Waiting for THE Phone Call for Ella – 8 y/o English Cocker Spaniel

[Steph n' Ella]

Hi! I am Steph and I am a new mom (picked her up in January) to Ella, an 8 y/o champion English Cocker Spaniel! My family has been involved in this breed for a while and when I was thinking about getting a dog, we put the word out that I could give a show dog a furever home.

Ella lived her life with a breeder in what I call a “deluxe kennel”. She was kenneled for 7-8 hours a day while the breeder was at work and then kenneled again at night while breeder was sleeping. Kennel was separate from main house in an aluminum-type building with gravel floor, heat & AC, flat screen TV, sofa for Breeder and Hubby, and 10+ dog beds for their 10+ dogs. The property was in the country on 7 acres of farm land.

Ella has not been officially diagnosed…I am waiting on the call and the more I read, the more I am stressing out!

I think the Breeder noticed some early signs of problems with Ella’s health but attributed it to living in a kennel and not in a home. The first few weeks I had her, I knew something was not quite right. She had an infected ulcer between her toes that she was licking and she had a pseudo pregnancy that breeder just noticed the night before I came to picker her up (not related to Cushing’s, but what the heck…last heat was 6 months ago?!)

Contrary to what the Breeder described as “no personality” Ella was a very sweet girl who was very slow and calm (I attributed to age) and did cute little circles when she was up and about (boy, can this girl circle).

Additionally, though she has a long “skirt” that covered her udders, which were hanging down to her knees with the pseudo pregnancy, her coat was in poor condition. Bald spots on her side, rump and belly. Plus really weird bumps on belly (mostly on those saggy udders) and scaley, flakey, hairless skin. When I mentioned to vet, she said that it was a result of breeding (Ella had two litters of puppies)/pseudo pregnancy. We went back to get her spayed but pre-op blood work showed Ella is anemic and her white blood cell count off. So surgery was canceled.

Then I got side tracked when Ella when into heat in March. House training went out the window and I was super-busy changing doggie maxi pads… I don’t ever want to have to do that again! Looking back, water intake was increasing and of course there were lots of accidents but I attributed that to her heat. Then heat ended but the accidents didn’t. Also weight went from 34 to 37 lbs…no change in diet or exercise level.

Called vet to re-schedule spay and Local Vet said wait 4 months after heat ended. I wasn’t really satisfied with this answer and didn’t feel like the vet was taking her other issues (skin/housetraining) very seriously so switched. New Vet immediately said belly looked bloated and called for an x-ray and more blood work. The x-ray showed what looked to be a very large liver. Blood work came back anemic (31 on scale of 37) and her thyroid level a .4 (normal is 1-4). Yesterday we had an ultra sound… first glance showed abnormalities with the liver, kidneys and adrenal glands.

Now I am waiting on the call from the vet on the ultra sound report. He had the tech take stills of the ultra sound, email them to an internist, and the internist should have sent him a diagnostic report today. Others who have used this vet says that he makes phone calls on diagnostic reports late in the evening…so I am waiting. It actually has helped pass the time, writing all this out.

Of course I’ve been telling the Breeder all of Ella’s medical stuff along the way (Breeder still owns and is showing one of Ella’s daughters). Today she asked me if I wanted to bring Ella back! What the heck, lady?! I’m not returning my dog! I’m in it for the long haul!!!

Sorry to post something so long! I hate to be acting like a "google vet" but I am thinking cushings...

[Roxee's Dad]

Hi Steph and welcome to you and Ella, :)

Seems to be a lot going on with your poor baby :( Their will be many that will stop by and help you along. Please ask your vet when he calls for the test results and any other abnormal bloodwork and post them here in your thread. It will help us to better understand what may be going on with Ella.

I manually approved your post, Please check your e-mail for a message from k9cushings and follow the link. This will complete your registration and your post will no longer have to be approved. :)

Bless you for taking Ella in and keeping her for the long haul. It sounds like she needs a loving mom to look after her needs. :)

[Steph n' Ella]

Thanks so much...just called vet and the ultra sound report didn't come in today...so more waiting for me and Ella!

[Roxee's Dad]

Hi Steph,
Just me again, I re read your post and just wanted to add that with all the issues that Ella is experiencing, your vet might get a flase positive on the cushings testing. Often times thyroid issues can mimic some of the cushings symptoms. Has your vet prescribed soloxine or anything else to address the low thyroid issue?

Also wanted to ask if she has an excessive appetite?

[Roxee's Dad]

We have some great information in our resources section.... here is a link to some Thyroid information that may give you some insight as to what is going on with Ella.

http://www.k9cushings.com/forum/showthread.php?t=2256

[Chancie]

Hi Stephanie!

I am new here (my pup was just dx), but I wanted to welcome you!

This is a great group of people and you will get tons of advice and information!

Barbara

[Steph n' Ella]

I am glad to be here! Yes, picked up soloxine on Tuesday for the low thyroid. I have read that if it is Cushings, then thyroid issues should be resolved first before starting any treatment. So I am glad we have started that already. She is loving taking her pills 2x a day...I wrap them in a small bit of kraft cheese and it is like a super-yummy treat!

[Steph n' Ella]

Oh and appetite...it is hard to tell with Ella if there is an increase since she was a kennel dog.

Breeder had trained all dogs to eat 1x a day in the evening so that they don't bark in the morning to be fed. Also, she was potty trained in a kennel so was let out on a regular schedule. As a result, Ella doesn't really know how to "ask" people for anything...food, going out to go potty.

