New Arrival - Sienna

[Shirley]

Hi, my name is Shirley. At the end of August I did an adoption from a rescue group and named the new family member Sienna. She is a sweetie. When she arrived, I was told that she was on antibiotics for loose stools, but the rescue group felt she had a UTI also. I followed up with my local vet who confirmed the UTI and prescribed more antibiotics. However, the frequent thirst and urination did not go away. Following a second urine test I was informed that Sienna has Cushings, although at this time I do not know if it is tumor caused or not. Of course I am devastated. I have 3 other dogs, one with thyroid problems and another with chronic AIHA. Needless to say my intent was to adopt a healthy dog as a play partner for my one existing healthy dog. I have seriously considered asking the rescue group to take her back, but I know that future adoption for her is unlikely. I was also told that she was approximately 2-1/2 yrs old, but my vet is thinking that this age has to be way off.

I would appreciate any and all information regarding what I may be looking at, going forward in the treatment of Sienna. The scary thing for me is the responsibillity of 3 unhealthy dogs, both from a financial stand point and time taken away from work to do vet visits for frequent blood work. Also, my AIHA pet will be taking prednisone for the rest of her life, which may result in Cushings, so I could very well have two pets with the same disease.

Thank you.

[Boriss McCall]

Hi Shirley! welcome. You do have your hands full.:o
My dog has been on cushings meds for a little over a month now. so, I am fairly new to the game. It is definitely a costly illness.:(

The good thing is if your other dog on prednisone becomes cushings it is not forever. If you stop the preds it goes away.
More experienced people on here.. am I right? If not I am sorry for bad advice. :o But, I thought I read that somewhere.

Shirley.. we are all here to help. :)
More experienced people will be by with lots of information & questions for you.

[Shirley]

Thank you and thanks for the info regarding prednisone. Looks like I have some major decisions to make.

[addy]

Following a second urine test I was informed that Sienna has Cushings

Hi and Welcome,

I glad you found us. Cushings cannot be diagnosed through a urine test. There is a UC:CR test that can tell you if a dog does not have Cushings or needs more testing.

Could you possibly look back and confirm which test your sweet girl had to confirm Cushings and if possible list the results here?

Hang on and we'll sort things out.

[goldengirl88]

Shirley:
This may sound stupid, but do you think the rescue would help you, or maybe get the medical treatment done for the dog if you talked to them? The rescues I know about around here usually get treatment from the vets at really reduced prices, and RX'S at reduced prices. I feel for you. I have one cat, and my dog that constantly need medical treatment, and at times it is overwhelming. I give you credit for having 3, that is a lot of worry, and expense. Hope you have good luck with the situation, and your other two babies.

[Lady's mom]

GG makes a good point. A lot of rescues will help with medical expenses, especially if the dog was sick when they adopted her.

Good luck to you!

[Shirley]

To be more specific, different testing was done on the 2nd urine sample, which showed an extremely high level of cortisol (?). Based on that, my vet's opinion was Cushings. He is going to do a blood test, which I understand will determine if it is cushings or tumor caused cushings. Does this make more sense or am I confused? I believe that he questioned her age because he felt that Cushings is an older dog disease, but if she is really a young dog then it more than likely tumor related.

[Squirt's Mom]

Hi Shirley and welcome to you and Sienna! :)

Pituitary and adrenal based Cushing's both involve tumors - PDH, the pituitary form, is caused by a microscopic tumor on the pituitary gland, which is in the skull; ADH, the adrenal form, is caused by a tumor on one of the adrenal glands, of which there are two located in the abdomen just above the kidneys. PDH is the most common form - 85% of cush pups have this form of Cushing's. It is possible, but very rare, for a pup to have two adrenal tumors, or tumors on both the adrenal and pituitary.

There is another form called Atypical which does NOT involve cortisol elevations and there may or may not be a tumor with this form.

The fourth form is called Iatrogenic and it is caused by the use of steroids, whether orally, injections, creams, drops, etc and is "cured" but weaning off the steroids, if possible.

