My Savannah Belle (10 y/o lab/chow mix)

[FloridaAnn]

My name is Ann, and I've been fortunate to live with Savannah, a 10 year-old lab/chow mix, since she was 3 months old. She is my best friend. I took her to the vet this week because I thought she was showing signs of a bladder infection....frequent urination, tired during our walk, and leaning against me (her sign that something is wrong). The vet noted that the urine sample I brought in was diluted and recommended a blood test. The results of the blood test came back yesterday and were concerning enough for the vet to recommend a LDDST, which happened today. I've read through previous threads and am amazed at the collective knowledge of the members on this site, so I'm asking for help. If any of you care to share your wisdom, especially regarding the diagnostic process, I would be very grateful. From what I've read, it seems that a hormone panel needs to be done in Tennessee and probably an ultrasound of Savannah's belly. Is this correct?

I'm going to post numbers from her blood work, though I'm only including those that were above or below the normal range. Please let me know what other information would be helpful. In terms of her symptoms, she has trouble climbing into my SUV, but I thought that was from arthritis. I give her Dasaquin with MSM to help with that. Other than flea and heartworm preventative, she doesn't take any other meds. We moved to South Florida from Colorado in July, and she was drinking more water. However, she has slowed down with her water consumption now that the weather has cooled. We walk daily, and she swims twice a week. She has a number of fat tumors on her belly and chest, so I can't really tell if she has the potbellied appearance of Cushing's. She is not ravenous. In fact, she sometimes ignores her food for hours. At times, her urine has seemed copious, and she had an accident inside the house a couple of days ago. Other than some bare patches at her elbows, I see no hair loss.

Reading some of your success stories is the only thing that has given me any peace of mind. I barely slept last night. My brother had a motorcycle accident in January and hasn't regained full consciousness, so we moved to Florida to be with him. I really need for Savannah to be a success story. In addition to hopefully getting some input around the diagnosis, I'd also love feedback regarding vets in or near my area that are good with these issues. I live in Deerfield Beach, but would be happy to drive to nearby communities to see an expert.

So, here are her significant numbers:
10 years old and roughly 65 lbs.
Alkaline Phosphatase 813 normal range 5-131
Total Bilirubin .4 normal range .1-.3
Cholesterol 331 normal range 92-324
Triglycerides 337 normal range 29-291
UA Specific Gravity 1.006 normal range 1.015-1.050
Protein 2+

Thank you.
Ann

[Boriss McCall]

Hi Ann & Savannah Belle,

Welcome to the board. I am so sorry to read about your brother. I know it is hard to have a sick pup & deal with stressful scary things.

I have only been dealing with a diagnosis for a few months. so, I don't have all the great information like a lot of the people on here who will help you out.

It seems kind of out of the norm for cushing's that Savannah can ignore her food. My dog was scarfing down food & sometimes things that were not food just to get something in his belly. He would look around on the carpet for food the ENTIRE evening while we watched TV.

Do have hope in knowing that if Savannah does have cushing's it is NOT the worst thing possible. The symptoms can be treated & she can still have a comfortable happy life.

It has taken us awhile to get the right dosage for Boriss. So, I am still in the trying to find the right dosage for him & things are STILL way better than when I first came here.

I am glad you found this forum. I hope you find comfort here like I did.

Amy

[molly muffin]

Hello and welcome. I'm so sorry to hear about your brother and now worries about Savannah too. That's a rough road you're traveling.

Well, lets not go full cushings yet. As Amy said, the not being ravenous for food and able to ignore isn't what you normally see in cushings dogs. It's a big change too moving from Colorado to Florida, so that might have some impact on Savannah's symptoms. I wouldn't worry about a panel from Tennessee just yet.
You've had the LDDS so lets see what that comes back as. Then you could look into an ultrasound to actually see what the liver and adrenal glands look like. That might be more in line with next steps.

Some of our members who are more familiar with what the actual test numbers mean will be by to give their opinion. We have Many years worth of experience here, not just with cushings but with things that look like cushings. So, baby steps.

We're one big family here. I hope that you will feel comfortable with us. :)

Sharlene and Molly Muffin

[Harley PoMMom]

Hi Ann,

Welcome to you and Savannah, so sorry for the reasons that brought you here but glad you found us.

Cushing's is one of the most difficult endocrine diseases to get a confirmed diagnosis for. Not one test is 100% accurate at diagnosing Cushing's and other non-adrenal illnesses can create false positive results.

You mentioned about Savannah having an UTI (urinary tract infection), has this been checked? When the urine is diluted it is best to have a urine culture and sensitivity test done to rule out an UTI. A nasty UTI can make a dog drink and urinate more, have a lack of appetite, and also can cause protein loss.

