Shotzie

[jjgator99]

Hi! My name is Jan & I am the proud owner of a Lakeland Terrier named Max & a Miniature Schnauzer named Shotzie. Max was diagnosed with Cushings in June, 2012 after I insisted that our vet test him. He had all the classic symptoms: frequent urinating, excessive drinking, panting, loss of hair & faded coat, pot belly, loss of strength in back legs. He has been taking 30mg. Vetoryal daily & has been doing fine.
I started reading this awesome forum when I found out about Max's problem. Recently Shotzie had a fainting spell. I freak out anytime she even breathes funny because we almost lost her two years ago when she twisted her spleen & we didn't know about it until it was almost too late. She had a spleenectomy in May 2012.
After her fainting spell I took her to our regular vet. He detected a heart murmur which was never noticed before. Here are her abnormal labwork info:
RBC 5.34 Low (5.5 -8.5)
HCT 35.2 Low (37 -55)
RDW 790 High (175 -500)
ALT 275 High (10 -100)
ALKP 380 High (23 -212)
After discussing with my vet, he put her back on Clindamycin because she had previously been taking it for her teeth (she has peridontal disease in spite of my efforts to prevent it).
I then made arrangements to take Shotzie to the Univ. of Fla. Small Animal Clinic to see a cardiologist.
To avoid having to wait several days I took her the next day through the Emergency Room so I could get her in right away.
They did an ECG, Echocardiogram & more labwork.
Abnormal lab results: (CBC was pending so don't have those yet)
ALK PHOS 1209 High (8 -114)
ALT 297 High (18 -64)
AST 69 High (15 -52)
Albumin 2.7 Low (2.9 -3.8)
Glucose 123 High (79 - 120)
Cholestoral 501 High (124 - 334)
Potassium 5.4 High (3.5 -5.2)
TCO2 14 Low (18 - 28)
Anion Gap 26.4 High (14 -24)
Shotzie was sent home with a Holter Monitor to further investigate. It was noted that she has mitral valve disease secondary to endocardiosis. Not sure what that means but they told me the heart murmur should not have caused her to collapse. Due to her high liver enzymes that told me to have her regular vet do the ACTH Stim test to screen for Cushings Disease. There was also concern that her blood pressure was high (180) which they said could be caused from Cushings.
My vet did the ACTH Stim test last Friday, called me Sat & said she tested positive for Cushings. I was so shocked at the time I didn't ask him the number. I told him I wanted to take her back to Univ. of Fla. to get an ultrasound. I love my vet dearly, but I want to take Shotzie to a IM with lots of experience with Cushings. Called an made an appointment but we can't get in to see the vet I requested until next Tues. Shotzie's only sympton of Cushings is her pot belly.
She does sometimes pant in the evening. I am so worried aout her. She is my life! She is ten years old & is a therapy dog. I take her to a nursing home every Monday afternoon. She is such a sweetheart! They even stated that on the medical report I got from Univ. of Fla.
The nursing home patients love her dearly & look forward to her visits each week. So glad I have this forum to come to! Thank you for letting me talk! Sincerely, Jan

[jjgator99]

I just realized I started this thread in the wrong section. Hopefully someone will put it in the right one.

[jjgator99]

Hi! I just posted info about Shotzie who recently had an ACTH Stim Test for Cushings under How To & Comments. Was hoping maybe one of the moderators could move it to this section.

[lulusmom]

Hi Jan and welcome back.

I'm glad to here that Max is doing well on treatment but I'm sorry to hear that Shotzie is having such a difficult time. I am glad you have decided to see an internal medicine specialist. One acth stim test in a dog with no overt symptoms of cushing's is woefully inadequate to confirm a diagnosis. Does Shotzie look and act like a dog with cushing's. Does she drink and pee a lot? Is she always hungry? Any coat and skin issues?

I'll be waiting to hear about your IMS appointment but if you should get a copy of the CBC in the meantime, can you post the results for us?

Glynda

P.S. I moved your post in the How To subforum per your request.

