Shy, 14 year old staffy x - advice needed please

[Alison]

Hi all, I'm posting for a friend in Germany.

Her little old rescue girl, Shy, has been poorly recently and her vet is wondering if she needs to be tested for Cushing's disease. I'm not sure as her symptoms don't match those you'd expect for Cushings. She's had bloods done and had very high liver enzymes - which is why the vet is considering testing for Cushings.

Her symptoms are:

sore and itchy, scaly skin - her skin peels off a bit;
no real appetite;
drinking and peeing only a little;
very sleepy and drowsy;
staggering walk;
disorientation

I've attached up photos of her blood results and her skin.

Anyone got any ideas please?

http://i873.photobucket.com/albums/ab298/staffyclub_photos/Shy1.jpg

http://i873.photobucket.com/albums/ab298/staffyclub_photos/Shy2.jpg

http://i873.photobucket.com/albums/ab298/staffyclub_photos/Shy4.jpg

http://i873.photobucket.com/albums/ab298/staffyclub_photos/Shy3.jpg

[Harley PoMMom]

Shoot, I'm at work and their computer will not let me open those documents :( So without being to see the bloodwork results my guess would be a thyroid problem, or has this been ruled out?

Hugs, Lori

[Alison]

Ahh, they're in Photobucket - wasn't sure how else to upload them.

I'm not sure about thyroid. Daniela is on here but English isn't her first language so I offered to post for her to help her out.

I guessed that her staggering and disorientation was down to the high liver enzymes, but not sure what would be causing that. I asked if pancreatitis but the vet doesn't think so as she doesn't have vomitting and diarrhoea.

[Alison]

I'm just typing out the results that aren't within range on the bloodwork. Bear with me

[Alison]

ALT 651+ u/l (bis 107)
AST 71 u/l (bis 82)
Triglyceride 353+ mg/dl (50-100)
Urea 130+ mg/dl (22-52)
Creatinin 1.4mg/dl (bis 1.6)
Bilirubin <0.1mg/dl (bis 0.4)
Lipase 363+ u/l (bis 347)
Alpha Amylase 1064 u/l (bis 1686)
GLDH (I think this is glutamate dehydrogenase) 88.3+ u/l (bis 9.6)
Alk. Phosphatase 305+ u/l (bis 120)
Gamma-GT 14+ u/l (bis 9)
Creatine kinase (after IFCC) 79 u/l (bis 194)

Red blood cells 5.2 /pl (5.5 - 8.5)
Haemoglobin 11.2- g/dl (14.0 19.0)
Monocytes 5% (bis 9)
Eosinophile 2% (bis 10)
LUC 0 (bis 3)

[Harley PoMMom]

Vomiting and diarrhea are not always present with pancreatitis. My boy, Harley, pancreatitis was found on his first ultrasound and Harley never showed any symptoms of pancreatitis.

I know I'm a pain in the butt but could you edit your post and add the reference ranges to those bloodwork results for me...thanks!! Looking at those results I think something is going on and Cushing's would not be my first thought. Is Shy's tummy tender to the touch? Any blood in her stool? Will she eat and is she drinking water?

[Alison]

~Went to edit and my internet crashed but have done it now. I'm not sure what (bis) means on some of the results - I'm hoping you do!!

Daniela says she's not got much appetite - she doesn't want to eat or drink much and she has a little bit of a pot belly. She has had a look on here but didn't think Shy's symptoms were the same - I think the vet is going by the liver enzymes being raised.

I know she's gone to bed just now - it's about 2am where she is but I'll get definite answers to any other questions in the morning and tell her to check on here too.

[molly muffin]

I'm looking at the labs, and that will take some time to go through, but just wanted to add that "bis" means "to" as in "up to" . So looks like for instance bis 347 would mean the highest point would be up to 347.

Sharlene and molly muffin

[Harley PoMMom]

I'm looking at the labs, and that will take some time to go through, but just wanted to add that "bis" means "to" as in "up to" . So looks like for instance bis 347 would mean the highest point would be up to 347.

Sharlene and molly muffin

I am so glad you knew what bis meant, I have been searching for the definition and just couldn't find one.

[molly muffin]

Do you have any urinalysis results by any chance?

I'm wondering about kidneys.

Sharlene and molly muffin

[Daniela]

Hello... no urine analysis done yet, but the kidney related results in the blood test were ok...

[Alison]

Vomiting and diarrhea are not always present with pancreatitis. My boy, Harley, pancreatitis was found on his first ultrasound and Harley never showed any symptoms of pancreatitis.

