just diagnosed (8.5 y/o English Sheepdog Luna crossed the bridge)

[Heartbroken]

Hi,
This is my first posting. Brought Luna(8.5 year old OLD ENGLISH SHEEPDOG,Female) to vet with following symptoms(Drinking,peeing and very dark colour urine) Vet's first reaction was to do do a preliminaly blood analysis. Results came back and it is pointing to cushings. she is going to vet tomorrow for the day to have a couple of blood tests.
i'm reading a lot of how dreadfull this desease is. I see success and i see failures. I'm not scrared to say i dont know what i'm going to do. I want the best possible life for her without making her worst on these meds. As far as meds i want something with the least possible effects. My vet is pretty good. Last year she(Luna not the Vet) :eek: almost died of (Dont know the long term for it) her immune system was over active. She was put on Steroids(Heavy doses) for about a month. She pulled through and was a content dog and now this. I think the steroids may have caused this? Not blamming the vet at all as there sare always complecations to drug therapy. I guess i'm here for some advice and comfort.
I will keep all you posted on her prognosis later at end of week.
Thanks for listening.

[mytil]

Hi and welcome to our site. I am sorry your girl is having these troubles.

Cushing's is very treatable and dogs can easily live out their normal lifespan. Know you are not alone. The drugs are strong, but they actually have to be. Correctly administered and monitored, you will see good results.

Yes, it is a complicated disease and it is difficult to diagnose as there are other conditions that mimic the same symptoms. Other than excess peeing and drinking, are there any other symptoms you are seeing?

So, when you get the chance, post the results of any tests performed so far. The dark urine could point towards a UTI (urinary tract infection). Is she on any antibiotics at this point?

How long ago was she on the steroids?

Sorry for all the questions but the more we know the better we can help you and Luna.

Terry

PS - take a look at these links that described Cushing's, tests and treatments - http://www.k9cushings.com/forum/showthread.php?t=180

[Squirt's Mom]

Hi and welcome to you and Luna! :)

Take a deep breath....you are in good hands here and just as importantly, you will never be alone again. You have found the very best place to land - a family that has tons of experience, knowledge and support to share. We will do all we can to help you and Luna.


This is my first posting. Brought Luna(8.5 year old OLD ENGLISH SHEEPDOG,Female) to vet with following symptoms(Drinking,peeing and very dark colour urine)

Cush pups do not have dark colored urine. In fact, one of the hallmark signs is urine that is almost clear. Dark urine indicates an infection in the urinary tract. If this was not checked, do NOT let your vet do any testing for Cushing's as it will be a waste of your money and added stress to Luna. Any illness can and does cause false- positives on Cushing's testing so these tests should never be given when a pup is showing signs (like dark urine) of another condition unrelated to Cushing's...like a simple UTI. ;)

Vet's first reaction was to do do a preliminaly blood analysis. Results came back and it is pointing to cushings. she is going to vet tomorrow for the day to have a couple of blood tests.

Again, do not waste your money or stress Luna with tests that will be more than like skewed. Insist on a urinalysis only.

i'm reading a lot of how dreadfull this desease is. I see success and i see failures. I'm not scrared to say i dont know what i'm going to do. I want the best possible life for her without making her worst on these meds. As far as meds i want something with the least possible effects.

We are no where near ready to talk about treatment for Cushing's yet and when we are, we will be glad to help you decide which is best for Luna...IF this is Cushing's. IF.....the jury is still out. ;)

My vet is pretty good.

If your vet is going to test for Cushing's with the presence of dark urine, I question their knowledge and experience with Cushing's. This is not an uncommon thing for us to see. Many vets do not have a clue how to test, diagnose or treat this disease but are quite excellent in other areas of their field. Cushing's is one of, if not THE, most difficult canine disease to diagnose because it shares signs with so many other conditions AND other conditions will cause false-positives on the Cushing's tests.

Last year she(Luna not the Vet) almost died of (Dont know the long term for it) her immune system was over active. She was put on Steroids(Heavy doses) for about a month. She pulled through and was a content dog and now this. I think the steroids may have caused this?

It would be a GREAT benefit if you could get the records of this problem she had and let us know all the details - what it was, the meds used, how long, what dose, the actual test results through the duration of diagnosis and treatment. ***How long ago were the steriods stopped?*** It would be difficult for us to answer whether this could be related to what you are seeing now without more detail. ;)

Not blamming the vet at all as there sare always complecations to drug therapy. I guess i'm here for some advice and comfort.
I will keep all you posted on her prognosis later at end of week.

I sincerely hope you read this before going to the vet today and have the Cushing's testing done.

Thanks for listening.

We are always here to listen and offer any input we have that may help. As I said, you and Luna are no longer alone. You are family now. :)

Hugs,
Leslie and the gang

[labblab]

Welcome to you and Luna. I am very sorry that you have need of our group, but very glad that you have found us! I have a little girl Luna of my own (a Labrador retriever), so I am especially partial to the name. ;)

Can you tell us whether Luna has any other outward symptoms of Cushing's aside from the drinking and peeing? And do you know which blood abnormalities has made your vet suspect Cushing's? I am asking because dark urine is not typical. Instead, it is the opposite -- Cushpups usually have very light-colored urine because it is dilute from the excessive urination and thirst. Is Luna currently taking any medications or supplements? Has your vet performed a urinalysis/culture to check for the presence of blood, protein, infection, or other abnormalities? I believe that some foods and medications can darken the urine, as can liver or kidney problems, and also urinary tract infections. But generally, dark urine is not typical of Cushing's.

