is it Cushings or not?

[Gallagher's Mom]

We just had our 2nd urinalysis done at the vet with our 4 yr old Old English sheepdog/Newfoundland mix. Vet keeps saying his urine is diluted. He doesn't over drink or over eat, doesn't urinate more than normal, no hair loss....no symptoms that would indicate Cushings disease other than diluted urine. The vet wants to send him to Med Vet (expensive!!!) for an ultra sound which is the cheaper of the two tests that she has mentioned.
I just don't get it...if that is the only symptom, how does that make it Cushings?? My husband wants to get another opinion. Is there any tests that can help indicate whether its Cushings or not?
Just a very worried Mom with a limited budget. It just seems like our Vet wants to constantly sedate our dog for tons of tests that don't seem necessary. I could see if he had a couple more symptoms or all of them, then yes let's get the official diagnosis and get him on meds but I'm just not confident in her findings. Would someone be willing to give me some advice?:cool:

[lulusmom]

Hi and welcome to the forum.

I have manually validated your membership so there is no need to respond to the email that is automatically sent to you for validation.

I'm glad you are asking logical questions as symptoms are a huge part of diagnosis. Dogs with cushing's have dilute urine because the kidneys lose the ability to concentrate. They pee lakes and they drink buckets to stay hydrated so if your dog is drinking and peeing normally, I'm not sure why your vet is rushing to do testing for cushing's.. What lead you to take your dog to the vet in the first place? Is there something else going on with your dog? Is appetite normal, any weakness in the hind quarters, lethargic?

It would help us greatly if you could tell us what tests your vet has done so far. Please get copies of the urine tests and post the results here. Was a urine culture done? If not this should be done as well as white blood cells can be dilluted out and the dip stick method doesn't pick up the full scope of possible infections. If there is an infection, a culture will tell you which bacteria is involved so that an appropriate antibiotic can be prescribed.

Blood work should have been done before launching into full blown diagnostics. If this was done, please get a copy of those results and post the high and low values and please include the normal reference ranges. A lot of vets suspect cushing's when blood work shows abnormally high liver enzyme Alk (alkaline phophatase). Other abnormalities often seen are mildly elevated ALT, also a lliver enzyme; high cholesterol, high triglycerides and low T4. Not all of these will be abnormal but those are the most common. Posting results for us is a good start.

If symptoms were to warrant further testing, there is a relatively inexpensive urine test called a uc:cr (urine cortisol:creatinine ratio) that can rule out cushing's if the ratio is normal. If the ratio is high, high cushing's is not a certainty as any non adrenal illness or even high level of stress can yield a high result. That would be the first thing I would do but again only if symptoms warranted.

At this point, I'd want to know if there is an active infection affecting the urine that should be addressed with antibiotics. If no infections no clinical signs, no abnormal blood work and he's acting perfectly normal, I'd monitor the situation if and until other symptoms become apparently.

We'll be waiting for those test results and in the meantime, why not ask your vet to tell you what, besides dilute urine, is convincing him that cushing's is at play.

I'll be looking forward to your updates.

Glynda

P.S. We always tell members to keep complete copies of medical records for their dogs. They come in handy to have at our fingertips if you ever have to visit an after hours clinic. They alsso come in handy for times like this when we nag you to post test results. We're here o help in any way we can so ask a many questions as you have and take advantage of our Helpful Resources section when you have some time to devote some quiet time. It's some dry reading that takes a bit to absorb. The lightbulb will come on for you eventually and in the meantime, we cab pick up thee slak.

[molly muffin]

Hello and welcome to the forum.

Glynda has covered all the basics here already and I completely agree with her. Some vets really seem to jump on the cushings bandwagon way early it seems. I don't know why that is. So many other things come first, and cushings is really hard to diagnose under the best of circumstances like when all the symptoms are there and all the test results show cushings.
It really doesn't sound like your dog is a candidate for that type of diagnosis based on what you've said though.

Sharlene and Molly Muffin