She has never been around "people food"...again doesn't know how to beg/bark for something she wants. She likes the smell of my food but I don't give her any. I thought she didn't know how to jump to get into any food (also didn't know how to go up steps) but I am thinking both issues are b/c of weakness in back legs.

Since she was gaining weight, I've been strict. No people food...not many treats.

She inhales her once a day feeding...but that is typical for cockers.

It is really frustrating having a dog that doesn't know how to communicate with people! Even with her thirst...I often notice her water bowl empty and think, "why didn't you tell me, girl?" Then I remember she doesn't know how :(

[sunnie's mom]

Welcome, I'm new here too.My 10 yr Jack Rat has cushings. We have been on Vetoryl for 3 weeks. Things seem to be loking up for us.Three good days in a row!

[Steph n' Ella]

Wow! So glad to have started soloxine! Ella's energy is now back up to pre-heat levels (realizing the stress from that heat really threw this girl off). She's no where near a bouncing cocker but I am so relieved!

No call from doc yesterday, but I did confirm with office staff that the ultra sound report came in and that I am on his list of call to make...more waiting...

[BreeandDaisy]

Welcome. I have two dogs with Cushings (I win those odds but not the lottery!). Daisy (Malti-poo I got as a rescue at 10.5) will be 13 in a few weeks, and Bree (Havanese I got at 7 weeks) just turned 11. Bree's Cushings was long in arriving - we had about 8 years with an elevated enzyme I was told would likely manifest as Cushings eventually. Daisy's came on really quickly. We had just moved when the excessive drinking and urinating started to I attributed it to stress for a week before bringing her in. Both dogs are on vetroyl. Daisy has the enlarged liver and adrenal glands. Oddly she is losing some muscle mass (apparently common) so you can feel her spine/ribs through her fur but she has the bloated belly so looks over weight. Both dogs had some unrelated health issues prior to the diagnosis. (Bree was only dx a month or so ago whereas Daisy was dx in December). Due to Daisy's already enlarged heart and other issues her prognosis was about a year so we have had 6 months already. She could go longer but based on what I am seeing I doubt it. NOT to discourage you, Bree has a great prognosis of 3 - 4 years. One would never know that he has Cushings as the meds are keeping it well under control. (Daisy's meds are keeping her just in the average or just outside the average range)
There have been some great advances in treatments for Cushings so although it is not great to learn your dog has it, you certainly don't have the limited life expectancy that was the case even 5 or so years ago. (Noting Bree's situation I was watching the Cushings situations off and on for several years).

I am saddened that my dogs have it, of course, but I know there are far worse things they can have. (I have had dogs die of cancer etc in the past). Take heart that Ella can still live a normal life expectancy. Be sure to get a vet you trust, not just by what he/she says but trust your gut instinct about them. Keep up on the research, and most important of all, love your dog every day you have her. You are lucky to have each other.

[lulusmom]

Hi Stephanie and a belated welcome to the forum.

I've been meaning to post to your thread and am just now getting around to it. I'm glad to hear that the Soloxine is making Ella feel better. After reading your first post, I think hypothyroidism could be responsible for all of the symptoms you mentioned. Hypothyroidism can also cause false pregnancies so that piece of the puzzle fits too. Pseudo pregnancies cause hormonal imbalances so any organ and bloodwork abnormalities common in cushing's can be due to hyperadrenal activity caused by sex hormones/steroids other than cortisol. It's still early on in treatment so if I were in your shoes, I'd keep fingers and paws crossed that with continued thyroid supplementation and a spay, Ella will continue to improve and cushing's can be ruled out.

Glynda

[Steph n' Ella]

ARG! Finally got the call back. I am not sure if the Vet miss spoke on wed. (he was calling back 12 people who had ultra sounds on Tuesday) or if I miss heard, but the ultra sound showed normal adrenals but abnormal gall bladder (still abnormal Kidneys and Liver).

Kidneys – Looked small and irregular.

Liver – Abnormally large. Wants to get exact definition of the liver before any kind of surgery…especially the spay.

Gall Bladder – Abnormal and contained material

He is worried about internal bleeding and referred be to an internal medicine specialist. Got an appointment for Tuesday morning. I am going to try to get all test results faxed over to me before the EOD!

[lulusmom]

It looks like your girl has a lot of stuff going on so I'm glad to hear that your vet has referred Ella to an internal medicine specialist (IMS). Good for you for jumping right on it and getting her in. If Ella has gall bladder disease, that could account for the enlarged liver, elevated liver enzymes and the low thyroid. We'll be waiting anxiously for your update after the IMS appointment.

I just checked out Ella's pictures and yes, she was a gorgeous girl in her heyday but she's still gorgeous today. Please give her a big hug for me.

Glynda

[Steph n' Ella]

Yes. It is very strange (Vet even pointed it out) that her liver enzymes/blood work are normal despite abnormal appearance of liver and kidneys on the ultra sound...

[lulusmom]

It is extremely odd that with everything that Ella appears to have going on, her liver enzymes, would be normal. :confused: I'll be very anxious to see the actual abnormalities once youi've had a chance to round up the test results and post them here.

[Steph n' Ella]

Just posted JPGS of the test results in my image library. Still waiting on urinalysis results that I had done at an emergency vet when regular vet was closed (suspected UTI).

Here is a time line I put together for Breeder (This woman is really starting to annoy me! She says prognosis is looking up since adrenals are no longer involved... I'm freaking out even more getting the details on her kidneys and liver!)

2/29/2012 – Pre-Op Blood work shows anemic and white blood cells off. Surgery Cancelled.

3/15/2012 – Pre-Op Blood work attached. Still anemic, blood cells improved.