I do wonder whether Luna may have some residual organ impairment associated with her autoimmune illness. If she has been "off" the steroids for some time, the steroids should not still be causing Cushing's symptoms. But the illness itself may have resulted in some internal issues. And the reason why this is of particular importance is that the Cushing's blood tests can be skewed by the presence of other, nonadrenal illness. In other words, you can get a "positive" on the blood tests when something other than Cushing's is actually at fault. So this is why it is helpful to know the full range of symptoms that may be signalling the disease, and why it will help us to know more about Luna's entire health history and any other symptoms she's currently experiencing.

Sorry for so many questions, but the more info you can share with us, the more helpful we can be. So we'll be especially interested in finding out the name of the disease for which she was treated with the steroids, and also the results of the testing that has made your vet suspect Cushing's.

Thanks so much in advance, and once again, welcome to you and Luna!

Marianne

[goldengirl88]

Heartbroken:
I have walked in your shoes. and wanted to welcome you and your sweet Luna. I have read many places that the drug therapy for this disease can be worse than the disease. I am here to tell you, that is not the case so far with my beloved Tipper. I truly believe she would not be here today without Vetoryl. Her symptoms were so severe that I could have never not treated her, and left her go on like that. I also was, and still am scared to death of these powerful drugs, however my deep love for my dog made me overcome this. There is simply no other solution at present, so I chose to use the drug. Maybe I am being naive, but my Tipper seems to be doing as well as can be expected. I hope you get the strength to make a decision, after you get all your testing done, as I would never give this drug without all the testing to make sure of Cushings. I hope you and Luna have a better year in 2013. I know it is hard to do, but stay strong, and the people on here will guide you. God Bless you and Luna.

[Heartbroken]

Thank you so much for the advice. I will question the urine as what you say makes sense since she is drinking and piing a lot. Another symptom of cushing from what i read is a verocious appetite. Luna right now is the opposite.Hardly eats even her treats . She looks very depressed and sleeping a lot. As far as all the info you want i will try to get it and post it. The only meds is she on is soloxine which she is taking for thyroid.She has been on this for about 3 months. She was lazy then and with this she perked up and was Luna again. Also the vet put her on Hepato support,which i give to her twice daily. I was told it would stop her from frequencing the bathroom.

[lulusmom]

Hi and welcome to the forum.

Others have already commented that dark urine is not common in cushing's but I want to mention that it is common in autoimmune hemolytic anemia. You mentioned that Luna was on heavy doses of steroids for a time awhile back for an overactive immune system. Was Luna diagnosed with autoimmune hemolytic anemia or systemic lupus erythematos (SLE)? SLE requires lifelong treatment so that may not be what she has but relapses are common with autoimmune hemolytic anemia, especially within a year. Dogs can have both of these conditions at the same time and dark urine is common in both. Is the same vet treating Luna now the same one who prescribed the high steroid doses? Has the vet ruled out a relapse?

When was Luna's T4 (thyroid) level checked last? Did the increase in drinking and peeing start after starting the thryoid supplementation? If so and T4 has not been checked, it is possible that she has gone from hypo to hyperthyroidism.

Sorry for all the questions but based on the information you have provided so far, I would not jump on the cushing's bandwagon. The more information you can give us, the better feedback we can provide.

Glynda

[Heartbroken]

Yes i'm pretty certain it was autoimmune hemolytic anemia . Her gums were white. Also she tought that her thyroid could be an issue back then but Luna was so sick they concentrated on the Autoimmune systoms.She was on Steroids for about a month from large amount and decreased.That was in Oct/11 and she was herself by december/11. About 3 months ago she started to get lazy but her gums looked fine. We got bloodwork for the anemia done and also did a T4 test at the same time. The anemia was in check but her T4 results were very slightly borderline. Vet gave her Soloxine 1 pill twice a day(.8MG per pill Luna weights 85lbs). When i brought her in last week i was told to give her only 1 pill. Also had an Xray of liver and vet was surprised that it was not enlarged. The blood test came back and this is when she said it could be cushings but did not say 100%. They told me they would do a urine analysis there later that day(I brought a sample) I did not get the results of this. Can a vet do a urine analysys in the office or do they have to send it to a lab? All her bloodwork is sent to a lab. I should know more by tonight. I know she wants to do a couple of blood tests so Luna will be there all day.I will drop her off before the vet gets there but i have included aq bunch of questions for her to read.I forgot to mention that when she had the animia i dont rember her drinking a lot and Peing. Of course she did once she was on the Steroids.

[Megan]

Would be looking into thyroid more than cushings from the sounds of things. BUt I have NOOOO Idea what I'm talking about.

Question for others re: urine colour - if a dog is incontinent overnight on a white hospital kylie, would a cushpup usually dry and basically dissapear? My girl doesn't pee excessively dark but I can usually see a yellow circle and within that, a darker (almost bright) yellow blob in the centre, the epicenter of the pee so to speak. It's uncommon for it to be so clear as to basically disappear.

sorry to take over your post heatbroken, but I didn't know I didn't know this until I read your post and the responses ;)

[Heartbroken]

Hi all ,
Well so far we know she does not have a urinary infection.
Secondly we got the results of the urine analysis. Her Cortisol/creatine rario is 57.7. Doctor said anything over 34 CAN be suspectful of Cushings but she is being cautious to say a dog that is stressed and has no adrenal issues can cause these levels to be high.
she wants to do the low dose suppression test. Yes this will cause stress BUT i like that the vet is also cautious. This is all i know so far. Hopefully the next test will either put us out of cushings or not.
Fingers are crossed but we know there is an issue. As far as auto immune the preliminary blood work showed good and under control. When she first got the immune desease her gums were white and they are pink right now. I think my vet is fully aware of the auto immune symtoms as she was near death when she was first diagnosed last year(2011)
Well i'll keep all of you posted .
Thank you so much for the support from total stangers.