I wouldn't jump to conclusions that Sienna has Cushing's based on the second urine test...this disease is one of, if not the, most difficult canine condition to diagnose. And it cannot be diagnosed with urine - many things can cause elevated cortisol other than Cushing's. 2 1/2 is young to have this disease but we have had pups as young as three diagnosed. However, her age is another reason to take your time and make absolutely sure this is Cushing's. Do not let the vet rush you into treatment - Cushing's is a very slow progressing condition so you have plenty of time to do testing and learn as much as possible BEFORE starting treatment of any kind for Cushing's. ;)

Other than the UTIs, drinking and urination, what other signs, or changes in behavior, have you seen? Has her appearance changed? How is her coat? What breed(s) is she?

Hang in there! Keep reading and asking questions...we will do all we can to help you understand. It is a lot to take in at first, but you are no longer alone. You and Sienna have a new family here that will be with you all the way.

Hugs,
Leslie and the gang

[lulusmom]

Hi and welcome to the forum.

I assume the urine test your vet did was the urine cortisol creatinine ratio (UC:CR) and the test he wants to do now is a low dose dexamethasone suppression test. (LDDS) If you live in the U.S., you cannot diagnose cushing's based on a urine test. The UC:CR is a preliminary screening test which can rule out cushing's if normal but if results are high, it could be cushing's or any other condition that can elevate cortisol. That is why additional testing must be done.

My dog was diagnosed at three years old so while uncommon, younger dogs do have cushing's at an early age. With respect to dogs with adrenal tumors, the average age of dogs is actually older than those with pituitary dependent disease. Based on the little information you've provided, I have concerns about your vet's experience with cushing's. It is the most difficult disease to diagnose because no one test can be relied upon to be 100% accurate, thus the need for validating and differentiating tests.

What breed is your dog and did your vet do a complete blood chemistry, cbc and urine culture before doing the UC:CR to check for abnormalities associated with cushing's. Can you round up a copy of every test that was done and post the results here? It will really help us figure out what is going on.

I am a rescuer and I adopted a shelter dog knowing full well that he had cushing's and that if I didn't take him, he would have been put down. Some rescues don't have a lot of funds so spending hundreds or thousands of dollars on one dog would prevent them from saving scores of healthy dogs in danger of dying. It's a double edged sword and I'm a big sucker. Jojo had five good years with us and I don't have one single regret about taking him into our family. He passed in June and I still miss the snotty little guy like crazy.

I am in southern california. 40 miles east of L.A. and I can get some veterinary discounts so if you are in my area, I'll be happy to help in any way I can.

Glynda

[Shirley]

Thank you Leslie - I feel better. Sienna is a chow. So far I have seen only 3 symptoms, frequent urination (accidents in the house), substantial drinking and a massive appetite. I'm thinking that she is in the early stages. Also, thanks for explaining everything. I do have complete confidence in my vet and if he is uncomfortable with a situation, I know that he will refer me to someone who has more experience.

[Shirley]

Glynda, I also thank you for the information and I appreciate your offer, but unfortunately I'm in upstate NY. Actually, the reason my vet did the urine test was because I had taken the sample in to his office. I thought that Sienna had not recovered from the UTI that we had treated her for a month before. So, when he didn't find anything there and based on her symptoms, he ran additonal tests until he did find something. I believe he said that the cortisol level was at 70. Right now, I am waiting for him to schedule the blood work test. I don't really think the bathroom accidents in the house are related and believe she is not house trained well, but on the other hand when I make her go outiside every hour, she always urinates.

Shirley

[lulusmom]

Shirley, I'm going to be completely honest with you here because I've been down the road you are on with my own gp vet seven years ago. If your vet announced that Sienna had cushing's based on a urine test, you most definitely should not have complete confidence in him nor place blind faith in his abilities to properly diagnose and treat Sienna should a more definitive diagnosis be confirmed after appropriate testing.

