View Full Version : Alfie, Scottish Terrier - Cushings or Liver Problems
My Scottie had bloods done a couple of months back showing raised ALP. Rechecked with similar results. Tested for Cushings which came back negative.
Vet said to monitor.
Ive been reading up about Scottish Terriers being prone to liver problems and Atypical Cushings.
Anyone any knowledge of this?
He is poorly today, has vomited 3 times since this morning so keeping a close eye on him.
doxiesrock912
01-04-2014, 03:06 AM
Vomitting is not a sign of Cushings bit is definitively a cause for concern and you should alert the vet asap.
Thanks for replying :)
He was quiet yesterday but I kept a close eye on him and hes a lot brighter today, has ate some tinned food with no more vomiting.
If he had been any worse this morning I would have taken him to the vets.
molly muffin
01-04-2014, 06:28 PM
You can always try going with mushy rice and chicken, small meals. If he does stay poorly, take him into vets.
Sharlene and Molly Muffin
Bumping this back up.....
Alfies sickness was just an upset tum and cleared over 24-48 hours.
He had his blood checked again which showed his ALP has dropped from 623 to 480.
His BUN was also slightly lower than normal.
I just read this on a Scottish Terrier website.....
Cushing’s disease can present with a variety of symptoms and may also be involved with several different disease processes. Therefore, it is recommended that any dog suspected of having Cushing’s disease should have acomplete blood count (CBC), blood chemistry panel, andurinalysis performed as a routine part of the evaluation. Common abnormalities in these tests include increases in alkaline phosphatase, and ALT (liver enzymes), increased cholesterol, decreased BUN (a kidney function test), and dilute urine (low specific gravity).
He was checked for Cushings which came back negative though again I have read that can be common in Scotties....coming back negative when maybe positive.
Now hes well in himself and definitely no other signs of Cushings.
Thinking of starting him on a liver supplement in mean time.
molly muffin
01-17-2014, 05:46 PM
A liver supplement would probably be a good idea. Also nice to give the liver some support . Many things, including cushings can affect the liver, so if one thing is off in the body, then the liver may end up taking a kick to it.
I use Heppato Support Supplement, some use milk thistle, denamarin
Sharlene and molly muffin
Thank you, gave him some Milk Thistle this morning.
Just wondered if there is another 'not serious' reason why the BUN would be low. Im scared to Google.
SoggyDoggy
03-03-2014, 12:14 PM
Hi, I've just seen your post (I haven't been here for a while) but my boy Fraser was half Scottie so I too had read all those sites about the predisposition to cushings and liver cancer. Unfortunately, my boy was diagnosed with Cushings (hence me being here) and whether or not that was a correct diagnosis I will never truly know, as he ultimately succumbed to a very severe and aggressive liver cancer. Having said that, the liver support tablets I put him on (Denosyl) did work remarkably well to keep him feeling well during that time - without them he was quite ill and would vomit.
I wouldn't put too much stock in any particular breed being predisposed to cushings or cancers. The reality is, as we look after our pets better, they are living to older ages, and as anyone - human or canine - gets older, they get things wrong with them. Lots of old dogs get cancers of different forms, lots of old dogs get cushings disease - it doesn't have to be the end if you catch it early or manage it well. Treatments today are amazing, the downside is that they can be expensive.
My advice would be to keep an eye on Alfie, if you can run a full CBC on him and get an abdominal ultra sound - if for no other reason than to check and have a clean baseline to work with, but more really for your own peace of mind. I'm very glad to hear that his tummy upset had been just a quick little bug, I know how much that can freak a person out.
We first discovered raised AlkP and ALP levels in Fraser on a routine blood check before a dental cleaning, vet said could be one off so monitor. In saying that however, the levels were already over 1000. I took him back for a repeat test a month later, levels had increased to over 2000, which is when we tested for cushings. Knowing now that he had the liver cancer, his positive result for cushings could have been a false positive and I very stupidly didn't follow up with the recommended ultra sound. If I had, they would have seen the liver cancer much earlier than when we did finally see it. Despite treatment for cushings and liver support, his levels kept increasing until the final reading came in over 5000 and was so high couldn't be measure further. At that point is when I did the ultra sound. Finding out way too late that his tumour was so massively big there was absolutely nothing further I could do. I kept him on the denosyl tablets for as long as possible and they did help but there was no point in doing further blood tests.
