Hi there,
This is my first post regarding Dani, my 12.5 yr old female dachshund/Chihuahua mix. Dani weighs 19 lbs and her weight has remained consistent. Since mid-March, her thirst has become excessive and consequently she asks to go out more often. She’s also had several accidents in the house, something that she had never done before. And in the last month, her appetite is through the roof, though I am not feeding her more. To my knowledge, the only other sign of Cushing’s (I think) would be a small amount of flaky dandruff appearing on her back. I don’t see any thinning of fur or sores. She is not on any medication, but I do give her glucosamine and fish oil.
I contacted my vet who did a urinalysis and complete blood work up on 4/7/18. Here are the results that are out of range of normal:
ALT 14 U/L (range 18-121)
Platelets 532 K/uL (range 143-448)
Diabetes mellitus has been ruled out, though the vet said that the possibility of diabetes insipidus remains.
As a note, Dani’s creatinine levels (from 4/7/18 and 6/2/17) were 0.8 mg/dL (range 0.5 – 1.5) The note on the labs indicates: “Both SDMA and creatinine are within the reference interval which indicates kidney function is likely good.”
I had read on the forum and elsewhere that a normal creatinine level almost assuredly rules out Cushing’s (I hope I have that information correct).
The vet said that Dani’s urine is very dilute (sp Gravity 1.021) so she suggested doing the ACTH, which was done on 4/23/18. Results:
Pre-ACTH 8.0 ug/dL (range 2-6)
Post-ACTH 20.3 ug/dL (range 6-18)
The IDEXX report indicates that a post-ACTH level of 18-22 would be considered ‘equivocal’.
Because this test was basically inconclusive per the report and because Dani continued to show the symptoms described above, the LDDS was ordered to be done on 4/26/18. Results:
Pre-dex 3.7 ug/dL (range 1.0 – 6.0)
4 hrs post dex <1.0 ug/dL The interpretation lists anything <1 as ‘normal’
8 hrs post dex 1.3 ug/dL Range is 1.0 – 1.5 and is considered ‘inconclusive’
My vet consulted with the internist at the lab who then recommended coming back in 2-4 months for a repeat of the ACTH. If the symptoms get worse, then I should go in at 2 months, if symptoms remain the same, then at 4 months.
Except for the excessive thirst and hunger, I’m not sure if anything so far points to Cushing’s. But something is definitely not right. Aside from what my vet has already suggested about repeating the ACTH, do you have any ideas? Should we consider an ultrasound? My vet is very easy to work with and will consider any ideas or suggestions that I might bring to her. If the symptoms progress/become worse, at what point do I consider seeing a specialist? Are we on the right track with pursuing the follow-up ACTH? My head is spinning with all of this….
Thank you so much for your time,
Becky