11 year old schnauzer/poodle mix Annie - possible cushings diagnosis

[ccannie84]

Hi everybody,

My 11 year old sweetheart has been experiencing the weirdest hind leg issues, and after some research I believe she has Cushing's. I hope I am wrong as this seems like a horrible disease, but I am really panicking and hoping you guys can help me before I go to the vet tomorrow to make sure I ask for the right tests and ask the right questions.

A little bit of background: I adopted Annie when she was a baby. Her mom came into the shelter pregnant with puppies, and luckily Annie was one of them. She is an amazing dog. Just the sweetest thing you can ever imagine. She has had some health issues over the years, but nothing too bad. When she was about 7, she had surgery to remove a benign tumor that had grown near her paw. In 2011, she had another surgery to remove a benign tumor that had grown on one of her ears. Before that surgery, her bloodwork showed elevated ALKP levels. My vet asked if she had been drinking excessively, having accidents, or any of the other Cushing's symptoms, but she hadn't. He said that it just wasn't something we needed to worry about at that time. In 2012, she started having accidents and I was worried it was Cushing's. It turned out she had crystals in her urine, we put her on some special food, and she stopped having accidents and returned to her normal self. She has never been an incredibly active dog, so over the years I haven't been shocked when we are on long walks and got too tired to continue, but after doing my research, I am realizing that this may have been a sign of Cushing's all along.

Now here's where things have started to go downhill. I would say within the past 6 months, she has experienced what my vet assumed was arthritis. At first, it was her front carpal joint. Then, I noticed after she played really hard or was more active than usual, she would experience tremors in one of her hind legs. This would stop after a few seconds, though, and I just assumed it was part of her arthritis. However, this past weekend I went out of town and took her to a boarding facility that I really trust. When I picked her up on Sunday, though, she couldn't support herself on her hind legs. On Friday, things seemed perfectly normal, but suddenly on Sunday she couldn't really walk besides some hobbling. I have her on Metacam for the arthritis, but it isn't seeming to help with her hind legs. I'm now wondering if her hind legs are weak because of Cushing's. Is it possible for the symptoms to suddenly appear like this? She had bloodwork done on Sunday night. She is 21 pounds, and her ALKP levels were 316 U/L. Normal levels are 23 - 212, so this is obviously a very high level. I can't recall what her levels were the last time I got them checked in 2011, but I will find out before I go to the vet on Friday.

Any help would be appreciated. It's just me and Annie and I would be devastated to lose her, so I want to be sure I'm doing the right thing.

[lulusmom]

Hi and welcome to the you and Annie.

I have manually validated your membership so that others can now see your posts. You can disregard our email to you asking for validation.

In my opinion, it would be very unusual for a dog to experience advanced muscle wasting due to the catabolic effects of high cortisol without having at least a few of the other more common symptoms such as excessive drinking and peeing, voracious appetite, panting, loss of coat, etc. An Alkp of 312 is an extremely mild elevation, which is not uncommon in an otherwise healthy senior dog. Again, it would be unusual for a dog to have such advanced muscle wasting to not have higher alkp. We've seen dogs with Alkp levels in the 3,000 to as high as 5,000 range.

At this point, I would have a senior screening done. This includes a blood chemistry, complete blood count and a urinalyis. With hind quarter weakness being the primary symptom, I would have xrays done of Annie's spine to rule out any degenerative disc problems. I have an old Cockapoo with fused discs which effects her bladder control and sometimes bowels. She has extreme weakness in her back legs and occasionally knuckles over. She also has severe muscle wasting because of her back problems. Cushing's isn't the only problem that causes weakness, exercise intolerance and muscle wasting.

I'm sorry for the circumstance that brought you here but I'm glad you found us. We're here to help you to get things sorted out for Annie. The more information you can give us, the better we can help guide you with appropriate feedback and citations to credible references. For instance, if you have any relatively recent lab work, posting the abnormal values, with normal reference ranges, would be very helpful. If not, then we'll wait for you to post the results of all tests after Annie's visit with the vet tomorrow. In the meantime, let us know if you have any questions.

Glynda

[ccannie84]

Thank you so much for your quick reply. I am so glad I found this place, what a great resource and support community.

Thanks for the information on the alkp levels. I was under the impression that Annie's were very high but it seems to not be the case. I will look into a senior screening, and see where to go from there.

She had bloodwork done on Sunday, which is where the 316 U/L ALKP levels came from. What other results would be relevant to Cushing's? Well, actually I can tell you that the only things that were abnormal, other than her ALKP levels, were her NEU results which were 13.38 when the normal range is 2.95 - 11.64. Also, her MCV was 59.8 fL when the normal range is 61.6 - 73.5, and her MCH was 21.0 pg when the normal range is 21.2 - 25.9. She also had a low fever of 103.

[lulusmom]

The values you posted are for a blood chemistry and complete blood count so I'm not sure your vet would feel the need to repeat those; however, i would ask him him/her what the abnormal Neu MCV and MCH mean because they are not consistent with cushing's. Cushing's can increase Neutrophils, as can stress from being at the vet's office but I don't believe it effects the MCV and MCH. I'm not a vet professional but high Neutrophils, low MCV and MCH can indicate anemia. You may want to discuss this with him/her and ask if a fecal might be wise to rule out parasites or other tests to rule out tick borne disease.

I failed to mention to you that a dog with uncontrolled cushing's does not really require Metacam, nor should they be given any while cortisol remains high. Dogs with cushing's have extremely high levels of cortisol in their blood and as cortisol is our body's natural anti-inflammatory, cushdogs are self medicating themselves. If Annie has cushing's, which I'm not convinced she does, she wouldn't be feeling any arthritic pain. Arthritis is often unmasked, especially in older dogs, once treatment reduces cortisol to an acceptable level. It is at that point that Metacam can be prescribed. Metacam itself can elevate liver enzymes, specifically alkp, which is why liver values should be checked periodically by your vet. It can also cause internal bleeding so please discuss this with your vet as well.

Glynda

[ccannie84]

Thank you so much for your help! I really appreciate it.

[lulusmom]

Please let us know how today's vet visit goes.

[molly muffin]

Hello and welcome. How did the vet visit go?

My dog had some problems with hind leg weakness and it was her back, some inflammed discs problems, discovered on xray, so I'd definitely get that done as Glynda suggested. one of the things you have to do with that is to keep them from running, jumping up and down, no steps, for about 6 weeks.

i agree, it doesn't sound like cushings as that isn't the natural progression for muscle weakness. What Glynda said is bang on, it just seems like a back or other problem area.

Sharlene and molly muffin