3/22/2012 – Ella went into heat (I am having difficulty pinning down when her heat really ended. Only this week has her swelling gone down and discharge 100% gone.)

4/15/2012 – Urinalysis at Animal Hospital. Blood in urine but Doc not sure if from heat or not. White cell count high but no bacteria seen on slide. Culture came back negative. (5 days of antibiotic administered anyway) ---I am working on getting these results faxed to me---

5/5/2012 – Blood work attached

5/11/2012 – X-Ray report attached

5/15/2012 – Ultra sound report attached. Started soloxine .5 mg, 2x a day

[Steph n' Ella]

One interesting thing that I didn't know is that Ella’s thyroid was at a 1 before heat (at the low end of normal range) and then .4 after heat.

[Steph n' Ella]

Have some time to type some stuff

Pre-Op Blood Work 3/15
WBC 6.3 (4.0-15.5)
RBC 5.44 (4.8-9.3)
Hemoglobin 11.7 LOW (12-20.3)
Hematocrit 33.3 LOW (36-60)
MCV 61 (58-79)
MCH 21.5 (19-28)
MCHC 35.1 (30-38)
Platelet Count 538 high (170-400)
Platelet EST Increased Adequate
Differential Absolute
Neutrophils 3654 58% (2060-10600)
Bands 0
Lymphocytes 2142 34% (690-4500)
Monocytes 378 6% (0-840)
Eosinophils 126 2% (0-1200)
Basophils 0

-------
Reticulocytes 0.4 (0-1)
Absolute Reticulocytes 21760 (<60000)
Corrected Reticulocytes 0.3

[frijole]

I'm scratching my head. BTW loved the photos. I wish I could be of help but I'm stumped. We have a moderator that is a med tech with over 20 yrs experience and I have asked her to take a look at your tests in the album area when she has a chance. Fingers crossed.

Kim

[Steph n' Ella]

Blood Work 5/5
% Retuculocyte 1.5
Absolute Retuculocyte 74 (10-110 k/uL)

-----
T4 <0.4 (Reference 1.0-4.0 ug/dL)

-----
CHEM 21 with Comprehensive CBC
ALK Phosphatase 58 U/L (10-150)
ALT (SGPT) 59 U/L (5-107)
AST (SGOT) 25 U/L (5-55)
ALBUMIN 3.2 g/dL (2.5-4.0)
Total Protein 7.3 g/dL (0.0-0.4)
Globulin 4.1 g/dL (2.1-4.5)
Total Bilirubin 0.0 (0.0-0.4)
Direct Bilirubin 0.0 (0.0-0.2)
BUN 15 mg/dL (7-27)
Creatinine 1.0 mg/dL (0.4-1.8)
Cholesterol 920 mg/dL HIGH (112-328)
Glucose 91 mg/dL (60-125)
Calcium 10.5 mg/dL (8.2-12.4)
Phosphorus 4.0 mg/dL (2.1-6.3)
Chloride 95 mEq/L LOW (105-115)
Potassium 4.5 mEq/L (4.0-5.6)
Sodium 141 mEq/L (141-156)
A/G Ratio 0.8 (0.6-1.6)
B/C Ratio 15.0
Indirect Bilirubin 0.0 mg/dL (0.0-0.3)
NA/K Ratio 31 (27-40)
Hemolysis Index ++
Lipemia Index ++

-------
WBC 14.3 K/ul (5.7-16.3)
RBC 4.95 M/ul LOW (5.5-8.5)
Hemoglobin 10.8 g/dL LOW (12-18)
Hematocrit 31.2% LOW (37-55)
MCV 63 fL (60-77)
MCH 22.0 (19.5-26.0)
MCHC 34.9 (32-36)
Lymphocytes 34.9 (12-30)
Neutrophil Seg 75% (60-77)
Monocytes 8% (3-10)
Eosinophils 1% LOW (2-10)
Basophils 0
Auto Plantelet 202 K/uL (164-510)...
...platelet count and estimate may be affected by severe clumping or the presence of fibrin strands. Platelets appear adequate
Absolute Neutrophil Seg 10725 / uL (3000-11500)
Absolute Lymphoyte 2431 / uL (1000-4800)
Absolute Monocytes 1144 / uL (150-1350)
Absolute Eosinophil 143 / uL (100-1250
Absolute Basophil 0 / uL (0-100)

[Steph n' Ella]

Ultra Sound 5/15
Urinary System-
The urinary bladder presented a large amount of sand and debris. The bladder wall was unremarkable. Crinic urinary tract infection is likely

The left overay presented remodeling and nodulat changes

Kidneys in this patient were irregular in contour and small. The corticomedullary definition in this patient was ill-defined. The renal cortices were bright/hyperechoic indicating chronic, ongoing insult and scarring. The ureters were not visualized and assumed to be normal. No evidence of neoplasia or cystic disease was apparent at this time. Left kidney measured 6.17 cm. The right kidney neasured 5.6 cm.

Adrenal-
Both adrenal glands were visualized and recognized as having normal shape, size, position

Spleen-
The spleen presented multifocal, hyperechoic changes. This is consistant with amyloidosis and hemosiderin.

Liver-
The liver was diffusely hyperechoic with attenuating sound beam. The gallbladder presented significant, suspended debris. This is consistent with hepatic lipidosis and likely vacuolar hepatopathy. Possible suppurative hepatitis. FNA after coagulation panel would be warrented.

Gastrointestinal-
Stomach and intestine free of stasis, of normal wall thickness, acceptable curvilinear mural detail, and peristaltic activity. No obstructions. No abnomal lymphatic activity.

