Sydney 9 Year Old Boston Terrier Cushing's?

[kvl22]

Greetings,
First, I want to thank everyone for sharing all of their information on this board. It has been a great place to learn about Cushings. My dog, Sydney is going to have her low dose dexamethasone suppression test tomorrow. I am feeling very anxious and nervous. I want to know what is wrong with her, but I also do not want to accept that there is anything wrong. She is my heart dog, and it has been a long couple of weeks with her not feeling weird. I also am kicking myself in the butt for not thinking something was seriously wrong sooner. There have been signs, or should I say odd things happening that I just discounted. In May I noticed her fur was not as soft as it once was. I noticed that she had never healed up from skin scrape that was done in the previous fall. I asked the vet about it and they just discounted it too. We ran a blood panel in May, but nothing to the vet was really out of whack. We just ran another blood panel and things do not seem to be way bad. Yet, they have progressed.

In May: EOS K/uL was fine (0.10-1.49)
PLT 518 K/uL (175-500)
ALT 97 U/L (10-100)
ALKP 337 U/L (23-212)
GGT U/L was fine (0-7)
CHOL mg/dL was fine (110-320)


Now at the end of July: EOS 1.83 K/uL (0.10-1.49)
PLT 716 K/uL (175-500)
ALT 260 U/L (10-100)
ALKP 590 U/L (23-212)
GGT 13 U/L (0-7)
CHOL 331 mg/dL (110-320)
MONO was low .29 K/uL (.30-2.00)
LYM was low .47 K/uL (.50-4.90)
Cl was low 108 mmol/L (109-122)
MCHC 39.4 g/dL (30.0-37.5)
RDW 19.3 % (14.7-17.9)
But, boy, she is asking very strange now. She won't go outside on her own, she will literally hold the urine until I get home and walk outside with her. She is lethargic. She drinks a lot. She stares at the walls and seems lifeless. She doesn't greet me at the door when I come home. The list can go on and on...I am beyond upset and can't stop thinking about all of it. And the worse part is that I am not even for sure if she has Cushings. I keep seeing everyone else's blood work number, and it just seems that Sydney's ALT and ALKP aren't climbing as high as I would expected in 2.5 months time.

[addy]

Hi and Welcome,

I am so sorry Sydney is not well and I know how anxious you must feel about the upcoming tests. My pup did not have very high elevations in the beginning. Actually it took her a good nine months or more for her Alp to climb but she also had inflammatory bowel disease. I asked an endocrinologist about that and he said not all Cush pups have high elevations in those values.

As you have probably have read, Cushings is very hard to diagnosis and non adrenal illnesses can cause false readings on the various tests. History and symptoms play a big role in diagnosis.

Usually, a dog has a huge appetite, is drinking and peeing buckets, their urine is dilute, skin problems, hair loss frequent infections are just some of the symptoms. My girl started off with skin coat issues and we waited a year to treat her as her IBD was more worrisome than her Cushing symptoms at the time.

The fact Sydney is holding her urine as she is makes me wonder if there is not something else going on.

I would want to be sure of the diagnosis, so be thorough, take your time and tell us the tests results as you receive them, ok?

[Harley PoMMom]

Hi and welcome to you and Sydney from me as well! Could you edit your post to include the reference ranges and units of measurement for those values you listed, as an example; ALT 150U/L (5-50)...thanks!!

But, boy, she is asking very strange now. She won't go outside on her own, she will literally hold the urine until I get home and walk outside with her. She is lethargic. She drinks a lot. She stares at the walls and seems lifeless. She doesn't greet me at the door when I come home. The list can go on and on...

We love details, so if you would list all the changes in Sydney's demeanor it may help us to provide better feedback, ok?

And, please stop being so hard on yourself, dogs with Cushing's are generally seniors and symptoms can go years without a confirmed diagnosis because many times the symptoms are attributed to old age. Cushing's is a slow progressing disease so one does have time to get a confirmed diagnosis.

Hugs, Lori

[kvl22]

Thanks for the positive thoughts, I appreciate it. As for odd behavior or things that have happened here is chronological listing.

May 2013
A benign tumor was removed from her front left leg, it took forever for it to heal and hair to grow back.

July 2013
Odd skin issue on left side appeared. At first we thought it was ringworm but the test came back negative. The vet decided it was a bad reaction to a bug or spider bite. Yet, the area that the skin scrape was done has had very little hair ever regrow and took a long time to heal.