[lulusmom]

Can you please get copies of all bloodwork and urine tests that were done and post the results here? With respect to the urine cortisol:creatinine ratio, it is very important that the urine specimen be taken by free catch at home, preferrably before meals and meds. If your vet took a urine specimen by cystocentesis, you can forget about using the results of that test for anything. Stress easily drives up cortisol and if you stick a needle into a dog's abdomen and into the bladder, serious stress should be expected and so should an abnormally high ratio.

The dark urine doesn't fiit with cushing's because most cushdogs don't concentrate their urine so it is very dilute, completely clear and odorless. Urine specific gravity is low in dogs with cushing's so I'll be anxious to see the results of the comprehensive urinalysis. To answer your previous question about the urinalysis, vets can do a urinalysis by dipstick method inhouse but urine culture and sediment testing is usually sent to a lab. Did your vet do a urine culture as well? I'll also be anxious to see the other abnormal lab value that are driving your vet to pursue a cushing's diagnosis in a dog that has few, if any, symptoms commonly associated with cushing's.

Glynda

[Heartbroken]

Hi
I'm the one that had the container under her in the morning to collect the urine......Very hard to get from a female who squats low :)
She had no meds and empty stomach. The urine test was sent to a lab and not done at the vet's. That's all i know so far.Waiting for bloodwork results today.

[Heartbroken]

Vet got the results and her urine is high in billirubin.We do know from the xray her liver is the right size. She also got the bloodwork and it shows cushings but the vet will not treat her for cushings yet as she wants more information. she will be talking to a pathologist to try and interpret the bloodwork because of the urine and blood combined can really mask things to come to a conclusion. She was checked for autoimmune and this was fine. She suggested possibly an ultrasound may give us a better picture.

[addy]

If you can afford the ultra sound it may shed some light on things. Since non adrenal diseases can skew tests for Cushings and give false positivies and negatives it is a good starting point, so I am glad your vet seems to be following a good path.

Hang in there and keep letting us know what is happening. If you can, ask for copies of all tests so you can post the abnormal results here. Dont feel funny about asking for them. You paid for the tests and you should keep copies in a file at home for your pup.

[Heartbroken]

hi
I dont have the hardcopy results. All i know all test have shown high cortizol levels. As of now my vet consulted and i was asked to give anther urine sample for a bactirial test. Test came back and she has a bladder infection. She will be put on antibiotics.
As far as her symptoms now she is drinking about 4 to 8 cups of water per 24 hours(. She is urinating a lot less. She does not pant,does not have a verocious appetite(She is totally the opposite,extremely picky to eat and does not eat a lot. She is starting to loose control of rear legs. You can easily push her and she will fall. Very slow to walk. She is on Rx hepato support which seems to have helped clearing her pee to a yellow colour. Vet said she does not find any crysyillization in her Pee anymore.
Here is my question and i'm not being stick in the mud here. I really trust my vet but it seems you all ask to see the results of her tests. What wil this indicate here? Wil her diagnosis changed?
I really value everyones opinion here. I dont know what to do. i have looked at herbal remedies also because of the side effects of the vet drugs. I have to pick up her meds for her bladder infrction and will try to get all her results. I think i'm running out of time here and need to come to a decision.

[Squirt's Mom]

We ask to see test results because far too often we have seen vets who don't understand how to interpret the results. We ask to see them so there is a continuous record here that we call all refer to as time passes to have a history, to see patterns. YOU will also have a record of them here to refer to anytime.

You do not have to post them if you are uncomfortable with that but please understand that limits the input we can offer.

Hugs,
Leslie and the gang

[lulusmom]

Here is my question and i'm not being stick in the mud here. I really trust my vet but it seems you all ask to see the results of her tests. What wil this indicate here? Wil her diagnosis changed?

Asking questions does not make one a stick in the mud around here. That's how you learn to become the best advocate you can be for your dog. Cushing's is one of the most difficult canine diseases to diagnose which makes it one of the most misdiagnosed. Many of us discovered, at the expense of our dog, that our vets weren't the brilliant medical mind we assumed they were. Physical symptoms associated with cushing's are shared by many other diseases, blood and urine abnormalities are shared with other other diseases and the diagnostic tests to measure circulating cortisol are flawed and can yield false positive in the face of non adrenal illness or even stress. All of these things make it very difficult to correctly diagnose cushing's which makes it one of the most misdiagnosed canine diseases.

None of us are vets but I can tell you that we have seen more case studies on this forum than your average general practitioner sees in his/her lifetime. We've learned that there are a lot of pieces to the diagnostic puzzle and based on the information you have provided thus far, I believe your dog is missing a lot of them so red flags are going up all over the place. Even an experienced and extensively educated veterinary internal medicine specialist has a difficult time nailing down a diagnosis so with the inconsistencies you've reported to us and without the benefit of seeing test results, the diagnosis is definitely suspect.

I'll try to list the reasons why I personally would be concerned if it were my dog:

1. While not a legitimate reason to discount a cushing's diagnosis as any breed can have cushing's, there are certain breeds that are over represented and frequent this site and an English Sheepdog is not one of them.

2. Dogs with cushing's drink excessively because they are peeing excessively due to kidneys losing their ability to concentrate the urine. Urine is dilute, clear in color and this condition does not correct itself without lowering cortisol levels with effective treatment such as Vetoryl or Lysodren. Your dog's excessive peeing has improved and her urine has returned to a yellow color, neither of which is consistent with uncontrolled cushing's.

3. Dogs with picky appetites do not normally fit the profile of a cushingoid dog. Cortisol is a catabolic steroid that screws with all of the metabolic functions, including protein metabolism. Unless there is another condition causing low appetite, a cushingoid dog is always very, very hungry.

4. If, and I say, if muscle wasting is the cause of your dog's weakness, this is the only symptom right now that would fit but muscle weakness can also be caused by many other problems. Does your dog appear to have loss of muscle mass in her hind quarters? Has your vet ruled out hip dysplasia or other possible orthopedic causes for the weakness?