[jjgator99]

Thank you Glynda! Shotzie does have a pot belly. No skin issues or weakness in her back legs ( which Max definitely had). She has always always had a big appetite. Never seems to get enough food. She has been on low fat ID dog food ever since her splenectomy. She does drink a little more water than she used to, but I wouldn't say it's excessive. Doesn't really have accidents in the house but that's because I take both Max & Shotzie out to go a lot since Max was having accidents in the house. Ever since her splenectomy I've taken her pretty often for bloodwork. Her HCT (my vet calls it PCV) & RDW is always low. Her liver enzymes have been high but her most recent liver enzymes were much higher (which was brought to my attention by the emergency doctor at UF). She has been taking Vetri Liver Canine Bite Size Chews by Vetri Science Labs to help bring her liver enzymes down but it hasn't made much of a difference. The emergency vet said that if she had Cushings it wouldn't help. It has SamE in it & milk thistle
By the way Shotzie also takes Soloxine .1mg for her thyroid. Her numbers have been in the normal range while taking it.
I am real anxious to take her to her appointment which is a week away. Could have gotten in sooner but I researched their Internal Medicine Vets on their website & requested this particular vet. She recently published an article about atypical hypoadenocorticism.
I figured such she published an article about that, even though that is the opposite of Cushings then she must be pretty knowledgable. Her resume shows she has a lot of experience.
I am so glad to be able to go to this forum. It was so helpful to me when I first found out about Max when he was diagnosed with Cushings. I never really posted back then but I took advantage of reading a lot & it really helped!! Max was pretty easy to get on a good dosage & continues to maintain. He still gets Stim Tests to make sure he is regulated. Shotzie is more of a challenge. I worry so much about her because she doesn't have a spleen. She also has dental issues. She & Max eat the same thing & his teeth are fine. She gets tarter & plaque & it's hard to control. I sprinkle Perio Support on her food but that doesn't seem to help. I try to clean her teeth but she walks away when she sees me coming (was spraying her teeth with Dentahex, then tried putting Dentahex on a piece of gauze & rubbing her teeth with it). She hates that & cowers when she sees me with a piece of gauze or the spray. Thanks again for listening! Jan

[jjgator99]

Forgot to mention, still waiting for results of the heart monitor test. Just took the Holter Monitor back to UF last Sat. He said it would take some time for the cardiologist to read it. Also forgot to mention that she sometimes pants mostly at night when we go to bed.

[jjgator99]

I'm so disappointed that Glynda is the only one who responded to my thread. I was so looking forward to getting feedback about Shotzie. Feeling like I got stood up at the prom:(

[Harley PoMMom]

Oh no, we are so sorry, and I will read Shotzie thread. When Glynda replies to a member I feel that they are getting the best possible advice, but I always can throw in my 2 cents worth, ok? :o

[Harley PoMMom]

Ok, I have just read Shotzie thread, and I want to thank you for all those details, that really helps us.

I totally agree with Glynda that the Cushing's diagnosis is questionable. Since Max has Cushing's, you probably already know how difficult Cushing's can be to get a confirmed diagnosis for, usually multiple tests are performed to validate a diagnosis of Cushing's.

I see that Shotzie's liver enzymes are abnormal, particularly her ALT, AST, and Albumin. If this were me, I would have an ultrasound done to get a good look at her internal organs, especially the liver.

Seeing an IMS, I believe, would be beneficial because they usually have much more experience dealing with animals that have concurrent health issues.

Do let us know what the IMS has to say, and again I am sorry it took me so long to reply to Shotzie's thread.

Hugs, Lori

[Squirt's Mom]

Just FYI - Glynda is one of the resident gurus so when she speaks we all listen and can seldom add anything more. ;):D

AND, I assume you already know about Cushing's from Max sooooo that blows 3/4 of what I could share with you! :D I CAN share my Squirt's story with you. She had five tests to diagnose Cushing's - the LDDS, HDDS, ACTH, UTK panel and two ultrasounds - all positive for PDH. However after the second US I was told about a tumor on her spleen. Once that tumor and half her spleen was removed, her cortisol returned to normal. It was the stress from the tumor causing the cortisol to rise.

Shotzie is not presenting like the typical cusp pup so take your time, rule out every other possibility you can, and do not waste your money on cushing's test if she is stressed or ill from anything else (that may well skew the test results).

Oh, and welcome to you, Shotzie and Max! :)
Hugs,
Leslie and the gang

[jjgator99]

Thanks Lori & Leslie! I have been concerned about whether or not Shotzie has Cushings. Max had all the classic symptoms, excessive drinking, peeing all the time, hair loss, hair color faded, pot belly, panting, and loss of muscle strength in back legs. Shotzie has a pot belly & pants sometime at night. She drinks maybe a little more & is a little more urgent about peeing but hasn't had an accidents in the house. Of course I take them out constantly to prevent accidents.
I have an appt. Tues at the Univ. of Fla. with an IM. Based on her bio on their website, she seems very knowlegible & has published on hypoadrenocorticism. (I know thats the opposite, but she must have the experience.)
Just got the ACTH Stim Results:
PRE ACTH Cortisol 6.0 Range 2-6
POST ACTH Cortisol 38.5 Range 6-18

