Toby

[Toby]

Toby is a small breed dog 15 years old (rescued at approx 2 years of age)

At a recent trip to the vet it was suggested that he might have cushings and so a blood test has been taken.

Reading through the forums I found a list of major symptoms and have made a note of how Toby shows or doesn't show them.

Anybody have any comments? the blood test results are due this weekend.

• increased/excessive water consumption (polydipsia) - yes is up, and has been since before the warm weather
• increased/excessive urination (polyuria) - definitely taking longer pees when out walking
• urinary accidents in previously housetrained dogs - none bar that one single incident
• increased/excessive appetite (polyphagia) - I really dont think that this has changed
• appearance of food stealing/guarding, begging, trash dumping, etc. - lol when did he not do this?
• sagging, bloated, pot-bellied appearance - pot bellied yes, sagging? no
• weight gain or its appearance, due to fat redistribution - not noticed
• loss of muscle mass, giving the appearance of weight loss - not noticed any change like this
• bony, skull-like appearance of head - No
• exercise intolerance, lethargy, general or hind-leg weakness - A little of this but then he is 15 and it is HOT
• new reluctance to jump on furniture or people - only my bed, otherwise he still jumps on chairs/setteee etc
• excess panting, seeking cool surfaces to rest on - no except for extra hot weather which I would see as normal
• symmetrically thinning hair or baldness (alopecia) on torso - I do not see any of this
• other coat changes like dullness, dryness - a little duller than before but he is 15
• slow regrowth of hair after clipping - obviously not - irrelevent
• thin, wrinkled, fragile, and/or darkly pigmented skin - no
• easily damaged/bruised skin that heals slowly - no
• hard, calcified lumps in the skin (calcinosis cutis) - no bar lumpy nose cured with vaseline
• susceptibility to infections (especially skin and urinary) - no
• diabetes, pancreatitis, seizures - no evidence of this

The most common is the constant hunger 24 hours a day, and drinking water by the buckets that causes urination accidents in the home.

constant hinger? not really, drinking lots of water yes accidents no

[Squirt's Mom]

MODERATOR NOTE: Your post has been manually approved so that members can start responding to you. Please check your email, possibly your spam / junk folder, for a message from k9cushings. You will need to reply to that email so that your post go directly to the board and are not delayed waiting for approval. If you have already received and responded to the confirmatory email, please be patient. Your registration will be finalized shortly. Thanks and welcome!

[Simba's Mom]

Hello and welcome to you and Toby, you have found the right place to be if your Toby has cushings, lots of info and encouragement along the way...take care, there will be many other family members coming along soon....

[Budsters Mom]

Hello and welcome from me too. :)
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. We will do all we can to help, but be ready for lots of questions! So again, welcome to you and Toby.:)

[lulusmom]

He and welcome to the forum.

I'm sorry for the circumstances that brought you here but I'm glad you found us.

First I'd like to thank you for rescuing your precious boy. 15 years old is getting up there so he's either got good gene's, which is a rarity these days, or you are a stellar advocate for him. Either way, congratulations.

I'm looking at the symptoms you've mentioned and I'm not convinced your boy really does have polyuria/polydipsia. Cushdogs drink buckets and pee lakes like nobody's business and there is no mistaking an increase in drinking from hot weather Cushdogs have to drink more water to stay hydrated as the kidneys lose their ability to concentrate the urine. Cushdogs normally have very dilute urine. Your vet should have done a urine analysis, to include a culture to rule out a urinary tract infection. If that was done, please post the results. We would be particularly interested in the urine specific gravity.

Cushdogs usually have polyphagia (garbage disposal, eating anything and everything...begging for food 24/7). There's usually no mistaking a normal, life-long healthy appetite with the catabolic effects of excess steroids (cortisol) which causes a dog to feel like he's starving all the time.

With so few and questionable symptoms, I'm going to guess that your vet suspected cushing's because the liver enzymes were elevated, right? Blood chemistry and complete blood counts are normally part of a senior panel so I suspect these were already done. We'd appreciate it if you could please post the abnormal highs and lows....and please include the normal reference ranges. If your dog spent a few hours at the vet, the blood test you mention is probably the acth stimulation test. If he spent the whole day, the test is probably a low dose dexamethasone. Regardless, please get a copy of the results when available and post them here.

