My 14 yr old Jack Russell, Ted

[Jan]

Hello,

This is my 1st time on this site. I am feeling very unsure of what to do for my Jack Russell, Ted.

Ted is a 14 yr old "healthy chunkey monkey" I started noticing lumps on his body , frequent urination, increase in water consumption, loss of muscle in hind legs and some weakness, not sure about hair loss, as Jack's shed tons! I took him to the Vet with a urine sample, it was dilute, results inconclusive.

The Vet suggested meds to control his sphincer, therefore having better bladder control, I opted to take him outside every 4-5 hours.

We just completed his 1st complete blood panel. All liver, pancreatic levels are slightly elevated. The Vet wants to do the dexamethasone test.....Ted has HUGE anxiety around Vet's offices.

After reading alot on Cushing's and the treatment I am not sure that this would be the best way to proceed.....that Lysodren and all the blood work during tx sounds daunting for both of us.

He is happy, and pain free. Any personal thoughts and experienced wisdom would be appreciated. Thank you-
Jan and Ted

[Barney's Mom]

Hi Jan, welcome! Sorry to hear of the problems that Ted is having, but if you are suspecting cushing's disease to be at the root of his problems, then you have definitely come to the right place.

Here are a couple of links to get you started:
http://www.k9cushings.com/forum/forumdisplay.php?f=10 This is a link to the resources section of our forum. A lot of good sound information there on just about anything that you can think of that is cushing's related.

http://www.k9cushings.com/forum/showthread.php?t=216 This is another link from our resources section of our forum, that gives a lot more information into that diagnosis and testing of cushing's disease.

http://www.k9cushings.com/forum/showthread.php?t=180 More on the diagnosis and testing related to cushing's.

The resources section has a lot of other articles and information, I just posted the ones that I find the most helpful and informative.

It's also helpful if you post any lab work done and the results of those tests. It enables the members to see the bigger picture, and be of greater help to you and Ted.

Any questions that you have, just ask! We have lots of helpful members here that are more than happy to help.

Many of Ted's symptoms, the lumps on his body (calcinosis cutis), frequent urination, increase in water consumption, loss of muscle in hind legs, weakness, are all indicative of cushing's.

It sounds like the vet did a routine urinalysis and was looking at the specific gravity? Specific gravity is low in dogs with cushing's, but in other illnesses as well. The Alk Phos in the liver enzymes are elevated in something like 85% of dogs with cushing's disease. Elevated pancreatic enzymes aren't exactly diagnostic of cushing's, however cushing's disease does predispose your pet to pancreatitis, as many, many of our other members can attest to. If you have the numbers of the above tests, it would be good to post them.

I think that you have enough symptoms and abnormal findings in the lab work that the low dose dexamethasone suppression test would be the next step in diagnosing Ted.

Hope this helps, and I look forward to hearing more about Ted!
Cheryl

[frijole]

Hi Jan

Welcome! We have quite a few JRTs that are members here.. I understand your concern and at this point the key is to get a definitive diagnose vs worrying over something that may or may not be. But if it is cushings... it is NOT as big of a deal as most think. Treatable. Just takes love which you obviously have. ;)

Can you post the elevated items from the blood panel as well as the ranges for normal so we can take a look at what is going on? Any other tests pls share results.

If it looks like cushings doing the ldds would at least tell you if it is or not. Treating cushings gives your dog a chance at a normal lifespan. My dog has been on lysodren for 3 yrs now and she will be 16 in December! So there is hope.

Share some more info and again, glad you found us. Don't fret.. it will be alright. Kim

[gpgscott]

Welcome to you both,

Cheryl and Kim have begun the probing.

Others will probe more.

Thanks for joining, please listen to the questions and probe us back.

Best to you both..
Scott

[Jan]

Hello,
Thank you so much for your replies....I did request the lab work from the Vet, althought I am not too clear about everything!!!!
The alkaline pho. is 2.53, the cholesteral is 6.30 the lipase is 2106. Also the alt(?) is noted as high it is 124. The calcium is very high 3.61.
Is this helpful?
Jan and Ted

[StarDeb55]

Jan, welcome to you & Ted! On the general lab results that you have posted, could you please post the reporting units which will be something like ug/dl, ng/l, g/dl, etc. Also, we need to see the exact normal ranges for the tests that are abnormal. We ask for these 2 things as they can vary from lab to lab. Just to let you know, I'm a medical lab tech with over 29 years experience, so I'm used to looking at these kinds of numbers. Right now, the lipase result you have posted appears to be extremely elevated, & may be indicating possible pancreatitis. There should be another result on these general labs called amylase which in conjunction with the lipase result are used to diagnose pancreatitis. Right now, I would strongly suggest you ask your vet about the possibility of pancreatitis with this lipase result. Pancreatitis can be a life-threatening condition if it is severe enough, & not promptly treated. Cushing's is very slowly progressing, so it needs to take a back seat for the moment, until you can determine with your vet if Ted may be developing pancreatitis. I would really like to see the amylase result, & reporting units for these tests if you have them. Also, if something called a CBC or complete blood count was done, could you post the total WBC count, along with the % neutrophils, & absolute neutrophil count.


The other thing is the Low dose dex test can generate false positive results in the presence of non-adrenal illness. If pancreatitis is a possibility, you do not want to run the low dose right now.

I will be able to offer you some input on treating a senior pup as I have been treating my 14 yr. old Shih Tzu, Harley, for almost 1 1/2 years for Cushing's, but I would like to see those other test results.