I know I'm a pain in the butt but could you edit your post and add the reference ranges to those bloodwork results for me...thanks!! Looking at those results I think something is going on and Cushing's would not be my first thought. Is Shy's tummy tender to the touch? Any blood in her stool? Will she eat and is she drinking water?

Shy doesn't have any blood in her stools but if you touch her tummy near her back legs, she does have pain :(

Google translate had "bis" as "until" and I couldn't make sense of that - so glad Sharlene did!:D

[Harley PoMMom]

Shy is a staffy mix? From her blood work my best guess would be that the problem is either her liver or pancreas.

A Spec cPL test can diagnose pancreatitis: Spec cPL® Test (https://www.idexx.com/smallanimal/reference-laboratories/testmenu/innovative-tests/spec-cpl.html?SSOTOKEN=0)

When I have had this test done on my boy the cost was around $85.00, this is a blood draw test so the dog has to be fasted for 12 hours.

For the liver I would have a bile acid test done, IDEXX has a test called the SNAP bile test, here's a link about that: SNAP® Bile Acids Test ( https://www.idexx.com/smallanimal/inhouse/snap/bile-acids.html)

Hugs, Lori

[Daniela]

Hello...

Thank You for looking into the matter.... I will ask my vet on Monday about these tests.... I am very grateful for Your helpn and advice...

Thanks again..

Daniela

[lulusmom]

I am not understanding why this vet would possibly think Cushing's is Shy's problem based on her labs and symptoms. She is a very sick dog and I'm not sure I would trust this vet to know how to figure out what is making her so ill. When were these labs done and did the vet prescribe any medication?

[Alison]

The bloods seem to have been done on 4th August.

Shy is getting Rascarve hepar tablets and has antibiotics for her sore itchy skin and also painkillers.

[Daniela]

Hello... the blood test was done on August the 4th, as Alison wrote... lookind deeper into the matter and reading a lot of information on here, I think, it is not cushings, what Shy is suffering from... the vet bases her asumption on her liver enzymes and the skin problem.... I have the feeling, the two vets I have talked to, are not really expierienced with Cushings.... but the one treating Shy told me she would look into the matter and our next date is on Monday
Thank You for Your assistance and helpful thoughts..

Daniela

[Alison]

I hope she looks properly at Shy and works out what is wrong with her. Poor girl's skin looks so sore. :(

[Daniela]

Shy has had her second blood test for Pancreatitis today... now waiting for the results... thank You all for putting me in this direction and the helpful advice..

And special thanks to You, Alison...

[molly muffin]

Hoping for the nest. Let us know what the test show and the vet says

Sharlene and Molly muffin

[Daniela]

Hello Sharlene and Molly

Sorry I get back to You so late.... the test got somehow mixed up and had to be repeated today.
Results should be back on Tuesday... Shy is a little better, she is more lively and has a little appetite... let`s see what the vet tells me on Tuesday...

Hugs to both of You...

Daniela

[Alison]

I've just had a message from Daniela. After a lot of to-ing and fro-ing with her vet, she has Shy's blood results back and the poor girl does indeed have pancreatitis. :(

Any advice on the necessary treatment and/or dietary changes would be much appreciated.

[Woodydog]

Alison

Usually a bland diet like chicken or scrambled egg for a few days nothing heavy in the stomach. Woody usually had IV fluids when his flared up, also did shy get any pain meds woody would get Antepsin, metronizidol and he would get Zantac in with his IV fluids.

Sending positive thoughts to shy

[Alison]

Shy didn't have diarrhoea and vomitting - which is why the vet didn't think it was pancreatitis but following the advice here, Daniela asked for her to be tested. She had a course of antibiotics for her skin and also some pain meds I think. It's been about 3 weeks I think since she became poorly. She did seem to perk up a bit after the antibiotics and has improved.

Daniela has said that the vet said there wasn't much to do as it wasn't acute pancreatitis she had - she's to follow a low fat, low protein diet. I think Shy is fed raw - so any dietary advice would be helpful as well.

[Harley PoMMom]

Oh poor Shy, that darn pancreatitis :mad::( For pancreatitis a diet very low in fat is needed, a diet with less than 10 percent fat on a dry matter basis is considered to be low fat. A high quality protein with moderate fiber is also recommended. Since the diet has to be low in fat, carbs are used to substitute for those calories that are lost, carbs such as; rice, oatmeal, barley, quinoa, pasta, potatoes, sweet potatoes, pumpkin, and winter squashes (e.g., acorn and butternut) can be added.

