My Bella

[Tammer]

Hi everyone, I'm so happy to have somewhere to talk about my sweet girl Bella. She is a 6 year old Maltese/Shih Tzu.

I found out 2 weeks ago that she has Cushings. The vet said her levels were double normal..whatever that means.
This is so confusing to me because she seems so "normal."

The reason we had her tested was solely based on her weight, she is a tiny dog and weighs 16lbs but ideally should be 8-9lbs. She does have the barrel belly look.
She doesn't have any other symptoms other than she isn't as active as she should be. We just chalked that up to being twice the size she should be. Her weight gain started about 3 years ago.

Bella had surgery, 2 days ago for dental disease. She had 11 teeth pulled and I pulled 5 on my own(they were barely hanging on).
Somehow 6 others weren't there, and are believed to have fallen out..or just not there to begin with.
She is left with 20 tiny pearly whites now.

She was tested for diabetes at this time as well, and it came back all clear YAY!

I'm not in denial, but is it possible that this isn't Cushing's at all?
I just don't understand.

Any advice would b GREATLY appreciated.

[Harley PoMMom]

Hi and welcome to you and Bella! Cushing's can be difficult to diagnose and, unfortunately, it is often misdiagnosed. Many of the symptoms associated with Cushing's are shared by other non-adrenal illnesses such as a thyroid problem, liver disease or diabetes. Since there is not one test that is 100% accurate at diagnosing Cushing's a vet needs to perform multiple tests to validate a Cushing's diagnosis.

If you could get copies of all the tests that were done on Bella and post any abnormal levels listed along with the reference ranges and units of measurement that would be great, i.e...ALT 150 U/L (5-50)...Thanks! We are especially interested in the results of the tests used to diagnose Bella's Cushing's. The two diagnostic tests generally used for Cushing's are the ACTH stimulation, and the low dexamethasone suppression test (LDDS), did Bella's vet perform any of these?

Dogs with Cushing's usually have a ravenous appetite, have a pot-bellied appearance, drink buckets and buckets of water and pee rivers. Strong obvious symptoms do play a huge part of a Cushing's diagnosis and since Bella is not displaying the usual clinical symptoms I would question the diagnosis of Cushing's especially since only one Cushing's test was done.

Cushing's is when a dog's system produces excessive amounts of cortisol either from a pituitary tumor and/or adrenal mass, however other illnesses and even stress can cause a dog's body to produce high levels of cortisol. Since Bella did have dental issues this could be a factor for her high cortisol, if this were me I would wait until Bella's mouth has completely healed and then I would revisit having any additional testing done.

Please know we will help in any way we can so do not hesitate to ask all the questions you want. ;)

Hugs, Lori

[Dixie'sMom]

Hello and welcome! I am new to this forum as well as my little girl Dixie was just diagnosed. I can't help with your questions except to restate the symptoms of Cushig's and Lori has done that very well. There is tons of good information and experience on this forum so you are in the right place. I look forward to getting to know you and your sweet Bella.

Hugs!
Suzie

[addy]

Hi and Welcome to you and Bella,

I will try to guess that the vet did some blood work before the dental and Bella had some high liver values,maybe ALKP?

As Lori already asked and has you off to a good start with a routine drill, posting the test results, especially the Cushing diagnostic tests hep us a great deal.

My non Cush pup just had six teeth pulled, one pulled last year. The little dogs can have teeth problems.

We look forward to learning more about Bella and you.

Again,welcome.

[molly muffin]

Hello and welcome from me too. I wonder if the dental disease could be the problem, as it can cause high results on an ACTH, and other false results. I'm not sure that it would be a contributing factor to the weight gain though.

You'll want to rule out everything and likely retest cortisol levels after some time now that the teeth that were causing problems are gone.

Sharlene and molly muffin

[Tammer]

Thank you for the very warm welcome everyone!
Bella did have a test on July 15, they told us it was a special test they did for Cushings. I'm very new to this but I do believe it was a "stim" test. I will check the name on my papers and let you know. I also requested the results from our vet, will post when I get them.
Bella only eats less than a cup of Acana kibble per day, and we give her unsalted green beans as well. She drinks normally like my other dog, and doesn't beg for food at all...most times there is still food left in her dish!


Her teeth have been an issue for a while, sadly our pet insurance doesn't cover cleanings and its very expensive. Finally after her teeth were a cause for concern they covered the extractions and we paid for the cleaning.
Hopefully that test was wrong.

[lulusmom]

Hi and welcome to you and Bella

It sounds like Bella and a new shelter arrival, Sukie, are both fighting the battle of bulge. Both weigh twice what they should, which places them at high risk for any number of conditions. Getting the weight off of them is a priority. Sukie was adopted from a rescue in 2011. She was three years old at that time and weighed 24 pounds. The owner has become too ill to care for her any longer and returned her to rescue last week. She now weighs a staggering 54 pounds. She was diagnosed with low thyroid in 2012 and put on medication. It's not often that an owner gives us a medical file with the dog so I've already been in contact with their vet and am waiting for copies of her last labs. Of course, one look at Sukie and the cushing's flags were going up everywhere. Here she is on her back, which makes her look smaller.