Pancreas-
The right and left limbs of the pancreas were observed to be largely isoechoic to surrounding omental fat. Pancreatic duct and capsular were acceptably normal. No overt evidence of active inflammatory or neoplastic disease was noted.

Assessement-
Right attenyating liver
Renal fibrosis
Mulifocal, hyperechoic splenic changes
Nodular, remodeled left ovary

Recommend bile acid profile and FNA of the liver. Ursidiol therapy would be recommended long term. Eventual choecystectomy would be necessary in this patient. Ovariohysterectomy, oystotmy, bladder lavage and chlecystectomy with liver biopsy can also be considered. However, the liver appears very fragile. Slight pyelectasia was noted in the right kidney. Chronic urinary tract infect is likely.

[Steph n' Ella]

I'm scratching my head. BTW loved the photos. I wish I could be of help but I'm stumped. We have a moderator that is a med tech with over 20 yrs experience and I have asked her to take a look at your tests in the album area when she has a chance. Fingers crossed.

Kim

Thanks! I will be sure to follow up with everyone after the apt. on Tuesday to see what the IMS thinks...puzzle. PLUS BREEDER is running all this by HER vet...

[StarDeb55]

Hi, I'm the lab tech that Kim mentioned yesterday. I really hate to ask you to do this, but could you edit your lab results post to include the normal ranges of everything that you posted as high or low. It's hard for me to give in feedback without seeing the actual normal ranges. Right now, the only thing I will make a definite comment on is that Ella is definitely anemic. It's possible that the anemia may be stemming from what appear to be liver issues, but that's about all I can say for now. I'm making a guess that the elevated cholesterol is hugely elevated. In looking around, elevated cholesterol can be associated with a number of problems including liver disease, & kidney problems. This is a pretty good article giving an overview of elevated cholesterol in dogs.

http://www.petmd.com/dog/conditions/endocrine/c_multi_hyperlipidemia#.T7mV9nlYsTA

Debbie


PS-Even though you didn't flag the 2 reticulocyte results as high or low, I would like to see the normal range for those 2 results. A retic count is a measure of how well the bone marrow is working to try to compensate for the anemia.

[Steph n' Ella]

No problem! Also, there are the actual JPGS of the results in my photos...incase it looks like I made a typo.

[frijole]

Deb - if you go to her photo albums she has the actual lab reports scanned! I think you'll find what you need there. Kim Thanks so much

[Steph n' Ella]

ALSO -- this question is to everyone...

Sent all this info to the breeder. Breeder had only ever taken Ella to an actual vet office 1 time in her life...when she needed stitches in her ear. Instead, when ever the vet came out to the farm for any reason, he would look over the general health of all the dogs. She didn't have a chart or any other kind of paper work from these visits.

Breeder has forwarded all this info to her vet that did these house visits. She has offered to take Ella back to this vet after we see the IMS...on her dime. Should I take her up on her offer?

[lulusmom]

In my opinion, an internal medicine specialist is going to have a much better understanding of what is going on with Ella than the breeder's general practitioner vet. At eight years old, I'm really surprised that the breeder had not had at least one senior panel done. I'm not an expert like Debbie but it looks to me like Ella's most current bloodwork showed improvements.

[StarDeb55]

Ladies, unfortunately with my old eyes & bifocals, the font on those reports is way too small for me to read, that's why I went to the results that were posted. I couldn't see any way to enlarge those reports.

Deb

[lulusmom]

Deb, I had the same problem but was able to zoom in and read it. If you are on Safari, go to View and then Zoom In.

[Steph n' Ella]

In my opinion, an internal medicine specialist is going to have a much better understanding of what is going on with Ella than the breeder's general practitioner vet. At eight years old, I'm really surprised that the breeder had not had at least one senior panel done. I'm not an expert like Debbie but it looks to me like Ella's most current bloodwork showed improvements.

I know, my mom and her breeder said the same thing. They suggested that I try to carefully word an email to her asking for any past blood work. The problem is that I don't know if there is any...I guess all I can do is ask.

Oh and I added all the other details to her test resullts on the pervious posts.

[StarDeb55]

Since Glynda reminded me about zooming, I have taken a closer look at things. Out of everything, the anemia is what raises a red flag for me, & an even bigger red flag is the low, normal absolute retic count. Looking back at the hemoglobin/hematocrit result prior to the one done on 5/10, it clearly shows that Ella is trending down. It's not much of a change, something like 0.4, but looking at the bigger picture, it's concerning. The low retic count indicates that Ella's bone marrow is suppressed & not responding like it should to compensate for what appears, IMO, to be a significant anemia. There are simply scads of things that can cause bone marrow suppression, so I don't even want to hazard a guess. This is something that needs to be addresses with the IMS.

Debbie

[frijole]

Based on what Deb has said I wouldn't necessarily waste my time with the breeder's vet at this point. I would go straight to a specialist (IMS) as Deb has suggested (and Glynda as well) I trust Deb's take implicitly and based on her comment that it could be caused by a host of things and the fact that Ella has "significant enemia" I would get on this right away.

Do you know of an IMS in your area or a teaching hospital?

Kim

[Squirt's Mom]

Honey,

I'm gonna be real blunt here - that breeder didn't care enough about Ella when she was there to give her the proper care, the care she has always deserved and is finally getting from your loving heart, so I wouldn't waste anything further on her. ;)

I think the best bet for both of you is to see an IMS asap to see if some answers and solutions can be found, and get the two of you started on a plan of action. We will be right here with you the whole way.

