Dachshund diagnosed and needs advice/thoughts
Hi. I'm new here and need some advice and thoughts from others.
My 10 yr old Dachshund Tucker was diagnosed with cushings last year.
A few years ago his blood work showed high alkp, but the vet never mentioned anything about it.
As time went on the only symptoms Tucker had was excessive hunger. I was always told its because hes a Dachshund. I was even told this by 2 vets after getting another opinion. I didn't buy it because my other Dachshund isnt the same way.
As more time went on his drinking habits increased, but he never had accidents. He was also having weird random body jolts that vets were clueless about. He had ibs issues as well off and on.
Tucker ended up getting sick with a bought of pancreatitis after eating a bunch of box elder bugs after my neighbors cut a tree down. He threw up and had a bunch in it. Test showed his CPK was high. Followup was normal. All other labs were normal except the alkp which was high at 1604 (range 5-131). His weight did drop a few lbs because of it but he went back up to 16 lbs. The followup alkp came back at 1577 (5-131) so it actually dropped.
I saw a vet that was filling in for my normal vet at the time for the followup and mentioned the excessive hunger again and the high alkp. She said I should check for cushings even though my normal vet said if he put 10 dogs next to each other and looked at symptoms he'd pick the other dogs. He was pretty convinced he didnt have cushings because he didnt have the typical symptoms.
We first had a urine cortisol test done which came back high. He came back at 16. The lab range went to 13. Then we had the ACTH stim test done. Cortisol sample 1 came back at 3.5 with the lab range of 1.0-5.0 so normal, however the cortisol sample 2 after the injection came back at 23.5 with the lab range of 8.0-17.0.
He was then diagnosed with cushings.
He was put on 30 mg of Trilostane.
The followup test 2 weeks later showed sample 1 at 2.2 (range 1.0-5.0)
and sample 2 at 4.8 (8.0-17.0)
I was told to keep him on 30 mg and retest in 6 months.
During this time he was always lethargic and just never wanted to do anything. I kept bringing it up, but was always told we wanted him more on the low end of normal. I ended up finding a new vet who charges a lot less for the tests so I took him to the new vet back in May.
She ran a test and that test came back with sample 1 being 1.2 (1.0-5.0) and sample 2 at 2.7 (8.0-17.0)
She lowered his dosage to 10 mg twice a day. The followup test showed sample 1 at 1.8 and sample 2 at 3.5.
She said if I wanted I could try to give him 10 mg once a day or do twice a day and skip every other day to see how he is as far as being more like himself. Her whole thing was peeing accidents which he never had. She said she doesn’t usually put dogs on meds unless they are having accidents.
I tried once a day on the 10 mg, but he did start to have to go outside more often and his water consumption was increasing although he always drinks a lot right before eating not so much during the day. I ended up putting him back on the 10 mg twice a day and he seemed to be doing fine on it....although his hunger issues were still there....so much he would wake me and my wife up almost every night as if he never had food, he was still more like himself and had energy. I did notice his hair was shedding a lot more, but no bald spots and its stopped almost completely. I figured it was the season change.
This past week Tucker somehow injured his left hip to the point he cant put any pressure on it and he cant walk right. I honestly have no idea how it happened. He's had hip issues for while, but one morning he woke up and was wobbling as he walked then it got worse. Thinking it was some kind of spinal issue which he has had in the past we took him to the usual vet and had x rays done. The vet said the x rays didnt show anything other then an old calcified spot on his lower back that wouldnt be causing this and no physical test he did showed any signs of an acl tear, etc.. although when he pulled back on his hip he did yipe. I mentioned if the cushings and his cortisol being to high or to low could cause it. He said no especially with just one side. He also said high cortisol can cause muscle wasting, but he isnt seeing it with him. Nothing else showed in his abdominal area other then a full bladder.
I was told give him carprofen and tramadol. So far no difference.
I had the vet run some blood work thinking he'd run a full panel, but he didnt run a cbc. Just checked his liver/kidneys because he was giving him carprofen.
I was told his labs looked good other then the alkp which he said was from the cushings, but after looking at a copy his BUN is low at 6 (range 7-27)
and his AMYL is 378 (range 500-1500). The vet mentioned nothing about this. His last labs these were both normal. What concerns me is the Trilostane is causing it, but wouldnt his levels be high not low?
He has only been going pee outside twice a day the last few days because of his hip issue. He holds onto it until he cant.
The alkp has also gone higher. I thought when treated for cushions it should come down? Right now its 1912 (23-212). This last test was in house though where as the others were done by Antech so it was sent out.
Sometimes I wonder if he really has cushings and isnt something else, but based on the labs it would say yes. I havent had any tests done as far as ultrasounds or mri's.....I cant afford it. Pretty certain its pituitary though. The ACTH tests alone are breaking me, but I'm doing my best.
I know the medication only helps with the symptoms so could this just all be his cushings is starting to catch up?
Does his acth labs look optimal or to low?
I plan on having another test run soon as soon as I have the full funds since its been 90 days.
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