Her liver enzymes have been in the high range ever since her spleen was removed 5/12. But they have been consistently going up:
5/13 ALT 288 High 10-100
ALKP 468 High 23-212
TBIL 1.5 High 0.0-0.9

10/13 ALT 266 High 10-100
ALKP 544 High 23-212
GGT 7 High 0-7

12/13 ALT 321 High 10-100
ALKP 793 High 23-212

3/14 ALT 297 High 18-64
ALKP 1209 High 8-114
AST 69 High 15-52

Plan to have the ultrasound done at our appt. on Tuesday.
Very concerned! Any other advice would be gladly appreciated!!
Sincerely, Jan

[lulusmom]

I'm sorry you felt like you were stood up at the prom. Sometimes we get so many posts, threads drop off the first page and fall through the cracks. You did the right thing in posting again so it brought your thread forward. It is also possible that members were waiting for your consult with the IMS so that they had more information and could offer more meaningful feedback. I want to make it clear that I am not a veterinary professional. I am a 44 year veteran of the insurance industry. In my spare time, I'm a special needs rescuer and all around sick dog magnet who has a tremendous drive to research the illnesses my dogs have so that I can be a proactive participant in their care. I'm a layperson who is always searching for current developments on the canine cushing's front and prefers veterinary textbooks over romance novels and audios of endocrine lectures over music. I'm not a guru....I'm just an extraordinary geek. :o Anything I share with you can usually be supported with science based evidence; however, interpreting labs should be left to the professionals. I just know what I've become accustomed to seeing in reviewing labs with scores of vets over the years as well as reading thousands of threads on this site. With regards to cushing's, Shotzie's blood chemistry is not what I'm accustomed to seeing. Now that I've got that out of the way, please see my comments below in blue text.


Shotzie does have a pot belly.

Any underlying illness that causes enlargement of the liver or fluid buildup can cause pot bellies.

No skin issues or weakness in her back legs ( which Max definitely had). She has always always had a big appetite. Never seems to get enough food. She has been on low fat ID dog food ever since her splenectomy.

My little Pom always had a great appetite but with cushing's she started foraging, begging, wolfing down anything you put in front of her. There is a definite difference between a good eater and a Hoover. You know Shotzie best and I'm sure you would know if Shotzie's appetite increased.

She does drink a little more water than she used to, but I wouldn't say it's excessive. Doesn't really have accidents in the house but that's because I take both Max & Shotzie out to go a lot since Max was having accidents in the house.

This is another symptom that when it becomes overt, there is no question in your mind that something is wrong. Dogs with cushing's lose their ability to concentrate and they pee lakes. Once housebroken dogs are no longer housebroken. They have to drink more to keep up with the pee or else they will dehydrate rather quickly. This is why we tell members never withhold water from a cushingoid dog who has not yet been stabilized on treatment. Shotzie should have had a urinalysis, including a culture to rule out a urinary tract infection. If urine is dilute, the standard urinalysis will not pick up the true volume of white blood cells nor can the type of bacteria be identified. Part of the urinalysis is the urine specific gravity (USG) and dog's with cushing's almost always have low USG. Did your vet do a urinalysis and if so, can you post the results here?

Ever since her splenectomy I've taken her pretty often for bloodwork. Her HCT (my vet calls it PCV) & RDW is always low. Her liver enzymes have been high but her most recent liver enzymes were much higher (which was brought to my attention by the emergency doctor at UF). She has been taking Vetri Liver Canine Bite Size Chews by Vetri Science Labs to help bring her liver enzymes down but it hasn't made much of a difference. The emergency vet said that if she had Cushings it wouldn't help. It has SamE in it & milk thistle

The vast majority of dogs with cushing's have moderate to severe elevation in ALKP with mild and often no elevations in ALT. Dogs are the only species on earth that has an ALKP isoenzyme that is steroid induced. The steroid doesn't kill or damage the liver cells, it interferes with fat metabolism and the liver starts to store more glucogen. This is usually the reason for an enlarged liver. The concerning thing for me is that Shotzie has an almost a five fold increase in ALT which is not what we see with cushingoid dogs. This is more indicative of an underlying problem that is damaging or killing liver cells. For me, this becomes a more likely cause because Shotzie doesn't seem to have any of the symptoms commonly associated with cushing's. Cushing's is often misdiagnosed by vets who are inexperienced and start chasing after a cushing's diagnosis based solely on elevated liver enzymes. If cushing's is responsible for these liver enzyme abnormalities, liver support usually doesn't lower ALKP but it can be very helpful if there is active damage going on in Shotzie's liver. I am so glad you will be consulting with an internal medicine specialist as these vets are highly trained and experienced in all things endocrine.