Hugs,
Leslie and the gang

[Steph n' Ella]

IMS apt went well. She said that all of her problems could be from the hypothyroidism. She also mentioned cushings but then said that her liver enzymes were normal. Then in the same breath she said if hepatitis has been chronic over a long period of time, enzymes can normalize or even become low.

She is not putting much stock in the ultra sound and is more interested in getting results of FNA/biopsy of the liver to see what is going on at the molecular level. Ella is staying the day to get more blood work and they are going ahead and doing the FNA of the liver.

She said that bile in gallbladder can appear like debris in dogs with thyroid problems.


Based on what Deb has said I wouldn't necessarily waste my time with the breeder's vet at this point. I would go straight to a specialist (IMS) as Deb has suggested (and Glynda as well) I trust Deb's take implicitly and based on her comment that it could be caused by a host of things and the fact that Ella has "significant enemia" I would get on this right away.

Do you know of an IMS in your area or a teaching hospital?

Kim

This IMS seems to work closely with Penn State. Cytology for the liver FNA is being over nighted there.

FNA will only show if changes to the liver are due to lymphoma. I will proly end up getting a liver biopsy at the same time she gets spayed...

[Steph n' Ella]

Test results from yesterday's IMS apt are IN!

Never in my life have a been to happy to hear my Ella has a UTI!

Hopefully after she is treated with antibiotics, we will see improvement in her anemia...less water in-take and fewer accidents!

Liver enzymes are still normal and bile acids are normal.

Cytology from the FNA showed cells there are swollen, which could indicate cushings... but IMS called it a "non-specific" finding.

Cholesterol is down to 348!!! (after only a week on soloxine)

T4 sky rocked to 11.7 (so we are going down to .25 mg soloxine 2x a day--instead of .5--with the option to going up to .3, if needed)

Waiting on the urine culture...that way we will be 100% sure she gets the right antibiotic. Also I am 100% sold on the liver biopsy during her spay. Why does the liver look so abnormal while tests show function is normal?

Thanks for all the support here...don't know how I would have got through the last couple weeks w/o this forum!

~Steph & Ella

[marie adams]

Hi Steph and Ella,

Sorry I wasn't here to welcome you sooner.

That is such good news so far for Ella. I would take a UTI over Cushing's any day!! :D

I hope the liver biospy goes well and gives you more good news.

Take care!!!

[Squirt's Mom]

That sounds like a good news day indeed! :D So glad for you and Ella!

Hugs,
Leslie and the gang

[Steph n' Ella]

Culture of course shows a bacteria that is resistant to most antibiotics! Also, specialist thinks the infection may have also been in her bladder and kidneys. Poor girl! We have switched antibiotics and after a week I have seen an improvement in that Ella isn't stooping the min we get out the front door! Sometimes she even waits till we get to a small patch of grass a block or so from my house.

She is still drinking more than normal and having accidents even though I have been coming home to let her out during my lunch break. We will be on antibiotics for another 4 weeks to really kill this bug. So hopefully Ella will be 100% by then!

[Steph n' Ella]

All- Ella has shown much improvement since April/May! Her energy is way up, anemia has cleared up, and thyroid levels are in the therapeutic range!

I am still dealing with house training issues :( , though.

Before Ella's last heat (January-March) she settled in well at my house and she went from being in her crate while I was at work (returning at lunch to let her out) to having limited access to the house to roam around and do as she pleased. No accidents.
During her heat, she had accidents at first, which is pretty normal. But as soon as I got her on sanitary pads she would wait to be let out. She only peed her pad once when someone accidently let her outside with her pad still on.

Once the bleeding was over and all Ella had was a slight discharge, I took off the pads and the accidents started. I took her in to an emergency vet on a Sunday in April b/c I suspected a UTI but they couldn't see any bacteria on the slide. However, Ella’s protein levels where elevated and there was blood (not sure if from heat or not) in her urine. They said her culture was negative for bacteria but I had her do a week of antibiotics anyway. BTW I have never been able to get my hands on these test results...arg! :mad:

I have a feeling that she did have the start of an infection in April then I went on vacation for a week in May and Ella stayed with a dog sitter. This is when her infection got totally out of control with lots of accidents in the house and blood in her urine. Dog sitter decided to withhold/limit water...what can I say, she wasn't paid to stay at my parent's house so that was her last resort.

Right after I got back from vacation, I got Ella on long term antibiotics. I have felt bad for her and let her get away with peeing in the house because I figured she’s sick and needed to flush that infection out her system. On days when I am determined not to clean up an accident, we are going out once every hour. I feel like the water is literally going right through her!

Since she is more alert and less lethargic, she is getting up a couple times in the middle of the night to guzzle water…and of course I have to let her out otherwise there will be an accident. If I go to bed around 10 or 11, I am up with her around 2:30 or 3:00 and then again at 5 or 5:30 (when my boyfriend leaves for work so we are up any way). Then I sleep for a few more hours and she is right back outside having to pee at 8 am. I have now resorted to crating her at night...which kills me b/c she is crated for 8 hours while I am at work during the day. I leave her about a ½ a cup or ¾ of a cup to drink and it is usually dry by the morning/when I get home.

The results from her last urinalysis are:
>100,000 organisms per ml Proteus mirabilis (treated with 250 mg ciprofloxacin for 45 days)
Vet thought infection was in bladder, kidney and urinary tract.
WBC 15-20
RBC 75-100
Protein 1+
3+ammonium magnesium phosphate crystals
Ph 8.5
USG 1.016
(I have read that that USG is low…1.008 - 1.012 (dilute urine) shows 75% kidney damage and normal concentration should be above 1.025 and usually is greater that 1.045 (a concentrated urine)

She goes in on 7/12 for another urinalysis… should I ask about her kidneys and USG if it is still that low? How are the rest of these numbers impacted by infection vs. permanent damage?:confused:

[Steph n' Ella]

Reading around here... I am going to check out the Yahoo group on kidney disease... :( I really hope there isn't any permanent damage!

