My Emma...

[d3seagren]

Hello my name is Kim and my 8 1/2 year old rescue mix is Emma :) I dont know where to begin except to say THANK YOU for this website b/c I have a feeling you all will be my saving graces.

6 months ago I took Emma to the vet for her annual shots. My vet said her liver enzymes were a bit high, he put her on Pet Tabs (a multi vitamin) and said to do blood work in 6 months. Over the past 6 months the ONLY THING i noticed different w/ Emma was that she was drinking WAY MORE water than usual, urinating more and even going inside the house which she never did before. Thats the only thing thats been different. So last week that blood work came back and the liver enzymes were even higher (from 150 to 250, they should be below 120 i believe). He said lets run tests, it would take 2 days of testing but he was pretty sure it was Cushings. I said what is that? He replied "google it". Im not the biggest fan of my vet, he has 30+ yrs experience but his bedside manner stinks. Why I have never switched to someone else is b/c in the 7 years that I've had Emma she's never had any problems. We go in for annual shots and thats it. So I guess I thought I could deal w/ him as long as he knew what he was doing.

So all of last week while Emma was at the vet for 2 days I "Googled", read, studied and talked to anyone I knew that had any information on Cushings. As Emma and I were waiting for the drs office to call with the results she broke out into a bacterial skin infection all over her body. I called immediately and he said Cushings allows their immune system to be down, hence the sudden infection. So this past week she has been on antibiotics to cure that, which thankfully as of today is almost completely gone. Mind you this poor dog has NEVER had any health problems so this week has truly wiped her out! The vet finally called and said the tests indicate that she has Cushings (pituitary) and prescribed Vetoryl (30mg).

I have so many questions b/c unfortunately the dr rushes out of the room so fast I cant ask him the things I need to know!! So im just learning things online....which DOES help but its also confusing and scary. May I just list some questions and whoever can help me feel free......?

1) how do i know if she has a tumor? Isnt the statistic that 90% of cases there is a tumor?

2) do I trust that my vet has diagnosed her correctly? I read that cushings can be mistaken for other things, thyroid and liver diseases, how do i know if he tested for those? I asked for a print out of her tests from last week but i dont understand them. Just a few things on one page: cortisol pre dexa/cortisol post dexa.....cortisol post ACTH/cortisol post dexa 8hr....and then numbers follow.

3) do i trust Vetoryl?

4) my vet said start her on it in a couple days (she had to clear up the skin infection first)....but im going out of town next week so my question is, can I wait to start her on it or is her system being harmed w/o medication right now?

5) im thinking of switching vets (to someone else highly recommended in my area) should I do this NOW and get a second opinion?

Ok im sorry for rambling but I feel very alone here. Is there anyone out there to help me and my little Emma understand whats happening?

Thank you so much,
Kim, Emma's mom

[Roxee's Dad]

Hi Kim,
I would like to welcome you and Emma to k9cushings. Sounds like a lot of testing has been performed. Please do understand that Cushings is not a death sentence and if treated properly, Emma can go on to live a long and happy life.

We know this is a lot to take in and it certainly does sound like cushings symptoms. Just take a deep breath, read and educate yourself as we all had to do. We are here to help you through our own experiences.

Does your vet have any experience with Cushings? It does take a knowledgeable vet to work together with the owner as a team to successfully treat cushings.


The others as I affectionately call them will be along to ask the usual 20 questions :o:p:). With the collective knowledge and experience, we will help you and Emma get through this.

Please post the test that were performed to diagnose Emma. LDDS, ACTH, (please post the results and normal ranges) Please also post any abnormal blood results and the normal ranges.

Hang in there, we are here to help you and Emma.

[Harley PoMMom]

Hi Kim,

Welcome to you and Emma from me and my boy Harley! I am sorry for the circumstances that brought you here but so glad you found this forum. We will help you in any way we can, ok? I hope I have answered your questions that you posted in blue. Please know you can ask us as many questions as you would like, ok?


I have so many questions b/c unfortunately the dr rushes out of the room so fast I cant ask him the things I need to know!! So im just learning things online....which DOES help but its also confusing and scary. May I just list some questions and whoever can help me feel free......?

1) how do i know if she has a tumor? Isnt the statistic that 90% of cases there is a tumor?

Most pups with cushing's disease do have a tumor, either a pituitary tumor or an adrenal tumor. There is another type of cushing's called Iatrogenic Cushing syndrome. This happens when corticosteroid medicines are given to a pup over a period of time. Treatment for Iatrogenic Cushing syndrome is simply stopping the corticosteroid medicines slowly.

Sometimes the LDDS test can tell if it is PDH or ADH and if not then many of us have gotten ultrasounds done on our pups. An u/s done on a optimal machine and read by a qualified person will be able to show the adrenal glands. How the adrenal glands look and their size can determine if a pup has PDH or ADH.