By the way Shotzie also takes Soloxine .1mg for her thyroid. Her numbers have been in the normal range while taking it.
I am real anxious to take her to her appointment which is a week away. Could have gotten in sooner but I researched their Internal Medicine Vets on their website & requested this particular vet. She recently published an article about atypical hypoadenocorticism.
I figured such she published an article about that, even though that is the opposite of Cushings then she must be pretty knowledgable. Her resume shows she has a lot of experience.

It's a boon any time you can find an IMS with published articles. That's a pretty good indication that are up on the latest developments. I'm hoping you are comfortable with her. The good news is that your past experience with Max is going to make it much easier for you to understand what she tells you.

She also has dental issues.

Dental infections can most definitely increase liver enzymes so make sure you talk to the IMS about that. Hopefully they will check Shotzie's mouth and might even want to do some imaging.

[lulusmom]

I forgot to include a link to a page on Dr. Mark Peterson's veterinary blog which discusses an asymptomatic dog suspected of having cushing's. This particular dog also has dental disease.

http://animalendocrine.blogspot.com/2013/09/working-up-asymptomatic-dog-for.html

[jjgator99]

Thank you so much Glynda!!!! My gut feeling is that it IS NOT Cushings, since Shotzie does not have the symptoms that Max had.
I have been very concerned about her dental issues & am worried about the peridontal disease causing an infection in her bloodstream. Don't understand exactly how not having a spleen factors into all this but I do know the spleen filters the blood & since she doesn't have a spleen this is a concern.
I'm anxiously awaiting to see the IM. Sorry I have to wait until next week but would rather the wait so I can get in with this particular vet.
My vet didn't recently do a urinalysis. He did last fall because she had symptoms of a UTI -sudden urgency to go. It came back negative but he put her on antibiotics for 2 weeks anyway. Was different with Max, he would just go no matter what or where. And
like you said, he would go puddles!
The Emergency Vet at UF said there was a possibility of liver disease but she didn't have the symptoms of liver disease.
Will keep you posted when I see the IM. Thanks!
Jan:)

[lulusmom]

Hi Jan,

You and I were typing at the same time so I am just seeing the results of the acth stimulation test. A post of 38.5 is really high so it's possible That Shotzie has cushing's but is not yet displaying symptoms. I don't think I've ever seen a post stim that high in an asymptomatic dog. Others may and if so, I'm sure we'll here from them. Every time I post, I am more grateful that you are seeing a specialist. By the way, severe dental disease if allowed to go unchecked can damage the heart.

[jjgator99]

Wow! Glynda! Thank you so much for the link to the article! That was very informative! I'm going to print it out so I can refer to it. Thank you so much!!!

[molly muffin]

oh my gosh Jan, I'm so sorry that I missed your thread. I finally had a chance to skim through looking for anything new I'd missed and found 7!! YIKES. I'm going to catch up on all of them right now. :)

So glad to hear that Max continues to do well. That is great news. Now Shotzi. Poor dear. :( Well, you did get the members with the most experience right off the bat, so that is wonderful, Glynda, Lori, Leslie, you're in the prime group there.

I agree about those liver numbers all sky rocketing. I'd want an ultrasound to check that out and I noticed that her glucose was also high, along with the cholesterol. They might want to rule out diabetes, although she might be peeing more with that, you can't tell if it's just starting. Also though about the fainting spell and wondered about hyperglycemia. Not sure, because I might be on the wrong foot with this glucose thing, but if it dropped or something. How did she seem during that episode, was she awake during it, confused when she came out of it, etc?

Also, dental infections can send liver enzymes high as was mentioned previously. My thought is that something other than cushings is going on, and the ACTH might not in this case be a reliable test, since cortisol will go up if something else chronic is going on, or an infection. Even a UTI can make the ACTH be inaccurate.

So I think what we are doing, have done is to provide you some avenues to be checked out and to discuss with the IMS. I'm so glad you were able to get an appointment with someone with some knowledge in this area, who hopefully can fix Shotzi right back up and have her at the nursing home doing her thing for a long time to come.

hugs,
Sharlene and Molly Muffin

[jjgator99]

Thank you Sharlene! I was wondering if her cortisol was just high from being stressed. When I took her in to the vet's that day, she started shaking like she was scared. I requested to take her home & bring her back for the second blood draw just so she would be more comfortable at home. She has never started shaking going to the vets before. Was at the Emergency Vet all day just a few days before that & came home wearing the heart monitor for 24 hours. Think that maybe stressed her out. I was concerned about her cholesteral & glucose too.
Next Tues & our visit to the IM can't get here soon enough!

