Our 9 year old lab/cross abnormal blood and urine

[hfurlotte]

Well if one dog with atypical cushings "Zoe Claire" diagnosed in 2009 was not enough, we are dealing with our 9 year old Lab cross who started out about 9 months ago exhibiting signs of being skitish especially when walking across our floors and around corners. Having cats we originally thought maybe our Dewey may have startled him. As time has gone on this has gotten worse we even video taped his activity and took it into our vet. We tried him on anti-anxiety meds which have really not made any difference. We have noticed over the last six months he is showing some similar signs as Zoe did but there is so many things not in common. This guy drinks more water and to the point he vomits everything back, his appetite is obviously ravenous he will grab anything food wise he can get ahold of. Though weight gain is typical Stewie is losing weight, skin sores and multiple lumps all over his body. Most frustrating is the constant need to go out side

His specific gravity on his urine has been questioned on the pathologists report back to our vet so after his last repeat blood his anemia had resolved but his liver enzymes were elevated. In discussion with our vet we decided to do a low dose dex which came back normal ( that was dex being injected IM). Knowing what nightmare we went through with Zoe, I feel with Stewie my eyes are opened more. I keep thinking of what we did when we requested assistance from our vet to have Zoe's blood drawn following UTK protocol so I took a first morning urine in which I caught myself. So he was not under any stress at the time of collection, that was run for Cortisol:creatinine ratio the results was elevated but in a "Grey Zone" and concentrated despite his huge intake of water. As his dex was suppressed our vet has taken cushings out of the picture. We are going to go ahead and do an ultrasound to rule out possible hidden adrenal tumor. Stewie's blood sugar fasting was 7.0.

Our family is a whits end trying to figure out this little guys health issues. It is so hard seeing him showing some of the exact signs Zoe did but not having any answers or solutions. If anyone could offer me any suggestions I would greatly appreciate it.

[labblab]

Gosh, I am so sorry that Stewie is having these problems! One thought that occurs to me is the possibility of hyperthyroidism. We are much more familiar here with the opposite problem since low thyroid commonly manifests alongside Cushing's. But from viewing a symptom profile, it seems as though elevated thyroid might explain a number of Stewie's issues. It is a rare condition that is not always easily diagnosable from basic labwork alone. But take a look at this link and see whether it fits in with what you are seeing with Stewie:

http://www.petmd.com/dog/conditions/endocrine/c_dg_hyperthyroidism

Marianne

[hfurlotte]

Thank you for that wonderful link Stewie's thyroid level was checked and he was 21.2 his ALP was 392, Sodium 151 potassium 5.5, osmo calc was 501 this was done 19 Dec 2013.

In Oct his RBC were 5.49, hemoglobin 132, hct 0.372 and platelets 138. All these are indicated as low. His Alp at that time was 246. His urine specific gravity was low which has been consistent for his last two or three urine tastings. Cushings was mentioned by the pathologist in the report however anemia normally is not seen with cushings.

[labblab]

Does your lab report have the normal range printed for thyroid results? I'm not familiar enough with the range to know where Stewie's result falls. I did find it interesting, though, that the article says that some dogs suffer from hyperthyroidism even in the face of a normal T4.

Marianne

[labblab]

Actually, can you give us the normal ranges for all those results you reported above, because I can't tell whether they are high or low. One other wild card thought is Addison's disease, although ravenous appetite would not be expected there. But other symptoms do fit, including anemia and possibly other lab abnormalities depending upon those norms.

http://www.petmd.com/dog/conditions/endocrine/c_dg_hypoadrenocorticism#.Us7h0rK9KSP

Marianne

[lulusmom]

Can you please provide the normal reference ranges for the blood abnormalities you have posted?

[hfurlotte]

Here is the abnormal Here's labs range

Hematology RBC Stewie's 5.49. 6.0-8.9
HGB 132. 145-204
HCT. 0.372. 0.42-0.62
Platelets 138. 160-400. Platelets not clumped
Chemistry. ALP. 246. 21-122
Tetraiodothyronine 21.2. 13-44
Sodium 151 141-150
Potassium 5.5. 4.0-5.4
His repeat chem done had ALP increased to 392 normal as above

Osmo calc was301. Normal range 281-300

Sorry no normal values for urine.

Low dose dex values. Stewie at 0 was 95.5 Norm 0-280
4 hours less then 27.59. Same for 8 hour

Urine cort/ creat 3 x10-5 Ratio for norm is less then 2.9 but greater then 1.1 This was reported back as being in the elevated grey zone.

[lulusmom]

I see that you mentioned that a repeat blood chemistry was done so can I assume that the abnormal values you posted, that are indicative of anemia, were normal on the repeat test? Was AlKP the only abnormality on the most current blood chemistry?

[hfurlotte]

Anemia no longer present in his dec but sodium, potassium and ALP and osmo calc were only abnormality in his last. We have an ultrasound booked on the 16 so hopefully we will get some answers doing that.

[lulusmom]

Great! I was going to suggest that you consider an ultrasound.

[hfurlotte]

Well Stewie had his ultrasound done and we got the results last night 😟 he had an adrenal tumor and since his LDD was suppressed they suspect this is a non functioning adenoma,hyper plastic nodule or early pheochromocytoma. It is in the cranial pole and measures approximately 0.94 cm transverse direction x0.88 cm long x 0.70cm high.
Our regular vet is away until Tuesday and she said she would call so I'll have a chance to talk in more detail. I'm inclined to believe the pheochromocytoma is what we are dealing with as the symptoms fit our Stewie to a T.

[molly muffin]

oh gads. :( Sorry to hear Stewie might have a pheo. One thing to do is to check his BP, as pheos when they are active make the BP's go up.

Gosh what are the chances Zoe and Stewie both, have these sort of problems.

hugs,
Sharlene and Molly Muffin

[hfurlotte]

Yes his blood pressure was done and it's sitting high his top number was 190:(. The thirst, weight loss, panting and more a give away is the cortisol creatinine ratio but LDD was normal all his symptoms most certainly point that direction. Pretty sad we have two pups however we are more knowledgable this time around. I just feel so lost :(

[frijole]

So sorry to read this. I went thru this with Annie but there is so much more info today than 3 yrs ago. Did they say if surgery was an option? Hugs, Kim