2) do I trust that my vet has diagnosed her correctly? I read that cushings can be mistaken for other things, thyroid and liver diseases, how do i know if he tested for those? I asked for a print out of her tests from last week but i dont understand them. Just a few things on one page: cortisol pre dexa/cortisol post dexa.....cortisol post ACTH/cortisol post dexa 8hr....and then numbers follow.

Strong symptoms are a huge part of making the diagnosis and a cushing's savvy vet will not initiate any treatment without strong symptoms and a proper diagnosis. If you could get copies of all the test results and post those results here that would really help us help you.

3) do i trust Vetoryl?

Every pup reacts different so that is why one needs a proper diagnosis and a vet/IMS who is very familiar with the cushing medicine one is going to treat their pup with. IMO, Vetoryl is safe when monitored appropriately and with owner observation but it can have adverse effects. So "owner observation" is always a crucial component of treatment. Another important consideration is the degree of experience your vet has with Vetoryl. Cushing's requires a good partnership with one's vet.


4) my vet said start her on it in a couple days (she had to clear up the skin infection first)....but im going out of town next week so my question is, can I wait to start her on it or is her system being harmed w/o medication right now?

Cushing's is a slow progressing disease so you do have time. If it were me, I would want to make sure I had a proper diagnosis.

5) im thinking of switching vets (to someone else highly recommended in my area) should I do this NOW and get a second opinion?

I believe second opinions are always a good idea especially if you are going to see an IMS.

Ok im sorry for rambling but I feel very alone here. Is there anyone out there to help me and my little Emma understand whats happening?

Thank you so much,
Kim, Emma's mom

A couple of questions about Emma, how much does she weigh? Was there anything else on her bloodwork that was marked abnormal besides her liver enzymes?

Remember we are here for you and Emma and you are no longer alone on this journey. ;):)

Love and hugs,
Lori

[d3seagren]

Lori and John,

THANK YOU!!! You have already helped me! I have been doing research and reading so much about Cushings in the last week im going cross eyed lol. But to hear you and everyone on this site talk about their experiences and knowledge is really helping me put this all together.

Yesterday I had called my vets office and asked for a copy of her tests from last week (when she was there for 2 days). When I went in to pick up the paperwork it was one page and not much info on it. Let me know if you need more and if so what do I ask the office to give me? She even seemed hesitant to give me what she did. I almost felt guilty for asking! I know....I shouldn't lol.

Lori to answer your questions:
1) Emma weighs 28lbs
2) the vet told me the blood work only indicated her liver enzymes were high, that was it.

Here is the information that I got yesterday:

test / result / unit / normal range

Cortisol Pre dexa .... 3.7 ..... UG/DL ..... 0.2-6.0
Cortisol Post dexa 4hr .... 0.9 .... UG/DL ..... <1.5

Cortisol post ACTH .... 15.5 .... UG/DL ... 9.0-22.0
Cortisol post dexa 8hr .... 0.6 ... UG/DL .... <1.5

Please let me know if this helps and if not what else do I need??

Thank you again for EVERYTHING :)
Kim & Emma - woof!

[labblab]

Here is the information that I got yesterday:

test / result / unit / normal range

Cortisol Pre dexa .... 3.7 ..... UG/DL ..... 0.2-6.0
Cortisol Post dexa 4hr .... 0.9 .... UG/DL ..... <1.5

Cortisol post ACTH .... 15.5 .... UG/DL ... 9.0-22.0
Cortisol post dexa 8hr .... 0.6 ... UG/DL .... <1.5

Please let me know if this helps and if not what else do I need??

Thank you again for EVERYTHING :)
Kim & Emma - woof!
Hi Kim and Emma!

It is true that Emma is exhibiting symptoms that are commonly associated with Cushing's (excessive urination and thirst, elevated liver enzymes). However, I am REALLY puzzled by her test results. It appears as though your vet has performed two standard diagnostic blood tests for Cushing's (the LDDS and the ACTH) -- which is a good thing. But my own interpretation of the results as they are printed here is that neither test is consistent with Cushing's...:confused:

Emma's post-ACTH cortisol level was 15 which is squarely within the "normal" reference range given by the lab (a result greater than 22 would be consistent with Cushing's).

And her 8-hour post-DEX result was only 0.6 -- again a "normal" result (a result greater than 1.5 would be consistent with Cushing's according to the reference range for this lab).