May 2014
Hair missing on tip of tail

Weird almost like mushroom skin has grown on top of her nose

Hair very coarse, hair under her belly is very thin and seems almost hairless.

hair under her collar has fallen out or a very bad hair colic has developed

She has lost the ability to jump up on the bed

Weird behaviors with rawhides. She loves to chew on bones, rawhides, greenies etc. But whenever I give her one she obsessively chews it until its gone or shredded. I started monitoring "bone time" and placing time limits on it. Whenever she has a bone away she always ends up panting, breathing heavy, and her pigment was a red tone.

July 2014
Moaning and groaning when stooping to go potty

Listless and lethargic, sleeps a lot

Eyes are just not as bright as they usually are

She is/was a spitfire, always wild and running through the house. I have not seen that for a few weeks now.

No longer meeting me at the door when I come home

Staring into space or staring at the walls in the evenings when she usually would be sitting on my lap

No longer willing/wanting/perhaps able to go outside into my backyard using the dog door to go potty.....I am now carrying her outside to my front yard, placing her in the grass where she quickly potties and then she walks immediately back towards the house and wants back inside. Please note: in the past the front yard was off limits unless she had her harness on. She is a people lover and always runs off to if anyone is outside. Now she could care less if anyone, or even a rabbit is out there with her. She just wants to do her thing and get back inside. Also, if I put her in the grass in my backyard, she refuses to go potty.

Along with the coming inside from the front yard, there is one small step up from coming into the house. She hasn't been solid when using that step. It's like she is almost off balance.

This is a odd one. She has had her dog bed at the end of my bed on the floor since she got it for Christmas in 2013. It has stayed there until recently. Every night, while I am asleep, she moves it by tugging at it until it is right next to where I am asleep. I wake up and literally have to be careful, as she is right next to me on the floor as I am afraid I will step on top of her.

I think her belly looks swollen, although its hard to tell as she has always been very stout/stocky.

She weighted 17.4 pound in May and in July was the same weight. So no real loss or gain in weight.

I have noticed her gulping water down at night when I am home from work. But the water bowl doesn't get touched much during the day while I am at work. It was exactly the same this evening as it was this morning. Same goes for the food. I free feed, and she is mostly a grazer, so I have not noticed much of a difference there either.

This is all the oddness/weirdness that I know of at this time. I just feel so bad for her, as she seems miserable. I am so afraid that she is going to have seizures or any of the other bad symptoms that I have been reading about on this forum. I also am not convinced that the issues are cushings related. I have been doing nonstop Internet searches trying to see what else it could be. Thanks for all your help and information. This is a great forum.

[molly muffin]

Hello and welcome to the forum from me too. Everyone has covered a great deal already, I think that if you have the option I would go to see an IMS. (Internal medicine specialist) The blood values being off is not a normal sign of cushings, although the ALT and ALKP being mildly raised can be.
While some of the symptoms due seem like cushings, I think a second opinion from a specialist to see if they can figure this out might be worthwhile before jumping into cushings treatment.

Sharlene and molly muffin

[Harley PoMMom]

I agree with Sharlene in that some of Sydney's symptoms could be due to Cushing's but also to other non-adrenal illnesses such as a thyroid problem, has Sydney's thyroid levels been checked recently? Normally this is on a regular chemistry blood panel and is listed as "T4"

Hugs, Lori

[molly muffin]

Hi, how did the test go with Sydney? When do you get the results? Did they address any of things we had concerns about?

Hope all is going well
Sharlene and molly muffin

[kvl22]

Hi everyone,

Sorry for not updating sooner. The 8 hour low dex test came back positive for cushings. However, it did not determine the type. I also wanted to let everyone know that I had a T4 test done and it was within normal ranges. Sydney is going to have a CT scan on Thursday morning. If it does not show which type of cushings, they will proceed with the 8 hour high dex the same day.

It seems that her symptoms are getting worse. It's odd as everything I've read says its a slow progression. But her legs are loosing strength fast. She's having a very difficult time going up or down the 1 step off my porch to the yard. She's also become a vampire in that she's up all night. I have hard wood floors, and her walking around sounds like a horse trotting throughout the house. I usually get up with her and try to settle her down. I'm taking it day to day, but it's really hard. I am so sad that she isn't feeling well or acting like herself. I'm also afraid of the next step. I'm afraid of the drugs. I'm afraid of their effects on her. I don't want her to suffer while we are trying to get the dosage right.

Thanks for asking about!

Kristen and Sydney

[molly muffin]

Hi, did they mention doing an ultrasound to take a look at the adrenal glands, liver, and other organs? That would be a next step for me.

Sharlene and molly muffin

[kvl22]

Hi everyone,

Just a quick update...

Sydney had a ultrasound yesterday morning. The results can back inconclusive. However, they did send them out to radiologist office to get a 2nd set of eyes on them.

They also did the 8 hour high hose dex test. Those results are to come back later this afternoon.

Thanks,
Kristen