Gizmo
07-30-2013, 04:21 PM
Hi everyone! I've been making myself crazy researching Cushing's Disease online and then I found this wonderful forum! I have an 8 year old maltese named Gizmo that has received a possible Cushing's diagnosis based on his routine senior blood panel. I've read through some of the posts on here and you guys are much better at interpreting blood work that I am, so here are his abnormal numbers:
1. Alkaline Phosphatase - 1200 U/L (normal was stated at 5-131)
2. BUN/Creatinine Ratio - 35 (normal is 4-27)
3. Platelet Count - 606 (normal 170-400)
4. Monocytes - 920 (normal 0-840)
5. GGTP was at the high end of normal - 11 (normal is 1-12)
Everything else was within a normal range. I know that ALT is commonly looked at and his was a 43 (normal being 12-118). He also had a urinalysis done and his urine was yellow, the specific gravity was 1.046 (normal), and his PH was slightly high at 8.5 (normal 5.5-7.0).
At the time of the test he had been at the vet for nearly an hour having his routine yearly exam, including nails trimmed and anal glands expressed, and he was absolutely FRANTIC. He hates vets and has severe anxiety that increases by the minute while we're there. We also learned that he had a pretty severe worm infestation (thanks dog park!) at the time of the test. I've heard that anxiety can influence ALK so I'm hoping that combined with the worms may be a likely reason for the excessive numbers?
We were so taken aback by the blood work because he's had no real symptoms! I know that the most commonly seen symptoms are urinating frequently and clear-ish urine, but he still pees normally and it's always yellow; he's been an incredibly food motivated dog since he was a puppy so he's ravenous over what he considers GOOD food, but he happily leaves part of his kibble lying in his bowl on a daily basis; and he's always been a very high strung/anxiety ridden dog so heavy panting has also always been there. He has had persistent yeast infections between his toes and ear infections since he was 1, but they've both actually managed to clear up and look great for the past several months since going to a new vet and being more rigorous with his grooming. He doesn't have any hair loss or noticeable skin disorders, except for some cysts on his back. We had those aspirated a year ago and our vet said that they were just like doggy acne and come with age.
We ended up having a low dose dexamethasone test and had to leave him at the vet for 8 whole hours (the first time he's ever been left alone at the vet) and due to his severe separation anxiety and nervousness at the vet, I don't know how much I trust the numbers. Our vet said that the test was slightly inconclusive because the numbers didn't exactly follow the formula for either adrenal based or pituitary Cushing's, but that they leaned toward adrenal based.
His baseline cortisol was 1.9, his 4 hour level was 2.7, and his 8 hour level was 3.2 He also had a severe worm infestation during this test - we discovered it a couple of days later. I'm worried that these numbers are also a little skewed because of his severe anxiety at being separated from me and our other dog AND how much he hates being at the vet, but maybe that's just wishful thinking.
After this test we decided to have an ultrasound done to check for any adrenal abnormalities and the vet said that an adrenal tumor is unlikely (thank goodness!!) due to the lack of major differences seen between the adrenal glands - the left gland was 0.54-0.61 and the right gland was 0.58-0.63. There were no masses found.
They did, however, find a "well defined" nodule on the left cranial liver that was 0.67 cm (quoted directly from his paperwork). They did not seem concerned about this finding.
Wow, sorry for writing a novel for my first post :eek: I'm just so happy to have found this forum filled with people that know what I'm going through AND know about Cushing's! I've felt so lost and alone since all of this started happening - Gizmo is my baby and I hate to imagine him being sick :(
Where should I go from here? I want to see a specialist, but I don't even know what to ask at this point. What does this sound like to you guys?
1. Alkaline Phosphatase - 1200 U/L (normal was stated at 5-131)
2. BUN/Creatinine Ratio - 35 (normal is 4-27)
3. Platelet Count - 606 (normal 170-400)
4. Monocytes - 920 (normal 0-840)
5. GGTP was at the high end of normal - 11 (normal is 1-12)
Everything else was within a normal range. I know that ALT is commonly looked at and his was a 43 (normal being 12-118). He also had a urinalysis done and his urine was yellow, the specific gravity was 1.046 (normal), and his PH was slightly high at 8.5 (normal 5.5-7.0).
At the time of the test he had been at the vet for nearly an hour having his routine yearly exam, including nails trimmed and anal glands expressed, and he was absolutely FRANTIC. He hates vets and has severe anxiety that increases by the minute while we're there. We also learned that he had a pretty severe worm infestation (thanks dog park!) at the time of the test. I've heard that anxiety can influence ALK so I'm hoping that combined with the worms may be a likely reason for the excessive numbers?
We were so taken aback by the blood work because he's had no real symptoms! I know that the most commonly seen symptoms are urinating frequently and clear-ish urine, but he still pees normally and it's always yellow; he's been an incredibly food motivated dog since he was a puppy so he's ravenous over what he considers GOOD food, but he happily leaves part of his kibble lying in his bowl on a daily basis; and he's always been a very high strung/anxiety ridden dog so heavy panting has also always been there. He has had persistent yeast infections between his toes and ear infections since he was 1, but they've both actually managed to clear up and look great for the past several months since going to a new vet and being more rigorous with his grooming. He doesn't have any hair loss or noticeable skin disorders, except for some cysts on his back. We had those aspirated a year ago and our vet said that they were just like doggy acne and come with age.
We ended up having a low dose dexamethasone test and had to leave him at the vet for 8 whole hours (the first time he's ever been left alone at the vet) and due to his severe separation anxiety and nervousness at the vet, I don't know how much I trust the numbers. Our vet said that the test was slightly inconclusive because the numbers didn't exactly follow the formula for either adrenal based or pituitary Cushing's, but that they leaned toward adrenal based.
His baseline cortisol was 1.9, his 4 hour level was 2.7, and his 8 hour level was 3.2 He also had a severe worm infestation during this test - we discovered it a couple of days later. I'm worried that these numbers are also a little skewed because of his severe anxiety at being separated from me and our other dog AND how much he hates being at the vet, but maybe that's just wishful thinking.
After this test we decided to have an ultrasound done to check for any adrenal abnormalities and the vet said that an adrenal tumor is unlikely (thank goodness!!) due to the lack of major differences seen between the adrenal glands - the left gland was 0.54-0.61 and the right gland was 0.58-0.63. There were no masses found.
They did, however, find a "well defined" nodule on the left cranial liver that was 0.67 cm (quoted directly from his paperwork). They did not seem concerned about this finding.
Wow, sorry for writing a novel for my first post :eek: I'm just so happy to have found this forum filled with people that know what I'm going through AND know about Cushing's! I've felt so lost and alone since all of this started happening - Gizmo is my baby and I hate to imagine him being sick :(
Where should I go from here? I want to see a specialist, but I don't even know what to ask at this point. What does this sound like to you guys?