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Thread: Stalin (pug) may be joining the club

  1. #1
    Join Date
    Sep 2021
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    5

    Default Stalin (pug) may be joining the club

    Stalin is 13 years old, and possibly the most spoiled pug to ever walk the face of the earth. Unfortunately, it's looking more and more likely that he has Cushing's. Here's his timeline:

    March: Raised SDMA found when doing pre-sedation bloodwork (he had an MCT removed, all is well with that)

    May: SDMA raised to 23 so vet did full blood and urine. Blood was good, but urine was dilute. BP was through the roof. Started on BP meds, switched to K/D Rx food. He was starting to drink a bit more, but nothing extreme.

    June: Had several vestibular episodes with vertical nystagmus. Had MRI, shows that strokes or TIAs were likely the culprit.

    3ish weeks ago: Drinking has increased to the point that he's peeing in the house. He drinks like water is going out of style, it's like he can't get enough. He already has an internal medicine specialist so she did full bloodwork, urine, thyroid. Urine is fine except for the specific gravity, for obvious reasons. Blood was good except............alkaline phosphatase and cholesterol are raised. Nothing extreme apparently, but above normal.

    He's also gained a couple of pounds and is constantly starving. He's a pug, he's always been a food hound, but he's waking me up hours early for breakfast. He shakes until he gets his breakfast. He's never been like this, he usually likes to sleep in.

    He's scheduled for an abdominal US and an ACTH test (hopefully I got the abbreviation right) on 9/23 and we go from there. I'm just so upset and worried!

  2. #2
    Join Date
    Jan 2016
    Location
    Glen Cove, NY
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    1,779

    Default Re: Stalin (pug) may be joining the club

    Hi and welcome. The numbers on the tests would be very helpful. Blood work HIGHS and LOWS with the reference ranges. Always try to get the results sent to you so you have a record. I didn't do that with my first Cushpup, Lena, but I get them all the time with my second, Gable. It also puts the vet on notice that you are paying attention and involved. With Lena I didn't know enough and regret it every day since she died in 2016. But with Gable, I am constantly monitoring and the vets don't do anything unless I have put it to this group first and get their advice. I'm sure it drives my vets crazy! LOL! Tough, though.
    Joan, mom to my Angel Lena, Doree, Gable, Cooper, Angel Phoenix and now Sibble.

  3. #3
    Join Date
    Sep 2021
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    5

    Default Re: Stalin (pug) may be joining the club

    I definitely will. I will probably wait until after the ACTH test so I can get it all at once. Luckily, I trust this internal medicine doctor. He's been seeing her for years for his chronic lymphoplasmacytic rhinitis, and she's also monitored some spleen and liver nodules (that remain unchanged). She knows I am all over everything concerning him! She's very suspicious of Cushing's based on the liver enzyme and cholesterol, along with the symptoms I'm reporting. I'm happy he's established with her, she's otherwise booking out to February for new patients!!
    I'll let everyone know what the tests show once I get them. I'm just worried sick. He's my world. I'm thankful he's still acting like himself, as wild as ever. I'm hoping if he does have it that we caught it quick and that he responds to treatment!!

  4. #4
    Join Date
    Jul 2021
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    21

    Default Re: Stalin (pug) may be joining the club

    Krystal, others will offer more help on evaluating numbers but I thought I'd add that IF its Cushings, many Dogs live good lives with it once Cortisol levels are controlled. There's admittedly lots of variables but stay hopeful even if you do get a Cushings diagnosis. The ultrasound is an important step. Hoping all comes up well

  5. #5
    Join Date
    Sep 2021
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    5

    Default Re: Stalin (pug) may be joining the club

    Thank you ��

  6. #6
    Join Date
    Sep 2021
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    5

    Default Re: Stalin (pug) may be joining the club

    Okay curiosity got the best of me and I got his lab results.

    Urine specific gravity: 1.005
    Alk Phos: 227 (8-196)
    Cholesterol: 369 (131-346)


    Everything else is perfectly in range, except raised SDMA that bounces around from 15-23, up and down

  7. #7
    Join Date
    Apr 2009
    Location
    Georgia
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    14,737

    Default Re: Stalin (pug) may be joining the club

    Hello and welcome from me, too! I’m so glad Joan and Kevin have already greeted you, and thanks so much for the info you’ve given us so far. It sounds as though Stalin is in trusted hands with your internist, and for sure, we’ll all be interested in those test results on 9/23. The abdominal ultrasound is an especially good idea, I think, in order to help identify or differentiate possible functional problems arising with the kidneys, liver, and/or adrenals. The elevation in ALP and cholesterol (although very mild thus far), the dilute urine, and excessive hunger/thirst/urination are indeed characteristic of Cushing’s. Kidney and liver issues can also cause excessive thirst/urination, but I think you’d expect to see loss of appetite rather than increased hunger in those cases. Overall, though, it will be good to be able to take a good look at all those organs.

    I’m assuming the earlier MRI of his head did not reveal any abnormalities with his pituitary gland or you would have mentioned it. That being the case, if Stalin does indeed suffer from Cushing’s, we’d expect that it’s due to an adrenal tumor. So in his situation, the ultrasound becomes a doubly important diagnostic.

    OK, I’ll leave things at that for the moment since we should know a lot more after those tests are completed. But please feel free to continue to ask any questions in the meantime, and once again, welcome!

    Marianne

  8. #8
    Join Date
    Sep 2021
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    5

    Default Re: Stalin (pug) may be joining the club

    Even though he had the brain MRI, I was told that it's often a micro tumor and is not very visible on MRIs. Macro tumors are visible even on CTs. I'm hoping it's not an adrenal tumor as they're often malignant and metastasize quickly! His MRI was also 1 hour instead of 2, they did only the imaging that was necessary to rule out a brain tumor causing the vestibular episodes. I'm not sure if that makes it easier to miss the pituitary tumor or not. She did not want to keep him under too long because of the kidney concerns with the SDMA

    ETA: He did have an abdominal US in spring.....March? April? There's been so many vet visits! She keeps an eye on those spleen and liver nodules. All was well at that time at least. The MRI was done at the same location (it's a specialty referral center and ER) so at least everyone can see everything
    Last edited by Krystal; 09-16-2021 at 04:01 PM.

  9. #9
    Join Date
    Apr 2009
    Location
    Georgia
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    Default Re: Stalin (pug) may be joining the club

    Thanks so much for this clarification, and yes it makes sense -- that a microtumor might have been too small to visualize under these circumstances. So we won't jump to any conclusions yet, and will await the results of this newest ultrasound. It definitely sounds as though your specialist is on top of things, and that is a great gift!

    Marianne

  10. #10
    Join Date
    Dec 2020
    Location
    Detroit, Michigan
    Posts
    27

    Default Re: Stalin (pug) may be joining the club

    I echo what Kevin said...
    My little girl had a great quality of life as a "Cush Pup."

    - Sounds like Stalin is in good hands, regarding your attention... you will be quick to notice when things change.
    - if Cushings is the diagnosis
    In Loving Memory - Gigi (2006-2018)
    - Had a great quality of life as a "Cushings Dog"
    - And passed non Cushings related...

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