5. We have seen many misdiagnoses by vets who interpret cortisol as high when it fact, it is borderline or high normal. You haven't posted any results so there is no way to know if your vet has correctly assessed the diagnostic tests or that s/he did appropriate validation and differentiation tests to determine if your dog has pituitary or adrenal based disease. Do you know which form your vet has diagnosed?

Cushing's is a very graded disease, progressing at a snail's pace. It takes a very, very long time to shut down the immune system completely and shut down internal organs, hastening death. My dog was overtly symptomatic for well over a year before being properly diagnosed by an internal medicine specialist. If you truly do feel that your dog is running out of time which will require a decision to be made, I highly recommend that you make a decision to get your dog to an internal medicine specialist, who can sort all of this out for you and get your dog on an effective treatment that will improve her quality of life as well as your own. We all know how difficult it is to watch our pup's quality of life decline. If you are unaware of any specialists in your area, you can use the link below to search for one. You can also let us know what city you are near and perhaps members might be able to provide you with a name.

http://www.acvim.org/websites/acvim/index.php?p=3

Glynda

[Heartbroken]

hi,
I spoke to my Vet this morning and she had no issues giving me all the test results. I have them but dont know how to post them. I can give PDF copies on Monday.
Here are a few readings. Dont know if this is what you want.
Dec 29/2012
ALP 829 lU/L high
ALT 2125 lU/L high
Urea 2.2 mmol/L low
Platelets 100 x10E9/L low
Eosinophils 10.1 x10E9/L high
Free T4 >77.2 Norm 7.7 to 47.6 pmol/L
Urine: S.G. 1.010 Norm >1.030
Crystals in urine



Jan2/2013
Urine Cortisol 93 nmol/L
Urine cortosol/creatine ratio 57.7 nmol/L
Urine creatnene 1611 umol/L

Jan 3/2013
Cortisol (0) hour 137
Cortisol (4) hour 32
Cortisol (8) hour 18

Jan 14/2013
Urine;
Bacteria 1-2 +cocci & rods
S.G 1.005
Bilirubin +3

The Vet also told me that the results as far as what values they use to measure are different in Canada than the U.S. I assume it is units of measure.
As mentioned i can scan the full copies and possibly e-mail them on Monday from work.
Her symptoms right now is:
Drinking and urination is a lot better than before. She would drinks a lot less 4 to 8 cups in 24 hours.
She has never panted
She is not losing her hair
Her appetite is next to nil.
I find that she is losing control of her rear legs.
She is not interested in super long walks.
She also seems to be getting small seisures. Her head shakes up and down and as soon as i cerrss her they stop. Her siezures are rare. i only saw it 3 times but that does not mean she is not doing it when i'm not around or sleeping.
Meds: she is on Soloxine . Initially about 2 monts ago she was getting 1 pill of .8mg every 12 hours and now she is down to 1 a day. This is for her Thyroid issue.
She takes glucosamine HCL (500MG) twice a day. She has been on this for about a year.
She takes Rx vitamins Hepato support 2 capsules twice a day. She started to urinate and drink less since being on this.
She is taking (just started today) Amoxil (500mg). one capsulec every 12 hours for her blader infection.

Well that's about it.
I have to make a decision soon as far as putting her on , i forget the name ,stars a with a V i think it's veroxil. Because of her weight she would have to take the largest pills available. According to the research i did she would need 2 pills a day. Vet said she would start her on 1 a day then then see what happens . if it does not control it we would go to the 2 oills a day. The cost up here is $99.00 for 30 pills from the vet. She aslo asked if i would also do the blood work when needed but she said most people dont as this starts to get expensive.
My big question is "Is she in pain or suffering right now." She is very playfull most of the times(80%). Her endurance is not as high as before but remember she is almost 9 years cold and this is old for old english sheepdogs.
What can i do to get her to eat? Stuff like a piece of cheese and an egg she will not touch. She use to love this as a treat.I tried every type of dog food and she just smells it and walks away. The only thing she may eat is hamburger and brown rice but she wont eat much of it. do i just give her kibble and leave her alone and if she decides to eat then she can.
She does eat Milkbones and use to eat other types but she just noses it off. It seems cetain smells of food she used to like disgusts her.
Well let me know. i know this was a long explanation.
Thanks

[frijole]

Your vet is right and we need to know the unit of measures for all items in order to convert it to US measures so we can respond (at least I need them ;)) Can you add them to wherever we are missing them? Or just wait and provide the pdf's on Monday.

I too do not think it's cushings - a cush dog doesn't have a lack of appetite. They literally inhale their food without breathing and they spend every waking hour like a vacuum cleaner in search of a morsel they can eat from the floor.

I suspect the hypothyroidism is not under control. I'll let others look at the results of the panel and see what they think. The high ALT levels concern me. Cush dogs have slightly high alt levels and really high alk phos levels. Your dogs are reversed.

Don't buy the vetoryl. I don't think you need it and if you gave it to a non cush dog it could harm or cause death. Please don't. Thanks, Kim

[Squirt's Mom]

And if you would please, include the normal ranges for each one you list. Thanks!

[Heartbroken]

How can i post or give my results to you. E-Mail?

[Heartbroken]

How can i post or give my results to you. E-Mail?
Also live North of Markham ,Ontario...specificaly Lindsay Ontario, Canada

[Heartbroken]

I've added some values and the reference point for some tests
I will hold off with the vitorol.



