Female Labrador (the sweetest thing you'll ever meet!)

[lizzyjones]

So, our 10 1/2 yo Lab wasn't feeling well last week (wouldn't eat, drink and was lethargic). If she won't eat, I know she's sick. So, to the vet we went where they found her heart rate was spiking at 300 beats/minute. The vet was sure it was a heart problem--they began with an x-ray and EKG...neither showed a problem. We scheduled her for a cardiograph the next day--also normal. Her blood panel did show 3 elevated liver enzymes, so they are thinking Cushings. Cushings was mentioned last year as well when the vet noticed a slightly elevated enzyme...but he said we would just watch it as it was not terribly significant.
This morning I did a pee catch (she wondered why I was following her around the yard while she was out for her morning pee). They are going to do a cortisol/creatine ratio.
Nothing definite yet...I've tried to find if tachycardia (rapid heart rate) is associated with Cushings but haven't found anything...anyone here with your wealth of knowledge/experience come across that? She's on Diltiazam to bring down the rate and it seems to be working well...she is back to normal. Though I have noticed her appetite is way out of control--which I have heard is common with Cushings.

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[Harley PoMMom]

Hi and welcome to you and your girl! So sorry for the reasons that brought you here but glad you found us.

When a dog is diagnosed with Cushing's disease it means that there is elevated cortisol running through their system. Uncontrolled high cortisol, within a long period of time, will damage almost every organ in a dog's body.

The symptoms you are describing do not sound like a dog with Cushing's disease. Dog's that have Cushing's usually have a ravenous appetite, increased drinking/urination, pot-bellied appearance, among other clinical signs.

Could you round up copies of all tests that were done on your girl and post any abnormalities that are listed with the reference ranges and units of measurement...example - ALT 32 (12-118 UL.)

If a dog has a chronic illness or is even stressed the tests for Cushing's can create false-positive results. So, if this were me, I would hold off doing any Cushing's tests until the reason for the tachycardia is known.

Was your girl's blood pressure checked? Was hyperthyroidism ruled out? Any other health problems? Sorry for these questions but the more we know about your girl the better our feedback will be, ok?

Please remember we are here to help in any way we can so do not hesitate to ask any and all questions.

Love and hugs,
Lori

[jmac]

Hi there and welcome from me as well!

I am sorry to hear you and your dog are going through a stressful time, but I am so glad you found us, as we will help in any way we can. Lori already gave you some basic info. and asked for more info. from you. That will help the experts guide you as best they can. We are here to answer questions and help you in any way we can. We look forward to hearing more about your dog.

Julie & Hannah

[lulusmom]

Hi and welcome to the forum.

I'm sorry your girl had such an ordeal and I'm glad she's back to normal. Did your vet find out what was causing the inappettance and extreme lethargy? Please do post results as Lori has requested as that will help us a lot. We aren't vets but most of us have been dealing with this disease for a very long time and are getting pretty good at interpreting bloodwork and urine tests. There is a definite pattern in blood and urine abnormalities in a dog with cushing's so this is what we look for.

With respect to the rapid heart rate, there are two conditions involving abnormal adrenal activity that comes to mind. The first is pancreatitis. Cushdogs are prone to this condition. The second is an adrenal tumor that secretes different types of hormones called catecholamines. These are primarily dopamine, norepinephrine, and epinephrine and norepinephrine and epinephrine definitely increases the heart rate and blood pressure. There is no rhyme or reason as to when the adrenal gland is going to dump these hormones so symptoms are usually episodic. One day the dog feels fine and the next, they are lethargic and won't eat. We have a member, Kim, who is very familiar with this type of adrenal tumor and I'm sure she'll be by to share her experience with you.

https://www.addl.purdue.edu/newsletters/2007/Spring/CP.htm

Glynda

[lizzyjones]

Thank you all so much. I love how much you all care!

So, we did the urine analysis and they said it came back normal, so they are no longer pursuing a diagnosis of Cushings.

But that leaves us in the same place not knowing what caused the heart rate increase. For now we still have her on 30mg of Diltiazem every 8 hours--it seems to be working to keep her heart on track.

The liver enzymes that were elevated were ALK Phosphate, ALT (SGPT), and AST (SGOT).

ALK was 422
ALT was 165
AST was 137

The vet we saw last week wonders if maybe the liver enzymes were so elevated because her heart was beating so fast that it was an inefficient pump which may have affected the liver function. So we're going to repeat the blood work to see if we get the same values. If we do, I'll probably end up taking her to an internal medicine vet for further investigation. Were in Utah and there are not many to choose from.