Anyway, please know I am not saying this to try and freak you out, merely trying to suggest that if you are at all concerned about the possibility of cushings of liver cancers, please do investigate the abdominal ultra sound route. It won't rule out pituitary cushing's, but it can certainly help to rule out adrenal or liver cancers at this stage. I should also mention my boy was 14 when he passed, I'm not sure how old Alife is, but Fraser did really well health wise until those last 12 months - at least as far as I know anyway - who knows how long that tumour sat there until it took over? Bu the high resolution ultra sound can certainly give you more peace of mind if this is an issue that worries you.
I'm sorry, I can't answer your question about the BUN, it's not an area I researched or had to deal with, but please remember if you did/do resort to google, that with all rings medical it must be considered within the bigger picture of Alfie's health. Sometimes, often, the answers are a lot more complicated (and not necessarily in a bad way) than a simple web explanation.
Good luck.
Soggydoggy I just saw your reply as I hadn't logged on in a while but was coming onto update about Alfie, thank you for such a lengthy reply.
His ALT and ALP have crept up over the last few months, his ALP is 142 and ALP is over 1000.
He is drinking and peeing more than ever and sometimes continues to pee after dropping his leg (more likely if bladder fuller) and also had couple of accidents in house.
First when going round in circles on his bed to get comfy, pee'd a little not meaning to and second time was last night while lying on my knee.
His urine was dipped which was clear.
Urine gravity checked which was ok.
Prostate ok.
His toe was amputated two weeks ago as there was something wrong with his nail.
Eating well and bright as a button but something definitely not right.
My vets are suggesting we just sit on it and see what happens or see if something more obvious shows but I'm not happy with that.
Bit of update.....
Took another urine sample to vets today collected at lunchtime. It showed gravity as borderline so we're sending sample to lab to do UPC test.
Vets also said they have no Synacthen to do another Acth test.
Harley PoMMom
05-12-2014, 07:06 PM
How is Alfie feeling? Any more vomiting episodes? Are his poops normal?
Hugs, Lori
No vomiting, his tum is fine.
Poos are ok too.
Harley PoMMom
05-13-2014, 03:03 PM
Just to clarify for myself, a diagnosis for Cushing's has not been confirmed for Alfie, right? And he is not on any medications for Cushing's?
No definite diagnosis as yet and no meds.
Got results back today, his UCCR result was 86, over 34 needs further investigation so he's booked in for a low dose dex on Monday.
Urine still very dilute.
Other urine results from lab showed nothing out of the ordinary.
He definitely has some symptoms of Cushings but the bloody frustrating thing is, it could be numerous other things too.
High ALT
High ALP
Dilute urine
Drinking/peeing more
High UCCR result
Skin problems
jxeno13
05-16-2014, 03:53 PM
Hi!
I can't add anything to the conversation on Cushing's really. I popped in to say hi...and to add my Eli, a Cairn Terrier mix (cousin to Scottie's) was recently diagnosed with Cushing's in April. I might add though that his "real" symptoms (the drinking of buckets of water and peeing rivers) didn't start until after he had a surgical removal of a small tumor on his neck. I imagine the stress of the surgery really brought out those symptoms. I also read that on one of the Cushing's link...that I can't seem to find right now. :( Anyway......I'll post it as soon as I can find it for you.
Good luck with your baby, Alfie....
Jo Ann and Eli
Harley PoMMom
05-16-2014, 04:05 PM
No definite diagnosis as yet and no meds.
Got results back today, his UCCR result was 86, over 34 needs further investigation so he's booked in for a low dose dex on Monday.
Urine still very dilute.
Other urine results from lab showed nothing out of the ordinary.
He definitely has some symptoms of Cushings but the bloody frustrating thing is, it could be numerous other things too.
High ALT
High ALP
Dilute urine
Drinking/peeing more
High UCCR result
Skin problems
Yes, these symptoms that Alfie is displaying can be attributed to other illnesses, such as diabetes, thyroid problems, or a liver issue. Has the vet mentioned performing a bile acid test to see how the liver is functioning? And as for the thyroid and diabetes, these are usually checked on a regular chemistry blood panel, thyroid function will be noted as the "T4" level, and diabetes is the glucose and is usually marked as "Glu."
Hugs, Lori
Do you know what......Alfie had surgery three weeks ago to amputate a toe and I have thought since then hes been drinking more water than ever though didnt link that to having the op.
Hope Eli is doing ok :)
Thanks Jo Ann x
The vet and I have talked about a bile acid test but since then been thinking about Cushings so going down that road atm, cant say we wont do a bile acid test though if need be.
I also asked about diabetes but as far as I know nothing out of the ordinary showed up on his bloods regarding that.
I will mention about his thyroid when I take him in on Monday.