The more information you can provide, the better able we'll be able to provide you with meaningful feedback. Symptoms are such a huge component of a diagnosis so even if the blood test is consistent with cushing's, I don't think a diagnosis can be confirmed.

We'll be looking forward to your response.

Glynda

[Toby]

Thank you lulusmum!

I didn't take Toby to the vets so am not 100% sure how ong he stayed there. I don't think that they tested his urine but here was some comment made about his liver (based on what I am not sure)

I will get back to you and keep you informed.

In the meantime here is a picture of him I posted last year (taken when he was a young man!)

http://www.lancashireheelers.org/is_my_dog_a_lancashire_heeler.php

page 5 image 4

[Toby]

Seems that the vet has taken a general purpose blood test and bot a specific one for cushings itself

[spdd]

Welcome to the forum. The knowledge of people here blows me away and they continue to be so supportive as we walk through this journey.

[goldengirl88]

Hello:
I wanted to welcome you and Toby. It is wonderful that you rescued him, and that he is 15 yrs old. The members here will want to see test results that have been done to confirm if Toby does in fact have Cushings. I try to pass along helpful tips;
Start a daily diary of what your dog does.
Get and put into a folder all tests etc. from the vet, and post results here.
Keep track by measuring your dogs water intake, and weight.
If your dog does have Cushings you will need a vet who is knowledgeable and has experience treating this disease, or an IMS. This will save you time money and heartache as most vets know very little about this disease.
Listen to the members on here as they know more about this disease than the vets do. They will guide you thru everything and support you.
Learn and get as much knowledge of this disease as you can. Your decisions will impact the probability of you dog making it thru this journey successfully. Good luck to you and keep the faith, everyone here is ready to help you thru this. Blessings
Patti

[lulusmom]

I love Toby's picture. He's a cutie for sure and he couldn't look more relaxed and happy. :D

[doxiesrock912]

What a great pose Toby :)

You'll know the difference in appetite and drinking in a Cushingoid dog.
It's ravenous! They're hungry ALL of the time and will steel another's food immediately after eating their own.

It will seem as though their water bowl is always empty no matter how large it is or how often you fill it. Regardless of the weather.

[Toby]

Thank you all for your support and good wishes :-)

I will get back to you with the test results as soon as I have them (there could be a delay due to my going away for a week)

[goldengirl88]

Hi:
Just dropping in to see how things are going with Toby. Hope everything is going well. Blessings
Patti

[Toby]

been a while, but finally got the preliminary blood test results over the phone (am requesting a written version to post)

Toby seems a little anaemic
Toby's liver/kidney results are a bit poor (no idea how poor at current but he is at least 15 years old and could in honesty be older so wouldnt that be expected?)

Vet wants to do 4 hour tests for cushings two injections etc.

I do not think that it is worth it, he exhibits very few of the symptoms of Cushings to me.

There has been no other change since I last posted his symptoms.

Only thing to add is that now instead of a dozen or more territory marking wees he now does 3-4 longer ones but he always seems to aintain control - sleeps the whole night through (in my bed) without accidents or need to go outside.

thanks for all of your help and support

[goldengirl88]

It is definitely worth while to have your dog tested for Cushings. He made it this far to 15, and just because he is old doesn't automatically make his liver values bad. Cushings can cause high liver values, but could also be something else too. I think it is very worth while to have your dog tested to see what is wrong with him. At this age he really needs your help, so please reconsider looking into his health issues. Blessings
Patti

[Toby]

thanks for that, I will post the full test results when I get them.

