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

[Joan2517]

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

Okay, thanks Marianne. I'll try to calm down.....

[molly muffin]

Sorry I wasn't a round much the last couple days and all this went down for Lena. Goodness.

Okay you said they did an in house test in Nov and the glucose was a bit high right (i see that) I see that did a Fructosamine test in December and it was also high.
I do think I'd have the glucose rechecked. It might explain some of the abnormalities in the blood work like the electrolytes being off.
The main thing right now is to get rid of the fluid build up. That can build up rather quickly. Hopefully the antitibiotics and lasix shot will help with that.
Baby steps and one thing at a time here okay.

[Joan2517]

Thanks, Sharlene...the in-house was just to make sure they could put her out for the dental work on Nov. 16 and the December one was when I first noticed how much she was drinking and we were thinking diabetes. That's the one that came back so bad that my vet was shocked and wanted the ultrasound done the next day where they were looking at the adrenal glands...and the rest is history.

We are having the ultrasound done tomorrow afternoon. I thought they could also check the adrenal tumor, but that is considered another scan and will cost more, so that will have to wait, especially since the ACTH test will need to be done at the end of this week because we are at the 30 day mark on 30mg.

I am trying to stay calm but I am ready to jump out of my skin!

[molly muffin]

Wait. What ultrasound are they doing tomorrow that they can't check the adrenal tumor?

I just don't ant you to waste money if it isn't going to tell you anything. I have N vet heard of a different scan needed to be done to check an adrenal tumor compared to any other ultrasound. Do they mean a high definiti N? In which case I don't know the value of doing a low res ultrasound. Wouldn't it be better to have one high res that can check everything than two separate? Less something else is meant. Do they mean a MRI or ct to look at the adrenal glands?

I'm not sure how we got from thinking diabetes to checking the adrenal glands.
If the glucose is high and signifies diabetes that still has to be treated regardless of if there is or isn't a problem with adrenal glands. Did they in fact rule out diabetes?

Just want to make sue we have all the facts straight especially in light of this new dvelopment with the fluid.

[labblab]

Sharlene, Joan can correct me if I'm wrong, but as Sophie's mom has said, it sounds as though they are planning to do an echocardiogram tomorrow, which is an ultrasound of the heart. They are wanting to evaluate the possibility of congestive heart failure. So the adrenals will not be part of this chest imaging -- another abdominal ultrasound will probably be done later on.

[molly muffin]

Agh okay that make snse to me know Marrianne! Thanks. An EKG is dfinitely a priority. I've been getting internal organ ultrasounds too long obviously. Didn't even make the connection. D'oh

[Joan2517]

You are right, Marianne, they are just checking the heart. And the initial blood work on 12/5 was because of the excessive drinking which he said could be diabetes. If it wasn't, we were going to do other testing. But the test came back so bad that I think he knew then that it would be Cushing's, which is why we went for the ultrasound and found the tumor then the 8 hour test to make sure it was adrenal and not pituitary. There was no more talk of diabetes after that. And besides the ACTH testing, there has been no other blood tests done.

Should there be? They didn't even check her mouth after her dental work until I asked them to on Jan. 30 because I was worried about the fact that Cushing's dogs don't heal as fast.

I have used them for about 15 years, but I am not sure all of them are as knowledgeable about this as I need them to be. They keep telling me that she looks great for her age and I don't think they are taking my concerns seriously.

But they have been very good with other issues with the other cats and dogs....so I am conflicted.

I guess I will see what happens tomorrow...I'm so tired of being so worried and second guessing myself and them. I just want to make sure that Lena is getting the best care.

Thanks for all of your responses/suggestions/help. I don't know what I would do without you.

[labblab]

Joan, when they draw blood for the ACTH this week, I would ask them to also run a basic blood chemistry panel so as to monitor Lena's glucose, liver and kidney markers, and potassium/sodium balance. It will be interesting to see whether Lena's glucose has dropped back into normal range now that her cortisol is under better control. Although even as I write that, I realize this cannot be a fasted test since she needs to take her trilostane along with her breakfast. So her glucose may still hang a little bit higher on the testing. But you also want to keep an eye on the kidney, liver, and potassium/sodium level for a dog taking trilostane. So I think it would be good to have a chemistry panel run this week.

Marianne

[Joan2517]

Joan, when they draw blood for the ACTH this week, I would ask them to also run a basic blood chemistry panel so as to monitor Lena's glucose, liver and kidney markers, and potassium/sodium balance. It will be interesting to see whether Lena's glucose has dropped back into normal range now that her cortisol is under better control. Although even as I write that, I realize this cannot be a fasted test since she needs to take her trilostane along with her breakfast. So her glucose may still hang a little bit higher on the testing. But you also want to keep an eye on the kidney, liver, and potassium/sodium level for a dog taking trilostane. So I think it would be good to have a chemistry panel run this week.

Marianne

Okay,Marianne....that's what I will do. Hopefully nothing terrible shows up on the test today.

[molly muffin]

Joan. How did the test today go? What did it show?