Thanks Lori :)
Vet said not to fast before low dose dex test but I just read a website saying to fast for 12 hours. Does anyone know?
molly muffin
05-17-2014, 12:55 PM
For Diagnositic if I remember correctly, I'm pretty sure we fasted for the LDDS and didn't for the ACTH.
Sharlene and molly muffin
Harley PoMMom
05-17-2014, 02:58 PM
The usual protocol is to fast for a LDDS test but it is really up to the preference of the lab that is going to read and give the results.
Thank you, think lab said to feed.
He's a happy boy not missing his breakfast this morning, off to vets at 8.30 and collecting him 6.30.
Ok results back which are saying he doesn't have Cushings. Really frustrating as something isn't right but what. Vet said we could redo bloods and LDDS in a month or two.
goldengirl88
05-23-2014, 11:30 AM
Have you had a thyroid panel done, and checked for diabetes?
No neither.
Vet did mention both but said dogs with thyroid problems usually sluggish and didnt say much about diabetes.
Is it urine or blood that's checked for diabetes?
goldengirl88
05-23-2014, 12:15 PM
They can check glucose in the blood and if there is any glucose in the urine.
Harley PoMMom
05-23-2014, 03:55 PM
Ok results back which are saying he doesn't have Cushings. Really frustrating as something isn't right but what. Vet said we could redo bloods and LDDS in a month or two.
I was wondering if you would post those LDDS test results for us...thanks!
I was here last year talking about my scottie, he was tested for Cushings but came back negative.
Various things haven't been quite right with him for a while and I'm again thinking Cushings might be the cause.
Gloopy eyes but no infection.
Excessive drinking/peeing.
High alkp.
Muscle wastage round face/skull/shoulders.
Reluctance to jump up on chair/sofas.
Skin infection.
Not so energetic/keen on walks.
Now he has lower back/neck pain and has seen vet for acupuncture/laser treatment so for a while I've blamed some things on him being sore.
Full bloods done last week showed alkp at 225, the rest I think all normal.
Is creatinine/cortisol ratio test worth doing first?
Squirt's Mom
08-17-2015, 05:19 PM
MODERATOR NOTE: I have merged your post today with his current status into Alfie’s original thread. We like to keep all posts about each pup in a single thread as it makes it easier for members, and parents, to refer back to the pup's history when needed. Thanks!
Thank you, merging makes sense.
Chatting to other scottie owners on Facebook page and someone mentioned all similar symptoms with mass in bladder and kidneys.
Could be numerous things I suppose.
molly muffin
08-17-2015, 11:50 PM
Hmm it depends on what test they want to do. Did they tell you?
Have you had any regular blood work done? Like a CBC? If do where any of the results out of range. High or low.
Just to do say an LDDS that would be e pensive so they must be including other tests but not sure what.
Welcome to the forum too. :).
Full bloods checked last week showed only alkp elevated at 225.
It's a UC:CR test I'm thinking about, it can rule out Cushings I believe.
Squirt's Mom
08-18-2015, 07:15 AM
There is no way in you know where I would start a baby on either one of these very powerful drugs without having an ACTH and LDDS done. None. These drugs are way to dangerous to use without having a pretty darn good idea that the dog actually does have Cushing's - and the only way to know that is by testing. ;) Signs can help point in the right direction but they are far from conclusive because many, many things share those same signs. Elevated ALP or any other liver value is no good for diagnosing Cushing's either so you cannot base a diagnosis on the liver. The UC:CR can rule Cushing's out but cannot diagnose it. If the UC:CR is abnormal that simply mean *something* is wrong but that something could be one of 100's of conditions, none of them Cushing's. ;)
You have the copy of the last labs showing the ALP and know for sure that is the only abnormal value? If that is the case, Cushing's would be the last thing on my mind. The ALP elevation is very mild (or I am assuming such since no normal range was posted but we are used to seeing that value much, much higher in cush babies, like in the 1000's) so that would certainly not indicate Cushing's or liver disease in my mind. Has the thyroid been checked thoroughly? Not just the T4 run in the vets office but an in depth look at that organ, Free T's and all? Has diabetes been looked at recently? That disease can come on literally overnight so if that has not been checked lately, I would just to be sure. You might also consider a consultation with an IMS if you haven't already. This may well be a case that is out of the realm of a GP vet.
Let us know how things are going!
Hugs,
Leslie and the gang
Yes sorry I was thinking the Uc:cr would at least tell us he didn't have Cushings so no need to do other tests.
Vet said dogs with liver failure can have normal (ish) blood results as some of liver cells are dead so not giving a reading.
Urine dipped last week, don't think it showed anything out of the ordinary.