Dec 29/2012
ALP 829 lU/L high Reference: 24-141 IuL
ALT 2125 lU/L high Reference 5-95 Iul
Urea 2.2 mmol/L low Reference 3 to 10
Platelets 100 x10E9/L low Reference 165-550
Eosinophils 10.1 x10E9/L high
Free T4 >77.2 Norm 7.7 to 47.6 pmol/L
Urine: S.G. 1.010 Norm >1.030
Crystals in urine



Jan2/2013
Urine Cortisol 93 nmol/L Urine cortosol/creatine ratio 57.7 nmol/L
Urine creatnene 1611 umol/L

Jan 3/2013
Cortisol (0) hour 137 15 to 120 nmol/l
Cortisol (4) hour 32 0-10 nmol/l
Cortisol (8) hour 18 0 to 10 nmol/l

Jan 14/2013
Urine;
Bacteria 1-2 +cocci & rods
S.G 1.005
Bilirubin +3

[Harley PoMMom]

Dec 29/2012
ALP 829 lU/L high
ALT 2125 lU/L high
Urea 2.2 mmol/L low
Platelets 100 x10E9/L low
Eosinophils 10.1 x10E9/L high
Free T4 >77.2 Norm 7.7 to 47.6 pmol/L
Urine: S.G. 1.010 Norm >1.030
Crystals in urine



Jan 3/2013
Cortisol (0) hour 137
Cortisol (4) hour 32
Cortisol (8) hour 18


This looks like results from a LDDS test, is that correct? If so, IMO, the 8 hour mark is not consistent with a Cushing diagnosis.




Jan 14/2013
Urine;
Bacteria 1-2 +cocci & rods
S.G 1.005
Bilirubin +3



I am concerned with your girl's kidneys/bladder. It sure seems like there is something going on, might be a infection or stones starting to form. Also the elevated levels of the bilirubun found is quite a concern for me. Did your vet mention anything to you about these issues?

[frijole]

How can i post or give my results to you. E-Mail?

I know some have figured out how to attach them.. I cannot tell you how to do that though. :o Someone I am sure will chime in and help though.

[molly muffin]

If you would like the attachments uploaded to your thread, you can email them to k9cushings@gmail.com and someone will upload them for you.

Sharlene and Molly Muffin

[labblab]

Hello and welcome from me, too! Can you possibly double-check the reporting units that you've given for the three cortisol readings that make up the LDDS test? You've written down nmol/l, but I'm wondering whether that test was instead reported in units of ng/ml?

Thanks for the clarification!

Marianne

[Heartbroken]

Hi
Units of measure on report are as follows: nmol/L
Also was reading here that people think her thyroid issues is not undercontrol. I did some research and found that the T4 test is used for detecting this. Her T4 was >77.2 the reference is 7.7-47.6
pmol/L
about 4 months ago she was put on soloxine (.8mg each). one every 12 hours. when i brough her in because of her drinking and urination the vet dropped it to 1 pill aday.
I also looked at which lab did all my tests and it was IDEXX. I googled them and it looks like i can talk to them about the test results but i dont have a clue what to ask.
I started today to measure her belly to see if it increases, Cant see how it will increase if she has no appetite. The only thing she really eats is the pieces of wiener i use to get her to eat her pills.Her blatter infection pills are large like horse pills.
I still want to send PDF copies of results but i dont know how.

[Heartbroken]

Hi
I figured out how to upload test results. To view go to COMMUNITY,then pictures and albums this will bring up photo album of Luna. Click on picture and lab results are posted. Yea....

[lulusmom]

Thank you so much for posting those test results. I am baffled as to why your vet was chasing after a cushing's diagnosis when the bloodwork that was done on 12/29 is not suggestive of cushing's.

The urine low specific gravity is not surprising considering Luna was thrown into hyperthyroidism with too much thyroid meds. Given the numerous blood and urine abnormalities, I am not convinced that Luna ever needed thyroid supplementation as any underlying illness can cause a transient decrease in thyroid hormones which corrects itself once the underlying illness is treated.

The ALT is incredibly elevated which is suggestive of liver disease, not cushing's. 3+ bilirubin in the urine is an abnormality found with liver disease but not cushing's. Did your vet do a bile acid test? If not, that would have been a good place to start ruling out the more obvious problems. What your vet shouldn't have done is waste your hard earned money on tests that you could almost guarantee would yield false positive results. Do not, I repeat, do not even think about starting treatment with Vetoryl because it is highly, highly unlikely that Luna has cushing's. She does have something serious going on though that needs to be addressed by a specialist.

I'm not well versed on complete blood counts but Luna has two abnormalities that are common in parasitic infestations. Did your vet do a fecal exam? It's not always easy to detect parasites but a fecal is the first place to start.

After seeing the labwork, I am convinced that you need to get Luna in to see an internal medicine specialist asap because whatever is going on with Luna is clearly over your vet's head. I don't have time to help you search for an IMS in your area right now but others may help. In the meantime, IDEXX usually has an internal medicine specialist on staff and if they let you talk to him/her, then by all means, do it. Have all of your test results in front of you. Your vet did a dipstick urine test inhouse so make sure you have those results to give the IMS as IDEXX will not have that information to look at.

Glynda

[frijole]

Just so you know Glynda is very experienced and she did convert the numbers from Canadian to US readings to come up with her opinion. I attempted to look up a specialist however since I have no idea how close Markham is to any of these cities I ended up searching just Ontario. Here is a link - there are 3 pages. Also note that there could be more (usually are) that just don't put there name on this list.


http://www.acvim.org/websites/acvim/index.php?p=3


It is not unusual to see vets that don't have a great deal of experience treating these types of disorders because they are after all like a general practitioner and cannot possibly know everything.

I had to switch vets myself and it is hard but you really do need to find a specialist that can work with this vet. Trust me I know all about throwing thousands of dollars away on unnecessary testing. IT hurts.

