Mollie (8 y/o skye terrier)

[Jana]

I was volunteering for a local rescue group in Phoenix, Az when I went to the local animal control shelter to help with our selection of dogs from the e-list when I came across Mollie(the name I gave her when she came home). I asked the animal control workers if she was available for me to take to see if we could get her adopted out and they said no because she was unadoptable due to her mats and overall filthyness. I looked into her pin and told her I would be back tomorrow to get her. I also told everybody at animal control I would be back the next day to personally adopt her. The next day came, which by the way was February 13, 2012, and Mollie was on her way to her new home. As animal control told me, yes she was indeed filthy and matted, however all she needed was one day at the spa for a bath and haircut and she would be the beautiful dog she is today, a skye terrier, gray in color. After her day at the spa she got a nice visit to the vet where we figured her age was roughly 8 years old, even though her age didnt matter, I knew she needed a good home. At first Mollie needed a little time to adjust to her new surroundings, and her 4 new brothers and sisters, which she was not real happy with at first but has come a long way. Fast forward 2 years and Mollie has been diagonoised with cushings, however we are not certain which type at this point. I found this great website and am grateful to be able to share Mollie's story.
We are at the treatment decision stage and have a few weeks to think it through, either we treat her or we don't, as surgery is not an option, per our vet and the internal medicine doctor. Can we get some input from anybody and some help in our decision making. I will post Mollie's test results in a new thread for all to read if that is requested.
Thank you ,
Jana - Mollie's mom

[addy]

Hi and Welcome,

Thank you for giving Mollie a home, the rescue pups are always so special.

Cushings is a difficult disease to diagnose. What symptoms does Mollie exhibit that lead you to test for Cushings? What symptoms concern you the most? What tests were done to confirm the diagnosis? Could list the test results?

I waited a year to start treatment with my Zoe. At the time, her symptoms were mild, mostly skin/coat issues. She also had IBD which concerned me more at the time than the Cushings.

I am so glad you found us.

[mytil]

Hi and welcome from me too.

Cushing's is difficult to diagnose as many other conditions mimic the symptoms. During the testing did the vet rule out any thyroid or liver problems? And also what about diabetes?

Yes, please do post those test results here in this thread.

Here is a good link with some additional information about Cushing's, the diagnostic phase and the treatment options - http://www.k9cushings.com/forum/showthread.php?t=180.

Please do keep us posted and you're an angel for seeing through all that filth to what was really inside.
Terry

[Renee]

Wow, a true Skye Terrier? Very rare! We had two in rescue, and they were such unique dogs. I always think of them as low-riders because of their long and low body, lol!!

There are many threads on here with people using lysodren or vetoryl as treatment, so I think there can be success with both. Just depends on what you and your vet decide, and what is best (if any) for Mollie.

My pug just started on vetoryl a few days ago. I chose this, with my vets input, because I like the idea of being able to withhold the medicine if need be, among other reasons.

[Trixie]

Love your story about Mollie and how you gave her a 2nd chance and loving home.
Does she have some obvious symptoms? Drinking, peeing, panting, hunger...etc.?
I have been treating my dog (a mini schnauzer) with Vetoryl since last March...so almost 10 months now. If you do decide to treat with this medication make sure you start with a low dose... 1mg per pound. The brand name comes only in certain strengths but you can get the generic compounded in different doses if needed.
My dog has done very well so far though it took a number of months tweaking the dose to finally get her symptoms to subside.
Of course it's helpful to have a vet with experience treating the disease.
There are so many great people here who will help you through all of this...they will all want/need to know all the test numbers you have-blood work and any of the tests that were done for Cushings. If you don't have them you can ask the vet for copies and then post the numbers here on your thread. It will make it easier to advise and suggest.

Barbara

[Jana]

