An undiagnosed noob...(11 y/o rough collie) UPDATE Kel has passed

[Megan]

Hi everyone.

My (nearly) 11 year old purebred rough collie bitch and I are somewhat in limboland... Kel seems to have some symptoms of cushings, but seemingly not key ones - and I'm wondering if she's early stages, or doesn't have it? Wondered if anyone in here could help indicate either way - I realise that without all the blood tests etc we can't possibly expect a definitive answer (and perhaps not even then?) but my vet doesn't want to put Kel through all of the tests when she isn't bad, and for other health reasons (Kel comes with colitis, EXTREME nervousness and blind from birth), and she knows that it's beyond my budget.

Sidenote: My vet is pretty much a 'hands off' kinda vet and only treats with drugs if necessary, and is one of the rare vets to encourage holistic treatments where possible. In fact, this makes me reluctant to post in here as I don't want everyone thinking I'm a poor dog owner

So the nitty gritty. Kel is NOT drinking excessively - she has access to two water bowls each day, each holding approx. 1.5 litres (sorry I'm Australian!) of water each - she shares these bowls with her 40kg labradore x brother. As a rule, I change the inside bowl once a day (sometimes not empty but Kel is a big backwasher so it gets mucky) and unfortunately the outside bowl is harder to monitor as it sits under a tap that sometimes drips - but I def. don't fill it anymore than once a day so I'm inclined to think between the two of them (40kg lab x and 25kg collie) they don't drink anymore than possible 2l a day between them. The dog probably drinks most of that. So I figure it's a bit NO to drinking excessively.

Kel DOES pee the bed. She is only incontinent from the hours of 7pm - 6am, which is when she does her hardcore sleeping. She nearly never has accidents outside of that, even if she sleeps. I think it's only a problem when she sleeps deeply. She has been doing this for about 5 months now, and it wasn't fixed with stilbestrol, and we did test for infections and she's ok on that front. Sometimes it can flare up worse. It started after she caught a tummy bug from her brother that gave us hell for a week.

Kel doesn't really eat excessively - she does enjoy her food a lot, and does nag for it for up to an hour before feed time (we stick to a schedule) but doesn't hoover up anything she finds like I hear it's common for CD dogs. She will eat duck poo if she can get it from our ducks, but doesn't bother garbage bins, or hang around people eating. She has 3/4 cup dry for breakfast, and 3/4 dry plus a generous handful of human grade beef mince for dinner.

Kel HAS some hair loss - symmetrical - but not much, just in her armpits (total loss) and a little around the inside of her hips (total loss) - her belly was already bare. She has lost nearly all her undercoat (remember she's a rough collie so she still looks fully furred but - as my uncle put it - she's lost her boof) and where she was shaved 6.5 months ago has not grown back. Her coat is a little rough.

Kel had some grand mal seizures 6.5 months ago. This was when cushings was first bought up, though the vet can't remember why he thought it then. She was knocked on her arse by valium which caused complete amnesia for a week, then her memory all came back abruptly and there's been no issues with seizures since. We still don't know what caused them (unless it was CD?)

She pants. I'd say probably half to three quarters of the time she doesn't unless it's warm (which is normal for her) and the other quarter she's panting excessively (for her). Just last week and again six weeks before that she seemed to go on some crazy excess panting bender, where she'd spend three days panting more, then one day panting really hard to the point of distressed panting/laboured breathing where she'd grunt in her sleep, then three days coming back down off of that back to normal... I have no idea what causes this. I'm wondering if something is triggering anxiety related panting? Is this a cushings thing? This is what I find most distressing. Kel is very stoic so if this is pain, it must be bad pain.

Kel is showing no sign of the pot bellied appearance, but you can feel her spine quite clearly. She appears - visually - to be in good nick.

I feel she has some muscle wastage, she seems occasionally to be weak in the hind quarters. In saying that, her father was put down at 12 due to bad arthritis of the hips, and when she walks you can feel a click in her hips. Whether this is hereditary arthritis or clicky hips from lack of muscle support I don't know.

And lastly the thing that puzzles me the most... all of Kels 'symptoms' that may be CD - with exception of the incontinence and hair loss - seem to be erratic. If it's CD it's like it isn't always a problem, like the glands aren't producing excess all the time, just sometimes. I wonder this because of her hips (and to a lesser degree front right leg) - it's like she has arthritis which is causing her discomfort but the cortisone is masking it, and sometimes she limps, sometimes she doesn't, and when she is limping she seems happier, like the cortisone (if it's present) isn't producing so much to make her feel mucky in any other way. When she's walking smoothly is when the other symptoms flare up and she seems to have a 'cushings day'. If she's limping she's playing with toys and nagging me for attention, and scratching around her favourite bush. If she's not limping she sticks closer to the back door, is quiet and sleeps more.