So I am very confused as to why your vet would base a Cushing's diagnosis on these results. Here is a link to an explanation of LDDS results that should be helpful to you:

http://veterinarymedicine.dvm360.com/vetmed/Medicine/ClinQuiz-Interpreting-low-dose-dexamethasone-suppr/ArticleStandard/Article/detail/580093

And here is an flowchart explaining the interpretation of a diagnostic ACTH test:

http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/snap/cortisol/cortisol-acth-stimulation-protocol.pdf

Before proceeding on to Vetoryl treatment, I urge you to question your vet further about these test results. And if he cannot give you (or is unwilling to give you) a satisfactory explanation as to the interpretation of the results, I would most definitely make the switch to a different vet. Cushing's is a very slow-moving disease, and you have plenty of time to consult with a knowledgeable vet regarding the appropriateness of the diagnosis before prematurely launching into treatment.

Marianne

[Harley PoMMom]

Lori and John,

THANK YOU!!! You have already helped me! I have been doing research and reading so much about Cushings in the last week im going cross eyed lol. But to hear you and everyone on this site talk about their experiences and knowledge is really helping me put this all together.

When my boy was first dx'd with cushing's I was terrified and by some miracle I found this forum with these amazing and knowledgeable people. I was taking in so much cushing's material I thought for sure it was coming out of my ears!



Yesterday I had called my vets office and asked for a copy of her tests from last week (when she was there for 2 days). When I went in to pick up the paperwork it was one page and not much info on it. Let me know if you need more and if so what do I ask the office to give me? She even seemed hesitant to give me what she did. I almost felt guilty for asking! I know....I shouldn't lol.

Harley's vet knows that I get copies of all tests done on him and she has even written this in his file, she has no problem with me being a active member with his health care and no vet/IMS should.



Lori to answer your questions:
1) Emma weighs 28lbs
2) the vet told me the blood work only indicated her liver enzymes were high, that was it.

Here is the information that I got yesterday:

test / result / unit / normal range

Cortisol Pre dexa .... 3.7 ..... UG/DL ..... 0.2-6.0
Cortisol Post dexa 4hr .... 0.9 .... UG/DL ..... <1.5

Cortisol post ACTH .... 15.5 .... UG/DL ... 9.0-22.0
Cortisol post dexa 8hr .... 0.6 ... UG/DL .... <1.5

Please let me know if this helps and if not what else do I need??

Thank you again for EVERYTHING :)
Kim & Emma - woof!

This looks like a LDDS/ACTH combination test was done on Emma. It also looks like, at least to me, that both are normal...no cushing's. With the LDDS test, one first looks at the 8 hour draw ~ 0.6UG/DL. If it is within the reference range, either the dog does not have hyperadrenocorticism or there is a 5% to 10% chance that the dog has PDH. But with Emma's ACTH post stim, (15.5UG/DL) being within normal ranges, also, it is my conclusion that Emma is testing negatively to Cushing's Disease.

I will ask the other members to respond to her test results...hang in there, we are here for you and Emma.

PS...I see Marianne and I were typing at the same time and she has looked at Emma's test results and has given you some great advice and info.

Love and hugs,
Lori

[Buffaloe]

Kim,

Emma is a beautiful dog! I bet she is unbelievably smart.

I cannot tell exactly what test(s) were performed on Emma. She probably either had a combination ACTH/LDDS test or a separate ACTH test and then a LDDS test. If the tests were done separately, the results are pretty straight forward and easy to interperet. If she had a "combination" test done, then the results are difficult to interperet. My Shiloh had a combination ACTH/LDDS diagnostic test performed and neither my vet nor I could make heads or tails of the results. We eventually got a valuable intreperetation of the test results by going all the way back to the expert at the U. of Tennessee where the test was done.

Emma's liver enzymes are high (probably the alk. phos.) but they do not appear to be significantly elevated. Her greatly increased drinking and urinating and her accidents in the house are indicitive that there is something wrong. She could have one of the types of cushing's disease or it could be something else. The diagnostic process can be difficult. I actually used three different vets over a two month period and did many tests to get Shiloh's definitive diagnosis.

I think you should obtain absolutely all of the information you can possibly get regarding the test results from your current vet. Maybe you make another appointment and go in to see her/him and be as sweet as pie. Then, take all of that information and go see another vet or internist (IMS). From what you have written, I say it's time for a change in your veterinary professional. You said you have another one who is highly recommended and it looks like there are at least ten different veterinary vacilities in Sarasota.

Clearly, it is not time to start Emma on Trilostane. Hang in there and just do the best job you can in getting Emma's confirmed diagnosis. If you step on a couple of toes on the way, so be it.

Ken

[Squirt's Mom]

Hi Kim and welcome to you and Emma! :)

RUN! don't walk - RUN! from this vet. Based on Emma's tests she does NOT have Cushing's so please do not start her on the Trilo. If you haven't already paid for it, don't.

Ok, I'm thru with my histrionics! :o But, really, this vet doesn't seem to know anything about Cushing's test results so I would be terrified for him to treat my baby.