As Sharlene has said, the UTK adrenal sex hormone panel can wait and we would really be interested in the the results from the LDDS test. An abdominal ultrasound is non-invasive and can be a very useful as a diagnostic tool.

Please know we will help in any way we can so do not hesitate to ask any and all questions.

Love and hugs,
Lori

[mytil]

Hi and welcome from me too.

How horrible about your brother. And now your sweet girl.

I would like to also add, has your vet ruled out any viral or bacteria causes? For example, Ehrlichiosis (caused by ticks). Especially since you have moved to a new area where your girl may not have an increased immunity to.

With decreased appetite I would not suspect Cushing's just yet.

Looking forward to the test results.
Terry

PS I would love to see a photo of Savannah!

[FloridaAnn]

Thank you for your support. I've never been on a message board before, and I'm not really sure how to enter info, especially a photo. I'll try to figure that out. Is a urine culture and sensitivity test different from a urinalysis? When I took Savannah to the vet last Wednesday, I took a urine sample because I originally thought that she had a UTI, but no signs of infection were found. The vet injected her with an antibiotic that day and gave me oral antibiotics for follow up, but once the test results were back, he said I could stop with the antibiotics since she didn't appear to have an infection.

As far as food goes, she is always on the look out for a treat, but has a full bowl of kibble waiting on her right now. She might get around to it before dinner. I wonder if I should go back to giving the oral antibiotics the vet originally prescribed on Wednesday. She was fine on our morning walk, though she peed three times, which is more than usual. Any suggestions?

Thanks again. Since I spend all of my time either with my brother or at home with Savannah, I don't have any friends in Florida, and your support is priceless.

[frijole]

Well without spending a red penny on cushings tests I can tell you that if your dog lets a whole bowl of kibble sit idle and doesn't inhale it then she doesn't have cushings! No way. Kim

[FloridaAnn]

Okay, you all have given me some great feedback, and I'm going to start giving the oral antibiotics again. If she is still urinating more than usual once she has finished with the prescription, then I'll move forward with more testing. I'm quite disappointed that the vet didn't seem to know that the diluted urine might have been making the infection impossible to detect in the sample I brought. Given that we're new to Florida, this is a new vet for Savannah, and I think I need to find a new one.

[mytil]

Oh thanks for uploading those photos - she is certainly a cutie!

I see her mid section is a bit big - which could mean a lot of things.

Has this new vet ruled out diabetes? or thyroid problems?

Terry

[lulusmom]

Hi Ann and welcome to you and Savannah

When urine is dilute, a normal urinalysis won't detect the large amount of white cells present in an infection so a urine culture is done. If there was no bacteria noted on the culture, then it is pretty certain that there is not infection. While giving antibiotics won't hurt Savannah, it could help her build up an immunity to them which is why your vet old you to discontinue.

The blood and urine abnormalities you posted are certainly common in cushing's but with so few symptoms, your vet may be hard pressed to confirm a diagnosis even if the results of the LDDS are consistent with cushing's. I agree with others that the UTK panel is premature, pending receipt of the LDDS results. An abdominal ultrasound would be helpful in assessing the adrenal glands and surrounding organs.

Terry has asked a very important question about ruling out low thyroid or diabetes mellitus. If your vet did a complete blood chemistry, you should see results for T4 (thyroid hormone) and bg (blood glucose). If they are normal, you can pretty much rule those conditions out. It is common to see mildly high bg and low T4 in dogs with cushing's; however, these are usually transient abnormalities that normalize once the excess cortisol has been reined in with treatment.

It is possible that Savannah is in the early stages of naturally occurring cushing's or she could have atypical cushing's, which involves the elevation of the intermediate adrenal hormones with normal cortisol. Any time I hear about a dog with fatty tumors, I remember a discussion I had with the internal specialist who diagnosed my first cushdog. He had a patient presenting with blood/urine abnormalities and physical symptoms consistent with cushing's but the LDDS and ACTH stimulation tests were normal. This dog had a few fatty tumors that were quite large so he removed them. Once removed, the dogs symptoms resolved. and abnormal blood and urine values normalized. He was convinced that it was probably high levels of estradiol, one of the adrenal hormones that can be found outside the adrenal glands. Estradiol can also be found in fatty tissue so suspecting a fatty tumor makes some sense. Unfortunately, I haven't seen any reference material supporting his theory but you never know.