Hydration is very important, as it aids in the healing of the pancreas, so one has to make sure their dog is getting plenty of water, I would add water to everything Harley ate.

Feeding 3-4 small meals throughout the day is important, and having the dog maintain their ideal weight is recommended.

I'm providing a link to our Resource Forum that has some informative article regarding canine pancreatitis: Pancreatitis (http://www.k9cushings.com/forum/showthread.php?t=5210)

Unfortunately there are a few of us who have had to deal with pancreatitis, and believe me, it can be difficult to control but is manageable. If you have any questions at all please do ask them. ;)

Hugs, Lori

[Daniela]

Dear Alison, thank You for coming to my aid again.... and thank You Woodydog and Lori for Your informative and helpful advice... everything is much apreciated....

[Alison]

Daniela has said that Shy was tested for lipase but she has read that there is an amylase test as well - how important is this?

[Harley PoMMom]

Elevations in the lipase and/or amylase are not good markers for pancreatitis.There are other things that can cause the lipase and amylase levels to be high, which is why the spec cPL test is done,the spec cPL will test for the lipase that is specific for the pancreas only. Harley's lipase and amylase were in the normal ranges but his spec cPL test results were in the 500's :eek:

Was the spec cPL test performed on Shy? And if not, how was the pancreatitis diagnosed?

[Alison]

I'll find out from Daniela what blood tests were done. She said that it was lipase but she'd found out that there is an amylase test as well.

[Daniela]

I had a look at the sheet, the vet gave me.... the test is not named there... it only says, Canine Pancreaslipase 1000+

to 200 normal
to 399 questionable
more than 399 suspected pancreatitis

it is all in German, I tried to translate for You as good as I could...

Well there was no real diagnosis, I `d say... I asked the vet to test for it, because I was pointed in this direction on this forum... the vet did not really want to test her, but I insisted..... when the results finaly came, it was more a conclusion, looking at her skin, the bad results from the first blood test and the x- ray pic and the pain in her belly... right now I am trying to learn as much as I can about it AND I am trying to find a vet around here, with more knowledge on this matter...

[mytil]

I am not sure where in Germany you are located but here is a link to specialists in Germany (you will have to scroll down until you find German locations as the list shows a mixture of European locations) --- http://www.ecvim-ca.org/diplomate-list#internal

Also there is the University of Veterinary Medicine in Hanover.

Keep us posted
Terry

[Harley PoMMom]

I had a look at the sheet, the vet gave me.... the test is not named there... it only says, Canine Pancreaslipase 1000+

to 200 normal
to 399 questionable
more than 399 suspected pancreatitis
it is all in German, I tried to translate for You as good as I could...

I'm pretty sure those results are from a spec cPL test, Harley's spec cPL test reference ranges were identical to those reference ranges that you listed. Results in the 1000's are high but with a diet change and other modifications, which I listed, those numbers can come down rather quickly. Harley's numbers never returned to normal (>=200) his always ran in the 300's so don't be alarmed if Shy's numbers do not return to normal either.

You did a wonderful job translating, thank you so much!


Well there was no real diagnosis, I `d say... I asked the vet to test for it, because I was pointed in this direction on this forum... the vet did not really want to test her, but I insisted..... when the results finaly came, it was more a conclusion, looking at her skin, the bad results from the first blood test and the x- ray pic and the pain in her belly... right now I am trying to learn as much as I can about it AND I am trying to find a vet around here, with more knowledge on this matter...

You absolutely did the right thing in pressuring the vet to do more testing, Great Job Mom!!! One thing I did forget to mention, pancreatitis can be very painful, so having them on a pain killer to manage their pain is vital, I am sure I saw that Shy is on pain meds, right?

[Daniela]

Hello Terry, there is actually one of the specialists is in my hometown.... thank You so much... I will call her on the phone on monday... xxx

Dear Lori, I am very grateful for Your advice.... I won`t have to change Shy`s diet too much, because some of the things You mentioned are already on her menue and I am used to prepare her food on my own.
I saw on a german raw feeding site, that there should enzymes be added to her meals... but thanks to Terry I know now that there is a specialised vet near to where I live and I might get useful advice on this matter now too...

Thank You so much... xxx

Daniela

[Daniela]

Hello..... now, a few weeks later, Your good advice has worked out.... change of diet and vet has helped to improve things a lot...Shy is much more lively and got her fur back.... and also her appetite is much better now! Thank You so much everyone xxxxx