Introducing Molly (11 y/o yellow lab)

[mkmoser122]

Just wanted to say hello and introduce my dog, Molly, an 11-year old yellow lab. Molly has had lots of health issues - mainly allergies, but it seems like the past year and a half has been a little rough for her health wise. She is definitely slowing down and has had some weakness in her back end.

We also have been fighting skin infections...every 6 weeks or so she gets these scaly spots on her belly and legs. The spots are painful for her and she has hair loss when the scaliness comes off. We've been to a dermatologist and don't have a good answer as to why these continue, so the vet gives her an antibiotic to clear up the infection and the cycle continues.

Recently she has started panting a great deal more, and her breathing is a bit labored, so we are watching her for possible laryngeal paralysis. She had a blood test about a month ago and her blood calcium level was elevated and she also had elevated levels of protein in her urine. She seems like she is drinking a ton all of a sudden and needs to go outside more than usual (but that may be me just being keyed into her a little more, too).

So today, we went back for a recheck on her blood and urine and the vet and I discussed the possibility of Cushing's. I know the vet is going to look for an elevated alk phos (?) level - it was normal a month ago, and if it is high then she is going to do a test that takes 8 hours.

I guess I'm just looking for any thoughts or support you all may have. My dogs are important members of my family and I just want to make sure she has a good quality of life as she gets older. I'm just curious if a lot of these little problems she's having are related...

[Budsters Mom]

Hello and welcome!:)
I am sorry for the reason that brought you here, but very glad you found us.
You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. Others will be popping in shortly to welcome you also.

So again welcome to you and Molly,
Hugs,
Kathy and Buddy:)

[Harley PoMMom]

Hi and welcome to you and Molly,

So sorry for the reasons that brought you to us but glad you found your way here.

Did the dermatologist do a skin scraping or punch biopsy to determine what Molly's skin issue is? Does Molly have a ravenous appetite and/or pot-bellied appearance? Has diabetes or any thyroid problem been ruled out? These two illnesses, plus others, do share some of the same symptoms as Cushing's.

Has an urinalysis been done recently, and if so, could you post those results? Is Molly taking any other herbs/supplements/medicines? Gosh, I am so sorry for all these additional questions but the more information we know about Molly the better our feedback can be, ok?

If Molly does have Cushing's I want you to know that Cushing's is a treatable disease and dogs do live out their normal life span with treatment. We are here to help in any way we can so do not hesitate to ask any and all questions.

Love and hugs, Lori

[mkmoser122]

Yes, the dermatologist did a skin scraping and said it was a staph infection. I've done allergy shots with her, but the skin infection continues.

She does have a good appetite. She and my other dog get fed twice per day, and she is very excited for her meals (when she was younger I had to persuade her to eat.) She'll come over and bark at me, and I think that is because she wants a treat - and this is new. Not really seeing the pot belly, though.

I would assume (but maybe I shouldn't) that she had a urinalysis because the vet said the protein levels in her urine were elevated. I will definitely be more specific and ask about that when we get today's blood test results back.

She has been taking Benadryl for what seems like forever. She has lots of skin allergies and food allergies as well (she is on a very controlled diet). Most recently she has been on Simplicef for her latest battle with the skin infection. I give her a hip and joint supplement 2 times per day, and also she is taking tramadol for pain. I have Ace to give her in case she has a breathing issue. She had been on Rimadyl for a month, but we pulled her off of that when the initial blood test showed elevated levels. I'm sorry that I don't have more specific numbers, but I will get those!

We haven't talked about diabetes or thyroid, but it is something I will definitely discuss with my vet. I appreciate any and all suggestions!

I just want to get answers for Molly so she can get back to feeling better. She's much more clingy than usual, so I know something is up. As I read more about Cushing's, I do get a little concerned about treatment...Molly is a dog that tends to experience side effects. She can't have any sort of topical flea/tick prevention, as she has had major allergic reactions. I am a little concerned that the tramadol may be causing the additional panting, but she had a reaction when we tried to switch her to gabapentin. She's just kind of a puzzle right now.

[Harley PoMMom]

Since any kind of stress or pain will create false positive results from Cushing's tests, if this were me, I would wait until her skin infections are healed before any tests for Cushing's are performed.

Any and all test results that you can get copies for and post the results here that would help us in trying to decipher what could be going on with sweet Molly.

If Trilostane is the drug your vet and you decide to go with, starting at the low end of the dosage scale is recommended, and we do see less side effects when this is done.

There are a lot of things that can cause protein-loss in a dog's urine. Any type of bladder or kidney infection will cause protein-loss. Has an UPC (Urine Protein:Creatinine Ratio test) been done to evaluate the protein-loss? I know, more questions!! :eek::D

Love and hugs,
Lori

[mkmoser122]

Thanks so much for your thoughts! I don't mind more questions, at all. It gives me something to talk with my vet about. They know Molly really well, so I know they want to help her, too.

She doesn't have any infection now - the simplicef cleared it up. She takes it for about 3 weeks at a time.

I don't think a UPC test has been done. I have her bloodwork checked every year and this was the first time we saw some abnormalities. We wanted to rule out that it wasn't the Rimadyl causing things to go wonky. I had also been giving her a multivitamin that had extra calcium and Vitamin D in it. So my Dr. wanted me to pull her off both of those for a month and recheck everything. We'll look at the senior blood work and then decide if we need to look into something further.

While I was at the office today, we discussed the possibility of Cushing's because of the other symptoms she was presenting, and that there were additional tests that would help to diagnose it, but we'd discuss that after we get this first round back. I think we'll definitely talk about any and all possibilities - diabetes, thyroid, even just a simple infection.

There has to be something going on with Miss Molly's kidney or bladder, though. She drinks water like she's been in the desert and then (forgive the expression) pees like a racehorse!