My understanding with CD is that it's there... it doesn't come and go like that?

Sorry for such a long blathering post! Just trying to give lots of info and hoping you guys can give me some good news... like no, Kel doesn't have CD lol

[mytil]

Hi and welcome to our site. I am sorry your Kel is having these troubles. Has your vet screened for any thyroid issues? The symptoms you mentioned could point towards Cushing's, but without the ravenous appetite and drinking tons of water I would be suspect of her having it.

Is your girl taking anything for colitis that contains steroids?

Like you mentioned, one cannot really diagnose Cushing's without results of a series of tests. Here is a fairly inexpensive test that can RULE OUT Cushing's.

Urine Cortisol/Creatinine Ratio Test: Considered a screening test, this cannot diagnose Cushing's, but it can rule it out. A urine sample is examined for the relative amounts of cortisol versus a normally excreted protein metabolite, creatinine (the latter is used to control for the degree of dilution of the urine). The greater the ratio, the higher the cortisol level. High cortisol in urine is suggestive of high cortisol in the bloodstream. Many conditions other than Cushing's disease can cause false positives, so this test is not considered diagnostic. Nonetheless, if the cortisol/creatinine ratio is okay, the dog is not likely to be Cushingoid, so this is a good screening test.

Did your vet mention anything else about the grand mal other than Cushing's? What about epilepsy?

Terry

[labblab]

Welcome from me, too! I want to "second" Terry's suggestion re: performing the urine cortisol/creatinine ratio as a simple initial Cushing's diagnostic. A general blood and urine panel can also provide important information. There are certain irregularities about liver function, cholesterol level, and urine characteristics that are often associated with Cushing's. Additionally, low thyroid might be the chief culprit since it can be responsible for skin/coat issues, lethargy and also seizures. So I am wondering whether your vet has checked for hypothyroidism? The first step is the T4 level on a standard blood panel. If the T4 is normal, then you can basically rule out hypothyroidism. If the T4 is below normal, then there is additional blood testing that can determine whether the low thyroid level is secondary to another condition (like Cushing's), or whether it is the primary issue in and of itself. Thyroid supplementation is one of the cheapest and most easily treatable canine issues. So if it turns out to be your dog's primary probem, it can be easily solved.

So if it were me, I'd start with some basic blood/urine diagnostics. The results can point you in the direction of hypothyroidism, Cushing's, or another issue altogether. You are correct that, typically, Cushing's symptoms do not come-and-go. However I believe that some adrenal tumors may produce steroid pulses inconsistently. So Cushing's may still be in the "mix" for your dog. But I'd definitely start with some basic diagnostics first.

Marianne

[addy]

but my vet doesn't want to put Kel through all of the tests when she isn't bad, and for other health reasons (Kel comes with colitis, EXTREME nervousness and blind from birth), and she knows that it's beyond my budget.

Hi and welcome,

I can only completely agree with the advice and insight given by Terry and Marianne. One thing I did want to say is that my Zoe has colitis which was then diagnosed as inflammatory bowel disease. I waited to treat her Cushings until I had that under control. I just wanted you to know you can treat a colitis dog for Cushings if your pup truly has Cushings. We have managed to keep Zoe's IBD/colitis under control for two years now without a major flare up while treating with Trilostane.

First things first though. Cushings is seldom an emergency that has to be treated right away.

So glad you found us.

[molly muffin]

Hello and welcome to you and Kel.

Everyone has already given you some great advice. cushings is a bugger to try and diagnose, that's for sure. Heck, here I am still trying to figure it all out. We just ruled out thyroid for my dog, but it's worth checking out and a simple blood chem panel will do that part for you. Has she had a blood test panel recently? If so can you get those results?
The UC:CR is a good test, ask your vet how much it would cost it should be the cheapest of all the cushing test options. It can rule it out at least, but it can't confirm unfortunately.
If you were a bad dog owner, then you wouldn't be here asking questions. We don't think that anyhow. We all KNOW how expensive these tests can be and that money can be a factor, as can other conditions that Kel may have, like the arthritis.
What you will get here, is a very good support system to help you out when you have questions and just be there to lament together about how things are going.