827

The owner actually turned in a case of canned food with feeding instructions. Sukie was being fed three times the amount of food she should have been given for her healthy weight of 24 pounds. Are you following the feeding guidelines for Bella's healthy weight of 8 or 9 pounds? I don't know which Acana kibble you are feeding Bella but I checked Acana's Adult Small Breed kibble on their website and a 9 lb inactive dog should be getting no more than 1/2 cup kibble per day. I have found that the companies who make good quality feed are more likely to have trained nutritionists on staff. They are also more likely to be receptive to answering questions and helping pet owners with nutritional information, including recommending an appropriate choice of their kibble and proper feeding guidelines for overweight pets. Why not call Acana and explain Bella's situation and ask them for guidance. I've included a link to their contact page below:

http://www.acana.com/contact-us/

In response to your original question....yes, it is very possible that you are not dealing with cushing's. Maltese are famous for dental disease. They build up tartar quickly and get inflamed gums. I've shared my life with lots of Maltese babies over the years and even with religious cleanings every 9 to 12 months, they lost teeth and had infections. Dental infections can increase liver enzymes and I would expect it was one of the liver enyzmes that your vet said was twice the normal. Actually twice the normal ALKP in a dog with cushing's would be a very, very mild increase and unless there were other blood abnormalities and/or symptoms associated with cushing's, testing for cushing's would not be recommended. It would help us a lot if you would please get copies of the labs and post the results here. We need only see the highs and lows and please include the normal reference range.

I hope this helps.

Glynda

P.S. Also like Bella, Sukie's drinking and peeing is normal as is her appetite. She does not beg for food, even after cutting her portions.

[Tammer]

Still waiting for the results from our vet, but this is what she had done that day. The next day they told me she had Cushing's.

SYNACTHEN DEPOT
IDEXX:ACTH Stimulation (1pre, 1post)

Oh and she eats Acana Light and Fit

[lulusmom]

The info you posted appears to be what vets usually include on a copy of a bill. Synacthen Depot is a stimulating agent used for the acth stimulation test. You will have to ask the vet for a copy of the results. In the meantime, I've included a link to the nutritional and feeding guidelines for Acana Fit and Light. You will note that an 11 pound inactive dog should be getting 1/2 cup daily. If Bella's healthy weight is 8 or 9 pounds, it sounds like she may be getting 1 1/2 to 2 times the the recommended daily amount. I also input her weight and calories per cup in the Dog Food Advisor's calculator and came up with 1/2 cup per day as well.

http://www.acana.com/wp-content/uploads/2013/01/ACA-DOG-WEB-PDF-2014-LF.pdf?e05363

Dog Food Calculator:
http://www.dogfoodadvisor.com/dog-feeding-tips/dog-food-calculator/

[Tammer]

Yikes, I guess I better cut that amount back!!

[lulusmom]

You are not the only pet owner to not realize that you may be overfeeding your dog. Several years ago, my vet told me I was killing my dog and then went down a laundry list of things that kill fat dogs. Sometimes the weight creeps up on you and you don't really notice it because you live with them every day. That same thing happened to me and I did a much better job of getting the weight off of my dog. I could control his portions but never my own. :o Based on a thinning coat, a big belly and surgery to remove oxalate stones, that vet was convinced my dog had cushing's. It wasn't until I agreed to have an LDDS done, which was negative, that the vet finally dropped her pursuit of cushing's. It's a really small world...... a few years later, two of our members went through the same thing with this same vet. I had already parted ways with that practice due to their egregious vaccine practices and the botched bladder surgery they did on my dog. The good news is that my dog lost all of the excess weight, became much more active and never had another bout of colitis or bladder stones. If you get that weight off of Bella, you may just see one happy, healthy girl.

If Bella's weight is the reason your vet tested for cushing's, then I think we can safely say that overfeeding is the most likely suspect for Bella's weight. However, I would still be very interested in seeing the results of any tests your vet has done so far.

Glynda

[Tammer]

Thank you Glynda, I will be calling them tomorrow and asking where the results I requested are.

I swear I'm not in denial, Bella just doesn't have ANY of those symptoms I have been reading about.

[pansywags]

This is true. Boxers are very lean and I always had a hard time getting mine to eat so when her weight started to rise (in retrospect, one of the early indicators) I didn't notice it until two different people commented that she was getting a bit portly. Her weight was up from 46 lbs to 53. It was pretty easy to take it off but I really didn't notice her physical changes because I saw her every day. It took people who hadn't seen her in months to point it out.



Sometimes the weight creeps up on you and you don't really notice it because you live with them every day.

[molly muffin]

It is worth giving it a try to lose some weight and see if that doesn't help things. See what the results are.

Sharlene and molly muffin

[Tammer]

http://www.k9cushings.com/forum/picture.php?albumid=911&pictureid=6951

http://www.k9cushings.com/forum/picture.php?albumid=911&pictureid=6952

http://www.k9cushings.com/forum/picture.php?albumid=911&pictureid=6953


Hi everyone,
I got the results for Bella's blood work.