[molly muffin]

Well, yes stress can affect cortisol, but I am thinking more likely the things that I had mentioned earlier would be more the culprit.

Poor baby she has just been overwhelmed with everything lately I suspect. Molly Always shakes in the car on the way to the vet, or anywhere, but say, lets go home molly and she is perfectly fine for the entire ride back from where ever. So, yes, they can develop a white coat fear unfortunately.

Patience is not one of the things that many of us here on the forum have a great deal of. LOL More like want it done and results back, yesterday. :)

Sharlene and molly muffin

[jjgator99]

I keep counting the days until our appt. You're right Sharlene, we want the results yesterday! Shotzie loves going to the nursing home. She knows when I put her therapy vest on her that she is 'working'. She has the perfect temperament to be a therapy dog. So calm & gentle. Everyone calls her a little sweetheart. Would love to post pictures of Shotzie & Max but haven't figured out how to do that yet.

[molly muffin]

Hi to create an album and add photos, try this.

Top left corner is a button that says User CP, click that
on the left side is a panel, one of the items is Pictures & Albums, click that
You will see a button that says "add album" click that
Title the Album and mark the "make public" button (this allows others on the forum to see your pictures) if you don't want others to see the pictures, then keep private
Now you have an album, so you can Upload Pictures.
click on that, browse on your computer to the photo (s) you want to add to your album, choose them and upload.

Let me know if you have any issues with creating and adding pictures.

In the same User CP on the left hand side there is a button that says Edit Avatar. Here you can add a picture that will show up next to your "name" when you make a post on the forum.

Good luck!
sharlene and molly muffin

[jjgator99]

Thanks so much Sharlene! I will try to add pictures after our homeowners meeting I have to go to tonight.

[Trixie]

Oh so sorry to not have responded sooner myself! As soon as I saw the name Shotzie on the thread list I had a feeling it was a schnauzer! I started to write a post the other night but got pulled away from the computer and just got back to the board tonight.
How nice Shotzie is a therapy dog, she must have such a great disposition. Of course I love my little schnauzer Trixie but she is hardly therapy dog material! :D
Can't wait to see your photos of Shotzie and I hope of Max as I love Lakelands too.
We are just about a year dealing with Cushings. It took a pretty long time to get the right dose of Vetoryl so it was months of tweaking, but it finally kicked in. Hoping Shotzie will feel better soon and hopefully ends up not having Cushings.

Barbara

[jjgator99]

Thank you Barbara. I will put pictures on tonight of Shotzie & Max. I'm hoping Shotzie doesn't have Cushings but on the other hand if it's something else, that might be worse!

[jjgator99]

Tomorrow is finally Shotzie's appt. with the IM at Univ. of Fla. I can hardly wait! Have started to make a list of questions to ask. I'm also nervous too. So worried it may be something really bad. Will let everyone know how things go when we get back.

[molly muffin]

We'll be right here, waiting along with you. Remember when you go in, that you go in with a whole host of people and dogs with you. :) We call it angels on your shoulders and when you get a case of the nerves or can't remember what you wanted to ask, just take a deep breath, picture yourself surrounded by warm wishes and good people all there to support you no matter what.

Sharlene and Molly muffin

[goldengirl88]

Good luck to you both on this important visit. Everything will work out, so just know we are there with you in spirit. Blessings
Patti

[Squirt's Mom]

Hope all goes well today. We are all right by your side and I know you will do just fine talking to the vet.

[Trixie]

Good luck on Schotzie's vet visit today. Hoping all goes well and you get some answers.

Barbara

[goldengirl88]

Hope it all goes well. It will get easier! Blessings
Patti

[molly muffin]

Fingers and paws crossed!

Sharlene and Molly Muffin

[jjgator99]

Thank you so much. This forum has been a life saver! I feel like I know so much more since I've been on here. Waiting to meet back with the IM. They just finished with the ultrasound. Was told there were some abnormalities. Oh horrors! Now I'm more worried! The I M, Dr. Cooke is excellent! She seems to really know her stuff & is also very compassionate! I loved her, immediately. Think Shotzie is in good hands. She said she may have Cushings but is looking at other things. She is very thorough. Did X-rays, ultrasound &cortsol, creatinine ratio. Also fine needle aspirate Cncrmt with imaging, plus a few other tests. Should know something soon!

[lulusmom]

Oh my gosh, are you seeing Dr. Audrey Cook? If so, you couldn't be in better hands. She is an amazing and well published expert. She is on a short list of specialist that I follow so I'd be beside myself if she were my dog's specialist.

