Originally Posted by
lidy
Hi Glynda,
He is 13 year old neutered dog, Pomeranianm, weighted 15.2 lb
My vet sent me to the specialty facility to have the abdominal ultrasound done. last year there is 1. cm tumor on the right side of adrenal glands and the liver is enlarged and diffusely hyperechoic. The fact that the liver is enlarged and diffusely hyprechoic would indicate that the tumor on the right adrenal gland is over secreting one or more of the adrenal steroids.
The lelf kidney has 0.6 cm infart at its caudal pole (don't know what is that meant), what is that means? I believe infarct is short for an infarction. This is when an area of an organ is not getting enough blood supply which can cause a serious problem. This is an issue you should be discussing with your vet.
3 . The urine specimen is collected at home, not the first urine. The urine is collected at 11:00 pm. Collecting urine at 11:00 pm is not optimum but not sure it would invalidate the results. Did you refrigerate the specimen until you took it to the vet the following morning?
4. Blood chemistry and CBC test,
This year Last year Reference ran
MCHC 404 431 326-392 g/l
Platelets 804 644 143-448*10^ 9/L
Idexx SDMAV 15 19 0-14 UG/DL
Potassium 5.8 5.3 4-5.4 mmol/L
ALP 146 210 5-160 IU/L
Low value
Glucose 1.9 3.5 3.5-6.3mmol/L
Na:k Ratio 25 28 28-37
Chloride 101 106 08-119 mmol/L
Hematocrit 0.34 0.36 0.38-0.57 L/L
MCV 57.4 55.7 59-76fl
Those results aren't screaming cushing's to me but not every dog has every abnormality we see on blood labs. I wish my dog's labs looked that good.
5. Urine concentrated, specific gravity is over 1, no inflection culture is negative Specific gravity of water is 1.000 and most labs consider normal USG to be above 1.015 so >1 doesn't tell us whether the urine is concentrated or dilute. Anything below 1.015 would indicate urine is dilute to some degree. Is there an actual number on that test and if so, can you please share. If your dog's urine is concentrated, that would most likely rule out excessive drinking and peeing as being a clinical symptom of cushing's.
6.the black dot is recent issue - is getting better now. no history of black dot If cushing's was the cause of the black dots, I don't believe they would not have resolved without treatment. I'm therefore not certain these were a symptom of cushing's.
7. no thin hair or loss of hair. I trim the hair and it growth back. "Normal" regrowth of hair in a dog with uncontrolled cushing's is rare. My dog's right front leg has been bald for three months after being shaved for a splint.
Glynda, did your dogs loss any protein in urine. and how is his heart rate? did you treat with Vetoryl?, Your dog taked Enalapril, does it increase the potassium level? how much did it increase? My dog's heart rate is normal but his blood pressure was off the charts. His gp vet put him on enalapril which was not completely effective. His specialist took his pressure with a doppler and his bp was still over 200 so she put him on amlodopine (in addition to enalapril) which dropped bp to 160. His potassium was within normal range on his last blood labs done on 11/15. Petey has really high triglycerides and platelets so he is also on Plavix to lower his risk of stroke and blood clots. His urine test on 11/15 showed no protein in his urine which I attribute to good control of his blood pressure.
Is cushing dog have slow heart rate?,my dog has a slow heart rate of 48 beats per minutes. If your dog's heart rate is persistently low, there is either a problem with the heart that may not be a problem or it could be caused by an underlying disease and I don't believe cushing's is one of them. I highly recommend that you ask your vet for a referral to an internal medicine specialist who will most likely do an ecg. Since the abdominal ultrasound was done over a year ago, a specialist would almost certainly want to do another one to check for changes in the adrenal tumor. Sometimes adrenal tumors are incidental findings and are not functional so it's possible your dog may have pituitary dependent cushing's or he may not have cushing's at all. I want to mention that 50% of functional adrenal tumor are malignant so the prognosis is not favorable. What changes in your dog's quality of life have you seen in the last year since your vet visualized a mass on the adrendal gland? If a dog is a good surgical candidate and finances allowed, surgery can be a cure. However, this surgery is one of the riskiest and should only be performed by a board certified veterinary surgeon who has lot of experience with particular procedure. If surgery is not an option and symptoms are problematic, the first line of treatment would be Vetoryl (trilostane). Of course, discussing treatment options is premature as your dog would have to have a low dose dexamethasone suppression test (LDDS) to confirm a diagnosis. I personally would let a specialist do that test and discuss any appropriate treatments with you and your gp vet.
Many Thanks
Lidy