You are so right is saying many things can present as
Cushing's and yet not be Cushing's at all. Diabetes, hypothyroidism, liver disease, just to name a few. That is part of what makes Cushing's so hard to diagnose and why several tests are needed.

There is a simple test that can rule out Cushing's - it is called the UC:CR. It is a urine test. It cannot diagnose Cushing's but it can rule it out.

If I were you, I would find a new vet and start all over. Emma's tests do not support Cushing's but those same signs you are seeing in her could be something else that needs attention. Has she lost any weight recently? Has her appetite changed? Does she seem tireder than usual? Is she on any meds, supplements, or herbs? Has she been checked for an UTI and kidney function?

I'm glad you found us even tho Emma doesn't appear to be a cush pup and hopefully never will be. But you still have to stay in touch and let us know what is going on with Emma anyway. You're here, you're family now.

Hang in there!
Hugs,
Leslie and the girls - always

[apollo6]

Dear Kim and Emma,
I am Apollo's mom. First it doesn't sound right that the vet kept you Emma for two days, if I am right and only had one page of tests? Also why would she get rash after being at the doctor, don't think that is a cushing thing.
The tests should have been a full blood panel to see for elevated, liver, kidney, pancreas and other elevated results.
Secondly did Emma have an ultrasound of her abdominal to see if one or both adrenal glands are enlarged. Did you get a urinalysis, and only then do you do the
acht stim test. I hate to do this to you but read my thread. There are three kinds of cushing and your vet should have taken the time to explain this and what causes it:mad: , also the symptoms are many: excess water consumption, hair loss, pot belly, skin lesions, weakness in hind legs, to name a few, and yes the accidents with urine happened with me also.
Once you know if it is and what kind of cushing it is, then do you decide on treatment , and the right dosage is very important. Different medications for which every one it is.
Please don't start the Trilostane yet. How much does Emma weigh?

I know it is a lot to deal with right now. It took me from Sept 2009 until June 2010 after tests, getting the right Internal specialist, asking all sorts of questions , reading up on cushing, and getting help from this website.
Hugs from Sonja and Apollo:)
p.s. Emma is beautiful

[d3seagren]

Wow.....im not even sure where to begin. First and foremost THANK YOU again for your responses, care and concern. We dont even know each other and yet I feel like we're family, its pretty amazing :)

Marianne & Lori- your insight on her LDDS/ACTH combo tests were very helpful. It also makes sense!! I looked at it and yes, a few of the numbers fall under the normal range. Also you helped me understand the numbers better. Marianne I will look at those links to LDDS and the flowchart....i know it will only help me!! Thank you :)

Ken- Yes, my Emma is quite a smartie ;) She has a similar resemblance to your Shiloh, also beautiful!! Thanks for checking out the vets in my area, yes there are many that I hear great things about. I am getting certified in animal rescue and have gotten to know many great people...vets included.

Leslie- I didnt know about the urine test UC:CR, but dont worry its on my "list" now.
To answer your questions:
1) she has NOT lost any weight, she is the exact same weight she's been for a couple years, 28 lbs.
2) Her appetite is tough to pinpoint simply b/c she has never been a food driven dog. I have always fed her organic healthy food and although she eventually eats it all by the end of the day i would never say she's excited about it. When I go to my boyfriends house (he uses Beneful) she literally INHALES it. My conclusion is the cheap, chemically filled crap over the counter is what Emma truly loves lol. With that said her appetite "at home" hasnt changed.
3) She is NOT more tired. Last week she was simply b/c of the antibiotics for the skin infection plus 2 days at the vet. But overall no, her energy to chase squirrels and find rabbits is still there :)
4) the only supplement she has ever been on is Pet Tabs, a multi vitamin, that she started 6 months ago when the vet recommened it.
5) was she checked for a UTI or kidney probs....i have no idea :( But now thats on my list too.

Sonja- thanks for the insight on what my paperwork SHOULD show, ie: a FULL blood panel. I apparently didnt get any of that like I asked. To answer your questions:
1) did she have an ultrasound, NO. But I can assure you she will.
2) her weight is 28lbs.

To everyone-

I have contacted the vet I am going to switch too, she is calling me today to tell me what the process is from here on out (w/ transferring over). I WILL NOT start Emma on the Vetoryl, I plan to see what the new dr wants to do and go from there. I cant tell you how much I appreciate all of your comments and truly making me feel better. I even told the new vet that im not changing drs b/c im looking for a better diagnosis I just want to understand whats happening to my dog. I want someone who is going to sit down w/ me and explain whats going on. Tell me what tests shes having and explain the results. And thoroughly explain what the drug is that im about to put into my dogs body. My current vet handed me the Vetoryl and said "here ya go, come back in 2 weeks"....I had no idea even what the dosage was, I had to ask the vet tech when I was paying my bill!! But most importantly I want to listen to my gut....when my gut says something does feel right I go with it. Hence doing enough research to this find this amazing website and terrific group of people :)

I will be in touch on a regular basis and keep you posted w/ how things go when I transfer over. Also any other thoughts are always welcome!!