P.S. I just realized you are in Florida so you aren't seeing Audrey Cook but rather Kirsten Cooke. It does sound as though Dr. Cooke is being very thorough and leaving no stones unturned. You should definitely know something concrete by the time all of those results are in. Even a fine needle aspirate heh? Shotzie is definitely going to be worn out after this day is done. Please give her a big hug and a kiss for me.

[molly muffin]

You're doing awesome. Sounds like the IM is being very thorough, which is great!

We'll be waiting to hear the results.

Sharlene and Molly Muffin

[jjgator99]

Well, we are finally on our way home from Univ of Fla Small Animal Hospital. Dr. Kirsten Cooke is very good! Not all the tests are back but she doesn't think it's Cushings, but hasn't ruled it out. Her adrenals were normal size. Her increased liver enzymes are probably caused be benign hyperplasia. Qthats what they tqooqqqkqqq fine needle aspirations for, plus her pancreas. Will know the results of that tomorrow. She thinks she has low grade pancreatis or had pancreatis. Still checking on that. She also has regenerative anemia (mild case). I am typing this on my IPad in the car in the dark with Shotzie on my lap so I can't see to read the report they gave us ( my husbands driving). Her blood is too fatty & she wants to address that. Also, once we know all the test results, we need to take care of the dental issue. It was so late when we left (7:30PM) that there wasn't anybody to pay our bill to. She wants to repeat the ultrasound in three months. They still can't rule out cancer but if the aspirations come back normal it won't be as likely.

[molly muffin]

Well that isn't too bad and yay, not cushings! Take the positive :)

The high fatty doesn't really suprise me as schnauzers are prone to that.

So hopefully everything comes back benign and you'll have less worry's on your lap. :) :)

Sharlene and Molly muffin

[jjgator99]

Glynda, Kirsten Cooke is an awesome vet. I liked her the minute I met her! The first thing she did was come over to Shotzie (who was sitting on my lap) & started petting her & talking to her. She seems so thorough I confirmed things I have heard you guys talking about. She said Shotzie could have a false positive stem test & asked how soon after her day at the ER was the test run. I told her it was two days after. She said she could have still been stressed out about that. She said even if she had Cushings at this time, that she wouldn't recommend medicating her, just monitor her. When she met with us after all the tests were completed, it was after 6 PM. She spent about 45 minutes to an hour with us explaining everything.
Sharlene, Patti & Barbara, thanks for the support. Being able to talk to people on this forum really makes a difference.

[lulusmom]

I can't tell you how happy I am that things went so well for you and Shotzie today. It sounds like Dr. Cooke is a specialist we need to bookmark for future reference. I'm sure you have lots more to talk to the good doctor about when all those test results come back. Just know we'll all be waiting for your updates.

Glynda

[jjgator99]

Thank you Glynda. Still waiting for the other test results. They have a nutritionist on staff. Am wondering if I should set up an appt to meet with him. Want Shotzie to be ain't a good diet. Dr. Cooke said she may have to be on a very strict diet since her blood is so fatty. She is already on Lowfat ID dog food.

[lulusmom]

My mom's dog is on lowfat ID also and she really doesn't like it. It's so low in fat that her coat went from beautiful and shiny to dull and dry. If it were me, I'd probably talk to the nutritionist to see if there is an alternative.

[Trixie]

It sounds like you have a great vet looking after Shotzie. My schnauzer has the same issue, high triglycerides. We've been on low fat everything for years now. So glad to hear that it's probably not Cushings. Hope Shotzie is feeling good today..she's probably still recovering from the vet visit!!

Barbara

[jjgator99]

Glynda, Shotzie actually likes her dog food. Of course she has always liked whatever dog food we've given her.
We got a call back from the vet. It wasn't actually Dr. Cooke, it was the student working with her (who graduates from vet school in May). The urine tested in the low range which she said was normal, therefore they strongly feel that she is not cushionoid.
The fluid they aspirated from her liver was benign and the cells were consistent with benign nodular hyperplasia. She said that would cause her ALK Phos to be high. Can't rule out cancer but is unlikely that it is in the liver. The fluid they aspirated from the pancreas , the samples had a low level of cells in them so they could not determine if they were benign. They are concerned about her blood being so fatty.
She mentioned again that she may have an inflammed pancreas, but does not have symptoms of pancreatitis. She said pancreatitis is a fairly common cause of inflammation in the pancreas in schnauzers. It could be a chronic low-grade pancreatitis or she could have cancer of the pancreas. It was recommended to get a PLI blood test to look for evidence of pancreatitis. They are doing another blood chemistry
and suggest we get another ultrasound in 2 to 3 months.
Trying to look at the positive & think it's just low grade pancreatitis.
She said later they could do a liver biopsy, but I'm not sure I would want to put her through that. They will call tomorrow with the rest of the bloodwork. Staying positive!

