Possibly Cushings? 13 Year Old with Nose Bleeds

[Maggie13]

Hi everyone!

Unfortunately, my sweet baby Maggie has brought me to these boards. Here is the story. Three weeks ago? We noticed a few drips of blood around the house. We suspected the rabbit for a torn nail before we suspected Maggie. One week later I walk into the room to see blood slowly begin dripping out of her nose. This was the worst episode so far as I believe it caught her off guard and it was difficult to calm her down and stop her from sneezing. The following day she had a small nose bleed maybe ten minutes and I made an appointment for her the next day.

We did a full blood work up. Here are some of the results I think are most relevant:
AST Result: 24 Range: 10-88
ALT Result: 71 Range: 10-88
Bilirubin Result: 0.93 Range: .1-.6 HIGH
Creatine Result:.60 Range: .7-1.30 LOW
ALKP Result: 935 Range: 20150 HIGH
Glucose Result: 125 Range: 60-110 HIGH

Platelet and clotting profiles are fine with a count of 537.

The vet assumes she probably has Cushings but is not very concerned about it at this point. She feels the nose bleeds may be from cancer as her lymph nodes in her neck are swollen.

However, her WBC and LYM% results are on the lower end of normal. Her protein and calcium levels are also normal which elevated levels can often indicate tumors/cancer.

The vet wants to take the next steps of aspirating and testing her lymph nodes and checking her blood pressure.

My main question is could this nose bleeding be caused by the Cushings? Is it a result of hypertension exclusively? Also, is it too early to start homopathic remedies such as liver supplements with milk thistle?

She is currently eating the Budwig's cancer protocol diet until we confirm or dismiss cancer twice daily, 2 tbls cottage cheese blended with 1 tbls flaxseed oil with ligens, which I understand is beneficial to the liver.

Any advice at this point is appreciated. We seem to, hopefully, catching this moderately early so I would like to pursue any non-aggressive treatments available as soon as possible. Thanks.

[frijole]

I am going to manually approve your membership so you can post. I will be back but hopefully others will see your post and help as well. Kim

[frijole]

I have been here over 8 years and I don't recall nose bleeds so no it is not a sign of cushings. Was your vet not concerned about diabetes since the glucose is high? That would be more important to treat than cushings.

Cush dogs act like they are starved, have frequent urination issues, hind leg weakness - those are the top 3 symptoms. Does your dog even have any of those?

I am not sure I'd go down the milk thistle path yet (and I'm a believer in it) because you don't know what meds you might be put on for whatever is wrong and sometimes it might interfere should you require surgery or other stronger meds... I'd wait just a bit til you know what is going on.

The bloodwork is concerning. Other than the bleeding episodes how is your dog doing? What else is going on if anything? Thanks Kim

[Maggie13]

No she did not mention diabetes. I think she is less concerned with that given it is only slightly high. At this point I think she is mainly concerned with the swollen lymph nodes.

Maggie does have a slightly larger than normal appetite and I don't know if I would say excessive but definitely heavy drinking. I have noticed less muscle mass in her hind legs and she does have the characteristic pot belly. So those symptoms do make me think yes, cushings. However, I think at this stage we are more concerned with the nose bleeds and what is causing that given it normally indicates a serious condition and her blood tested as normal.

She went to the vet last Friday and have been taking the antibiotic Clindamyacin, given a ten day dosing. She had a bleeding episode last Thursday, then a short episode Tuesday. The last day or so her nose has seemed drier, less dripping, without any indications of blood. Her mono% is slightly elevated at 21 with a normal range of 3-10 which indicates infection but WBC is barely low at 5.91 compared to 6-17.

Since the nose bleeds have began she has had a bit of a runny nose mainly clear sometimes with blood, but that has stopped the last few days as I stated above. Her lymph nodes are still swollen with maybe some slight improvement since last Friday.

The vet wants to test for lymphoma and hypertension next. I just don't want to waste too much time beating around the bush.

[frijole]

I understand. Just so you know if cushings is at play there is no rush to treat it at all. Focus on whatever else is going on first. Another way to help the liver (reducing the alk phos level) is denamarin. I would pass it by the vet. They sell it but you can get it cheaper online.

Kim

[frijole]

You just added the avatar and that photo is absolutely priceless. Love it!!!

[Maggie13]

Okay, great. Just wanted to see if others had advice. I want to get through her antibiotics and see if she regresses once off them then head back to the vet for further testing. Then we can discuss what we can try. I have just been obsessively researching any possibilities which is how I found this board.

Thanks! She is my baby and my first dog. I am 22 and have had her since I was 8 so it is hard dealing with her aging. She had a tough year this past her losing a toe to cancer in January and an episode of vestibular disease.

If others have advice or experience with nose bleeds, I would appreciate any input.

[molly muffin]

Hello and welcome to the forum.
I agree with Kim, I think finding out what is causing the nose bleeds, the swollen lymph nodes is the most important thing at this point and that is what I would concentrate on, rather than cushings.
One reason I say this is because if something else is going on and it appears to be, the the cortisol will likely rise as a normal reaction. It's a defense mechanism naturally within the body. This would likely cause any cushing tests to be possibly inaccurate. So I would figure the rest out, address it and then if cushings is still a possibility, test for it later.

Again, welcome!
Sharlene and Molly Muffin

[spdd]

Just welcoming you to the forum. Great advice here from so many knowledgeable people.

Hope you can get to the bottom of this with the nose bleeds.

[goldengirl88]

Welcome to the forum. I just wanted to say that a dog can get a nose bleed from an upper respiratory infection. Also I don't know if this pertains to your dog, but Cushings dogs can get a narrowing of the nasal passages, whether that could cause a bleed I do not know. Has you dog been checked for Diabetes? I hope your baby gets to feeling better. Blessings
Patti

[doxiesrock912]

Maggie,
Welcome :-)

As others have said, I would address the nose bleeds and swollen lymph nodes. Any infection can affect Cortisol so testing for Cushings before other health issues are solved is pointless.

Once the other issues are resolved, I would write down how much she drinks, eats, and what her stools look like for a bit. Cushings progresses slowly and it's not necessary to treat immediately.