[Steph n' Ella]

Well...finally finished antibiotics and got the all "clear" from the UTI-kidney-bladder infection but the polydipsia and polyuria remain :( Also, last urinalysis numbers showed un-concentrated urine, again. We are going to do a "first of the morning" urine sample to test to get a better picture of her kidney function. IMS said it could be one of the following...

1) Psychogenic Polydipsia
2) Chronic Renal Failure
3) Pituitary Tumor/Issue

I feel like I'm going in circles with my poor little doggie!

Yahoo group on kidney disease was somewhat helpful. Got some attitude about posting without a CRF diagnosis...so why don't they call it the CRF yahoo group, then :P

[Steph n' Ella]

Ella had her spay and liver biopsy on Friday! It was such a relief as I have been trying to get her under the knife since February. Of course she was right at the top of the range of having anemia...37 :( Thank goodness I wasn't bringing her home after her pre-op blood work this time.

Ella is really cut up...poor girl. She is wearing my tank tops around to keep her from itching/biting the incision. Surgeon said that the liver looked fine to him. Also that her kidneys looked good but all he could see were the outside capsules.

Now that surgery is over I can focus on the PD/PU. Her USG was even worse in June than it was in May and the IMS finally said something about it.

In other news, my parents' 14 y/o English Cocker Max (short for Maximillion) has cancer in his spleen. They are considering a splenectomy. Anyone with any experience with canine splenectomy?!?

[nibbles-mommy]

Hi my nibbles had a splenectomy a few years ago, he was 14 or 15 at the time. He had a large tumor on it but it was benign. Took a few days to heal but he was up and about within a week. He was also neutered at the same time.

Good luck to both pups

Debbie

[Steph n' Ella]

Oh that is good to hear! Do you remember how much you paid?! The IMS in Northern Virginia is saying $5000 but my mom's regular vet in Maryland is saying he will do it for half of that. :confused:

[Squirt's Mom]

Hi Steph,

Squirt had a partial splenectomy in 1998, at the age of 10, due to a mass that proved to be benign. She was in the hospital for 2 days, came home 1 day, had an acute pancreatic attack and went back to the hospital for four more days. Once she was home for good, she did fine other than being very sore for a week or so. Our total cost was in the $8000 range...but she had more days in the UCI than normal due to the pancreas flare up.

I hope Max does well! Please let us know how he is doing!

What good news that Ella's surgery and biopsy went well and she is back home where she belongs! When you get the path report on the biopsy, let us know!

Hugs,
Leslie and the gang

[nibbles-mommy]

omg :eek:

The total operation itself was around $1000, which included the biopsy and neutering. Ultrasound $500 at univeristy of penn. We're in Philadelphia.

[molly muffin]

Might be worth checking out the U of Penn. Road trip! to say that much money would be worth it!

Glad everything went alright with the testing and spaying. :) Love good news.

hugs,
Sharlene

[Steph n' Ella]

Oh I'm not sure about traveling for dog surgery....and I am not sure how much price actually factors in to my mom's thinking. She's always willing to do anything for Max. Early last year he had back surgery to remove a herniated disk and lots of hydrotherapy after that. Then last Thanksgiving he had two strokes...after that even more hydrotherapy to recover. He's like a cat with his 9 lives!

No results from the biopsy for Ella...guess I'll call the IMS on Monday! Happy weekend all!

[molly muffin]

Goodness, Max does have a stroke of luck going for him (no pun intended) :)

Have a good weekend,
Sharlene

[Tina]

Hi Steph,

Thanks for the idea about using a t-shirt to keep my little Shelby from messing with her sutures after getting spayed. I tried to use one of her doggie shirts, but she is still able to lick the incision. So I have had to put the e collar back on. Jasper, my cushpup, is afraid of the collar! He is avoiding her at all costs.

I hope Ella is feeling well as she recovers from her surgery, and that her biopsy is negative.

Hugs,

Tina

[Steph n' Ella]

WELL...free catch USG is at 1.015 :( Grrrrr.... we are going to culture her urine just incase there is still infection...

Liver biopsy showed hepatic nodular hyperplasia, which is benign, and swelling (again, non-specific finding for Cushings).

Since Ella is still having accidents, panting, and seeking out cool places (sleeping on the tile...head on top of the ac vent) IMS discussed doing LDDS to look at Cushings. I will let you all know when we have a date for the test!

Also, going to post a photo of Ella in my tank top soon! It's all blinged out! Sooo cute!

[molly muffin]

Hardest thing ever to diagnose. Everyone says it and I believe it. Let us know how things are going.

Hugs,
Sharlene

[Steph n' Ella]

Here she is with her tank on!
http://www.k9cushings.com/forum/picture.php?albumid=526&pictureid=4024

[Boriss McCall]

awe.. cute baby!