Can you round up all of the testing that has been done thus far and post the results for us? The urinalysis should have included urine specific gravity (USG) which is low if a dog is not concentrating her urine. When urine is dilute, a normal urinalysis will not pick up all of the white cells, which makes it necessary to do a urine culture to determine the types of bacterial involved so as to prescribe an appropriate a/b. Was the UC:CR done when Sienna had an active urinary tract infection? If so, that test is invalid as any type of infection and /or stress on the dog's body can yield a high UC:CR ratio.

We're here to help you in any way we can and that includes helping educate vets who may have little experience. My best advice to new members is to educate yourself so that you can take an active participation in your dog's treatment. Most of us were frazzled when we arrived here, skidding in sideways, thinking holy cow, I have no idea what cushing's is and I have no idea what I am going to do. It's amazing what I learned from members who have walked in my shoes, had hands on experience for a very long time, compassion beyond compare and a willingness to support me and my dogs and help me learn how to take care of them. You no longer have to walk alone on this journey. Were are with you with every step. You are family now and we're here to hold your hand, prop you up and give you the information you need to be the best advocate you can be for Sienna.

Glynda

P.S. Have you called the rescue to see if they are willing to help you with testing? If not, I would recommend that you do so because you have nothing to lose.

[Shirley]

I'd like to thank all of you for the information you shared with me when I first posted. It seems that Sienna's extreme thirst and frequent urination has declined. Although, she still has a large appetite. I spoke with my vet and we have decided to monitor her for the time being until we see a sign that that her symptoms are getting worse. Overall, she seems to be happier and more playful. I'm still very concerned about her health but I honestly feel that she is acting much differently. I'd like to monitor her water intake to be sure that it is a comfortable level, but can't really do this with all 4 dogs drinking from the same container. Does anyone have a formula for what the average water consuption per day should be?

Thank you,
Shirley

[lulusmom]

Hi Shirley,

I understand the dilemma with trying to monitor water intake when you have four dogs and in my case four cats. I personally wouldn't worry about doing that. I'd be more interested to know if Sienna's pee is dilute with low specific gravity. My dog had chronic pu/pd and his pee was completely colorless and odorless. His kidney's never concentrated his urine, even after stabilizing on treatment. If Sienna's pee is concentrated, it could be that she is just a dog that drinks more than most. To be sure, I'd recommend that you ask your vet if he checked the urine specific gravity.

Glynda

[molly muffin]

Hello and welcome. If it comes down to it, and you still are worried about cushings, then I'd go with a full blood panel and probably and LDDS test to see if she can suppress cortisol or not. Otherwise, monitoring till you really know what she is all about and until she is really feeling settled might be an option. Resuce dogs can take awhile to get that really comfortable settled feeling in a home. I got mine from a rescue when she was 11 months. She has always had issues with going in the house at times, when she is acting up in response to something she doesn't like. Which just makes it that much harder when watching for cushings.
However, like I said, if still worried, then those are the tests I'd go with, have in fact gone with. Another thing and you might already do this is to get copies of all the lab test results and keep your own file. This is good for all your animals and peace of mind. Being able to refer back to them if needed down the road.

Congratulations on your new family member by the way. :)

Sharlene and molly muffin

[Shirley]

No, pee is not diluted and at this point I honestly don't believe that Sienna has Cushings. I believe that she has a thyroid problem because she displays the same symptoms that my boy Benny did when first diagnosed with thyroid issues. I also believe that she has been through a rough time and is very insecure & nervous. When I left the house with out her, she urinated, which is why I never caught her in the act. She truly does not want me out of her sight. Poor girl, we have a lot of work ahead of us. So, once again, thank you. I am going to watch her for a few more weeks, but everything I am seeing now is pointing away from Cushings and pointing to behavior and a different medical concern.

