Rosie has pituitary Cushing's — Rosie has crossed Rainbow Bridge

[Roxee's Dad]

Yay !!!

[Trixie]

That is so great!! Good for Rosie and you too. It's a relief when those symptoms drop off isn't it??
Hope Rosie continues to feel great!! Sounds like you're doing a great job!
Barbara

[addy]

HURRAH!!!!

We LOVE dry pee pads

[molly muffin]

Yay!!! We Do love the dry pee pads. That is a good sign

Sharlene and Molly Muffin

[FemaleK9]

I got the results of the urinalysis today, and Rosie does have a UTI. The antibiotic is Baytril, 22mg, two tablets once a day. They said it could go in food, as there wasn't a nasty taste, so I put the tablets in her dinner, and it worked. Two less pills to poke down her throat!

I also got copies of her recent blood test and LDDS.

The blood test shows the following results out of range:

Albumin 3.8 (2.5 - 3.7)
ALT 590 (10 - 100)
AST 128 (10 - 100)
Sodium 156 (139 - 154)
Triglyceride 182 (25 - 160)
CPK 338 (14 - 260)
Hemoglobin 20.0 (12.0 - 18.0)
Hematocrit 58.7 (37 - 55)
RBC Count 9.06 (5.5 - 8.5)
Platelets 428 (170 - 400)
Lymphocytes 434 (690 - 4500)

The LDDS:

Pre-Dex: 7.31
Post-Dex 1: 2.19
Post-Dex 2: 5.67

[molly muffin]

When these tests where done, did you suspect Rosie of having a UTI at the time?

Are you giving her Denamarin? A liver support supplement? If not you probably should consider it. I think all dogs with cushings should be on a liver support supplements because it is one of the organs that can be affected. I know you had her on them for a couple weeks but not if you continued or not. It has taken months and months for me to see a positive change in molly's liver values through her hepato support supplements.

I think after the UTI is cleared up completely that you might want to rerun the blood chemistry and compare the values of the next one to this one. So you will know how much the UTI was affecting different values on this test.

So, I am looking at this test as a base line if you will, by which you can compare the next ones going forward to see how Rosie is doing.

yay, I'm glad that Rosie is doing so well on the trilostane.

Sharlene and Molly Muffin

[FemaleK9]

No one was thinking UTI pre-diagnosis. Because of the extreme drinking and peeing, I knew there was something seriously wrong and was thinking more along the lines of kidney failure and other dire conditions, and the vet looked at her urine on that first visit and there was no sign of a UTI.

It was me that suspected a UTI later on, after the Cushing's diagnosis, because of the way she was licking at herself, plus the worsening incontinence. When I voiced my suspicions, they said the lack of an indication of UTI might have been a false negative due to the quantities of urine going through her system. Apparently the dilution of the urine due to the copious drinking of water can make for an environment that bacteria can thrive in and yet escape a cursory examination (I think maybe they just look at it under a microscope?) so they sent the urine out for a culture, which confirmed a UTI.

I just ordered a chewable cranberry supplement for dogs that I hope will prevent recurrences.

As to the liver supplement, yes, I did stop it after a couple of weeks. I was wondering if I should continue, but I'd also like to keep the number of pills I have to poke down Rosie's throat to the bare minimum necessary. I guess I'll leave it to the vet to decide.

I should say that I have great confidence in my vet. They appear to be quite knowledgeable about Cushing's, which I understand is not always the case, and I noticed from the copy I got that the LDDS endocrinology was done by Cornell University.

[FemaleK9]

Any comments on the LDDS results posted above (Post #25)?

[Trixie]

Wish I could help with those numbers...I'm just not expert enough to know yet but I'm sure the ones who do know will be posting soon.
Hope Rosie is feeling okay!
Barbara

[molly muffin]

The LDDS test is consistent with pituitary cushings. When they suppress some at the 4 hour mark, but then can't as much later at the 8 hour mark that is usually consistent with pituitary cushings.

Approximately 30% of dogs with pituitary-
dependent hyperadrenocorticism have serum cortisol suppression at 4 hours < 1 mg/dl or <30 nmol/l), with a rise in cortisol values by 8 hours after dexamethasone administration. This escape from suppression is diagnostic for pituitary-dependent hyperadrenocorticism, and further tests to determine the cause of hyperadrenocorticism are not necessary. Failure to show adequate
suppression of serum or plasma cortisol at both 4 and 8 hours (i.e., >1 mg/dl or >30 nmol/l) is diagnostic for hyperadrenocorticism but can not aid in determining the cause of the hyperadrenocorticism.

http://animalhospitalofmtpocono.com/...20and%20Rx.pdf

I Would still retest the blood work later after the UTI meds complete to compare to this one.

Yes, that is it exactly. When a dogs urine is dilute, sometimes the only way to confirm a UTI is to culture it. It just will not show up under a normal microscope check.

I think I would discuss a liver supplement if the values remain as they are when you retest . Although her ALP isn't elevated, ALT, AST, are liver specific and are elevated that I would want to give support.

I think some of the test values such as Lymphocytes being low, could signify that she did have a UTI at the time of this bloodwork.

Of course you have to look at the entire picture and that is why if it were me I'd probably check the whole out again after the UTI is gone.

Sharlene and Molly Muffin