Kim

[molly muffin]

I see that the Toronto Vet Emergency Hospital has Internal Medicine Specialist on staff, specializing in Endocrinology | Hematology. http://www.tveh.ca/our-team.html

Dr. Kelly Mitchell
Phone: 416-247-VETS (8387)
Toll Free: 1-888-593-7068
Fax: 416-287-3642
email: askus@tveh.ca
Adress:
21 Rolark Drive
Scarborough, Ontario
M1R 3B1

It could be worth a call to them. I go to the Mississauga Oakville, Emerg. Vet. Hosptial and I know people
come from all over Ontario for specialized surgeries, etc there. But I would try the one closer to you first.

If you want to call IDEXX first, they do have an internal medicine specialist on staff that specializes in Endo issues I believe and yes, just have your test results in front of you.
One of the things that a specialist is going to more than likely want to do is an ultrasound to look at the internal organs.
Let me know if there is anything that you have any questions about or that we can help you with and how you want to proceed. We'll do all we can.

Sharlene and Molly Muffin

[Heartbroken]

Well got a referral from my vet to a specialist but she prewarned me to have the credit card ready. she told me the last dog she sent down cost $5000.00. From what you see from my tests what should i be asking before they do any tests? I know i have a lot invested now but running out. Luna is near her average life span for her breed but............ dont know what to do.........Should i just go in with the rsults i got and just talk to the specialist and express my concerns and costs involved. before proceding further. Since she is on antibiotics for the next 14 days should i wait to see what this does before going to the specialist?

[frijole]

To help out the specialist bring in copies of all tests that were done. Do a write up in chronological order with symptoms, tests done, things ruled in/out. This will help make sure you don't go down a wrong path and /or pay for the same test again.

Your vet can throw out the $ comment, however you spent thousands with him/her and were given a wrong diagnosis. Which is worse? Sorry.. just upset about the comment.

Same thing happened to me. You are doing the right thing. Hang in there, Kim

[Harley PoMMom]

From what you see from my tests what should i be asking before they do any tests?






Dec 29/2012
ALP 829 lU/L high Reference: 24-141 IuL
ALT 2125 lU/L high Reference 5-95 Iul
Urea 2.2 mmol/L low Reference 3 to 10
Platelets 100 x10E9/L low Reference 165-550
Eosinophils 10.1 x10E9/L high
Free T4 >77.2 Norm 7.7 to 47.6 pmol/L
Urine: S.G. 1.010 Norm >1.030
Crystals in urine
Jan 14/2013
Urine;
Bacteria 1-2 +cocci & rods
S.G 1.005
Bilirubin +3

All the abnormal values that are listed is what I would ask the IMS to explain.

[Heartbroken]

has anyone dealt with a holistic vet with cushings?

[molly muffin]

I can tell you that is baloney if you have copies of all your test results with you for the IMS to look over.

You are paying for a consult and if you want an ultrasound, then that. This is basically to find an opinion based your results. I went to the specialist and it was around 700. for the consult and the ultrasound to be done. I did the LDDS test with my own vet because it was cheaper. (the IMS asked me where I wanted to have it done and what I would be comfortable with, so that was my choice)

I think we have some who have tried various herbs, acupuncture has been shown to work in some cases for arthritis, etc. This is usually done in addition to the treatment of cushings by your normal vet.
The problem is that if it cushings then the only way to lower the cortisol really is through traditional treatment. This is what we've seen on this forum, where we see 100's of cases. I really wish there was a magic ingredient that would do the trick.
You can try liver support supplements etc, but until you know what the problem actually is, it is hard to treat it. :(

Sharlene and Molly Muffin

[Heartbroken]

Hi,
Well i am updating the condition of Luna.
As stated before the vets diagnosis was cushing's. Basically the symptoms she had were:
1) heavy drinking and urination. She would urinate all day and all night(She had a pungent smell to her and also her urine really stunk).
2) no appetite
3) discoloured urine.
Had the cushings test done and her cortisol levels were high. Vet consulted with someone and they suggested a urine culture test. The test showed positive for an urinary infection.she was put on antibiotics on Jan 20th.
Today:
Her drinking level is back to normal.
Her urination is back to normal.(The smell of her urine is non existent)
Her appetite is not 100% but i would say maybe 75%
I'm assuming it will take a little while to get back up to speed with her eating.
Her urine is getting lighter(From orange to hopefully yellow) I'm monitoring this.
she had light head seizures(Slight shaking of the head) before the antibiotics. I have not seen her do this since then.
She loves to go for walks. she plays and jumps . Just her looks and attitude are night and day.
The only thing i've noticed is she sems to be not as steady on her legs.
I'm hoping that it's because her body has been under a lot of strain over the last month and she needs to get this back. i know one symptom of cushings is lost of muscle mass.How long does it take to get this muscle loss with cushings? I assumed a dog with cushings would take awhile to develop this. Luna also has had mild hip dysplacia. Could what she has ben going through and this be causing the unsteadyness? she can run and jump no problem.Her going up and down stairs has no changed from a year or 2 ago. I think if sh is loosing muscle mass i would notice here going up and down stairs would be different.
Well i guess what i'm looking for is what do i do next. The vt wnated to put her on Vetoril last week but i'm looking at everything and wondering does she truly have cushings or was she going through hell with the urinary infection? I talked to a physician friend and he told me to wait at least 21 days from when she wnet on antibiotics to see if all her urinary symptoms go back to normal, especially hr urin colour.
Any comments would be appreciated.
Thanks
Luna

[frijole]

I think your physician friend has given you great advice. I'm not sure your dog ever had cushings. So best to wait and see. This is a great update. Do keep us posted ok? Kim

[Squirt's Mom]

I agree with Kim. Just because she had elevations in cortisol does NOT mean she has or had Cushing's. Many, many things will cause an elevation in this hormone, UTIs among them. The stress from the hip problem alone could cause an elevation.