I am most worried about it being a pheochromocytoma. I've read a few other folks' stories on here about that--quite alarming!

Thank you each again for sharing your time and caring!

[frijole]

Hi. I'm Kim who Glynda mentioned and my Annie had a pheochromocytoma. What you described is similar both with the irregular heartbeat that comes in episodes as well as the lack of appetite.

The way to rule it out or in is to have an ultrasound done on a high definition machine (most vets don't have at their offices so you might have to go to a specialist). They would focus on the adrenals and determine if a tumor is present.

If you are near a teaching vet school I highly recommend going to them as they can work with your vet and would have highly skilled specialists that would be more familiar with this very rare tumor.

I am here to answer any and all questions you might have. I pray it isn't a pheo but encourage you to investigate it quickly as surgery could be an option. It took us so long to figure it out that by the time we were sure it was not as safe. My girl fought it for two years but to be honest I think it was harder on me because there is so little info out there on them.

Kim

[lizzyjones]

Thank you Kim. I'm so sorry about what you and your sweet Annie went through. As you weren't able to do surgery did you use any medications to try to keep it at bay and/or reduce symptoms?

I guess we'll see what the next round of blood tests show and go from there...looks like Ft. Collins and Laramie are the closest Vet Schools...I may do some preliminary checking just in case...plan for the worst and hope for the best!

[frijole]

THanks. There is no medication other than meds for the blood pressure. I gave her Pepcid AC daily for her tummy as it growled a great deal (gas caused from the adrenaline that resulted in heartburn, ulcers and most likely the inappetance)

I took her in for acupuncture which seemed to help keep her calm - she absolutely loved it. I think it added at least a year to her life. Course that is speculation.

I ended up having to drive 5 hrs each way to the specialist at K State University. So I totally understand rural health care and the challenges presented. I share my story because if your girl is health enough now and a candidate for the surgery it is something to consider. How is her overall health?

To learn the details of my story you can click on my screen name (frijole) and go to the photo album for my dear girl Annie. You will see photos of when she was normal, photos of when we figured it out July 2010 and then exactly one year later - she had gone from skinny to a skeletal. She still was quite active and happy believe it or not but other health issues arose, primarily a corneal ulcer (hole in her eye) - probably from the pressure on the eye when the blood races to the brain when the tumor is active.

You are also free to read her thread though I warn you it is very long and the journey includes a whole lot of misdiagnosis. I just hate to see anyone waste time and money when an ultrasound could give you a quick answer. I pray it is pancreatitus but share with you that my little girl was a feisty fighter that got every single inch of life she could during her stay here on earth. So I don't regret all that I did to keep her happy.

Sending love, Kim

[lizzyjones]

Oh, my heart sunk when you mentioned the growling stomach...2 days before the "heart event" she threw up twice with no seeming provocation (I can usually pin it to something) and then that night her stomach growled so loudly...much more than I have ever heard...it lasted maybe an hour or so, but in relation to everything else it might be one more clue pointing in the same direction.

We definitely will get her in for an ultrasound if the blood tests continue to be of concern. Overall her health is good...since we've gotten her heart calmed down she's back to normal...thinking only of food and snuggles and her daily walk to smell all the news of the neighborhood.

I'm glad you were able to get that extra time with a happy Annie...that's my hope with our girl--to keep her as happy as long as possible...her joy is mine! Really the entire family's!

I'll take some time to read your story...thank you for sharing your journey--painful as it was (and probably still is).

[lizzyjones]

I read Annie's story...truly a will to live! I'm sure it's because she had such a wonderful life with you!

So, we did the ultrasound this morning with my girl...no abnormalities detected with the adrenal gland...what a relief! The did find a very small node on her liver which may be of future concern, but the vet said at this point it is so tiny that we are just going to keep an eye on it. He's recommended Denosyl to support her liver functioning...especially while she's still on the Diltiazem.

We're going to keep her on the Diltiazem for another 2-3 months and then wean her off to see what her heart does. It may be an electrical problem...or it may have been a fluke...we still have no idea what caused it.

But she's happy--just a little too warm! This is a girl who LOVES the snow and cold. It's because she insists on wearing her fur coat at all times!

Thank you again for your support--it means so much to find a community of people who really "get it". These creatures are truly living souls.

[mypuppy]

Belated Welcome to you and the sweetest thing you'll ever meet from me and my choco lab, Princess, also the sweetest thing you'll ever meet :D. lol.

Warmest regards and tight hugs,

xo Jeanette

ps: Would love to see some pics of your precious girl...