Shirley

[lulusmom]

Hi Shirley,

I'm sure you already know that Chows are no strangers to hypothyroidism and I'm sure you also know that hypothyroidism can cause any number of behavioral changes in a dog. I'm hoping and praying that Sienna's biggest problem is low thyroid as it is so easy and economical to treat. When you take Sienna in for a full thyroid panel, you may want to ask your vet to send the blood sample to Hemopet. This is a great non profit facility offering the most staqte of the art thyroid testing in the country. We've had a good number of members who have used Hemopet and have communicated directly with it's founder, Dr. Jean Dodds. She is very good about answering any questions pet owners may have. See URL below.

http://www.hemopet.org/

Please don't leave us because we're rooting for you and Sienna and would love to keep getting your updates on her progress.

Glynda

[molly muffin]

Glynda is right, did we forget to mention that once you join us, cushings or not, you're family for better or worse, sickness and health? :)

We mean it. So do check in and let us know how things are going.

Sharlene and Molly Muffin

[Squirt's Mom]

Hi Shirley,

I have been privileged to share my life with one Chow - or rather, he honored me by staying with me. :D He was a stray that wondered up on our property one evening and sat by a light pole near the road. If I walked toward him, he would stand, growl and dare me to approach - I didn't and instead would stop when he growled, sit on the ground and just talk to him. After three weeks of these visits several times a day, I woke up one morning and went out on the back porch to find his spot by the pole empty. I was saddened that he was gone as I had been enjoying our talks and hoped he would be safe where ever he had gone.

With a cup of coffee in my hand, I walked around to the back yard to check on my mama cat and her kittens. Suddenly I felt a sting on my butt and whirled around, spilling coffee in a neat little air-born circle to find Red, the Chow, behind me, grinning from ear to ear and wagging his tail like crazy. When I had turned to fully face him, Red dropped his front end down in play pose then leapt up as if to land in my arms. From that moment on, Red was my dog and he let everyone know it.

When company came, Red was the first to meet them - at the car, where they stayed until I said "ok" - literally. I never taught him this, he did it on his own. There were a few occasions when even after I had said it was ok, he still didn't want those people out and on his property - and he was absolutely right...they should have never been allowed at our house and they never came back.

He always went to the barn with me and dearly loved the horses. As I groomed, he would stand under them, licking their bellies - and they loved him. One of my little fillies would come running across the pasture when she saw Red coming just so he could lick her belly. :p He seemed to catch on to their training and helped me work them every day without being taught. If they were out in the fields and I needed them in the barn, all I had to say was, "Where are the horses, Red?" and he would go find them and drive them to the barn, putting each in the right stall. I have never saddle-broke a foal so easily as when Red was around. As I laid the saddle on their backs, he would stand under them, softly licking their belly, and they never once bolted, reared, or bucked - they stood calmly, bearing the new, strange, dangling weight.

I used garbage bags, among other items, to help the horses learn not to shy at things. The little filly who would come running to have her belly licked would take a bag in her teeth, then run off with it flapping out behind her as Red chased her around the pasture. They had great fun together and it was hilarious to watch. :p

My butt and back of my thighs always had red whelps from Red sneaking up behind me and nipping just to see me jump. :D:p:D Why he didn't lick my belly instead, I'll never know! :D He would also nip my husband but Red didn't drop down in play pose after with him but just stood there as if daring him to move. Again, sign of good character judgement. ;)

Red stayed with me for nearly two years then one morning he was not there and I never saw him again. Jubilee, the playful filly, and I mourned him for months.

I have never forgotten that time with Red and think of him every time I see a horse or a Chow, praying the remainder of his life was full of love and joy.

Nothing about this post concerns Cushing's or any other health issue, but I don't get to talk about Red often and wanted to share some of my memories of him with another Chow mom. ;) Red was an amazing boy and I was blessed to share a couple of years with him and his quirky ways.

Hugs,
Leslie and the gang

[Boriss McCall]

ah.. tears.. what a sweet story!

[goldengirl88]

Leslie:
Oh my goodness what a beautiful story!! That must have been one special baby!!

[molly muffin]

It is good to be reminded that not all of our dog stories has to do with cushings. :) Thanks for that Leslie.

I hope Red had a good happy life too. What a wonderful adventure the two of you shared.

Sharlene