Hello,
My dog, Winston, a 12 yr (almost 13yr) old pit/chow/boxer mix was diagnosed with Cushing's last week. I had actually suspected it for close to 3 years now but each time I asked any general vet if that's possible they seem to be convinced his problems were due to a GI issue or disease. Two weeks ago my dog became listless and I took him to the ER where they took his vitals. He had a high respiratory rate and was running a fever. When I finally met with an ER doctor she asked me his acute symptoms (one bout of diarrhea earlier that afternoon but really nothing else other than feeling too weak to walk and the fever and refused to eat). I then went over his changes and symptoms historically and she said, "He looks like a Cushing's dog" then told me she suggested they do full lab work (CBC, Urinalysis and Culture in case it was a UTI) and an ultrasound. Well bloodwork showed show abnormal numbers and ultrasound found that his small intestine was thickened (has been for a while), his bladder was partially distended, liver was inflamed and both adrenal glands were enlarged. His last ultrasound prior to this was back in March 2018 that showed normal adrenal size and everything else was normal except for the thickened small intestine.
Anyway, long story short, he was given fluids, pain medication because his abdomen hurt upon palpation and I decided to take him home rather than hospitalize him. They also gave me Metrodizanole (?) to take home. The following morning his poop was completely normal and thereafter so I did not give him the metrodizanole. A few days later I had an appointment with an Internist at a vet speciality hospital. The internist seemed young (think she just completed her residency this past year) and immediately wanted to test for Cushing's disease. She didn't mention any other possibilities. Just immediately went off on the whiteboard and explaining cushion's and the two tests. Her recommendation was the ACTH stem test and a cPL (?) test for pancreatitis. She explained why she preferred ACTH over LDDS, but I can't remember why that is now. So they took him and the following day the results came back and she confirmed his diagnosis as positive for Cushing's.
Here's where I'm beginning to question the diagnosis now, even though I suspected it for years. She told me it was a complex disease to diagnose. So the fact that I literally got a diagnosis based on just the ACTH stim test has me questioning everything and maybe feel like she's not begin thorough enough to find out what is really wrong with him. So I asked her why she was so confident just from that test and she said it's also because of his clinical signs and symptoms, his ultrasound showing two enlarged adrenal glands combined with the ACTH stim test which was positive and when all those are combined there is high confidence of Cushing's. Am I being paranoid now? Now I'm worried there are actually other problems and maybe it's not Cushing's. Sometimes I wonder whether he is simply just Hypothyroid? His symptoms are:
-Ravenous Appetite (3 years now)
-Distended Abdomen (3 years now)
-Loss of hair on his tail, around his neck and around shoulders where his harness sits, a bit on the underside of his belly and underside of his thighs (gradual loss of -hair over the last 3 years)
-The hair all along spine to where the tail meets is very rough in texture (just started this summer)
-Increased thirst (just started this summer - vet blamed it to UTI)
-He is NOT incontinent, no house accidents, can hold it in up to 8 hours
-A hell of a lot of muscle mass loss. He's gotten very bony, can see and feel his ribs. The vet gave his body score a 3...but his appetite is through the roof and we feed him the same amount as he always had before, maybe if not more and have had a hard time getting him to put on weight. His spine has been sticking out severely for a couple of years now. It was one of the first symptoms along with the slow loss of hair on his tail.
-His skin used to be pink/whitish and now has varying degrees of black spots (3 years now)
-Oily dandruff (1 year now)
-Strange clusters of tiny black scabs developing under the arm pits (just this summer)
-weird skin nodules across his body (popped up over the last 3 years)
-He DOES not pant but his breathing, always closed mouth and through his nose, sounds labored (started a year ago) when he's sleeping at night and snores now.
-Sleeps all day long, lost interest in long walks, does not hang with his people anymore, stays in the bedroom, only shows excitement when treats or food is involved. (for a while now)
Should I be questioning my dog's diagnosis?? Does this sound familiar? Does it seem odd that after just one visit and one test with the Internist that the diagnosis is confirmed??
Thanks everyone.