As for the leg weakness you are seeing, it could certainly be connected to the hip dysplasia. If I were you, I would forget about Cushing's and concentrate on getting her over this UTI and finding some good support for her hips. That is a very painful condition. ;)

Now, this does NOT mean you get to go away. No ma'am. You are family and we expect to hear from you! 'k? :)

Hugs,
Leslie and the gang

[molly muffin]

This is a great update! Cure the UTI, take care of the pain in the hind legs and then see how things are going.

:)
hugs,
Sharlene and molly muffin

[addy]

Looks like a consensus to me;);););)

Keep us in the loop!!!!

[Heartbroken]

Hi
As stated earlier Luna seemed to be comming around but things have gone bad again. She is urinating during the day but this is not my main concern. She seems to be loosing muscle mass in her hind legs. She seems to have more control outside than inside. She is slow going up the stairs and a lot slower going down. She used to wiz by me when going down the stairs. She is asking to go out at night to pi,but a lot less than before. She can be goog on walks and sometimes does not want to walk far. She has this infactuaton with eating snow. She is getting really agressive even when i just approched her yet sometimes her will have no issue with me petting her on her head. She always loved having her tummy rubbed and scrachted. She wil not let you do this anymore. she wont even let me lay by her on the couch as she literally snaps at you and growls. Yes she has bit me a few times and broke skin. these were not little snaps but very traumatic. When i first repaorted she seemed to have slight head seizures. she would move her head side to side and now she shakes it up and down more rapidly. I have to be so carefull around her as i dont know how she will react. I really think she has a tumour and this is really changing her personality. I did consult with a specialist and i really cant afford an mri ,ultrasound more and more bloodwork. She will be finishing her antibiotics on Saturday BUT.........
There is no guarantee . I;m down to making a choice. As stated by my original vet to try and put her on low dose Vetoryl and see if this helps. I feel bad and guilty that it can be a financial decision that can affect my poor Luna. I dont want her to suffer. I think i need compasion advice on what to do. With what is happening should i go for the vetoryl. My doctor friend told me that a cushings person can have good days and bad days as the cortisol level can change. I think this is what is happening with her.

[Harley PoMMom]

Sudden onset of aggression can be attributed to Hypothyroidism, has Luna had her thyroid levels checked recently?

Here's a link to an article by Dr Dodds, who is a renown expert in canine thyroid problems: http://www.k9cushings.com/forum/showthread.php?t=1627

[molly muffin]

Oh my gosh this is very serious. That sort of behavioral change isn't what we normally see in a cushings dog. Not to that sort of extreme anyhow. More likely if there is a macro tumor but the LDDS test did not seem to be overly consistent with pituitary cushings from what I remember. Lori, expressed concerns about that at the time you posted them.

I don't know if that is because she just feels so bad, and maybe it is more than a UTI or what. Has the behavior gotten any better being on the antibiotic? Like does she seem to feel better? How is her eating? What exactly did the specialist tell you? I see that her T4 was high previously did your vet discuss thyroid issues with you as this commonly can cause aggressive behavior to start up. UTI's if they have not cleared up can also cause aggression from what I've just read. (I've been trying to do some research on what could be causing this as an underlying reason)

I am sure the others that have way more experience and might have some ideas will pop in soon. I find the biting you and breaking skin to be worrisome, and to the point on not really wanting to be touched at all just so different from what Luna use to be like.

I know that this is very very upsetting for you and I would be upset too. You are probably at your wits end trying to figure out what to do.
Lets see what the others have to say and go from there. I'm thinking that if it is Not cushings, then giving vetroyl wouldn't help. If it is, then maybe.

hugs,
Sharlene and Molly Muffin

[addy]

What did the vet say about the crystals in her urine? Something is not right here and I am not so sure it is Cushings, this dog does not feel good at all and is hurting plus Sharlene is right her Free T4 was high as well.

What antibiotic is she on? How are her stools now? Is she still eating? What color is her urine now, has it gotten darker again?

I am so sorry you are going through this. We'll all put our heads together and maybe can come up with things to ask your vet. Poor Luna. I know how bad you feel when she bites you. I go through it with my little girl. One day she is sweet miss and the next she is Kujo but she always has had a bit of a behavior problem.:rolleyes:

Hang in there, we'll figure out something!!!!!

[Squirt's Mom]

I would definitely get the thyroid looked asap. Hypothyroidism can change the personality like that but we don't usually see that in Cush pups. Hypothyroidism is easy to diagnose and cheap to treat. Talk to your vet about this today if you can. It may just be that with a little help from an inexpensive drug, Luna will turn right around and be her old self again. ;)

Hugs,
Leslie and the gang

[Heartbroken]

Before i brought her in for any tests for cushings she was on soloxine for her thyroid. she was prescribed .8mg twice as day. When she began her cushings tests the vet dropped her soloxine to once a day and is still on once a day.i assume this is for hypothyroidism and not hyperthyroidism.

[Heartbroken]

Hi,
I have not checked in for awhile reason being that Luna was under care for her health with my new vet(DVM/Holistic). He did say that she did not have the normal cushings deasease symptoms but seemed to be more of a possible some type of cancer, most likely Liver.She was very lazy but at times so full of life. She really seemed to be doing better. Her urinary infection was gone, her head shaking(Tremors) were rare burt her appetite was never really good. Today she did not want to eat but was good for walks. She ate snow like crazy and her breath was hot. She cuddled with me all day. Things went to really bad around 10 tonight and she was panting heavily and could hardly stand but would not lay down. She vomited hardly anything as she did not eat today. She was foaming at the mouth. She finally went to sleep and i was awaken as she was laying down with her eyes rolled back and full fledge culvulsions. I know she was in terrible pain and i knew deep down that there was nothing that would help her. I had such love for Luna that i had to put her out of her misery. This was the hardest thing i had to do in my life.
I hope all the people who read this do not take offence to this.
I guess i just needed the forum to let it all out. I know she is up in doggy heaven playing with all the other dogs who passed away on this forum.
Thank you so much to all of you for listening .