[molly muffin]

awwwww, what a sweetie.

hugs,
Sharlene

[Squirt's Mom]

If I put something like that on Squirt or Trink they would lay down and look at me like, "Who do you think you are?!" :p Neither of those girls would stand for it and I so wanted to dress Squirty up when she was younger but she taught me early and well that was NOT gonna happen! :rolleyes::D

[molly muffin]

I put booties on molly once, to try to protect her feet when walking outside in the snow, ice and salt they put down. She laid down and refuse to move an inch. You couldn't drag her to her feet and if you picked her up and put her down she'd just collapse back onto the ground and look at you like you have lost all the marbles in your head.
Nope, wouldn't happen for us either. :( I do make her wear her coat in the winter though when it is really cold out side. At least she doesn't refuse that outright, just prefers Not to have it. (and it's so cute too, all pink and shearling) *sigh*

Sharlene

[Steph n' Ella]

I donno if it is b/c she was show doggie or what but Ella lets me do anything to her w/o squirming at all! For grooming she stands up on the grooming table and "stacks" herself like..."I know what to do up here...hurry up and get it over with"! After every drink of water she lets me dry off her jowels so she doesn't get dry rot, every morning she lets me scoop her eye boogies out, and she loves getting her ears cleaned! Part of it is she loves the attention!

[Boriss McCall]

What a good baby.. sweet Ella.. Boriss loves putting his clothes on. Luckily in Texas we don't have to worry about the cold so much. I don't think he would be a fan of the shoes & ice.

[Steph n' Ella]

Vet confirmed no infection from the urine culture. Ella is really starting to feel better since her spay. I knew her hormones were all over the place but I never realized how much it was distracting her from leading a normal doggie life. House training has finally "clicked"...even though she is drinking lots and I am taking her out lots... she finally "gets it"! If she goes outside and does her business she gets a treat; if she has an accident there is no treat! Boy is she food driven!

Yesterday my bf caught her staring out the front window watching the foot traffic and barking at other dogs! It made me well up with emotion... finally able to act like a normal dog and not be stuck in a bubble of feeling ill.

I live about two blocks from Camden Yards... Yankees played the Orioles last night. I am sure Ella was barking at those damn Yankee fans ;)

[Boriss McCall]

YAY! It is so good to read good things about everyones pups. Glad she is feeling happy.:)

[Steph n' Ella]

LDDS is scheduled for Wednesday the 19th! I am starting to feel nervous...on one hand I want her to suppress and on the other it would be great to have a diagnosis and medicine to reduce water intake/panting/searching out cool places to rest. I have seen somewhat of an improvement lately...not sure if Ella is more comfortable due to the weather change or her spay?! Hummm....

[Steph n' Ella]

Just got the results from the LDDS...negative. I am happy b/c no cushings...but upset that Ella is continuing to have PU/PD issues. I thought she was doing a little better last week...and then on Tues. I was running around the house and had to go in to the guest bedroom...pee everywhere (old and new stains.) :( :(

I am going to drop off another fee catch urine sample at the IMS and they are going to get another USG on Ella. Also, we discussed treating for diabetes insipidus. :confused::confused::confused:

[Squirt's Mom]

Hi Steph,

That was going to be my suggestion, too - check for DI. It is rare but we have seen a few cases here. Here are a few links about DI -

• Polyuria, Polydipsia and Diabetes Insipidus
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2556

• Diabetes Insipidus
http://www.petplace.com/article-printer-friendly.aspx?id=3258

• Diabetes insipidus
http://www.provet.co.uk/health/diseases/diabetesinsipidus.htm

• Diabetes Insipidus
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/40507.htm

How is Ella doing otherwise? She is such a lucky girl that you took her into your heart and home.

Hugs,
Leslie and the gang

[Boriss McCall]

Steph,
Like you I am glad she doesn't have the cush.:)
But, I know you have to be very frustrated.:( Hope it all gets sorted out soon.

[addy]

I am so glad Ella does not have Cushings. Keep trying to sort it out. You are doing an amazing job!!!!

[3bostons]

Hi, I completely know what you mean about the nervous feelings of an approaching vet appt, it happens to me every time :(
Glad to hear your pup doesnt have cushings, hope you find out some answers soon and help put your mind at ease.
hugs, kona and deb

[molly muffin]

Yea for noncushings. :) Now to just try and figure out what Is going on. Hopefully the tests you are planning can eliminate some other possibilities or confirm as the case may be.

You're doing an awesome job!

hugs,
Sharlene

[Harley PoMMom]

Hi Steph,

I noticed while reading your thread that Ella is taking thyroid medicine, has her thyroid function been tested lately? Hyperthyroidism symptoms in a dog are excessive drinking/urinating, among others.

Love and hugs,
Lori

[Steph n' Ella]

Hummm... I will have to see about thyroid function. I have noticed that she has calmed down a bunch since the she had testing in June and her T4 was at 11 or so and then we halved her soloxine. Less pacing/circling and able to lay down on her bed or cuddle on the sofa. Also, I go ahead and give her the soloxine along with her morning and evening meal...she seems to absorbing just fine.

The vet seems to think Ella's vulva and teats are not as swollen as before...but to me they are both still abnormally large. I am hopeing that since her spay last month they will continue to shrink up.

Like I said earlier, her fun little personality is really starting to shine through and she is acting more and more like a "house doggie" and less and less like a kennel dog everyday. Ella has figured out how to get up on the sofa--notice I do not say "jump" because she doesn't jump. She gets her front two paws up on the sofa cushion no problem. Then slides forward as much a doggie possible...untill her "tummy" (really its her big udders back there) hit the sofa. Then her little back legs start scampering and bending in until she gets her tipie tip toe on the very edge of the sofa...supporting her little bum bum up there. Boy is she proud of herself when she finally makes it!

She knows a bunch of really great "show room" comands like "stay" and she is a dream on a lead/leash but she didn't know how to "sit" on command for the longest time. Well now she is sitting for all her treats! Yay! Who says old dogs can't learn new tricks?!

Now if only I could get her interested in fetching or playing with toys...

[molly muffin]

Oh Ella is making such progress and you have worked with her so hard. Congratulations to you both!