Debbie

[Jan]

Hi Debbie,
Interesting that you mentioned pancreatitis. The Vet asked about Ted's diet. Especially if he was eating alot of rich food, She suggested a low fat diet-Medi-cal? I asked about the thirst and peeing and she swtiched topics main stream from pancreatitis to Cushing's.
The chemistry that you have asked for is amyl is 558. The WBC is 13.4x10. Also there is L/M=2.5x10, % L/M=19%. Calcium is 3.50.
I hope this helps. What can I do if he has pancreatitis?
Jan and Ted

[StarDeb55]

A low fat diet is necessary in dogs who are prone to pancreatitis. Is Ted having any problems such as nausea, vomiting, lethargy, or diarrhea which could be possible symptoms of pancreatitis. The only thing that can be done if a pup is acutely ill with pancreatitis is to withhold all food & water, placing them on IV fluid for about 24-48 hours to give the GI tract time to rest. Even water has to be withheld as it can act as a stimulant to the pancreas. If Ted is not acutely ill, there is another more sensitive test for pancreatitis called a PLI, I believe, that could give a definitive diagnosis. The amylase value appears to be normal, but as I said earlier, it would be very helpful, if you would post the normal ranges & reporting units. IMHO, if one of my pups had a lipase result this elevated, I would pursue having the PLI test done with the vet to have pancreatitis ruled out before I began any Cushing's diagnostic testing. The PLI is not a test that your vet can do in his office, it would have to be sent to an outside lab.

Debbie

[Barney's Mom]

Hello,
Thank you so much for your replies....I did request the lab work from the Vet, althought I am not too clear about everything!!!!
The alkaline pho. is 2.53, the cholesteral is 6.30 the lipase is 2106. Also the alt(?) is noted as high it is 124. The calcium is very high 3.61.
Is this helpful?
Jan and Ted

Hi again Jan :)
Your lipase really is elevated. Not sure of the reference ranges for your lab, but anything over 1500 at my vet is considered abnormal. Elevated lipase can be caused by things other than pancreatitis, but the higher the number is the more likely this is to be a pancreatitis. Your vet can also order a cPL, that test is specific for pancreatic lipase and would tell you for certain if your elevated lipase is due to a pancreatic issue. As Deb mentioned, if you are dealing with a pancreatitis, you don't want to do the dexamethasone suppression test at this time, as this could give you a false positive result. Something else that warrants a second look is the elevated calcium. High calcium levels can cause pancreatitis, but usually the levels have to be pretty high to cause this. Not sure of your vets reference ranges, but this does appear to be significantly elevated. High calcium levels will also cause muscle weakness. Sounds like your vet has much to keep him busy ;-)

If I were you I would see if you can't resolve some of these issues first before you begin testing for cushing's. There are many, many experienced members here who are happy to help :)

Cheryl

[StarDeb55]

Jan, what are the reporting units on the calcium? I looked up the reference range for calcium for the lab that my vet uses, & that range is 8.9-11.4 mg/dl. Based on that range, Ted's calcium is actually low, this is why it is so very important to post the reporting units.

Debbie

[jrepac]

Also, how is Ted's appetite? Has it increased markedly? (which would be indicative of Cushings).....

My first Aussie developed pancreatitis and she did not want to eat....not sure if that is typical or not....

Cush pups are usually quite the hungry bunch...

and, I have been told that low-fat diet is advisable both for Cushings and pancreatitis....

I read the ingredients on every darn can and bag of food nowadays...it is sad that so many of the brands are loaded up on fats...[or useless fillers for that matter]

[Jan]

Hi Debbie,
You can probably see that I am not the sharpest crayon at this lab stuff. I will write exactly what the lab report for calcium is.....ca= 3.61 mmo1/L (1.90-3.00)
Thanks for your patience-
Jan and Ted

[Harley PoMMom]

Hi Jan,

Welcome to you and Ted...you poor dear...all these issues going on here. My boy Harley has pancreatitis, he doesn't show the symptoms, but his recent cPLI results were elevated, but not that bad. Susy, one of the moderators here posted a very informative article in my thread about pancreatitis and I thought I would share it with you.


Hi Lori,


You did read the Pancreatitis section in Dogaware.com, right? I've posted the link on so many threads I just can't remember if I did it on yours... but, you're on the forum so much that I'm sure you've read it:p:D;), but here's a link just in case:
http://dogaware.com/wdjpancreatitis.html

-Susy

Jan, you have definitely come to the right place for help, these amazing and kind people have so much knowledge about Cushings and anything related to the disease and much more. They are also so willing to share their wisdom and experiences with anyone who asks. They have helped my Harley and me tremendously and I know they will do the same for you.

Hugs.
Lori

[StarDeb55]

Thanks for posting the reporting units, Jan, it helps tremendously. Converting your result to mg/dl gives a value of 14.4 mg/dl which, indeed, is pretty elevated. As Cheryl has already indicated, an elevated calcium may be an indication of pancreatitis, but it can also be an indication of several other things. Based on everything you have told us so far, I would certainly pursue the pancreatitis possibility with your vet before doing anything else. As I said last night, if Ted does have pancreatitis, even chronic pancreatitis, it will not not be a good idea to proceed with any Cushing's diagnostic testing at the moment. You would be at high risk of getting a false positive result due to non-adrenal illness.

Debbie

[Barney's Mom]

Hi Jan,
Just checking in to see how you and Ted are doing?