Diagnosis undetermined (8.5 y/o Rottweiler)

[Rotpaw]

Hi All,

I am new to this forum and wanted some opinions on my dog.
"Chesney" is a S/F, 8 1/2 year old Rottweiler who has been in great health her entire life..until now. :(

Chesney's first symptoms were PU/PD and a slight increase in her appetite. She has always been a great eater so the appetite thing didn't really come up until we discovered the PU/PD. From what my husband and I have figured out (he was filling the water bowl and so was I and didn't know each other were doing so, as we work different shifts and have 3 Rottweilers) was she has been PU/PD for about 2 months.

Initial testing:
UA: SG 1008, rest normal - no glucose
UA Culture: negative for growth

Blood Panel & CBC: All normal except
Cholestrol 454 (lab normals 92-324)
Triglyceride 483 (lab normals 29-291)
EOS: 15% (lab normals 2-10)

These tests were normal:
ALK Phos was 100 (lab normal 5-131)
BUN was 14 (lab normal 6-31)
Creatinine was 1.0 (lab normal 0.5-1.6)

Water Deprivation Test 24 hour period: Urine SG was 1026
Urine Cortisol/Creatinine Ratio: 12 (lab normal 3-12, indicated anything over 13 is suspect of Cushings Disease)

At this point my vet is thinking she is either early Cushingoid or early kidney disease. She is thinking since we are very intune to our pets that whichever disease we have caught it in the early stages.

My vets logic is to wait on futher testing for 3 months and then repeat Blood chemistries, Urine SG/UA & add LDDS +/- ultrasound, depending on the results.

I am wondering if anyone else has any suggestions? Thanks in advance for any assistance.

BTW - I have some experience with this disease as I have had a previous Cushings dog, she also was a Rottweiler and was diagnosed in 1998 and passed in 2000. At that time we used Lysodren and she eventually became Addisonian.

Thanks,
Danette

[frijole]

I can see why you would suspect either cushing's or kidney issues. So did you rule out diabetes insipidus with the water deprivation test? I'm not familiar with the labs on that so not sure if that was a negative - just checking.

Hypothyroidism mimics cushings so you might want to do a full thyroid panel. Lastly we have seen dogs show signs of cushings that have tumors on the spleen or adrenal glands that were only discovered via abdominal ultrasound. Once removed the problems can go away so you might want to investigate that.

Otherwise your vet is right - could be early stages and the best thing to do is wait to treat. I'm a bit surprised the liver enzymes are both within normal range. That's why I'd investigate the thyroid and if that is normal do an ultrasound. Kim

[Rotpaw]

Kim, thanks for the input.

We did a total body funtion profile and it does contain a T4 but I know there are additional thyroid tests (T3, Free T4, T4 by ED) if I remember correctly. I am a registered vet tech, although have not worked in private practice for 6 years, so some things are a little hazy. :) Rottweilers are prone to hypothyroidism so that would be a good avenue to pursue. Her high cholestrol is also indicative so we will pursue.

Her Blood Glucose was 83 (lab normals (70-138) and she didn't have any glucose showing up in her urine so we ruled out diabetes mellitis.
But we didn't discuss diabetes insipidus but I will mention it to my vet.

Liver Enzymes were:
AST was 27 (lab normals 15-66)
ALT was 33 (lab normals 12-118)
Alk Phos was 100 (lab normals 5-131)

Thanks for the input on the ultrasound findings that mimic Cushings, think we will pursue the Thyroid Panel and go from there.

Thanks Again!

[molly muffin]

Hi and welcome from me too. Yep, I'd definitely look into other things since usually one the first signs with cushings, even before you may see symptoms is that ALP going up. So, either very, very early or maybe other cause. No protein in urine? So if kidney's it hasn't progressed very far.

Let us know what you find out with your follow up tests. It's usually a long road as you know having already gone through this once.

Sharlene and Molly Muffin

[Rotpaw]

Thanks Sharlene!

I forgot to mention that Chesney has no other symptoms of Cushings, at least at this time. No hairloss/poor haircoat, no pot belly, no panting, no skin issues and her activity level is normal.

I can't seem to find her actual UA results (the above results were from my notes I had taken after speaking with my vet but not the actual report) so will call the vet's office today and have them send the report to me and double check the protein. The initial UA was obtained via ultrasound guided cystocentisis and they did verify the bladder wall showed no growths and no stones were present.

I have yet to have a dog that reads those dang medical books. :rolleyes:

Danette

[molly muffin]

I know what you mean, wish they'd all use their study guides. Makes it less confusing for us poor humans :)

I really don't get that cushings feeling from what you've said.

Sharlene and Molly Muffin

[Harley PoMMom]

Hi Danette,

A belated welcome from me to you and Chesney. Diagnosing the reason for PU/PD can, sometimes, be difficult. I found an article from Dr. Peterson's blog which PU/PD is discussed: http://endocrinevet.blogspot.com/2011/01/diagnostic-approach-to-pupd-urine.html

An excerpt from this article:


Differential diagnosis based on urine specific gravity (SG) determination in animals with normal results of initial tests (CBC, serum biochemical profile and urinalysis)...


Urine SG of 1.008--1.029

Atypical hyperadrenocorticism (most common!)

Atypical leptospirosis

Early renal disease

Typical and occult pyelonephritis

Hyperthyroidism (cats)

Psychogenic polydipsia

Diabetes insipidus (partial)


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

Love and hugs,
Lori

[Rotpaw]

Lori - thanks so much for the link, I will take a look at it and forward to my vet for review.


This forum is awesome!!! :D

[SoggyDoggy]

Hi and welcome from me too! (Even if I am a few days late :p)

Totally agree with you, this forum is awesome! And so are the people!

You sound like you have a running jump start on the rest of us here, having been through this all previously and your vet tech knowledge, lucky you! I do hope you manage to find out what is going on with Chesney soon though. Tough when none of them do their homework and the required reading isn't it?