we won't be repeating ourselves or, even worse, overlooking important info.

I am so sorry that Charlotte is doing so poorly and looking increasingly ill. From the list of symptoms and the new elevations in liver enzymes, I am betting that Cushing's is a very strong possibility and I'll be keeping my fingers crossed that Charlotte makes it into the Davis research study. She really sounds like a perfect candidate to me.

Even if her thyroid testing turns out to be low, this does not mean that Cushing's is not actually the underlying issue. Kat has already explained this well. So regardless of the outcome of the thyroid test, I would additionally want her worked up for Cushing's, and Davis will do a great job of that if she's accepted into their study. It's a pain that it's a holiday week, because that may slow down the communication. But again, I think she sounds like a perfect candidate and I hope you'll hear back quickly. If she's not accepted, though, then we can help you sort through the most efficient testing protocol with your new vet.

I can really sympathize with your worry, though. We were really slow in arriving at a diagnosis for my own Cushpup, even though in retrospect, it seemed clear he'd been advancing with the disease for quite a long time. By the time we determined he did have Cushing's, he looked really, really bad (and also had trembling episodes). I truly thought we were going to lose him, and I could not get that first capsule of medication in his mouth quickly enough! But we did see some rapid improvement right away once treatment was begun.

So please try not to feel too downhearted, and do let us know just as soon as you hear back from Davis.

Marianne

[LaurieS]

Thank you Kat for the good explanation of the thyroid condition and thanks Marianne for merging my two threads so all the info is in one place. This forum is so helpful and although my heart breaks for all the people and their pups that are going through this, it's so great to be able to get help and support from all of you.

I will post the additional results here later today when I get them. my vet suggested we start her on an antioxidant that will support her liver (similar to milk thistle) along with Ursodoil and Baytril. She does not have a fever and her white cell count is good but the vet still thought there could be a minor infection of the liver or gall bladder, or possibly gallstones, causing the liver problems. Thoughts on these medications would be greatly appreciated. I don't know how long it will take to get her into the UC Davis program, if she is even accepted, and I feel like I should be doing something for her in the meantime but don't want to put her on something that could cause more problems.

She slept in bed with me last night because my husband is out of town and she trembled non-stop, I hardly slept. My heart is breaking for her because I don't know if she is in pain and I feel like I should be doing more to help her. I will be taking her to work with me today because she stresses so badly when she is left home alone. She still enjoys socializing with people so maybe this will be good for her.

[tank&kat]

Your welcome. You are doing everything humanly possible to make her feel better. I know what you mean though. My boy used to stare at me as if he was asking me to help him but I didn't know how. Those were the worst times. It gets better. You'll see.

~Kat

[LaurieS]

I didn't get by to pick up a copy of the bloodwork today but I did get an appointment for an exam at UC Davis to see if she will be acceptable for the study. Unfortunately the first available appointment wasn't until December 12th. I hate to wait! So here is my question to all of you who are so knowledgeable about this...

My vet thinks we should go ahead and put her on the Baytril antibiotic along with Ursodoil and the antioxidant to support her liver. Is there any reason I shouldn't go forward with these meds? I'm very cautious about unnecessary meds but then if I can be helping her while we wait to see the vet at Davis I sure want to do anything I can.

[molly muffin]

Did she have sludge in her gallbladder? If so starting on Ursodoil would be helpful. I've seen vet prescribe antibiotic before if they think there is an underlying infection and to be on the precautionary side. So it might be worth a shot since you can't get into UDavis till mid December.

Poor baby. I hope this helps her to feel better. If it were me, I'd probably give it a try.