Newbie with questions.

My 11 yr old boston had surgery to repair a compound fracture in her front leg. ER vet did routine bloodwork to make sure she could undergo anesthesia safely. Results were elevated ALP and ALT values high cholesterol CBC was normal also has enlarged liver and heart. ER suspects cushings. My regular vet diagnosed her with lyme disease and compromised kidney function and put her on antibiotics and a special K/D diet food low in protein back in march of 2019 after I took her in for excessive e drinking urination and weakened legs. She did bloodwork and urinalysis. Did my vet miss something or interpret the results incorrectly. . The ER vet said my dogs kidney values were within normal range but the liver values were well above normal. ER doc suggested cushings testing. She had the surgery on her leg and is rehabbing for 8-10 weeks. Is there anything I can give her until for the possible cushings until her rehab is over and she can be tested. ER doc suggested denamarin for the enlarged liver. Should I keep her on hills science diet K/D for her kidneys or is there a special diet for dogs with cushings? She has an extremely big potbelly and is begging for food all the time. I feel that if she does have cushings it will be hard to treat her with her bad liver and kidneys. I have read a few posts on here about giving melatonin and lignans, adrenal harmony gold. Are these safe for dogs with kidney and liver problems? She went in earlier this week for a check up for her leg and doc is happy with her progress, leg is healing wonderfully but all I can think about is what is to come. Has anyone else had a dog with bad kidneys/liver/heart and cushings? What treatments did u try any advice/experience is greatly appreciated.

Hello, and welcome to you and your little girl! It’s great to hear that her fracture is healing nicely, and I hope to reassure you that if she indeed suffers from Cushing’s, waiting a few more weeks to proceed with testing/treatment shouldn’t have any great effect since Cushing’s is typically quite a slowly progressing disease.

The ER vet’s observations and recommendations sound quite reasonable to me, and starting the denamarin now likely has no downside and could prove to be helpful. As for the other Cushing’s-related supplements, I’d hold off on considering them until you’re further down the road with an actual diagnosis. In terms of diet, our experience here is that there is no specific type of food that is better for Cushpups. In my own mind, whether or not your girl should remain on the K/D food relates to a larger question. If her kidney values are normal now, does she still even suffer from any kidney problems at all? And have kidney problems ever been a genuine issue?

You say that your vet diagnosed her with Lyme disease and associated kidney disease back in March. Did her labwork actually show kidney abnormalities back then, or did your vet just put her on K/D food as a type of precaution? Whether or not your girl actually suffers from an ongoing kidney problem would have an impact on acceptable Cushing’s medications. But if there was just a temporary issue which is now resolved, then she may not need to continue with the K/D food or face medication issues. So it would be very helpful to find out more specifics about that.

As far as her liver, virtually all Cushpups exhibit elevated liver enzymes and they can also have some abnormalities in the appearance of their livers. These all result from the effect that high circulating cortisol has on the liver. If your girl’s abnormalities are caused by Cushing’s, then the conventional prescription meds would be OK and can help ease the liver abnormalities rather than worsen them. As far as her heart, we do have dogs here who have been successfully treated for heart problems alongside their Cushing’s.

So in summary, none of her problems may rule her out as a good candidate for conventional Cushing’s treatment should she truly suffer from the disease. However, we need to especially find out more about the March diagnosis of kidney problems. In the meantime, I don’t think there would be any harm in starting the denamarin, and otherwise the overall course that the ER vet has recommended makes sense. Let her body fully recover from the fracture and surgery, and then consider proceeding with Cushing’s diagnostics.

Marianne