Smiles,
Kim & Emma :)

[apollo6]

Dear Kim
I am glad you are listening to your gut. Just remember we are hear to help. Don't jump into anything without knowing all the facts.
I am giving you the website on Internal specialists , to look up the ones in your area.
http://www.acvim.org/websites/acvim/index.php?p=3
Just a sample :
Dr. Anne Elisabeth Chauvet
Specialty: Neurology
Species: Small Animal
Areas of interest:
Type of Practice: Specialty Practice
Other Affiliations: AVMA |
School Attended:
Organization: Veterinary Neuro Services, LLC
Address: Pet Rehab. & Performance Center
3900 Clark Rd., Ste. M-4

Sarasota
FL
USA
34238
Phone Number: (941) 929-1818 -
Fax Number: (941) 929-1819
E-mail: chauveta@aol.com
Website: www.petneuro.com


Hugs from Sonja and licks from Apollo

[judymaggie]

Hi, Kim! I live right up the road from you in Riverview. Coincidentally, Dr. Chauvet was my Maggie's neurologist -- she is wonderful!! :D Her staff and facility are top-notch as well. She even gave me her cell phone number and said to call her day or night if I needed her. Unfortunately, I did and she was gracious and knowledgeable -- a great combo.

I hope you get settled with a vet who communicates with you -- one of the most important qualities, I think.

Take care!

[Franklin'sMum]

Hi Kim,

A belated welcome to you and Emma. As you've found, this is an amazing group of people. The combined knowledge here (not just about Cushing's) is second to none. I just want to wish you luck with your new vet and the diagnostic process. Hopefully this vet will be everything you need for Emma.

Jane, Franklin and Bailey xxx

[Loladog]

Hi Kim,

Welcome to you and Emma!:) I'm so happy that you are switching to a new vet because the last one sounds like a real jerk. A good vet should absolutely take the time to explain a disease, lab testing and give strict instructions with medications (especially one with the potential for serious complications).

Everyone else has given you such great advice but I just want to add that I would discontinue the "Pet Tabs" if I were you. A couple of years ago I read that they were tested and found to have a high lead content. I believe I read this on Consumerlab.com which tests and reviews vitamins and supplements. Emma shouldn't need a multi if she's on a healthy, balanced diet. Depending on her diagnosis, she may need other supplements down the line but wait on those until when/if you have an actual diagnosis.

Take care and keep us posted on what the new vet says.:D

[d3seagren]

Sonja and Judy- Thank you for that information!! I will see what my new vet says and then if I need to go that route I will. Thanks for the info, wow you are all so thorough and helpful :)

Jane- Thank you! Finding this website possibly saved the life of my dog. Im so appreciative :)

Aimee- Its funny you suggested that about the Pet Tabs b/c I DID stop those. I keep checking those lists to see if those tabs are being recalled and so far so good. I did NOT know anything about a high lead content :( But when all of this started w/ Emma a couple weeks ago I stopped them. Again, something in my gut said too. Thanks for the advice!

To everyone else- I'll keep everyone posted on my little Emma. She is doing well, skin infection cleared but she does seem a bit lethargic and still drinking and urinating more than usual. Im out of town this week but next week she has an appt w/ her new vet :) I cant wait!! I will definitely keep you posted and im sure i'll be asking more questions then.

Seriously....all of you possibly saved my dogs life and for that I am eternally grateful.

Smiles,
Kim & Emma :)

[apollo6]

waiting to hear from you.

[d3seagren]

Thanks, Im waiting too. My new vet informed me that my old vet never sent her files over so they are waiting to get those, or im going today to get them. Emma is good, ive actually noticed her drinking seems back to normal. Shes not drinking as much hence less urinating.

Again thanks for the concern!! I will keep in touch and let you know when she sees her new dr :)

Have a great day,
Kim and Em :)

[gpgscott]

Hi Kim and a late welcome from me.

I am very glad to hear you are seeking another Dr. and that a main critieria is the Drs. willingness to involve you personally in the treatment. If Emma does have Cushing's you and she both will benefit from you being completely informed.

Looking forward to the diagnostic work of the new Dr. Like most of the others have expressed I also do not see a clear indication of Cushing's in the results you have posted so far.

