Yohnny 11 year old Shih-tzu with Cushing-like problems

[labblab]

I’m so relieved you’ll be seeing the specialist tomorrow!! I really don’t have any more suggestions to add, but I surely do wish you good luck with the appointment. Please stay very safe, yourselves, and we’ll be so anxious to hear what the specialist has to say.

Best wishes for finally getting some answers!
Marianne

[Jayessi]

Thank you, Marianne. I was originally scheduled for March 30 but the hospital called and wanted to re-schedule me to April 24th! Because of pandemic they had to only focus on emergency cases. I was devastated to have to wait another month after waiting so long already. I took a chance and called the other hospital we have and they booked me in tomorrow! I guess they are handle in things better? Anyway, I am just so relieved I got in. Thank you for your well-wishes. Will let you know when I have more info. /Amanda

[Jayessi]

Saw vet yesterday. No diagnosis yet. Vet sent a thyroid test along with new blood and urine tests. Ultrasound showed that both adrenal glands where enlarged (the left one slightly more) and that liver also was enlarged and had structural changed (reactive). Once vet has results next week we will no more. Now all I do is try and stay calm and enjoy my boy every chance I get.

[labblab]

Thanks so much for this interim report. Bilaterally enlarged adrenal glands and an enlarged liver can all be caused by Cushing’s, so perhaps we’re headed more directly down that road. We shall see!

[Jayessi]

Here is update on Yohnny:

(let me know if anything is unclear am translating swedish vet terms to english)

He has high liver values and proteinuria. Thyroids tests done came back negative.

Proteinuria show leakage in kidneys. Vet gave us Fortekor (hypertension medicine) which he started to take 2,5 mg per day today april 3.

He will go back in for his second LDDS test in two weeks as cushings is strongly suspected. They will also do a hypertension check-up and a Cystocentesis for protein/crea quote.

At this point they are trying to find out if he has atypical Cushings or Cushings that is in early stages.

Vet also mentioned some kind of hormon test (on hte blood) they could do - but we will wait to see what the result of the LDDS test is.

I asked vet if the proteinurea and kidney issues and the suspected cushings are part of the same problem or different issues - she said they where most probably seperate issues. But I have read that proteinurea and hypertension is commin in cushngs dogs. Isn't it?

Abnormal test results

Blood

Trombocyter-Sys 677 x10*9/l 148 - 484
ALP-Profil 16,6 ukat/l < 1,4
ALAT-Profil 2,3 ukat/l < 1,2
Cholesterol 13,1 mmol/l 3 - 10,3

Urine
U-Densitet-Profil 1,025 > 1,03 ulli
U-Volym 4 ml 5 10 ulli
U-Färg gul ulli
U-Protein 3 0 - 0
U-Protein/krea kvot 1,4 < 0,5

Ultra sound
Liver sightly enlarged with slightly rounded edges. Both adrenal glands moderatly (close to substantially) enlarged bilateral with normal echogenicity and no vascular invasion so suspect central hyperadrenocorticism, or possibly inflammation rather than other neoplasm.

Any thoughts or input much appreciated. Thank you.

[Harley PoMMom]

He will go back in for his second LDDS test in two weeks as cushings is strongly suspected. They will also do a hypertension check-up and a Cystocentesis for protein/crea quote.

I strongly recommend that only the LDDS test be done at that time because this test is sensitive to stress, if those other procedures are performed this could add more anxiety to Yohnny which would make his cortisol rise and could make the LDDS yield a false positive. Is it possible for other things to be done at a another time?

Hugs, Lori

[Jayessi]

Hi Lori. That is a good point you make. Thank you. I will talk to vet about this. Your input is much apprieciated. /Amanda

[Jayessi]

Lori. Would you recommend I just go in with him for the LDDS tests and then take him home in between? That is what I did the first time (we have taken LDDS test one but it was negative) but now I took the option of leaving him there as they were going to do the other things too.

[Harley PoMMom]

Lori. Would you recommend I just go in with him for the LDDS tests and then take him home in between?

Since you took him home between draws the first time the test was given I would definitely do that again.

[Jayessi]

Thank you Lori. /Amanda