Would diabetes show from urine dipped or would urine need sent to lab?
Can't remember if his thyroid was checked in the past, would need to ask vet.
labblab
08-18-2015, 08:25 AM
I was here last year talking about my scottie, he was tested for Cushings but came back negative.
Various things haven't been quite right with him for a while and I'm again thinking Cushings might be the cause.
Gloopy eyes but no infection.
Excessive drinking/peeing.
High alkp.
Muscle wastage round face/skull/shoulders.
Reluctance to jump up on chair/sofas.
Skin infection.
Not so energetic/keen on walks.
Now he has lower back/neck pain and has seen vet for acupuncture/laser treatment so for a while I've blamed some things on him being sore.
Full bloods done last week showed alkp at 225, the rest I think all normal.
Is creatinine/cortisol ratio test worth doing first?
Hello and welcome back, although I'm sorry you have reason to be concerned again about your boy. Given his symptom constellation and even just a mild elevation in ALKP, yes, I do see why you are thinking about beginning with a UC:CR test, although as you already recognize, it cannot definitively diagnose Cushing's (but can perhaps rule it out). I do not have personal experience with UC:CRs myself, but one endocrinological expert here in the U.S. has told us that the most accurate result will be obtained if urine samples are pooled from three successive mornings, rather than just a single sample being tested. You will want to obtain samples from the first morning pee, and keep the "pool" refrigerated until being taken to the vet for analysis. So the UC:CR can be a place to start. Although in the alternative, if the UC:CR comes back positive, you would still have to progress to additional testing, so perhaps you would prefer to put all the money towards a more definitive test. You can check with your vet re: relative pricing and see how that may affect your decision.
As far as diabetes, the glucose level would most likely have been included on the blood panel performed last week. As long as it was within normal range, diabetes would have been ruled out. Similarly, if his T4 level was normal on last week's bloodwork, that would typically rule out thyroid issues as being the most pressing problem although, as Leslie says, there is more involved thyroid testing that can be done. If his T4 was normal, though, like you I think I would be wanting to check cortisol now, too.
Marianne
labblab
08-18-2015, 10:16 AM
In looking back through your thread, I see there were times in the past when Alfie's ALKP was much higher in addition to other liver enzyme elevations. Typically those liver values do not decrease all on their own in untreated Cushpups. So that part of things does remain a hand-scratcher, and I'm really not sure what to make of that, myself...
Marianne
Thank you for reply. I know Scottish terriers are prone to high liver readings, especially alkp.
I'm worried now it's his liver, was worrying the same last year mind you but there seems to be a few more problems since then.
Vet I have been dealing with is back in tomorrow so will get a chat with her
molly muffin
08-20-2015, 11:03 PM
Let us know what your vet says.
If you aren't doing liver support supplements like denamarin, then that is something you could add in.
Thanks. I have started him again on Zentonil and liquid Milk Thistle. Vet didn't ring me yesterday so will try again today.
molly muffin
08-24-2015, 11:23 PM
I guess as it is only just monday that we should give you a chance to have a chat with your vet. :) But do let us know the vet says.
Vet doesn't think it's Cushings but said we could do a Low Dose test if I wanted.
She's talking again about his liver. Mentioned a liver biopsy but not keen on going down that path.
I have him on liquid milk thistle and Zentonil.
Tried to get a chat with a vet in a different practice about doing an ultrasound but he's not available until Wednesday.
He's still drinking a lot but in good form and eating well.
molly muffin
08-31-2015, 10:17 PM
Well, it wouldn't hurt to schedule an ultrasound when you can. Maybe that would tell you more about what the internal organs look like and what is going on.
If it's not cushings, that would be a good thing. One less thing to worry about.
Spoke to other vet who does ultrasound today.
He said things can be missed by the ultrasound and mentioned a biopsy but I'm not that keen on doing one.
Speaking to normal vet again tomorrow to discuss.
Sometimes it's hard to know what to do for the best.
Squirt's Mom
09-03-2015, 07:42 AM
Personally, I would do the biopsy. Talk to the vet about the procedure and see if that doesn't help you feel more comfortable with it.
Thing is at the minute we don't know for sure the liver is the problem so I worry about doing a procedure unnecessarily.
Haven't got hold of vet today to discuss.
Homeopathic vet who saw Alfie last week for acupuncture and laser treatment also thought biopsy was maybe unnecessary.
molly muffin
09-05-2015, 09:44 PM
Ultrasound first Then you'll know more to base a decision on.
Harley PoMMom
09-08-2015, 04:09 PM
A bile acid test may be able to tell how the liver is functioning, has this been mentioned by the vet?