[Mel-Tia]

We do the best we can,no one will take offence. They know how much you love Luna as we love our pups just as much. I asked questions and then didn't post for a while. I told them that we had lost Tia on Friday and everyone has been so kind and supportive

Little Luna will be running pain free now.

I am so sorry it must have been so traumatic for you to deal with

Sending you lots of love and hugs

Mel and Tia x x

[addy]

I am so sorry to hear about Luna. You did everything you could for her out of love and devotion and you knew her best. Letting them go is the last loving act we can do for our pups

Please stay round, we have pretty broad shoulders and we are good at listening.

We understand the pain, the sorrow.

((((((((((((((((hugs)))))))))))))))))))

[Heartbroken]

Thank you so much Addy. The tears will never stop for my beloved Luna. I will stick around and feel the pain of other cushings dogs and wish i could wave a magic wand and make this terrible desease go away.
My love to all other cushing members and i will think of you all.

[NoonelovesmelikeNorman]

Dear Heartbroken,

I wanted to extend my sympathy on Luna's passing. You did the best you could for Luna. She knows you loved her and tried to figure out all that was going on. It sounds like it was quite tramatic, I feel for you. It was time to let Luna pains be lifted and run free in heaven. Vent/share all that you need...this group is a wonderful support.

Wishing you comfort, (((hugs))) and peace.

With Love,

Sharon, Norman (cushings) and Millie

[molly muffin]

I am so very sorry to hear that Luna has passed on. You tried everything in the world to figure it out and help her. She was a very strong girl to try and hold on for so long and you were a great mommy to her.
I share your tears this morning, it is so hard to reach that place where there are just no other options to help them get better.
Thinking of you and Luna
Hugs,
Sharlene

[Squirt's Mom]

Oh, sweetie,

You have not offended anyone. How could such an selfless, loving act be offensive? You took away the pain and fear Luna had been given, you took it away out of love for her, love for your baby girl. That, darling, is never offensive. It is the opposite. It is the strongest proof of our love that we are willing to accept the awful pain you feel today in order to relieve them of their pain. I have no doubt you made the right decision at the right time for your precious girl nor do I have any doubt that Luna is very grateful to you for doing so. You freed her from a failing body so that her Spirit could soar. That Spirit will always be with you, always looking over you, and one day your Spirit and hers will be reunited for all time.

I am so sorry for your loss and anguish. It is obvious how much you love your Luna so I know the next few days and weeks will be tough. Please know that we are here any time you need to talk - about anything. We know how you feel, we do understand.

Our deepest sympathies,
Leslie, Squirt, Trinket, Brick, Sophie and our Angels, Ruby, Crystal, and Tasha


Love’s Final Gift
By Cheryl Goede

I know it is hard on you, there are no words that can describe
the piercing sorrow which does not lessen with time.

When you had to bring me with you, on that last car ride to make,
all the while knowing the course of action you needed to take.

I know you feel guilty, I feel your sorrow, it’s true,
I could always sense your each and every mood.

When they called my name I knew that your heart was breaking,
you carried me to the room…getting closer to my new awakening.

The friendly doctor I know gave me treats and spoke low,
he was giving you the time that you needed to let me go.

All left the room, and you gathered me close,
as you wondered how you could do this for me when you needed me the most.

I tried to convey, my last wishes to you,
I looked into your eyes with all the love you are used to,

Mom and Dad, this earthly body has served me well,
but the time has come for us to part, to no longer dwell.

You understood the signal, and knew it was time for me to go,
but before I leave there is just one more thing you should know.

I will look out for you, each day I will guide,
my spirit in some way will always be nearby.

Before I make it to the Bridge to stay,
I will return the love tenfold in hopes for my debts to be paid.

For when that new pup or dog will enter your world,
a new love will blossom and slowly unfurl.

I hope you realize that new dog is Love’s Final Gift,
sent from me, your baby girl.

That new dog was chosen by me, to lessen your pain,
like the gentle warmth of the sunshine after the rain.

When you hear him bark, it’s my bark too,
when he cuddles you close, it’s what I would do.

So open your heart when the time comes to see,
that the love he gives comes also from me.

Take comfort, hug him, and reminisce
as he gives his love freely in the form of a dear doggy kiss.

It’s what I would do, if I still could,
and what you would want that is understood.

But the time has come to let me go,
to make that unselfish choice, even though tears will flow.

Hold me, cherish me, until my last breath,
but please don’t look at this as my death,

Someday we will be together again, come close for one last kiss,
I know this it true, as it is my soul’s last earthbound wish.

Now I can feel my spirit floating it is traveling high,
as though I were a cloud in the endless blue sky.

Please find peace, you have honored my life with this,
For I have been reborn through your Love’s Final Gift.

[goldengirl88]

So sorry to hear about your beloved Luna. Everyone on here will walk in your shoes sooner or later. It is a most difficult things to carry out you will ever do. She will always remember your deep love for her, and your selfless devotion to let her go. I am crying along with you as I think of my own journey with my precious Tipper. God Bless you and Luna and give you the strength to get thru this trying time. Tipper and I will pray for you.

[infoviewer]

So sorry for the loss of your beloved Luna. Letting her fly free from her pain is the greatest love you could give her. We all hope we have enough love for our precious dogs to free them from their pain when the time comes. She has joined all the other furbabies at the Rainbow Bridge. Love, JoAnne

[mytil]

I am so very sorry your Luna has passed on. We all know how incredibly hard it is to make this decision, but it is even harder to see them suffer terribly.

Thank you for coming back and telling us. We are all here for you. I have added your sweet girl to our very special list in our In Loving Memory section - http://www.k9cushings.com/forum/showthread.php?t=4794/

Always remembering Luna
(((hugs)))
Terry