Scott

[d3seagren]

Thank you for your input Scott, I really appreciate that! Spoke to the new vet yesterday and Emma's first appointment is Monday at 4pm. They got the paperwork they needed from my previous vet but were disappointed that he didnt have any "notes" in her files. She said usually drs write notes, there was nothing. Anyway im anxious and excited and feel really good that a fresh new dr will be looking at my little girl. I will definitely update you guys on Monday :)

Thanks again,
Kim & Em

[Franklin'sMum]

Hey Kim,
Wishing you luck for Monday :). How's Emma feeling? Oh, BTW, the drinking doesn.t cause the urinating as such. A Cush pup can't concentrate their urine, so they pee a lot. Peeing a lot causes them to drink a lot. I think of it like a Betsy Wetsy catch 22!
Jane, Franklin and Bailey xxx

[frijole]

Thank you for your input Scott, I really appreciate that! Spoke to the new vet yesterday and Emma's first appointment is Monday at 4pm. They got the paperwork they needed from my previous vet but were disappointed that he didnt have any "notes" in her files. She said usually drs write notes, there was nothing. Anyway im anxious and excited and feel really good that a fresh new dr will be looking at my little girl. I will definitely update you guys on Monday :)

Thanks again,
Kim & Em
I find this very strange and if possible I would make a stop/surprise visit to the old vets to look at your file and verify that there are no notes. Unheard of. Perhaps sour grapes... worth a trip if you are up to it. Glad you are switching. Kim

[d3seagren]

Jane - wow thank you for explaining that but (and please dont laugh) what do you mean when you say she cant "concentrate" her urine? Almost like incontinence? As for how she's doing, honestly she's just same ole Emma lol. The odd thing is, shes not having accidents in the house like she was there for a couple weeks. She's drinking her normal amounts again and peeing like she normally did. Not sure what to think of it.

"Frijole"- you're right, good point. I will stop there myself and get ALL of her paperwork. That is techincally MY stuff right? If I go in there I can ask for everything??

Thanks again....all of you are so great, I feel like you're family :)

Kim & Em

[frijole]

Yes - you own the information and they can't withold it. Its hard to lie when you are looking at it. Unless they destroyed the file you will be able to get the records.

I'll let someone more technical explain urine concentration but I'll give you the layman's version - her urine is CLEAR and not YELLOW. :D

Hope this help! Kim

[StarDeb55]

Kim, urine SG is used as one of the measures to determine how well the kidneys are functioning. I know what it is but wasn't sure I could explain it very well, so I found the following explanation which is pretty good:


The role of the kidneys in humans and other mammals is to aid in the clearance of various water-soluble molecules, including toxins, toxicants, and metabolic waste. The body excretes some of these waste molecules via urination, and the role of the kidney is to concentrate the urine, such that waste molecules can be excreted with minimal loss of water and nutrients.

The excess cortisol due to Cushing's is slowly damaging the kidneys, besides other internal organs, & this damage is what is affecting the kidney's ability to concentrate the urine. This means that our pups are losing excess water from their systems because of this, & this is why they have to drink gallons to keep up with this fluid loss.

Hope this helps.

Debbie

[d3seagren]

Frijole- thanks, regarding my paperwork.... im on it!!! In regards to the urine, should I pay attention to the color? Honestly I never notice b/c she pees in the grass lol. I guess it would be good to pay attention so if the vet asks i'll have an answer. So it should be a darker color, yellow? Not clear.

Debbie- very informative.....wow, that makes so much sense. You explained it perfectly, THANK YOU!!!

I wish it was Monday at 4pm.

Kim & Em

[gpgscott]

Hi Kim,

You can carry a couple pieces of toilet tissue and drop on under her when she gets into position, this will let you see color and if you are in your own yard you can just leave the tissue it will be gone in a day or two.

Scott

[d3seagren]

FABULOUS IDEA :) :) :)

Thanks Scott!!!

[d3seagren]

Did the paper towel under her while she peed lol....emma's urine is definitely yellow :)

[Franklin'sMum]

Yay! Debbie's quote is great, and really explains it. Another thing you could do is catch some pee if you want to check Emma's urine for colour or use dipstix. Not as messy as it sounds (usually). With boys, it's pretty easy- they lift their leg and using a container (ladle, cup, plastic container, all thoroughly washed and rinsed before this moment) wait till the peeing starts and then slip the catching thing into the stream.
I don't have personal experience with girls, but some people have used a flat dish (like a pie dish) taped to a stick to slip under. Even read of just using pee pads and putting the stix against the pee on the pad.
The stix I'm talking about can be bought from chemists for about $20-$50, depending on how many things it checks. Don't know if you've ever seen one, but it's a little strip of paper with tiny little squares on it. The squares are different colours, and after dipping the stix strip in urine, the squares get checked against the picture on the bottle at certain time intervals (15, 30, 45 secs type thing) for colour change and result.
They can check for blood and protein in urine, specific gravity, white cells, glucose, bilirubin and a few others. Some things say that the spec gravity readings aren't reliable in animals, but when I've taken a dipstick from the same urine sample that goes to the vet for lab analysis, it's been identical or .001 different.
Jane, Franklin and Bailey xxx