Thank you all for responding. Some of the things that were concerning to me were, pot-belly, increased appetite, able to feel her back bone, and thinning of her hair. Then she got lethargic and that scared me. That is when I took her to the vet. Here are her test results:
Chemistry results from IDEXX VetLab In Clinic
BUN/UREA = 35 MG/DL H Range 7-27
CREA = 0.8 mg/dl Range 0.5-1.8
PHOS= 6.6 mg/dl Range 2.5-6.8
Ca = 9mg/dl Range 7.9-12
TP = 7.5 g/dl Range 5.2-8.2
ALB = 3 g/dl Range 2.3-4
GLOB = 4.5 g/dl Range 2.5-4.5
ALT = 62 U/L Range 10-100
ALKP = 954 U/L H Range 23-212
TBIL = 0.4 mg/dl Range 0-0.9
CHOL = 246 mg/dl Range 110-320
AMYL = 2500 U/L H Range 500-1500
LIPA = 5632.8 U/L H Range 200-8000
GLU = 105 mg/dl Range 74-143
Sodium = 149 mmol/L Range 144-160
Potassium = 3.9 mmol/L Range 3.5-5.8
Chloride = 112 mmol/L Range 0-7
GGT = 3 U/L No Range given
ALB/GLOB = 44 No Range given
Na/K = 38 No Range given
OSM calc = 303 mmol/kg No Range given
Hematology results from IDEXX VetLab In Clinc
RBC = 6.24 M/ul Range 5.65-8.87
HCT = 37.3% Range 37.3-61.7
HGB = 13.7 g/dl Range 13.1-20.5
MCV = 59.38 fl L Range 61.6-73.5
MCH = 22 pg Range 21.2-25.9
MCHC = 36.7 g/dL Range 32-37.9
RDW = 15% Range 13.6-21.7
%Retics = 0.2% No Range given
Retics = 10.6 K/uL Range 10-110
WBC = 13.93 K/uL Range 5.05-16.76
%NEUT * 74.4% No Range given
%LYMPHS * 15.4% No Range given
%MONOS * 8.3 % No Range given
%EOS* 1.8% No Range given
% BASO = 0.1% No Range given
NEUT * 10.38 K/uL Range 2.95-11.64
LYMPHS* 2.14 K/uL Range 1.05 - 5.1
MONOS* 1.15 K/uL H Range 0.16 - 1.12
EOS* 0.25 K/uL Range 0.06-1.23
BASO = 0.01 K/uL Range 0-0.1
PLT = 161 K/uL Range 148-484
MPV = 10.9 fL Range 8.7-13.2
PDW = 13.8 fL Range 9.1-19.4
PCT = 0.17% Range 0.14-0.46
Band* Suspec No Range given
WBC Abm Scatteergram
Band neutrophils suspected

Also did a urine test to check for Protein and none was found which is a good sign according to the Vet.
No liver masses but possible adrenal masses
Tested positive for cushings but not type
Please let me know what other questions you have as I was able to get a copy of Mollie's records from the vet.

Thank you I am so glad I found you,

Jana

[lulusmom]

Hi and a belated welcome to you and Mollie.

I have bolded the abnormal blood values you posted. Can you recheck the results and confirm that the reference range for Chloride is correct. If it is, the results are really high and I'm wondering why. I notice you didn't mention excessive drinking and urination as one of Mollie's symptoms. Is she drinking and urinating normally? It sounds as thought your vet only did one diagnostic test to confirm a diagnosis. Can you get a copy of that test and post the results here? The two usual tests are the acth stimulation test and the low dose dexamethasone suppression test (LDDS).

I didn't see any thyroid values on the results you posted. Most blood chemistry tests include T4. Can you double check the results to make sure you didn't miss it. Hypothyroidism shares many of the symptoms that are associated with cushing's so this is something your vet should have ruled out.

Did your vet talk to you about doing an abnominal ultrasound before starting treatment to 1) determine which form of cushing's Millie has and 2) to look at the surrounding organs for the usual abnormalities caused by cushing's as well as check organs for other possible problems? If it were me and I could afford, I would definitely want an abdominal ultrasound done before starting treatment. 15% to 20% of dogs with cushing's have an adrenal tumor and if the dog is a good surgical candidate, surgery is the first treatment of choice and is a cure.

Sorry for asking more questions than providing answers but blood wok is the first step so we'll need more information. The more information you can provide, the better able we will be to provide you with meaningful feedback.

Glynda

[Jana]

Wow, Looks like I have a lot of questions to answer. Please be patient with me.
Renee, I am not sure that Mollie is a pure Skye Terrier, however she does resemble the pictures of a Skye very much.

The test results I posted were from her first test in October which resulted in her having Pancreatitis. Here are the most recent test results sorry for the confusion:
Chemistry results from IDEXX Vetlab In-Clinic
BUN/UREA = 25 mg/dL Range 7-27
CREA = 0.9 mg/dL Range 0.5-1.8
PHOS = 6.4 mg/dL Range 2.5-6.8
Ca = 8.5 mg/dL Range 7.9-12.0
TP = 6.7 g/dL Range 5.2-8.2
ALB = 2.5 g/dL Range 2.3-4.0
GLOB = 4.2 g/dL Range 2.5-4.5
ALT = 61 U/L Range 10-100
ALKP = 1292 U/L H Range 23-212
TBIL = 0.3 mg/dL Range 0.0-0.9
CHOL = 253 mg/dL Range 110-320
AMYL = 1081 U/L Range 500-1500
LIPA = 4722 U/L H Range 200-1800
GLU = 167 mg/dL H Range 74-143
Sodium = 147 mmol/L Range 144-160
Potassium = 4.4 mmol/L Range 3.5-5.8
Chloride = 114 mmol/L Range 109-122
GGT = 3 U/L Range 0-7
ALB/GLOB = 0.6 no range
BUN/CREA = 28 no range
Na/K = 33 no range
OSM calc = 300 mmol/kg no range

