Possible CushingÂ’s?

[Mmp01]

Good morning, so glad I found this forum!
My ten year old mix (probably husky/border collie/gsd) had a senior panel done. It came back with all values normal except the ALK Phos around 525-550 (I don’t remember which, just that it was mid 500s). Normal would have been below 150.

My vet said it could be Cushing’s or possibly related to arthritis. He has had both his CCLs repaired, as well as one meniscus surgery. Thyroid levels fine.

We did the cortisol:creatinine test with a result of 37. >34 is out of range.

The vet said we could do the test for Cushing’’s- the one where they draw blood, inject something, then retest in an hour or so, or we could retest in a month.

I’m sure the anxiety will get to me and I’ll do the test.

Eating/drinking seems normal, no panting. He is overweight and I’’m working on that. The only symptom I see is he is sometimes slowing down on walks. Other times not. Not as active as he used to be when out in the yard. He will sometimes stand near the treat jar.

Just wondering if anyone’s dog was diagnosed with Cushing’s with numbers like this?

While a diagnosis of Cushing’s is no walk in the park, part of me hopes it is because I’m reading that high alk phos is present in dogs with bone cancer. No limping or swelling, though, so that’s good. Plus, I would want to do any warranted Cushing’s treatment sooner rather than later if he needs it at this stage.

My vet uses western and holistic treatments. My dog is raw fed.

Thanks for any help!!

[Harley PoMMom]

Hi and welcome to you and your sweet boy! We, too, are happy you found us but are sorry for the reasons that brought you here, and we will help in any way we can. An elevated ALK Phos is found in dog's with Cushing's, however there are other health issues that cause the ALK Phos to be high and it is even routinely seen in senior dogs. Also, even though dogs with Cushing's generally have high elevations in the ALK Phos, usually seen are mild increases in the ALT, blood glucose, and high blood cholesterol concentration. And on the complete blood count (CBC) dogs with Cushing's syndrome have what is called a "stress leukogram," which refers to a specific white blood cell distribution in the blood. This includes a high total white blood cell count with increased numbers of neutrophils and monocytes and decreased numbers of lymphocytes and eosinophils. Since your boy is not displaying the most common Cushing's symptoms, such as increased drinking/urination, ravenous appetite, pot bellied appearance, panting, hair/skin issues, and the anomalies weren't found in his blood work, my opinion is that it's not Cushing's.

Has the vet mentioned about performing an ultrasound? I feel the ultrasound is one of the most useful diagnostic tools, especially considering it's non-invasive. It can give an "inside look" at those internal organs and it might clarify whether or not there are primary issues with your boy’s liver or gallbladder, for instance, that might account for that high ALK Phos reading.

I want you to know that Cushing's is rarely a pressing condition, it is a slow progressing disease taking years to do any real damage so there is no need to panic about waiting to start treatment. Please remember that you are not alone, we are here for you and your precious boy, and never hesitate to ask questions.

Lori

[Mmp01]

Hi Lori. Thanks so much for the response.

The vet said we could do the Cushing’s test, or wait and retest blood. She leaned toward waiting and retesting, going from there. She left the decision to me because she knows I will worry and will most likely want the test she told me about.

She mentioned it “could” be arthritis related, which sent me down the bone cancer rabbit hole.

I’m no vet, but I would think if it were liver cancer his other values would be off, or jaundice or not eating? I know this is a Cushing’s forum so I don’t expect an answer to that. Of course, I will ask her about this.

Again, many thanks for your help so far. Ultrasound sounds like a great idea.

[Squirt's Mom]

Hi and welcome to you and your precious baby boy!

I second everything Lori had to say especially the recommendation for an abdominal ultrasound. This test gives us the biggest bang for the buck as one former member used to say! Not only can it tell us how the organs themselves look, it can go a very long way in diagnosing Cushing's based on the appearance of the adrenal glands...and which form the pup is likely to have, pituitary or adrenal. In the pituitary form both adrenals are typically enlarged while in the adrenal form one will be enlarged while the other is much smaller, even atrophied. Cushing's can very easily be misdiagnosed if there is a tumor present on the spleen or kidney or liver, etc. and this test can help prevent starting the very powerful drugs used to treat Cushing's if something like that is found that can account for elevated cortisol. The other tests - LDDS and ACTH - can only tell us that the cortisol is elevated but not why. The ultrasound can help with that "why". So if I needed to ease my mind, and I certainly understand the need for that!, the US is where I would start.

As for liver disease, yes you would expect to see the other liver enzymes elevated along with the signs you mentioned. Liver disease, kidney disease, diabetes, and other diseases share many of the same signs and can cause false positives on the LDDS and ACTH tests. Another reason that ultrasound is such a great test.

I'm glad you found us and look forward to learning more as time passes. Never hesitate to ask questions and we will do our best to help you understand. You and your baby boy are part of our little family here at K9C now. You will never be alone.