[apollo6]

Be firm and ask for copies of all tests and diagnoses in future. And never be afraid to ask questions. Ask what the tests mean, if you don't understand, ask. Take notes .
It was suggested to me to list all the questions I had. I had over 12 questions. Remember no question is stupid. Remember you are Emma's spokes person.
We will be waiting to hear from you.
HUgs Sonja and Apollo

[d3seagren]

THANK YOU THANK YOU THANK YOU!!!! Today is Monday....4pm seems like forever away lol. I have questions in hand and throughout the day will write more as I think of them.

If you have any questions for me to ask the new vet i'd love to hear them and write those down too!! Hope im asking the right things :confused:

xoxoxo

[d3seagren]

My story of today's appointment w/ our new vet :)

We were in the exam room when this lovely woman w/ a huge smile on her face walked in and greeted Emma first, this never happened at my old vet so obviously im already VERY happy! She played w/ her on the floor for 5 minutes and then stood up to greet me, i immediately felt comfortable. She pulled out Emma's records and literally raised her hand to her forehead, scratched it and said "i have to be honest, im a bit puzzled...". From there she explained how she has looked over the information on Emma several times and still cant put together how my old dr came to the conclusion that she had Cushings. She was very polite and not bashing him but saying she was very confused. She said that the tests he performed on her aren't enough to determine cushings and that even those tests showed no sign of it. Or for that matter of anything else wrong.

She spent a lot of time asking me questions about Emma, explaining what Cushings is, why Emma doesnt display any signs and then talked about other possibilities of things that might be wrong. IF anything IS wrong. She drew blood and took urine and explained what she was testing for, i asked her what the tests were called and she gave me the name and i forgot it!!! (sorry lol) Basically it tests for everything all of you have mentioned: diabetes, thyroid, liver, kidney, uti, cushings. Then she did a great physical exam on Emma, feeling her abdomin and body to see if she felt any enlargement of her liver or possible tumors. She said her lower abdomin was hanging a bit lower and that IS a sign of Cushings but she said that could also be age, body changing, or too much beer lol ;) Also Emma has lost 1.5 pounds in past couple months and she said most Cush dogs GAIN weight.

Again she was very respectful when it came to discussing my previous vets determination but said from what she can tell right now, Emma does not have Cushings. BUT its always possible and w/ these tests she will know for sure. She will call me tomorrow w/ the results. I told her about finding you wonderful people and that listening to my gut brought me there, she said "thats wonderful, Emma thanks you".

I will update tomorrow after I hear from her and am hoping everything looks good. I understand Emma is older, almost 9 now, but will pray nothing else comes back questionable.

Thank you everyone for your support, advice and input. You have literally saved my dog :)

Smiles,
Kim and Emma :)

[apollo6]

Sounds like you are on the right track.:p
We'll be waiting for the results.
Hugs Sonja and Apollo

[Franklin'sMum]

Hey Kim,

Sounds like this new vet of yours is great!! :) I'm so happy that you're comfortable with her, and I really hope that nothing is wrong with Emma. Maybe her belly being lower is just middle aged spread! Fingers and paws crossed,
Jane, Franklin and Bailey xxx

[gpgscott]

Thanks for the update Kim,

Sounds like very good news for you and Emma. Looking forward to new results.

Scott

[d3seagren]

Thanks I will let you know the results when I hear. Jane- regarding her belly, I honestly think its the same shape/size as its always been. Obviously I look at Emma everyday but over the years its a blur when things change slightly. I looked back on pictures of her from the past few years and her belly looks like it does today lol. We'll see, im just glad she's in good hands and having ALL the tests shes needs done :)

ahhhhhh :)

[d3seagren]

UPDATE ON RESULTS:

So sorry I didnt get back to you yesterday, LONG day and when I got home bed was the only thing on my mind. The dr called me at 10am w/ the results....here goes....and forgive me if I leave anything out or dont explain clearly....

Emma looks good, everything came back "normal" regarding her liver, thyroid (i think she gave a number regarding the thyroid and Emma was 1.7), kidney, no diabetes, white blood cell count was good.... The thing that did show was that Emma has a severe UTI. Dr B went on to explain the urine concentration (which i understood thanks to you guys) and said she wants to take 3 weeks to knock it out w/ antibiotics (Ampiciliin, 250mg 2 times/day). She explained how at that point she will test the urine again and see how its concentrated. If the infection clears but the urine is still dilute then she will test for Cushing's. If infection clears and the urine is concentrated then Dr B said she'll be sure Emma does not have Cushing's.