Hugs from me and my girl!

[molly muffin]

Hello and welcome to you and Molly :)

There are tests that can be done to for cushings and it normally takes a couple different ones to determine for sure if it is cushings and often an ultrasound is recommended to see the internal organs, specifically adrenal glands and liver, but always good to take a look at spleen, pancreas, etc too.
However, first should be to rule out the things that Lori mentioned as they all mimic cushing symptoms. With the high protein I'd want a full kidney panel run, including UPC to check that out. You can also do a UC:CR urine test as an easy first test for cushings. It won't confirm if cushings if the cortisol is there, but if it isn't, it can rule it out. Hope that makes sense.

Again welcome. We'll be eager to see the numbers on the labwork as that is the first place to start. One of the other things that many of us do is have copies of all labwork going back for a year or two so that you can easily refer to it and see what is what and do comparisons. Knowledge is your best friend, no matter whether this is a cushings diagnosis or not. Just asking questions and learning what you can is a good first step and writing down the questions/topics you want to discuss with your vet. I hate it when I walk out having forgotten half the things I wanted to talk about while I was there. (I always think of them either on the drive home or as soon as I get home) LOL :)

Again welcome to the forum
Sharlene and Molly Muffin

[mkmoser122]

Thanks for the welcome. I will post her results when I get those back (hopefully tomorrow).

This is definitely a new area for us...I'm pretty good with the allergy and the orthopedic stuff at this point (2 ACL surgeries!), but most of that was due to seeking out message boards for support and additional information. So thankful that others want to share their experiences and expertise.

I don't want to rush to lock in to one specific diagnosis without knowing all the facts, but just want to be mindful of all possibilities and be informed.

And you're right about writing down questions...I had a whole pageful today, which helped the discussion. I, too, am one of those people who kick myself for forgetting to ask a certain question or mention something else that has come up!

Thanks for listening and the advice!

Kristi

[mkmoser122]

So, Molly's blood test results are in...alk phos levels were elevated, but not super high. CK(?) was high - not sure what that means. And Albumin was just over the allowed limits. Vet thinks we may want to go ahead and do the 8 hour test on Monday. Thoughts? No urinalysis done, but if she goes in Monday, I may see if we can go ahead and do that as well.

I'm going to go ahead and post these (sorry if this is too much information)! Normal values are in parentheses.

ALK PHOSPHATE 215.0 (10-150)
ALT (SGPT) 79.0 (5-107)
AST (SGOT) 38.0 (5-55)
CK 370.0 (10-200)
GGT 7.0 (0-14)
AMLYASE 1076.0 (450-1240)
LIPASE 531.0 (100-750)
ALBUMIN 4.1 (2.5-4)
TOTAL PROTEIN 7.7 (5.1-7.8)
GLOBULIN 3.6 (2.1-4.5)
TOTAL BILIRUBIN 0.0 (0-0.4)
DIRECT BILIRUBIN 0.0 (0-0.2)
BUN 16.0 (7-27)
CREATININE 0.7 (0.4-1.8)
CHOLESTEROL 283 (112-328)
GLUCOSE 97.0 (60-125)
CALCIUM 11.3 (8.2-12.4)
PHOSPHORUS 4.7 (2.1-6.3)
TCO2 (BICARB) 23.0 (17-24)
CHLORIDE 111.0 (105-115)
POTASSIUM 4.3 (4-5.6)
SODIUM 149.0 (141-156)
A/G RATIO 1.1 (0.6-1.6)
B/C RATIO 22.9 (0-0)
INDIRECT BILI 0.0 (0-0.3)
NA/K RATIO 35.0 (27-40)
HEMOLYSIS INDE 0.0
LIPEMIA INDEX 0.0
ANION GAP 19.0 (12-24)
T4 1.8 (1-4)
WBC 8.4 (5.7-16.3)
RBC 5.82 (5.5-8.5)
HGB 14.0 (12-18)
HCT 40.9 (37-55)
MCV 70.0 (60-77)
MCH 24.1 (19.5-26)
MCHC 34.2 (32-36)
NEUTRO SEG% 75.1 (60-77)
LYMPHOCYTES% 15.7 (12-30)
MONOCYTES% 4.2 (3-10)
EOSINOPHIL% 5.0 (2-10)
BASOPHIL% 0.0 (0-1)
AUTO PLATELET 499.0 (164-510)
NEUT SEG ABSOL 6308.0 (3000-11500)
ABSOL LYMPHOC 1319 (1000-4800)
ABSOL MONOCYT 353.0 (150-1350)
ABSOL EOSINOPH 420.0 (100-1250)
ABSOL BASOPHIL 0.0 (0-100)

Thanks in advance for your thoughts and guidance!
Kristi and Molly

[molly muffin]

Oh gosh these results look really good and not at all what we normally see with cush pups. We are use to seeing ALKP's really, really high, like in the thousands.
Actually you only need to post anything that is High or Low . I don't know that I would go ahead with cushing testing based on this.
If anything, you might want to start a liver supplement, just as a proactive measure. If you are still thinking cushings then maybe a UC;CR, which would at least show you if there is cortisol present in the urine and then you could do further testing if warranted. If would however rule out cushings if it is negative. If positive then you can do the 8 hour test (LDDS) or the ACTH.
But this is good test results for any dog. Even with the Albumin being just a tad high and the ALKP. This could definitely be a result of the persistent infections. I just don't see any cushings results here. I know this is about the skin infections though. When you have infection, you have a normal rise in cortisol production, it's like a self medicating mechanism. When you have high cortisol you can have skin problems. It is a catch 22.
Maybe the others will have some other thoughts when they get a chance to look through the test results and review the thread again.
Hang in there!
hugs,
Sharlene and Molly Muffin