Hematology results from IDEXX VetLab In-clinc
RBC = 5.83 M/uL Range 5.65-8.87
HCT = 35.3% L Range 37.3 -61.7
HGB = 13.1 g/dL Range 13.1-20.5
MCV = 60.5 fl L Range 61.6 - 73.5
MCH = 22.5 pg Range 21.2-25.9
MCHC = 37.1 g/dL Range 32.0 - 37.9
RDW = 15.0% Range 13.6-21.7
%Retics = 0.2% no range
Retics = 12.2 K/uL Range 10.0-110.0
WBC * *18.92 K/uL H Range 5.05-16.76
%NEUT * *83.8% no range
%LYMPHS* *10.2% no range
%MOMOS* *5.7% no range
%EOS* *0.2% no range
%BASO* *0.1% no range
NEUT* *15.87K.uL H Range 2.95-11.64
LYMPHS* *1.93 K/uL Range 1.05-5.10
MONOS* *1.08 K/uL Range 0.16-1.12
EOS* *0.03 K/uL L Range 0.06-1.23
BASO* *0.01 K/uL Range 0.00-0.10
PLT = 225 K/uL Range 148-484
MPV = 10.3 fL Range 8.7-13.2
PDW = 12.6 fL Range 9.1-19.4
PCT = 0.23% Range 0.14-0.46
NRBC* Suspected
Band* Suspected
Band neutrophils suspected
nRBSs suspected

There is also some information in her test results/records from the vet that states:
recurrent pancreatitis vs cushings, low thyroid
Diagnostics: abd: x-rays very large bladder, liver enlarged, stool in colon, no masses noted. Blood work - mild anemia, high alp, abnormal cpl. manual pcv 36%, usg - 1.018
Treatments: walked outside-urinated large volume. 10mg famotidine sq. 0.7 mls buprenorphine (0.3mg/ml) SQ. 300 mls plasmalyte-A sq, 1.2 mls convenia sq
Dispense e/n and tramadol.

Ok based off this information please ask what questions went unanswered.

After this was done was when her urine was tested for protein and came back with none, which was a good thing according to the vet.

Her drinking water and urinating is not out of the ordinary.

Monday I will call the Vet and ask about running a T-4 on her.

Renee why vetoryl and not lysodren?

Also, one more note both her adrenal glades are enlarged per the internist, and also per the internist Mollie is not a candidate for surgery due to her age which is approx. 11 now.

Thank you for all your wonderful feedback and again your patience as I get all the information gathered and to you correctly!

Jana

[Jana]

I am going to ask about LDDS and T4 on monday however I did find:

Endocrinology
Test Result Range
PRE-DEX 4.5 ug/dL 1.0-6.0
4 POST DEX 2.2 ug/dL
8 POST DEX 4.1 ug.dL

Low-Dose Dexamethasone Diagnostic Intervals
4 hours: 8 hours:
<1 <1 Normal
1.0-1.5 1.0-1.5 Inconclusive
>1.5 and >50% >1.5 and >50% Consistent with hyperadrenocorticism

Thank you

Jana

[Squirt's Mom]

Hi Jana,

To save you a bit of typing and time, we only need to see the values that are too high (H) or too low (L). That will save your fingers some strain. :D

Hugs,
Leslie and the gang

[labblab]

I am going to ask about LDDS and T4 on monday however I did find:

Endocrinology
Test Result Range
PRE-DEX 4.5 ug/dL 1.0-6.0
4 POST DEX 2.2 ug/dL
8 POST DEX 4.1 ug.dL

Low-Dose Dexamethasone Diagnostic Intervals
4 hours: 8 hours:
<1 <1 Normal
1.0-1.5 1.0-1.5 Inconclusive
>1.5 and >50% >1.5 and >50% Consistent with hyperadrenocorticism

Thank you

Jana
Hi Jana, just wanted to let you know these are actually results for a diagnostic LDDS, and the numbers are consistent with pituitary Cushing's (8-hour result higher than 1.5; 4-hour result very slightly less than 50% of the baseline pre-dex value). So that is one question already answered!

Marianne

[Renee]

It looks like you've already had an LDDS test, based on your last post.