Sharlene and Molly Muffin

[Megan]

Thanks so much for your replies so far! I forgot, in my haste to post last night - I think Kel also has calcitis cutis. She has little while 'pimples', primarily in one spot - the bald spot in her right armpit - but has a few on the left side too, and the odd one throughout her coat. Perhaps more that I can't see for her hairy hair.

Mytil - Kel isn't taking anything for colitis at present other than chamomile tea, which I had recommended and believe it or not, works a treat! Other than that we have it controlled with a strict diet which if we even look like varying from... look out. I have tried tinkering with it to encorporate or drop things that weren't ideal for cushings but... we're back to the original diet, after some poopy, sad faced days. So no, no steroids to cause the cushings symptoms. Kel is on nothing ATM other than some vitamin suppliments and a holistic herbal treatment for cushings.

Thank you for the advice with the test - I will discuss it with my vet and see if that's something we can do here in backwater Tas, Australia! I hate to think we're focussing so hard on the potential of CD that we lose sight of the fact it may be something easily treated!

And re: the grand mals (three of them in 6 hours) - we felt we would not treat them as epilepsy until they happened again, and with the time span that has fallen between then and now - nearly 7 months - we've assumed she is not epileptic. He felt to put her on epilepsy medication after one occasion may not be ideal and that we would deal with it as it arose, which is hasn't since, thank heavens.

Labblab - thanks for the advice re: the potential for 'pulsing' adrenal tumours. If Kel DOES have CD I wouldn't be surprised if this turned out to be the case, as that is the exact word I used to describe it to someone else - like the gland is pulsing occasionally and pushing out too much, which affects her for a few days and then she's back to normal (barring the piddling). It's very perplexing. I should be thankful, as she's really a normal dog a lot of the time otherwise. It is the main reason I came here, to find out what is 'normal' for cushings because people keep feeling sorry for us when I mention it, but I can't see why as Kel seems ok most of the time? I am hoping for a misdiagnosis.

Addy - thanks for the heads up with the colitis Great to hear your pooch is doing well with it with the CD medications! Is Trilostane the chemo drug? Or are they all chemo drugs? I am keen to avoid that one if I can.

Molly muffin - Kel had a blood panel done when she had her seizures but unfortunately for all of us, it seems to have been misplaced somewhere along the way. I know that makes my vet sound incompetent but they're really not - this is the first time this has happened and we have a reasonably good relationship with them due to some... lets say well looked after pets lol.

I gotta say.. wow. I've been involved in a lot of forums over the years and you guys are far and away the nicest, most accepting people I've ever come across on the internet. Thank you for not judging!

Another two questions - do dogs with CD become a bit vague sometimes? Kel will occasionally act what I think be best described as 75% of herself - she loses personality sometimes, gets vague, can be hard to get through to. I often wonder if she's actually developing dementia too. Her hearing is going as well which I doubt is related. I think I'd be going deaf too if I were her, her ears being so close to her mouth... anyone who has lived with a rough collie will understand what I mean

And...

How does CD progress? If Kel has this, what can I expect with an untreated dog? Will she continue to develop more CD symptoms, will the ones she have get worse, or will she just remain statistically more likely to develop kidney/heart/liver issues and/or be more open to infections? Or do we really have no idea?

Thanks again for your help I will def. pass these recommendations on to my vet, I think she's keen to learn more about CD herself. And yes Kel has seen two vets at the same practice, hence the he and she lol

[Trish]

HI Megain
Welcome to the thread, I am not much good on the cushings part. My dog had a few of the symptoms too, but tested negative for cushings and long story short he had an adrenal tumour. But I see all the experts are lending you a helping hand, I truly believe I would not have got through all the testing, diagnosing etc without their sound advice so you are in good hands All the best in getting everything sorted!
Trish and Flynn

[mytil]

Hey again,

When you get the chance, can you post some photos of Kel - especially with this new development.

I think Kel also has calcitis cutis. She has little while 'pimples', primarily in one spot - the bald spot in her right armpit - but has a few on the left side too, and the odd one throughout her coat. Perhaps more that I can't see for her hairy hair.

Keep us posted about your vet's input on the advice, especially thyroid issues.

Terry

[Megan]

Terry, can I post pics from my desktop straight on to here or do they have to be on another page or??? Will try and get some tomorrow, but Kels is not the most willing model lol

[addy]

You can go to my album of Zoe's skin. I took a photo of her"pimples". Is that what your pup's look like? The derm vet asperated them; they are not pimples but hard calcium deposits diagnosed as Calcinosis Cutis. I consider myself and Zoe blessed that we have not had it progress but seem to be holding it as bay.