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Thread: Vet thinks my boy has Cushing's. I'm very worried.

  1. #1
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    Default Vet thinks my boy has Cushing's. I'm very worried.

    Hey folks. Just searching for information and a supportive group to share my concerns with.

    I'm the proud dad of an awesome boxer dog, Kobe (pronounced Kobay). He'll be six in September. I don't know for sure if he has Cushing's but I took him in to a vet with many of the symptoms I'm now reading are common with Cushing's and after some blood work, the vet informed me that he had an elevated marker that along with the symptoms I described could indicate Cushing's. He's now scheduled to go back in 11 days for an all day (8 hour) long test. And not a cheap test at that. :-\

    Needless to say I'm super worried. Like most pet parents my boy and I are very attached to one another, and I don't want to lose him any earlier than a boxer would normally live.

    The most prominent symptom that increasingly got my attention was that he was drinking a lot more. He was always a very thirsty dog, but over the last 2 or 3 months not only I but other family members noticed he was spending a lot more time at his water dish, and often drinking until it was empty and I'd have to refill it for him. That and he was sleeping a lot more and was very low on energy (normally being an energetic dog).

    I chalked it up to the warm weather, his getting older, his paws seeming a bit red & swollen (which I thought might be from walking on hot pavement), and his putting on excess weight from I thought too many snacks and less activity/walks which he stopped wanting to take.

    Then just over a week ago he had an accident in the house. He hadn't had one of those since he was a puppy. I thought I wasn't attentive enough to his wanting to go out. Then he had a 2nd accident, and a 3rd. He failed to inform me he needed to go out, or couldn't hold it for 5 minutes of whining it would normally take for me to notice he needed to go out. This triggered me to think something was definitely amiss. I had a vet appointment for him 2 days later (yesterday). By then he'd had a 4th accident. :-( The rug cleaner is getting a work out. 8

    So other than the blood test with a super high value of something that suggests Cushing's, (oh and the doctor found he had a fungal infection on his paws and infection of his *ahem* penis, which she gave antibiotics for)

    His symptoms have been:

    * Significantly increased thirst.
    * Increased urination. Way more stops while walking, and now accidents in the house.
    * Very lethargic. Not the bouncy energetic pup he'd been even 6 months ago. Rarely will chase ball anymore.
    * No longer likes long walks. Wants to come home right away, or find a shady tree to sleep under.
    * Increased appetite. Used to have to mix in 1/2 a can of wet food into his dry. Now he'll gobble up the dry asap and eat treats he used to turn his nose up at and beg for more.
    * Much more frequent panting, even in comfortable conditions.
    * His svelte boxer physique is mostly gone. i.e. Still has his deep chest, but his belly is lower, less pulled up.
    * He used to be a unstoppable lick machine, to dog and person alike. Now he turns away from human attention & just sniffs other dogs. I'm lucky to get a peck rarely now.

    Otherwise he seems largely content and not particularly distressed.

    So... yeah from what I've read, I'm thinking this sounds almost certainly to be Cushing's. I'm still hopeful it will turn out to be something less serious and temporary, but I expect to be told it's what he has.

    If so, I will be hoping to hear other pet parents experience with this disease, and what my fur baby's prospects are for a long, happy, healthy, and bouncy life.

    Thanks in advance for the support.

    - Glen
    Last edited by FoxFire; 09-11-2018 at 02:59 PM. Reason: Added pronunciation of his name Kobe (Kobay)

  2. #2
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Hello Glen, and welcome to you and Kobe! You’ve done a great job of introducing your sweet boy to us, and yup, I gotta agree that Cushing’s sounds like a definite possibility. I’m guessing that Kobe’s elevated lab value is his ALKP (alkaline phosphatase). This is a marker that results from liver changes associated with high levels of circulating steroids, and it commonly accompanies Cushing’s. If this is the case, it does not mean that Kobe’s liver is damaged such that it is not functioning properly, but it does signal steroidal effects on the composition of the liver. Along with dilute urine from the excessive thirst and urination, it is often the first lab abnormality to be noted with the disease.

    When there is no other known illness present, the 8-hour LDDS is the “gold standard” for detecting Cushing’s, so I think your vet is on exactly the right track with Kobe. In the meantime, I know the temptation might be to start limiting his water intake in the hope that might lessen his accidents, but unfortunately it would be dangerous to do so. He has to be able to drink freely to avoid dehydration. But the good news is that excessive thirst/urination is one of the Cushing’s symptoms that typically resolves the most quickly once effective treatment begins. So if you can hold out a little bit longer, I’m really hoping you’ll soon get an answer and see some improvement.

    Once diagnosed, the two most effective Cushing’s medications are Vetoryl (trilostane) and Lysodren (mitotane). Please do start glancing through our “Resources” forum in order to find helpful info about treatment and monitoring protocols for both of these meds. And also please feel free to continue asking any questions that come to mind! We’re really glad you’ve found us, and we’ll do our very best to assist both you and Kobe in the days ahead.

