Lena, Teacup Poodle w/ adrenal tumor - Lena is now an angel

[Sophiesmom]

I'm sorry your pooch is not feeling well. An echocardiogram (ultradound) will show if there is flid around the heart which is CHF.
I hope this is not the case. Having a sick dog is heartbreaking. We are going through issues with our beagle as well and have not been told everything by our vet.
Keep us updated as to your girl's health. They stopped Vetoryl on our dog as well.

[Joan2517]

Sharlene, could you weigh in here? I am supposed to take her for an ultrasound tomorrow and I don't want to have them perform another test if it is not one that is needed or will tell me what is wrong....I think I may not give her the Vetoryl tomorrow.

If the blood work from 12/5 showed that she might have been in congestive heart failure or kidney failure, then shouldn't that have been addressed before the Vetoryl???

Or is what might be going on now, Congestive Heart Failure of Kidney Failure.

I am very confused and upset right now. I have my grandsons here and I am ready to lose it!

[lulusmom]

The creatinine on 12/5 shows 1.5 with a ref range of 0.5 - 1.6. The urinalysis on 12/7 has a Specific Gravity with results showing 1.018 with a ref range of 1.015 - 1.050.

These are both better than I thought they would be so that's good news. My layperson's opinion of what the lab abnormalities look like are just that, a layperson's opinion based on my own experience with both kidney disease and congestive heart failure. As I mentioned, your vet would be the appropriate person to discuss these abnormalities with you. I will say this, however, if this blood chemistry is what your vet used to pursue a cushing's diagnosis, I personally would be concerned because this is not what we are accustomed to seeing on blood chemistry. I think having an ultrasound at this point is a very good idea.

Glynda

[labblab]

Hi Joan, I'm not Sharlene, but it sounds to me as though the ultrasound has been ordered to check to see whether or not the "crackling" is related to fluid overload in the lungs or around the heart. Ultrasounds can be focused on different areas of the body, but an ultrasound of the area around the heart can be used to check for fluid that is associated with congestive heart failure.

It is a good thing that Lena's creatinine and urine specific gravity are both within normal range. So it appears as though Lena's BUN is the only abnormal renal marker in the bloodwork, and that elevation was perhaps caused by something as simple as dehydration.

I did notice that her urine was cloudy and had both blood and protein in it back in December. This would be consistent with a urinary tract infection. I can't remember whether this was noted at the time and whether or not she received any treatment for a UTI?

At the moment, I don't think there is any cause to skip Lena's trilostane unless the vet has told you to do so. It sounds like a good plan to go forward tomorrow with the ultrasound, however, and let's see whether it reveals anything of interest.

Marianne

[Joan2517]

These are both better than I thought they would be so that's good news. My layperson's opinion of what the lab abnormalities look like are just that, a layperson's opinion based on my own experience with both kidney disease and congestive heart failure. As I mentioned, your vet would be the appropriate person to discuss these abnormalities with you. I will say this, however, if this blood chemistry is what your vet used to pursue a cushing's diagnosis, I personally would be concerned because this is not what we are accustomed to seeing on blood chemistry. I think having an ultrasound at this point is a very good idea.

Glynda

They did an ultrasound on 12/7 and found an adrenal tumor, which was where the final diagnosis came from. The 12/5 blood work was looking for diabetes, but after it came back they suspected Cushing's.

[Joan2517]

Hi Joan, I'm not Sharlene, but it sounds to me as though the ultrasound has been ordered to check to see whether or not the "crackling" is related to fluid overload in the lungs or around the heart. Ultrasounds can be focused on different areas of the body, but an ultrasound of the area around the heart and lungs can be used to check for fluid that is associated with congestive heart failure.

It is a good thing that Lena's creatinine and urine specific gravity are both within normal range. So it appears as though Lena's BUN is the only abnormal renal marker in the bloodwork, and that elevation was perhaps caused by something as simple as dehydration.

I did notice that her urine was cloudy and had both blood and protein in it back in December. This would be consistent with a urinary tract infection. I can't remember whether this was noted at the time and whether or not she received any treatment for a UTI?

At the moment, I don't think there is any cause to skip Lena's trilostane unless the vet has told you to do so. It sounds like a good plan to go forward tomorrow with the ultrasound, however, and let's see whether it reveals anything of interest.

Marianne

They never said she had a UTI and was never treated for any...this was all back in December...could she have had one all this time?

[Joan2517]

They never said she had a UTI and was never treated for any...this was all back in December...could she have had one all this time?

She hasn't had any bloodwork, except for the ACTH tests, since December 5.

[labblab]

Test Requested Results Ref Range
Urinalysis
Appearance cloudy *clear
Protein 3+ Neg
RBC 4 – 10 (HIGH) 0 - 3

This is the result I'm looking at. If I'm correctly seeing cloudy urine with a protein level of 3+ and a Red Blood Count of 4-10, then yup, this could definitely signal a bad UTI that may still be persisting. Without doubt, I would bring this to the vet's attention tomorrow and ask, "What's up with this???"

[Joan2517]

Maybe that's why she hasn't felt so good all along? Her tummy has been hot all along, would that be from a UTI? Would the antibiotics she's been taking for the possible abscess clear a UTI up as well? Maybe I should bring a sample with me tomorrow and have them test it...her first urine of the morning is usually 5:00 or 5:30. Does it have to be the first?

What if it is congestive heart failure, Marianne? I feel so sick now, like I should've know this, and what if I put my faith in a vet who hasn't done what he should have for Lena? I will never forgive myself if this is the case....

[labblab]

Duh! Yes, I'd forgotten she's on antibiotics right now. They might indeed clear a lingering UTI, as well. It would just depend on whether the UTI bug is sensitive to that particular drug. How long will she be taking this course of med? You may want to hold off on the urine sample until she finishes the antibiotic, in hopes that her urine will be cleared up at the end of the course. But I would still point out that urinalysis result tomorrow so as to have a gameplan in place.

Also, try not to panic about the possible CHF. It may be newly developing since the "crackling" wasn't heard before, and therefore nobody's fault that anything has been overlooked. Plus, depending on the severity of the condition if it even exists, it may be managed satisfactorily with medication. You've got to keep in mind that Lena is 15, and body parts just wear out over time. We are very lucky that we live in a time when veterinary medicine has advanced so far and even parallels human medicine in many ways. Let's just see what the ultrasound shows us and then go from there.

Marianne