[jjgator99]

Barbara, doing another blood chemistry to look at her triglycerides & her cholestoral. She did say yesterday that sometimes they have to put doggies on cholestoral meds just like people take. Is your Trixie on any meds for that?

[jjgator99]

BTW, Shotzie seemed fine today, very perky. I still think she had a bad infection & needed antibiotics. She just completed being on antibiotics (clindamycin) for the past two weeks. Think its because of her dental issues. Needs to be scheduled for a cleaning. Anybody have any good tips to keep their teeth clean?

[Trixie]

Trixie is not on meds for high trigylcerides..her other cholesterol number was down in the normal range. Many people here on the board suggest fish oil to lower the triglycerides. I've yet to try..I'm always so afraid to introduce something new with her sensitive gastro system..I do need to talk to the vet about the fish oil.

Trixie got very sick last month, throwing up all night. We had to take her to the ER and they ran the pancreatic test. She's had them before, but they always came up negative. This time she was borderline..in the grey area, her symptoms all pointed to pancreatitis, but the ultrasound showed the pancreas as normal, no damge. They all pretty much concluded it was a pancreatic attack or pretty close to one. She recovered well after a couple of days but it was scary while it was going on.

They thought she must have gotten into some kind of fatty food but she didn't and I know because I was with her the whole time for a few days before it happened, we had been inside due to snow and cold. It's not like I have fatty foods laying around the house.
Was your dog fasted when they ran the blood test. Our last blood test where Trixie's number was high was not on a fast so I'm hoping the next one we do is improved.
Did they put Shotzie on a liver supplement? Trixie still takes Denamarin, it's taken almost nine months for her liver number to come down.
I found a few different treats that are very low in fat. I'll only give Trixie 6% fat and under. I use Charlie Bear treats, Wellness Apple&Yogurt bricks and I just discovered Blue Buffalo Health Bars White Fish & Sweet Potato,and White Cloud Baked Buddy Biscuits, Roast Chicken flavor. Those were all the lowest fat I could find, of course Trixie loves them all but she'll eat anything!! ;)
Really happy Shotzie doesn't have Cushings! Hope nothing else serious going on, so far it sounds like you have a lot to be positive about.

Barbara

[jjgator99]

Hi Barbara. Shotzie was fasting when her blood was drawn. They said it was very high for a dog fasting. I took the treats in to show the vet. They were going to research them & let me know if they are OK. I'm not home so I can't look at the label but I think it's Nuturo apple treats. They are real small so I can give them to her more often. Also give her Frosty Paw (frozen treat like ice cream) once or twice a week. She loves them! But she will eat anything. Read a really really good article about pancreatitis under resources in this forum. Plan to print it out so I can refer to it. They said we can't week or diet & supplements but haven't gotten into that yet. Did not do the PCL but said I could get it done by our regular vet. Not sure why they didn't do it but guess they didn't know we would need it until after they got the other test results. Seems like they are pretty conservative about running tests.hoping we find out its chronic pancreatitis and not pancreatic cancer.

[Squirt's Mom]

Try some things like fresh or frozen (not canned) green beans, carrots, apples, bananas, etc for treats instead of the commercial ones. Most of them are full of fats and additives that aren't the best. ;) I am using some treats by Cloud Star and Isle of Dog that seem pretty good. They are more expensive than the others but I am much more comfortable with those companies and the ingredients that most of the others.

[Trixie]

Im hoping it's not the later....I'm no expert but if it was the really bad one I would think Shotzie would be so sick all the time and not have much of a appetite. Hoping the very best for her and that you get some answers soon!! :)

Barbara

[lulusmom]

I'm glad Shotzie is not a picky eater and enjoys the Hills Low Fat ID. We've seen lots of mini schnauzers with high blood lipids here, including one or two who were misdiagnosed as having cushing's. A great number of mini schnauzers have primary hyperlipidemia which means it's genetic and not being caused by any underlying endocrine disorder. Trying to get the triglycerides down can be challenging and diet is paramount in achieving this. I've included a link below to one of Dr. Mark Peterson's blogs where he discusses a diet he prefers for primary hyperlipidemia.

http://endocrinevet.blogspot.com/2011/11/best-diets-for-primary-hyperlipidemia.html

I'm also including a link to an informational page, with credible citations, on the UFAW site that discusses mini schnauzers and their predisposition to pancreatitis and hyperlipidemia:

http://www.ufaw.org.uk/PANCREATITISMINATURESCHNAUZER.php

I'll be interested to see the results of the triglycerides and cholesterol.