    Marianne

  3. #3
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Hi Glen and welcome from me too. It does sound like Cushing's is a possibility. Both of my Cushpups had all of those symptoms. I had forgotten about the change in preference for other dogs over humans. When my Lena started hanging out with our other dogs instead of me, I just figured it was because she was with them all day while I was at work. And now with my Gable, he is constantly sniffing the little girls which he never used to do. Gable has had many fungal and bacterial infections. We are fighting some now, possibly from flea bites.

    But he has been on Vetoryl now for almost three months and he looks and acts much better. He has hips, which we haven't seen in a long time and his belly has gone back to a normal shape. He's playing again and doesn't seem so uncomfortable and restless. His drinking has slowed down, he still drinks a lot, but not as frequently. I was filling the water dishes four or five times a day, now only a couple.

    I had my doubts about treating him, but am now happy that I did. I couldn't have done it without the wonderful people on this forum. They know more than my last vet did. I am using one of his associates with Gable who is willing to apply what I have learned here and things are going much better this time around.

    So you have come to the right place if Kobe does indeed have Cushing's. If he doesn't, they can steer you in the right direction for help.
    Joan, mom to my Angel Lena, Angel Gable, Angel Phoenix, Angel Doree, Cooper, Sibble, and now Raina.

  4. #4
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Thanks Marianne and Joan. I'm really glad I found this forum. It helps to know there are others in the same boat (not that anyone wants to be) and I'm not alone with this. It does ease my worries to know that other pet parents are successfully treating their pups that have this condition.

    Marianne, thanks for that advice on water. You must have read my mind, because I was actually wondering if I should cut back on Kobe's water availability so he would be less likely to have accidents. I haven't yet, because I didn't know if that would be okay to do, so it's good to know that I shouldn't do that. I have started putting him outside more often, even if he's not asking to go out, and he's not had an accident in the house since. When he does give me indication he needs to go out, unlike how he used to just walk down the deck stairs to the yard, he'll now bolt to get down to the grass, like he's about to burst, and then pee for a long time.

    Yes, ALKP, that sounds like the blood test I was told was high (unfortunately the paper work they gave me doesn't have his blood test information). The vet said his last blood work several months ago was well within normal on that, and now it's well above normal.

    Joan, I'm happy to hear that Gable is doing better with his medication. That gives me hope that this is indeed manageable if Kobe does in fact have this. I'm sure everyone hopes they will have a health problem free pup, but nevertheless it's good to find out that if they do have something there are treatments available, and they can still live a relatively normal life.

    I'm glad to hear that the excessive drinking / urination does start to subside after treatment. I'm wondering if his bubbly personality will return, where he couldn't get enough of greeting people and playing with other dogs. And of course chasing his ball. I'm sure to some degree it's just his getting older and more mature, but the decline in his perkiness was pretty rapid (over just a few months) so I suspect much of it is due to the illness.

    Thanks again for welcoming me here. I'll keep everyone posted on what Kobe's prognosis is.

  5. #5
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Hi Glen,

    Welcome to you and Kobe from me as well! Marianne and Joan have done a superb job of covering all the bases but I do have a few questions to ask. How much does Kobe weigh? Could you get copies of all test/s that were done on your boy and post those values that are abnormal with the reference ranges and units of measurement..for example ALP 200 U/L (5-50). Besides the antibiotics for the fungal infection, is Kobe taking any other herbs/supplements/medications?

    While the LDDS is the hallmark test used to diagnose Cushing’s, it is also the most likely to yield a false positive result in the face of a non adrenal illness or even severe stress. Since Kobe has a fungal infection you'll want to make sure that it is completely gone before having the LDDS test performed, I do see that this test is not scheduled for another 11 days so hopefully his paw/penis will be healed in that time-frame. Did the vet mention to fast Kobe for the LDDS test? Although fasting is not mandatory it is preferred, unless this would cause undue stress for Kobe.

    Please know we are here for you both and we will help in any way we can.

    Lori

  6. #6
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Hi Lori,

    Thank you for your welcoming, and helpful input. Kobe is 94 pounds. He is taller and more solid than your average boxer, yet is still a bit overweight. At an earlier vet visit the doctor said he should probably lose 5-6 lbs, which would put him at the upper end of his ideal weight. As I recall, the doctor said that his previous blood work nearly a year ago had his (ALP?) at 68 I believe, and she said it ought to be no higher than 200. This time it was above 600. I'll look in to getting the blood work results so I can post them.

    Other than the antibiotics which he just started, he's not taking any other medication. I do give him Vitabone treats which have vitamins in them. I had him into the vet about two months ago, because at the time he was already showing signs of slowing down, not wanting to walk or play as much, but I hadn't yet noticed any other symptoms (although he probably was showing some that I just didn't catch on to). At the time the vet thought he was suffering from some hip pain (or something don't remember) and might have injured himself or was starting to get arthritis. He was arching his back, tightening his back muscles. She prescribed some pain medication and a course of muscle relaxers to see if there was any improvement. During and after that course of medication he didn't seem to improve much. I didn't get back to the vet about these results, and figured that maybe he's just disliking this really warm summer. But then, he was getting even more lethargic, and I began noticing his other symptoms like the excessive thirst, urination, hunger, panting, etc. When he started having accidents I figured it was time to get him back to the vet.

