New here, 13 yr old doggie possible cushings

[daizydog]

Hello. My name is Stacy and my dog, Daizy, might have cushings. She is 13 (will be 14 in may) and the past 2 yrs she has really aged. A few months ago I took her in because her eyes were bulging and blood shot. She also had a bacterial skin infection that was being treated and not getting better. Her blood work showed elevated Alk phos at 250 and low thyroid .9. She has been loosIng weight and is now 12lbs under weight.she also has spindilosis so she is somewhat sway backed and wobbly with her back legs. This sounds like a lot but she really is in pretty good shape for being her age. So, we just got blood work again and Alk phos is up to 330 and thyroid down to .9. I ha e to decide if we wil do a test for cushings Or a test for thyroid to confirm hypothyroidism (TSH and free T4) I am unemployed with 3 kids and just tarted back to school to finish my bachelors. Money is really tight. How do I decide what test to spend the $ on? Does it sound like cushings to you? She is a husky/shepherd mix
She also pants a lot and has started peeing in the house sine she seems to have to go every2-3 hrs
Thanks for reading and any advice
Stacy

[frijole]

Stacy I wouldn't waste one penny on cushings testing at this point because the symptoms you described are really not consistent with cush dogs. The level of alk phos you mentioned are really not high at all... my dog's levels are over 2000! It doesn't take much of an illness (of any kind) to raise the alk phos levels above normal so I wouldn't be worried about that at all.

If I had to test I would test for thyroidism but really - before I did that please tell us everything wrong with your dog as well as all drugs the dog has been taking for the skin, eyes and spine.

Thanks. We appreciate that all of this is expensive and you don't need to spend money on unnecessary tests. Kim

[Cyn719]

Welcome Stacy and Daizy

So sorry for the problems that Daizy is having but I am glad you found this forum. Our members as you cn see are always ready to help. Like Kim said post everything you can about Daizy. It will really help the members get the whole picture. Hang in there:)

Hugs xoxo

[daizydog]

http://youtu.be/4YLZW0LYhLs
this is a video clip of my Daizy that I took tonight. Please ignore the commentary, I was on the phone while videoing her. About 2-3 yrs ago Daizy started to really slow down and last year she started drinking heavily. I took her to the vet and they ran her bloodwork and said nothing looked abnormal. About 6 months ago she started with the bacterial skin infection. The hair would matt, look dirty and then fall out in clumps. Started antibiotics and antibacterial shampoo from vet. About 3 or 4 months ago her eyes started looking blood shot and bulging so I took her back to the vet. They ran her bloodwork again and said her thyroid was on the low side, normal being 1-4 and she was at .9. they did an additional thyroid test and said it wasn't hyperthyroid. Given her symptoms the vet said he thought she had cushings but they wouldn't suggest treating her because of her advanced age. Yesterday we went back to the vet because she started urinating in the house and needed to go out every 2-3 hours. I thought maybe it was a UTI. She is now on tramadol for pain and ciprofloxacin antibiotic but vet didn't think it was a UTI, he thought it was another symptom of possible cushings. They did more blood work and alk phos was going up and thyroid going down
So overall :
drinks a lot
urinating a lot (but not diabetic)
spindilosis (sway back)
weak rear legs - trips a lot and very unsteady at times
panting whenever she is not laying on her side
thinning hair - "rat tail"
blood shot eyes (vet said probably from elevated blood pressure)
slight bulge to eyes
cries in pain if you palpate her belly
mostly deaf and I'm not sure how well she sees anymore, but I wouldn't say blind
lost 12 lbs in 4 months
appetite was decreased but seems to be back, had to add wet food or chicken/rice to encourage her eating
alk phos 330
thyroid .5

I think this is it. I really appreciate the help and understanding.
Stacy

[labblab]

Hi Stacy,

I only have a moment to post right now, but one easy and inexpensive Cushing's screening test that you could consider is the UC:CR (or urine cortisol:creatinine ratio). It involves testing a urine sample. A "positive" on this test does not guarantee Cushing's, because other illnesses or even stress can give a high result. But if the test comes back "negative," you can almost certainly rule out Cushing's. Here is a quote from the Veterinary Merck Manual:


The urine cortisol/creatinine ratio (UCCR) is a rapid and easy screening test; however, it is very sensitive and can be associated with false-positive results. Therefore, a normal UCCR can only effectively rule out the diagnosis of hyperadrenocorticism, whereas an increased UCCR requires an LDDS or ACTH stimulation test to confirm the diagnosis. Collection of the first urine sample in the morning may be a better reflection of cortisol production over time than random urine samples obtained throughout the day when the time since the last urination may have been only a few hours.

We have been told that it is best when the urine sample is collected at home (so as to minimize the likelihood that the dog is stressed), and that it should be the first pee of the morning. One veterinary specialist has told us that it is even better if a sample is collected on each of three successive mornings and then "pooled" together for analysis. Any urine sample should be refrigerated until it can be taken to the vet for analysis.

One "question mark" about your Daizy is her lack of appetite and weight loss, and also the pain when you palpate her belly. Cushpups are normally ravenous, and the pain does make me wonder whether there is some other internal organ issue going on with her, perhaps even in addition to Cushing's. Do you know if her kidney results have always been normal on her labwork?

Marianne

[daizydog]

They have never mentioned anything abnormal for her kidneys but did mention Possible X-rays to see if they can look for tumors. I have to ask the vet about the cost of X-rays. $ is limiting my options so I'm looking to run the tests in the least amnt of $ but the most telling.

[Squirt's Mom]

Hi Stacey,

Just a note to let you know that you don't want an Xray - that would be a huge waste of money for what we are looking at. What you would want to consider is an abdominal ultrasound. It is more expensive than an Xray but will tell so, so much more...not only about the possibility of Cushing's but if there were other problems with internal organs like the liver, kidneys, intestines, stomach, and so on. One of our mods says that the abdominal ultrasound is "the biggest bang for the buck" and I can't agree more - it saved my Squirt's life. So don't let your vet talk you into spending money on an Xray. ;)

Hugs,
Leslie and the gang

[marie adams]

Welcome Stacey and Daizy!!!!:)

I can see you are already benefitting from the experience and knowledge of our experts. They will guide you in the right direction and answer all your questions or research to get you answers.

Take care and you are in good hands!!!:)

[Harley PoMMom]

Hi and a belated welcome to you both.

Eyes that are bulging and bloodshot are seen when a dog has high blood pressure. Has Daizy's BP ever been checked?

[jrepac]

as others have said, get the UC:CR first...it's cheap and can rule out Cushings.

After that, you can decide if an ultrasound (not x-ray) is worth pursuing.