[Tammer]

If anyone can tell me how to read those results that would be appreciated!!
A couple of them say "high" beside them.
I did read that the one result, I believe the PLT can be elevated because of infection. Just a reminder that Bella had her dental surgery after these tests, so the results may reflect that she had an infection in her mouth at the time.

[molly muffin]

Okay I pulled the values that are off (high in this case) from your results and will post them here. This is all you really need to do.

Urea 11.1 nmol (2.5 - 9.6 nmol)
PLT 492 (148 - 484 k/ul)
PCT .53 (.14 - .46%)

ACTH
Pre 673 nmol (28 - 120 nmol)
1 hr post 1013 (220 - 559 nmol)

The Urea is the one that probably gives me the most concern, as I would want to know if there is a stone, or anything else that is causing that to be high. I don't know if anything would show up on an xray, but maybe an ultrasound if you haven't gotten one yet would be an option?

That is a high ACTH result alright, but there might be a couple contributing factors for that, such as the dental inflammation problems and if there is a kidney issues (bladder or kidney stones, etc) Something causing that UREA count to go up.

All other results are within normal ranges, so once you figure that out, then it isn't a terrible lab result.

Bella is so cute, I hope she is feeling better from her dental surgery.

Sharlene and molly muffin

[Tammer]

Oh dear now I'm worried! You would think they would say something to me if there was cause for concern!

[molly muffin]

No need to jump the gun yet. These are just ideas I had that I would ask the vet about.

Hang in there
Sharlene and Molly muffin

[Tammer]

Thanks I certainly will be asking them!!

[Tammer]

Hi there everyone, I have been away a while.
My husband had open heart surgery in July,(from an accident at work) and I have been quite busy.

Bella's surgery went well, she recovered wonderfully..and still has 21 teeth!!
She isn't losing any weight, which bothers me immensely.
No new symptoms, if any expect the weight issue.
She does however snore loudly and pants really fast sometimes.
I must add that I find the panting is only when we are closed in my room and she becomes hot, or not enough air flow for her.
Funny thing is I can tell when it's time to groom, after I get her coat cut she has a LOT more energy...for Bella that is!
She has a FULL, beautiful coat and trust me there is no thinning at all on her.

I have been thinking about the diet again, wondering if I should change hers, any thoughts?
She eats Acana Light and Fit kibbles, and I add a few no salt green beans.
Hope everyone is well, look forward to chatting about our fur babies again!

[Renee]

Hey there -

Did you cut back her food to 1/2 cup or less per day? So 1/4 cup in the am, and 1/4 cup in the pm? Acana is a very good food, but I wonder if the calorie content is low enough?

How about treats? If she's eating less food, but getting a lot of treats, you may never see good results. Have you cut back or eliminated treats?

My pugs were overweight for years. Pugs are notorious for it. I could never make a significant dent in their weight until I took them completely off kibble. Now they eat The Honest Kitchen or homecooked.

[Tammer]

They rarely get treats, and when they do it's treats we have here called Zoe Lifestyle Antioxidant Treat Sticks for dogs.
Yes I cut back her food like you advised. I added the green beans to help her feel fuller. Should I take them away? It's no salt no fat beans, I assume they aren't fattening but I'm usually wrong.
The vet suggested some prescription food by Hills, however there are grains(corn) in it and that worries me.

[Renee]

You are very, very smart to not give the Hill's food. I have heard good success with their new metabolic food... but, the ingredients are so horrible, I cannot imagine making any dog eat it. First ingredient is chicken by-products, followed by a disturbing amount of grains. :(

Have you had thyroid checked? That may account for the weight.

A new food is not a bad idea, even though I think Acana is one of the best dry foods there is.

[Tammer]

Thanks I certainly will be asking them!!
Hi everyone its been a while!
Im desperate for some of your advice again. Its been 10 months since Bella had her testing done and she had dental surgery right after.
She has been great and has lost 2 pounds since her surgery! She still doesnt exibit many signs of cushjngs at all!
The only ones are her weight and panting.
She doesnt pee alot and can go more than 12 hours at night no problem.
Her drinking and eating is normal, and as I said she has lost just over 2 pounds with no change to her lifestyle at all. Her coat is amazing as well.
Here is where I need some advice.
I took her to get her shots and the vet checked her file and noticed her stim test results ( they are in a post in this thread) and has recommended I start meds.
I'm reluctant to start any meds and am terrified it may damage her liver or other organs if I don't!
I'm still not convinced she has cushings and they are only going off the results from that one test ( before and after results)
As mentioned by another in this thread, I'm wondering if her stress and infection from the dental disease contributed to her high results?
Should I have her tested again?
Just at my wits end to know what is best for my baby, she is only 7.

[molly muffin]

I would have an ldds test done or another acth now that the dental disease is past. Dental disease can cause a temporary increase in cortisol, any kind of problem like that can end up causing a false positive.

So I wouldn't make a decision to start until you had a follow up test.

[Tammer]

I would have an ldds test done or another acth now that the dental disease is past. Dental disease can cause a temporary increase in cortisol, any kind of problem like that can end up causing a false positive.

So I wouldn't make a decision to start until you had a follow up test.

Thank you, I needed someone that knows this disease to echo my thoughts!