Spoke to the vet yesterday about the ultrasound so going to ring the vet who actually does the scan and see what practice it's done in.
Alfie was at vets yesterday for UTI and is on antibiotics so will maybe wait till that settles before I put him through anything else.
He had a bile acid test done last summer which didn't show any untoward if I remember rightly, though the fatty meal he got for the test did give him awful colitis which I'd hate for him to go through again.
Please get an ultra sound and have them check his bladder. The UTI has me concerned. I lost my female doxie last month to TCC. Scotties are prone to TCC for some reason. Not trying to scare you but time could be wasting here and if it is TCC you need to move fast and not have vet treating UTI for 2 to 3 months.
Ultrasound booked for Wednesday morning.
I'm nervous at what they might find, if anything at all.
molly muffin
09-14-2015, 11:03 PM
Hopefully it help to narrow down what is going on and you'll be able to use it to create a treatment plan that will help him.
I know I am always nervous waiting on ultrasound results too.
I feel ill worrying.
Over the last few months a handful of times Alfie has been sick or wretched like going to be sick but it wasn't something I was overly concerned about but since starting on antibiotics for uti last Thursday he has been sick three times so vet said last night to stop antibiotics though he was still sick overnight.
Back at vets this morning, urine dipped which was clear, temperature ok.
Will see what ultrasound shows tomorrow.
Squirt's Mom
09-15-2015, 08:25 AM
Let us know how he is and what the US shows.
Ok back from vets.
I gave Alfie breakfast this morning as no one told me not to so vet had a full tummy to scan around.
From what he could see bladder looks ok, liver not showing anything to panic about.
There is a build up of sludgy bile and his pancreas looks inflamed or scarred. Also looks like he has a gallstone or polyp in the gallbladder.
He couldn't really get a look at the adrenal glands.
So not the worst news I was expecting.
He is contacting my regular vet for a chat and will go from there.
So happy that ultrasound showed clear bladder. I hope between the 2 vets they can find out what the problem is with your Alfie.
Ok had chat with my own vet this morning.
Vet who scanned Alfie yesterday mentioned possible tumour in the pancreas but it could equally be just inflammation or scarring.
They want him started on a drug called Desolit which helps with bile.
So I'll get this new drug and maybe look at his diet for the pancreas.
Feel like I shouldn't be posting here anymore now that we know he's not got Cushings.
Squirt's Mom
09-17-2015, 10:48 AM
Nope! You don't get to leave! :D We want to know how our sweet boy is doing regardless - ya'll are family now, ya know. ;)
Thanks, that's a lovely thing to say xx
Harley PoMMom
09-17-2015, 03:08 PM
I agree with Leslie 100%, you are family!!!
Bit of update.
Started Alfie on new drug Destolit Friday week ago and last weekend he was really dull, urine sample on Monday showed uti was back so started antibiotics for that.
He seemed little brighter after couple of days but over last few days he's very dull again. Bright when he's getting food or out on walk but in the house the rest of the time he's quiet.
His eyes seem a bit empty and he isn't interested in his usual ear rubs when he would roll about the mat. I can't stop blooming crying as it feels like I'm losing him.
I feel so guilty thinking whatever is going on we should have picked up before now but I've no idea if that would have made a difference anyway.
Tried to get hold of vet on Friday who scanned him but he's to ring me tomorrow.
Harley PoMMom
09-27-2015, 12:05 PM
If the pancreas is inflamed this could make Alfie feel yucky. My boy, Harley, had pancreatitis and it can be a bugger to get under control because anything can make that pancreas angry :eek::(
With pancreatitis it can be painful so pain medication is needed. A very low fat diet is required and should be fed in small meals throughout the day. There is a test that can diagnose pancreatitis it's the spec cPL, here's a link about this test: http://www.idexx.com.au/smallanimal/reference-laboratories/testmenu/innovative-tests/spec-cpl.html
Dogs are so stoic and it can be really difficult to know when something is going on, wish there was a crystal ball that we could use to help us to determine what exactly is wrong. :( I think you are being to hard on yourself, so stop that, ok?
Hugs, Lori
Thank you for the kind words.
I will get a good chat with the vet tomorrow, I have a list of questions to ask including about pancreatitis and pain relief.
I don't even know if he has pancreatitis or if it's the tumour the vet mentioned. I haven't dare Google tumour as I'm scared what I'll read.
I keep saying no more dogs once this lot leave me as I can't stand the heartache.
molly muffin
09-28-2015, 04:55 PM
Did you get to have a chat with the vet today? If so what does he think is going on with Alfie?
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