[goldengirl88]

Will be waiting to see the test results so you can get your baby some help. Blessings
Patti

[Toby]

here are the full results


Standard Screen
Full Blood Count
WBC.................... 11.4 x10^9/l 6.0 - 15.0
RBC.................... L 4.60 x10^12/l 5.00 - 8.50
Haemoglobin............ L 11.4 g/dl 12.0 - 18.0
PCV.................... L 34.0 % 37.0 - 55.0
MCV.................... 73.9 fl 60.0 - 80.0
MCH.................... H 24.8 pg 19.0 - 23.0
MCHC................... 33.5 g/dl 31.0 - 34.0

% x10^9/l Range
Neutrophils 75 8.6 3.0 - 11.5
Bd Neutrophils 0 0.0 0.0 - 0.3
Lymphocytes 18 2.1 1.0 - 4.8
Monocytes 6 0.7 0.0 - 1.3
Eosinophils 1 0.1 0.1 - 1.25
Basophils 0 0.0
Film : Scanty polychromatic cells seen
Abs Retics = 23x10^9/l
Slight anisocytosis
Occasional Howell-Jolly body seen
Occasional target cell seen
Platelet count appears normal in film
Total Protein.......... 75.0 g/l 54.0 - 77.0
Albumin................ 33.9 g/l 25.0 - 37.0
Total Globulin......... 41.1 g/l 16.0 - 50.0
Sodium................. 147 mmol/l 139 - 154
Potassium.............. 4.50 mmol/l 3.60 - 5.60
Sodium : Potassium..... 32.67
Chloride............... L 100 mmol/l 105 - 122
Calcium................ H 3.11 mmol/l 2.30 - 3.00
Phosphate.............. 1.43 mmol/l 0.80 - 1.60
Urea................... H 13.3 mmol/l 1.7 - 7.4
Creatinine............. H 130 umol/l 20 - 100
Total Bilirubin........ 3.1 umol/l 0.0 - 16.0
ALP.................... H 1,625 u/l@37C 16 - 55
ALT.................... H 254 u/l@37C 18 - 56
Gamma GT............... H 9.0 u/l@37C 0.0 - 6.0
GLDH................... H 36.0 u/l@37C 2.0 - 6.0
Bile Acids............. H 23.8 umol/l 0.0 - 10.0
CK..................... 214 u/l@37C 50 - 230
Cholesterol............ H 10.7 mmol/l 3.8 - 7.0
Triglycerides.......... H 8.51 mmol/l 0.56 - 1.69
Glucose - Random....... H 6.2 mmol/l 2.0 - 5.5
Amylase................ 655 u/l@37 C 100 - 900
Lipase................. H 418 u/l@37 C 0 - 250

[Toby]

some results are way off, in particular the ALP and ALT which are extremely high

[Squirt's Mom]

Has Toby had an abdominal ultrasound? If not, I highly recommend he have one asap. I don't know how to interpret those results but in googling what a couple of them could mean, if he were mine I would want them to get a good look at his insides soon. One, the Howell-Jolly body, can mean the spleen isn't functioning properly. The spleen isn't a vital organ but if it ruptures that is a life-threatening situation where minutes can count.

Hopefully someone who understands these will be along to help soon.
Hugs,
Leslie and the gang

[molly muffin]

You know, I agree with Leslie, I think I'd want to have an ultrasound done to see what is going on inside.

Sharlene and Molly Muffin

[Harley PoMMom]

With the elevation in the Creatinine and the abnormal levels with the Chloride and Calcium, I do believe Toby has an issue with the kidneys. Has the vet mentioned any type of treatment for the kidneys?

Love and hugs, Lori

[Toby]

The vet just keeps pushing us to do the cushings tests

[Toby]

He doesn't exhibit many of the other symptoms of cushings however (see initial post for the full list)

[lulusmom]

I'm still not convinced that Toby has cushing's and in the absence of any symptoms, I would not incur the expense of testing at this point. Symptoms are a big component of a diagnosis and since Toby has none, I'm not sure why your vet is pushing you to test. The goal of treatment is to remedy problematic symptoms as well as reverse the impact of high cortisol on the body. Yes there are some blood abnormalities that we see a lot like elevated, ALKP, ALT, Cholesterol & Triglycerides but we see them with other conditions as well. What we don't see are cbc results consistent with anemia and elevations in both BUN and Creatinine which points to possible kidney disease. I think there is something else going on with your boy that your vet needs to rule out before pursuing a cushing's diagnosis. I think spending your hard earned dollars on an abdominal ultrasound would be a much better option at this point.

[goldengirl88]

Hope you find out what is wrong with Toby I know once you do all this will make sense to you. Blessings
Patti