Cushings and Lymphoma

[Milo's Mom]

Hi,

My name is Jenny and I am Milo's "Mom." Milo is a 12-1/2 yr old neutered Pekingese.

About a year ago, Milo was diagnosed with Cushings. His "symptoms" included drinking more water than my other dogs (but he had always done that) and, more importantly, 2 seizures. He exhibits none of the typical physical manifestations of Cushings. I brought him into the vet for the seizures, and lab work indicated we test for Cushings. The cortisol challenge test came back positive and he was started on Trilostane. After many months, more tests, and an increase in his dosage, his cortisol level was considered acceptable.

Last week I took him in for removal of an abscessed tooth. When the vet ran the preop labs he found he was hypercalcemic (elevated calcium) which, in dogs, can mean Lymphoma. We decided the vet should x-ray and ultrasound for enlarged lymph nodes, but none were found and Milo had several teeth extracted.

When I searched for a connection between these two diseases, I got some "hits." (One from this forum.) My concern is that either Cushings (or Trilostane) is somehow linked with Lymphoma. If he is eventually diagnosed with Lymphoma, I don't think I could afford to put him through chemo... I'm also concerned about what else the hypercalcemia might mean. Could he be at the beginning of renal failure? Besides my concerns, he has now started drinking water like crazy again...

Thanks for reading my post! I look forward to hearing your thoughts.

[Trixie]

Hi Jenny,
Welcome to the board and sorry to hear you have some worries about Milo. I don't know of any connections between Cushings and Lymphoma, though I am only dealing with Cushings for one year. Perhaps some more experienced members know more about it. I do know that hypercalcemia can be related to a parathyroid problem too...perhaps that's something to look into which would not be as serious as some other causes.
However I did find a link for an article by Dr. Peterson who is a Cushings expert...you may have already found this while researching yourself but I'll include the link in case you haven't seen it.
I hope you find out that Milo is okay though and this proves not to be Lymphoma.

Barbara

http://endocrinevet.blogspot.com/2012/05/top-10-differentials-for-hypercalcemia.html

[goldengirl88]

If I were you I would ask about a thyroid panel. Your thyroid controls calcium. My dog had a low thyroid function and high calcium. When she was put on Soloxine for a hypothyroidism her calcium went back to normal. I am surprised that the vet did not consider this before the other test. Blessings
Patti

[StarDeb55]

Jenny, welcome to you & Milo. I am probably the one you found with your search concerning lymphoma & Cushing's. My first cushpup, Barkley, developed Lymphoma at the age of 13, after being successfully treated for cushing's for about 5 years or so at that point. I have never seen any research that documents an actual link between Cushing's & lymphoma. What I will say is that Cushing's does cause an overall immune system depression which may, let me emphasize may, allow malignant cells to grow. The other thing is that Barkley had severe allergies which is another indication that his immune system was a total mess, so the development of lymphoma doesn't totally surprise me looking back on it. B did go through chemo which gave him another 20 months with a great quality of life.

I agree with Patti & Barbara about checking thyroid function first. Thyroid problems are much easier to treat. On the off chance that Milo might have lymphoma, I will be happy to talk to you further about my experience with Barkley & his chemo.

Debbie

[steiny]

Hi Jenny,
I don't know if dog's can have parathyroid tumors but my husband recently when through a work up for hypercalcemia (found on a routine blood test) and was found to have a benign tumor on one of his parathyroid glands which was recently removed and his calcium levels are back to normal. The surgery itself went very well. I didn't know anything about these glands before my husband was diagnosed but humans have four of them and they are rice sized and are located next to the thyroid glands. They have nothing to do with thyroid function as their main function is to maintain correct calcium levels in your blood. My husbands endocrinologist said that untreated they can cause a multitude of problems. Might be worth asking your vet about.
Kelly

[Milo's Mom]

Great info. Thanks! I think my next step is to check his parathyroid.

[Harley PoMMom]

I'm pretty sure that the Parathyroid gland controls calcium not the thyroid gland.


Primary Hyperparathyroidism (PHPT) is thought to be the second most common cause of pathologic hypercalcemia (increased serum calcium) in dogs. It is caused by an inappropriate secretion of parathyroid hormone (PTH) by autonomously functioning "chief" cells within the parathyroid glands in the neck of the dogs. There are four parathyroid glands, two on each side. They are called "para" thyroid because they are next to the thyroid gland but functionally they are distinct from the thyroid gland. Thus parathyroid diseases are not connected to thyroid diseases like hyperthyroidism or hypothyroidism. Parathyroid hormone is an important factor in maintaining calcium homeostasis (normal calcium concentrations and function). Primary Hyperparathyroidism (PHPT) Testing (https://ahdc.vet.cornell.edu/Sects/Molec/PHPTtesting.cfm)