Glynda

[jjgator99]

The vet called & said her cholesterol & triglycerides are still high. She is mailing us a complete report & copies of tests. Said to keep Shotzie on a low fat diet. No Frosty Paws & limit Nutro crunchy treats to 2 per day. She can have some cut up Apple or carrots, green beans as a treat. (Interesting, you guys already recommended that.)
She also needs to take 2000 mg of fish oil per day. Glynda, thanks for the links. So far everything I've read leads me to believe she has what you were talking about in your last comment (can't remember how to spell it). I am so glad we took her to the IM though. Otherwise we would have thought it was Cushings. They still won't rule out cancer. Want to recheck her blood in a month & redo the ultrasound in 2 months to see if there are any changes. They still haven't ruled out cancer, which really bothers me! Shotzie was really upset with me when I didn't give her a treat when we got home tonight. I always give her a treat after they go outside. They are very small treats so she doesn't get too much. I gave her an ice cube & she spit it out & just looked up at me waiting for something else.

[Trixie]

oh Shotzie...I can imagine the look you got when no treats appeared as they usually do. Trixie also gets a treat when she comes in the house. Have you looked at Charlie Bear treats? They are small lentil shaped and have only 3 cals and 3% fat. They're so small...I give one or two when we come in. Very little of anything in one or two but Trixie thinks she's getting her reward.
I think I really should be doing the fish oil too. I've got to figure that out with my vet.
I hope Shotzie will adjust to getting some new veggie treats!

Barbara

[jjgator99]

Gllynda, the links to the articles you gave me were very informative. They really explain everything. Thanks. Barbara & Leslie, the treats you mentioned, do you have to buy them online, or do they have them in pet stores?
Our regular vet, Chet, called me today to find out how Shotzie was doing. He plans to call Dr. Cooke, the IM to get all the results.

[Squirt's Mom]

I get them at PetCo but you can find them online, too.

[Tina]

Hi Jan,
A very belated welcome to you from another Mini Schnauzer mom. I have been reading along on your thread, and am happy to read that the Drs don't think Shotzie has Cushings. My Jasper also has hyperlipidemia, and we recently had to switch him from a renal diet to low fat to try to manage the sky high triglycerides. He also gets fish oil to help with the triglycerides, in addition to treating the protein loss from his kidneys.

He was getting fish oil to treat the hyperlipidemia before he got Cushings. He has also had a couple of episodes of what my vet feels was pancreatitis, one of which landed him in the hospital. (We did not have the blood test done to confirm, but he had a lot of the symptoms, and we treated him as if it was). For the most recent one, he was very sick but we managed to keep him out of the hospital. My vet feels it was at least partially triggered by high triglycerides, which were 11 times normal at that time. He was switched to a low fat diet in December, and it has helped to get the triglycerides down, along with the fish oil.

What are the cholesterol and triglyceride results for Shotzie? It seems all our schnauzers have a lot in common. I hope Shotzie adjusts to her low fat diet and treats like Trixie and Jasper have.

Glynda, thank you for the link to the UFAW article, I had not seen that one before.

Tina and Jasper

[jjgator99]

Tina, hope Jasper is doing well. The excellent article I read that Glynda sent said that 1/3rd miniature schnauzers have this. The thing that concerns me about Shotzie, she was already on a low fat diet. She has been on ID Lowfat for the last two years. Prior to that she was on Royal Canine UD to prevent stones. One of the articles said that can cause problems for fatty blood or pancreatitis. So that May have caused the problem in the first place but since she has been on Lowfat diets for 2 years, not sure what else we can do. I think her treats (nutro apple treats) are pretty low fat & low calorie too. The Frosty Paws were probably higher in fat (doesn't list on box) but she only got those twice a week. Wonder if giving her enzymes or probiotics would help.

[Trixie]

Trixie has been on a low fat diet for a long while too so still a mystery as to what triggered the last pancreatic episode she had. As I mentioned before the vets at the Animal Med Center were very convinced she ate something that triggered it but I don't think so.

Anyway...you can get Charlee Bear treats in most pet supply stores..they have them at Petco. They are online too at many websites. I suggest them because they are really small, very few cals and practically no fat. They're great when the dog is "expecting" something as you can give 5 or 6 little bites which add up to very little of anything, but hopefully the dog feels like they got something.
They come in flavors but I use original Liver Flavor.
http://www.charleebear.com/
You can check the faqs on their site to read about the ingredients. I don't know what I'd do without these treats because Trixie is always waiting for something!!

Barbara

[jjgator99]

Thanks for the info Barabara!