Glynda

[Harley PoMMom]

Thank you for your support. I've never been on a message board before, and I'm not really sure how to enter info, especially a photo. I'll try to figure that out. Is a urine culture and sensitivity test different from a urinalysis? When I took Savannah to the vet last Wednesday, I took a urine sample because I originally thought that she had a UTI, but no signs of infection were found. The vet injected her with an antibiotic that day and gave me oral antibiotics for follow up, but once the test results were back, he said I could stop with the antibiotics since she didn't appear to have an infection.



An urine culture and sensitivity test is much different than a regular urinalysis. In an urine culture and sensitivity test the sediment of the urine is incubated for bacterial growth, usually for 48-72 hours. If bacteria growth is present the lab will know exactly what bacteria it is and can recommend exactly what antibiotic to use to get rid of it. The urine culture and sensitivity test is the only test that can absolutely confirm/rule out an UTI.

Some dogs do not show any symptoms of an UTI but when a dog has diluted urine and has increased drinking/urinating, it is very important to rule out an UTI.

You are doing a great job at entering information on the forum! Remember we are here for you and Savannah, ok?

Love and hugs,
Lori

[FloridaAnn]

Thank you all so much. It seems that there may be another issue, related or not to her frequent urination. Her coat is smelly. Since she swims twice a week in a fresh water lake, I didn't think much of it when the vet noted it on Wednesday. He thought that she might have rolled in something. A friend from Colorado, who knows Savannah well, came for a visit today, and she also noted the smell. I'm now wondering if, in addition to the other issues, she also has a yeast infection, and I'm back to thinking that perhaps I shouldn't be giving the antibiotic. I talked to the vet this morning about the urinalysis, and he agreed that perhaps the diluted urine masked a possible UTI. He said that she could go back on the antibiotic because she is an old dog and might have an infection of some kind. I'm actively looking for a new vet, but I may try to get her with him again tomorrow to see if she has some sort of fungal infection. Her coat feels a little sticky in places on her back too. She still hasn't eaten the kibble from last night's dinner, but she has had a few treats today.

[molly muffin]

Yep, definitely want to get that smelly issue checked out. I don't know if this will help you to find someone but I looked it up for another one of our members who is in Florida and seems to have some good links on it. Maybe use it to find a specialist or just check out what is available in your area.

http://www.floridapetpages.com/BusinessListings.asp

hugs,
Sharlene

[FloridaAnn]

In my earlier post, I neglected to mention that Savannah's T4 and bg levels were within the normal range. I'm very curious about the possibility that her fat tumors may be contributing to her elevated alkaline phosphatase level. Her tumors seem quite large to me, and new ones seem to be popping up pretty often. You all have given me a number of good questions to ask the vet. I'm hoping to see one tomorrow. I really want to have the possibilities of a UTI and yeast infection addressed again. At about 11:00 p.m. tonight, she finally ate last night's dinner. Otherwise, she seems pretty happy....just kind of smelly.

[mytil]

Oh I most certainly would have the smell and the sticky coat checked out. Not a normal thing.

Terry

[FloridaAnn]

Savannah's LDDST came back as normal. I'm sure that many of you are not surprised since you were skeptical that she could have Cushing's and not be eating much. I still don't know what caused the elevated alkaline phosphatase level, but she is back on antibiotics and got a very long bath with antifungal shampoo today.

Thanks so much for your kindness and knowledge. I hope you know how much difference you made.

Ann

[frijole]

Don't run off just yet - we are used to this and want to help! :D If you go back to the last post of the first page Glynda gave you the entire list I would be talking to your vet about. It isn't unusual for this to happen and thus the usual list of alternative illnesses is the place to start. Hang in there and ask away... Kim

[molly muffin]

Hi Ann,

Absolutely, whatever Is going on, we can get it all figured out. There are so many things that can mimic the same symtoms as cushings. We have seen many of them. We are not Just about cushings, we are about family, friendship and support. Cushings is just the word, the fear, the worry that brings many to the doorstep. It's comfort of community that makes you pull up a chair, sit down and dig in.

hugs,
Sharlene

[mytil]

Please do not feel you have to leave just because the LDDS came back normal (post those numbers when you get the chance).

There are many here who are dealing with lots of issues besides Cushing's.

Hang out with us and keep us posted on her symptoms.
Terry

[molly muffin]

Hi Ann, just wanted to wish you and Savannah a Happy Thanksgiving. Did you find out anything else yet?

I don't know if you noticed on my signature line or not, but Molly's LDDS came back normal too. She doesn't have cushings either. (not now at least) So you are definitely not "out of place" :)

have a wonderful holiday,
hugs,
Sharlene and Molly Muffin