Hugs,
Leslie

PS. Be sure to check out the Helpful Resource section for lots of good info! http://www.k9cushings.com/forum/foru...Cushing-s-Dogs

[Mmp01]

Thank you!
My vet doesn’t seem to be overly convinced it’s Cushing’s, which might be why she suggested retesting in a month, first.
But she knows me too well. My mind always goes to the worst case scenario and then works it’s way back. Once I have a diagnosis and a plan I’m always better. But it’s not about me, it’s about my dog.
I am compiling a list of questions for her, the first being an ultrasound. I’m lucky that I live within a few miles of excellent veterinary specialists if ever needed, so an ultrasound shouldn’t be a problem.

I really do want to rule out masses on the spleen and other organs, as well as the specific gland if it does turn out to be Cushing’s.

Hoping the elevated ALK phos is due to arthritis, but I want peace of mind there’s nothing sinister going on.

Glad I found this family. Thanks for welcoming me and my baby boy. Hope yours are doing well!

[Squirt's Mom]

My mind always goes to the worst case scenario...

Boy! can I relate! Many years ago my first cush pup, Squirt, and I were laying on the bed and I was rubbing her belly. All of a sudden I realized she had lumps on her belly. That was around 10PM. By midnight I had diagnosed breast cancer and was beside myself with grief and worry. I rushed her to her vet first thing the next morning, waiting on him when he arrived, and sobbing, told him she had breast cancer. He put her on the exam table and took a feel, a very careful feel. I stood there sobbing, my heart already broken. After a few minutes he looked up and me and said, "Those are her BOOBS, you big booby!" She had lost weight and I could feel her boobs for the first time in years! LOL So you aren't the only one who take the darkest path first!

[Mmp01]

We are kindred spirits! I’m the same way. I had a dog that had a hip replacement. Surgeon called to say he was out and it went well. However, the tube for the anesthesia caused a little irritation on his lip so he was sending him home with a cream for it. I asked him if it was cancer. Lol. He must have thought, this idiot. I just told her it was an irritation.

[bmschiotis91]

Good morning, so glad I found this forum!
My ten year old mix (probably husky/border collie/gsd) had a senior panel done. It came back with all values normal except the ALK Phos around 525-550 (I don’t remember which, just that it was mid 500s). Normal would have been below 150.

My vet said it could be Cushing’s or possibly related to arthritis. He has had both his CCLs repaired, as well as one meniscus surgery. Thyroid levels fine.

We did the cortisol:creatinine test with a result of 37. >34 is out of range.

The vet said we could do the test for Cushing’’s- the one where they draw blood, inject something, then retest in an hour or so, or we could retest in a month.

I’m sure the anxiety will get to me and I’ll do the test.

Eating/drinking seems normal, no panting. He is overweight and I’’m working on that. The only symptom I see is he is sometimes slowing down on walks. Other times not. Not as active as he used to be when out in the yard. He will sometimes stand near the treat jar.

Just wondering if anyone’s dog was diagnosed with Cushing’s with numbers like this?

While a diagnosis of Cushing’s is no walk in the park, part of me hopes it is because I’m reading that high alk phos is present in dogs with bone cancer. No limping or swelling, though, so that’s good. Plus, I would want to do any warranted Cushing’s treatment sooner rather than later if he needs it at this stage.

My vet uses western and holistic treatments. My dog is raw fed.

Thanks for any help!!

Hi I have an 11 year old shihtzu who had similar results in her liver enzyme on her senior blood work. Another vet called back and recommended we check for Cushing's with an ultrasound and I have been freaking and googling for hours ever since. I was wondering what came of your case? My baby girl Bella panted a lot but it was summer, and she has gained 2 pounds so I have noticed weight her in belly area. She does no eat more than usual (she eats once a day and picks at the dry food once a day), she drinks normal and pees normally. She does have sebaceous cyst on her back but those are common in her breed. She is very active, runs outside and active when indoors. I am so worried and don't know what to do. I asked for my primary vet to call me back but thanks to you and Lori I have other questions to ask about her blood work. Thanks for your time and I hope your baby boy is doing ok. Isn't it insane how much we love them? Wouldn't have it any other way.

Administrative Note: Bella now has a thread of her own, so folks can reply directly on her thread if they have thoughts or suggestions they’d like to offer.

http://www.k9cushings.com/forum/show...ng-diagnostics

[Mmp01]

Hello!
Sorry it’s been a while, no real update. I’m taking him soon for blood work.....and then the wait begins. The vet wanted to do one more blood work before we go down the diagnostic route, especially in the absence of any symptoms.

In the meantime, I’ve been googling like crazy. I found cod liver oil can raise ALK phos? I was giving him that so I cut it back. Giving it a little time to see if that helps bring his level down. I also found something called benign hepatic hyperplasia that can raise ALK phos levels.

I’m still hoping it’s the oil or his arthritis, but prepared to follow this through until I know what’s going on and can treat it.

Knowing me, no matter what, I will want the ultrasound. I’ll check out your new thread.

[labblab]

Thanks so much for checking back in again! We’ll be anxious to hear once you get those new blood work results. In the meantime, please give your sweet boy a big pat for us ;-).

Take care, and good to hear from you,
Marianne