I bet the play stuff will happen eventually too, or at least I hope it does. Nothing like seeing a dog walk around with it's toy in it's mouth. It's hilarious. The other day, there was a dog trotting with it's owner with I swear it was a GI Joe, hanging out of it's mouth, just as proud as could be.

hugs,
Sharlene

[Steph n' Ella]

Ok...here are the numbers:

LDDST 9/22/2012

Pre cortisol level - 2.7
4 hours - 0.8
8 hours - 1.2

IMS writes -- recommend drop of "first of the morning" urine sample to check for DI (less than 1.008). Also, maybe check blood work for kidney values and calcium level, which may cause excessive thirst. I am doing some reserach now on calcium levels. Does anyone else understand how high blood calcium levels are connected to polydypsia?

[molly muffin]

How is Ella doing? Still making progress I hope :)

Sharlene

[molly muffin]

Happy Thanksgiving!!!

hugs,
Sharlene and Molly Muffin

[Steph n' Ella]

Sorry I have been away for a while! I started a new job in October and am now really busy during the day!

We have lowered Ella's thyroid medicine and her excessive thirst is lessening. I am now able to leave her for 5-6 hours w/o accidents instead of rushing back home every 4 hours...progress!

Max, my parents' dog, lost his battle with cancer two weeks ago. It was a very sad day but they have desided to be a happy single dog owners. Their Caleb is 8 and enjoying all the attention all he time!

Saw this post from Fiona Apple, a singer song writer, and thought of you all... her dog is 14 y/o and has addisons. She is not traveling over the holidays b/c she want to spend the time she has left with her doggie.


Fiona Apple

23 hours ago.


It's 6pm on Friday,and I'm writing to a few thousand friends I have not met yet.
I am writing to ask them to change our plans and meet a little while later.
Here's the thing.
I have a dog Janet, and she's been ill for almost two years now,
as a tumor has been idling in her chest, growing ever so slowly. She's almost 14 years old now.I got her when she was 4 months old. I was 21 then ,an adult officially - and she was my child.
She is a pitbull, and was found in Echo Park, with a rope around her neck, and bites all over her ears and face.
She was the one the dogfighters use to puff up the confidence of the contenders.
She's almost 14 and I've never seen her start a fight ,or bite, or even growl, so I can understand why they chose her for that awful role. She's a pacifist.
Janet has been the most consistent relationship of my adult life, and that is just a fact.
We've lived in numerous houses, and jumped a few make shift families, but it's always really been the two of us.
She slept in bed with me, her head on the pillow, and she accepted my hysterical, tearful face into her chest, with her paws around me, every time I was heartbroken, or spirit-broken, or just lost, and as years went by, she let me take the role of her child, as I fell asleep, with her chin resting above my head.
She was under the piano when I wrote songs, barked any time I tried to record anything, and she was in the studio with me all the time we recorded the last album.
The last time I came back from tour, she was spry as ever, and she's used to me being gone for a few weeks every 6 or 7 years.
She has Addison's Disease, which makes it dangerous for her to travel since she needs regular injections of Cortisol, because she reacts to stress and to excitement without the physiological tools which keep most of us from literally panicking to death.
Despite all of this, she’s effortlessly joyful and playful, and only stopped acting like a puppy about 3 years ago.
She's my best friend and my mother and my daughter, my benefactor, and she's the one who taught me what love is.
I can't come to South America. Not now.
When I got back from the last leg of the US tour, there was a big, big difference.
She doesn't even want to go for walks anymore.
I know that she's not sad about aging or dying. Animals have a survival instinct, but a sense of mortality and vanity, they do not. That’s why they are so much more present than people.
But I know that she is coming close to point where she will stop being a dog, and instead, be part of everything. She’ll be in the wind, and in the soil, and the snow, and in me, wherever I go.
I just can't leave her now, please understand.
If I go away again, I’m afraid she'll die and I won't have the honor of singing her to sleep, of escorting her out.
Sometimes it takes me 20 minutes to pick which socks to wear to bed.
But this decision is instant.
These are the choices we make, which define us.
I will not be the woman who puts her career ahead of love and friendship.
I am the woman who stays home and bakes Tilapia for my dearest, oldest friend.
And helps her be comfortable, and comforted, and safe, and important.
Many of us these days, we dread the death of a loved one. It is the ugly truth of Life, that keeps us feeling terrified and alone.
I wish we could also appreciate the time that lies right beside the end of time.
I know that I will feel the most overwhelming knowledge of her, and of her life and of my love for her, in the last moments.
I need to do my damnedest to be there for that.
Because it will be the most beautiful, the most intense, the most enriching experience of life I've ever known.
When she dies.
So I am staying home, and I am listening to her snore and wheeze, and reveling in the swampiest, most awful breath that ever emanated from an angel.
And I am asking for your blessing.

I'll be seeing you.
Love, Fiona

Hope you all have a great thanksgiving and give the pups a big hug from me and Ella!

[Squirt's Mom]

Steph, that is absolutely beautiful. Thanks for posting it.

I hope you and yours have a wonderful Thanksgiving!
Hugs,
Leslie and the gang

[molly muffin]

Thank you. Truly soul enriching to read her words and understand them so completely.

Hugs,
Sharlene and Molly Muffin

[Boriss McCall]

wow.. that was heavy. I had to walk away from that & come back a couple of times. Everything she said is so true! thanks for sharing.

[molly muffin]

Hi Steph, Happy Holidays to you and Ella.

Hope the job is working out okay.

Have a safe and wonderful holiday.

hugs,
Sharlene and Molly Muffin