I hope I explained this correctly. I was on the phone w/ her for 15 minutes and writing down what I could and asking TONS of questions....i even called back TWICE w/ questions during the day and spoke to her again lol. But its still difficult to get it all. I did write down that Dr B said Emma's globulin level was up slightly but this could be b/c of the UTI. Also (what started all of this 6 months ago) her liver enzymes have risen to 425.

Overall the dr wants to treat the UTI and then go from there. I feel VERY confident in her and am happy Emma is in her hands.

Any thoughts.....???

Kim and Em

[d3seagren]

This new vet is so awesome she mailed me all the test results from last week!!! So if anyone wanted specific numbers i have them :)

Emma has responded to the antibiotics for her UTI very well. Her full energy is back, no accidents in the house and i can tell she feels better overall :)

I can only hope this is all, just a UTI.

Just wanted to update :)

[lulusmom]

Kim, it would be great if you would post the results of the tests.

[d3seagren]

Ok but there are A LOT of things on here, 2 full pages. One section is called Superchem, another section is CBC and the last page is urinalysis.

I will type it all out but it will take some time!! Maybe tonight when i have more time. Unless there are specific numbers you want.

Hmmmm unless i can scan it and post that....??

[apollo6]

We'll be waiting. Glad to hear some good news.
Hang in there.
Hugs Sonja and Apollo

[Bichonluver3]

Hi Kim and welcome!
To have all the numbers is important as they all go together to make a total picture. Highs and lows of different numbers (values) in combination with other highs and lows indicate different diseases and/or conditions.
When you post these, you will find some of our senior members who are VERY knowledgeable about reading these results will jump in to clarify them for you.
We will be waiting....
Carrol & Chloe

[d3seagren]

Emma finished the UTI medication and had her vet appt yesterday. They tested her urine and its VERY dilute. She is being scheduled to have the Cushings testing later this week. I was hoping it was just a UTI. Ugh. Keep you posted.

-kim and em

[apollo6]

Hang in there . We'll be waiting.
Remember you don't have to decide on anything right away.
We are here to support and help you.
Hugs Sonja and Apollo

[d3seagren]

I would like to start this day by giving you all very good news....Emma DOES NOT have Cushings :)

Yesterday she did the 8 hour cushings test and Dr B called this morning and was happy to report she passed it w/ flying colors!! She explained all the numbers to me and how the test worked. I will get the paperwork today of the test results so I can post those if youre interested. She said she thinks the diluted urine is an after effect of the UTI. She will test her urine again in 2 weeks. All of Emma's others functions are good, kidneys, pancreas, thyroid, no diabetes, etc, so the dr is concluding that this was all from a urinary tract infection.

I will keep you all posted and am happy to share the numbers from her test if you like. I'd also like to thank you for all of your support and love. I couldnt have done this without you <3

Question, what do I do about my old vet? The misdiagnosis and the fact he didnt even do the correct tests and just assumed Emma had cushings. Should i write a letter to him? Also what do I do w/ the package of Vetoryl? (i didnt pay for it, my old vet said it had been opened and gave it to me for free)

Thank you for everything my cush friends,
Love,
Kim and Emma :)

[Casey's Mom]

I am so happy to hear your news about Emma. Thanks to you for being her advocate and doing such a good job.

Love and many hugs,:):)

[apollo6]

So glad to hear the good news.
that is up to you about your old vet. You could just call say the test done and give back the Vetoryl, explaining you appreciated all his help but a second diagnose showed other wise, to advise him if he comes upon it with another pet what needs to be done. Kindness is always the best way to go. Or just not say anything.
I would not write a letter.
Just curious as to what tests where done?


Question, what do I do about my old vet? The misdiagnosis and the fact he didnt even do the correct tests and just assumed Emma had cushings. Should i write a letter to him? Also what do I do w/ the package of Vetoryl? (i didnt pay for it, my old vet said it had been opened and gave it to me for free)


Sonja and Apollo

[littleone1]

This is good news about Emma. I hope all goes well for you and her.

Terri

[d3seagren]

Sonja, i will be getting those test results in the mail and i'll post them for you. I'd love to get feedback from you all on them :)

I know she had a urine test and a cushings test.

[Franklin'sMum]

Hi Kim,

Great news about Emma :) !! I am so happy for you both :D:D.
Why don't you give the trilo to the new vet? They may have a client who needs it but is struggling to afford it? (And you know the new vet is thorough with their testing, so wouldn't give it to a non-cush pup), it's just a thought.
Again, congrats!! :D:D:D

Jane, Franklin and Bailey xxx

[Bichonluver3]

Kim all I can think of to say is.....YIPPEEEE!!!!:D
Carrol & Chloe