    Yes the vet did say Kobe needed to fast for 12 hours prior to his test later this month. I think you may be right that she wanted to clear up his infections before the test.

    - Glen

  7. #7
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    I dropped Kobe off for his appointment this morning. He's still at the vet. But I did pick up his blood work results.

    These are the results that were abnormal from 9/18/2017 and 8/18/2018, as well as the corresponding value from those dates if one date was normal.

    _____________ 9/18/2017 ______ 8/18/2018 __ Reference Normal

    ALKP...................... 63 .................... 678 (high) ....... 23 - 212
    Amylase ............ 2,500 (high) .......... Not done ....... 500 - 1,500
    Lymphocyte ......... 1.13 ................... 0.84 (low) ....... 1.0 - 4.8
    Basophil % ...........1.4 (high) ............ 0.2 ................ 0.0 - 1.1
    RBC .................... 7.64 ................... 8.63 (high) ..... 5.5 - 8.5
    Hemoglobin ........ 20.3 (high) .......... 19.9 (high) ...... 12 - 18
    Hematocrit ......... 56.55 (high) ......... 61.1 (high) ....... 37 - 55
    MCH .................. 26.6 (high) .......... 23.1 ................ 19.5 - 24.5

    So... hopefully this means something to you all. I've no idea about these. Though obviously the most relevant one ALKP is much higher than normal.
    Glen, Kobe's dad.

    (pronounced Kobay)

  8. #8

    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Hi welcome!my boxer girl mona is also 6 years old,and she was diagnosed in july�� she had the same sypmtoms.i hope kobe will be healthy with treatment.sorry i dont know much about tests results but the friends in here will help you

  9. #9
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Hi again, Glen. Thanks for posting these results. Both the elevated ALKP and the low lymphocytes are characteristic of Cushing’s. The high circulating cortisol of Cushing’s can produce abnormalities in white blood count profiles known as a “stress leukogram.” Low lymphocytes are the most common expression of this effect. I’m guessing that the very mild elevation in the red cell counts was simply the result of dehydration at the time the blood was drawn and don’t really signal much. We’ll surely be anxious to find out how things went today.

    Marianne

  10. #10
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    Default Re: Vet thinks my boy has Cushing's. I'm very worried.

    Thanks Gingerbeer! Great to hear from another boxer parent. Don't they have the most adorable derpy faces? And ridiculous energy (when they aren't ill). Have you begun Mona on any medications? If so which one(s) and how has she been doing on them? Have there been any negative effects? As much as I'm worried about this disease, I'm also worried that the medication could be problematic.

    Edit: P.S. Just read the thread you started Gingerbeer. So I guess that answers all the questions I had above. Sorry to hear that Mona is still having some issues, perhaps with getting the correct dosage, or perhaps with an additional disease along with the Cushings, the thyroid problem. That could surely complicate things I expect. I hope Mona feels better soon!


    Thanks Marianne, Great to hear from someone with a lot of knowledge and experience on this disease. So these blood results are consistent with Cushing's. That's what I expected to hear. Kobe had his 8 hour test today, but I won't find out the results until Friday. I'm still hoping it turns out to be something not so serious. Though I'd definitely prefer it be something treatable like Cushing's than something worse. Looking at the paperwork from today, the test they did is called Dexamethasone Suppression Test - RefLab (ES), which was $200 for that test (if that price means anything, hopefully I was charged a usual price for that sort of test). Is that test the same as the LDDS test you mentioned?

    Reading other threads I've noticed that it's said that the LDDS can have "false positives". Is there any way to know if you do get a false positive?

    Kobe did finish his course of anti-biotics. I'm not sure it helped his paws much. They still seem kind of red and swollen. Maybe not quite as swollen. Presumably it helped the infection he had on his 'boyhood' .

    Things I've noticed since the vet first suspected he had Cushings (based on the symptoms I described and the blood test), since he was on the antibiotics, is that he might not have been drinking quite as much. He still drinks a lot, but then he was always a big drinker. I feel like he's still drinking more than usual, but less than he was 2 weeks ago. He hasn't had any more accidents in the house, but then I'm being much more diligent with getting him outside, even if he's not asking to go out. He does seem like he's had a bit more energy lately, though still he sleeps A LOT, and he's still a lot more lethargic than he was say 6 months or more ago. He's been a bit more willing to go on walks, even somewhat longer walks (especially if he knows we're going to the ice cream shop). However, he seems like he's more reluctant to go up and down the stairs at home. He will still jump up on the bed, but more frequently chooses to sleep on the floor or in his kennel where his doggie bed is. Finally he seems to be panting less than he was 2 weeks ago, before he had his antibiotic course.

    So... I guess now that the symptoms have subsided A LITTLE bit, I'm concerned about what might happen if I get a false positive on the test for Cushings? What might happen if he started on medication and it wasn't necessary? Will I know it's not right?

    I'll discuss this all with the vet when the results come in, but any insight would be very appreciated. Thanks!
    Last edited by FoxFire; 08-29-2018 at 09:48 PM.
    Glen, Kobe's dad.

    (pronounced Kobay)

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