Batavian
10-18-2014, 10:48 PM
Hello, my name is Joe and I have an 11 year old female black labrador retriever named Chelsea. Chelsea was a rescue. She and her brother Koda were 6 month old puppies found at a “high kill” shelter in Ohio. These type of shelters euthanize after 72 hours. Both her and her brother were saved by some saintly folks, transported to Rochester NY, and put with foster homes until forever homes could be found. I discovered her on Petfinder.com. When I met her for the first time, she came and sat next to me. So she picked me, not vice versa! And I’ve been in love every since. I’m happy to report that both her and her brother Koda (a chocolate male) both found forever homes for these past 10 years or so.
This past summer I noticed that she was panting excessively and drooling. I just figured that she can’t handle the heat very well now that she is older. I recalled some panting back in the summer of 2013 which was a hot summer. But summer 2014 here in western New York was very cool. Of more concern, was her panting and drooling at night.
So I took her in for a checkup and she had a fever! It was 104.8F! And her liver enzymes were elevated. Her liver enzymes had been elevated in the past (more about that later) so the priority was to get the fever down and treat the infection. She was first given Amoxicillin, test after a week, still had fever, so was given some Ciprofloxacin. She was tested again. Fever was gone but still had elevated enzymes, so was given Metronidazole. Tested again and still high liver enzymes. In retrospect, the Metro did nothing for her and was surprised (again in retrospect) that it was prescribed. The fever/infection was probably knocked out by the initial Amoxicillin and/or certainly the Ciprofloxacin. There was been no re-occurance of fever since but her liver enzymes remain high, actually getting worse. Here is a table of her liver enzyme test results.
Normals>> 0-7 23-212 10-100
GGT (U/L) ALKP (U/L) ALT (U/L)
10/16/2012 0 354 133
7/23/2014 13 2000 375
8/9/2014 16 1792 546
8/26/2014 7 1781 250
9/6/2014 12 1736 226
9/16/2014 22 2000 334
Xrays showed no growths or abnormalites other than a slightly enlarged liver. Xrays and ultrasounds showed no bile stones and no detectable bile sludge. Ultrasound and needle biopsy showed normal bladder, spleen, stomach, bowels, gall bladder, kidneys, and adrenal glands. The liver was still slightly enlarged and a little paler than normal. No tumors seen. Slides of the aspirate (needle biopsy) looked like vacuolar degeneration (or vacuolar hepatopathy) which often occurs in Cushing’s or pancreatic issues.
So on to the Cushing’s test. First was the urinalysis. Cortisol = 5.9 ug/dL, creatnine = 17/1 mg/dL. According the urinalysis, it stated hyperadrenocorticism (Cushing’s) was highly unlikely.
A follow-up Cushing’s blood test (dex suppression) was performed. Her cortisol baseline = 3.3 ug/dL, post dex 4hr = 2.0 ug/dL, post dex 8hr = 1.5 ug/dL. I was told that if either the 4 or 8 hour numbers are less than half the baseline, then it’s a positive test for Cushing’s. But the 4 hr is not half and the 8 hr is borderline. Coupled with the urinalysis, the diagnosis was no Cushing’s.
Some side notes. She has some of the symptoms of Cushing’s including drinking more, increased hunger, and panting. But no hair loss, pot belly, obesity. Other info…she’s been tested for heart worm, Lyme, E. canis, and something called A. ph. All negative.
So the diagnosis is ? Right now, she will occasionally pant excessively but no drooling. I having been giving her Denamarin daily which seems to be wonder drug. And she will be starting Science Diet L/D next week. I will do that for a month, then test for the enzymes again.
Sorry for the long drawn out post. It’s probably not Cushing’s or if it is, it's very early in its progression. I will report back the liver enzyme test results in a month. But in the meantime, if any have any ideas about what might be going on, I’d appreciate the comments. Maybe there is a doggie liver forum as great as this Cushing’s forum you could direct me to. If the enzyme results don’t improve, I’m considering taking her to Cornell which is relative close to me and suppose to have an excellent vetrinary school. Right now my local vets are totally perplexed.
This past summer I noticed that she was panting excessively and drooling. I just figured that she can’t handle the heat very well now that she is older. I recalled some panting back in the summer of 2013 which was a hot summer. But summer 2014 here in western New York was very cool. Of more concern, was her panting and drooling at night.
So I took her in for a checkup and she had a fever! It was 104.8F! And her liver enzymes were elevated. Her liver enzymes had been elevated in the past (more about that later) so the priority was to get the fever down and treat the infection. She was first given Amoxicillin, test after a week, still had fever, so was given some Ciprofloxacin. She was tested again. Fever was gone but still had elevated enzymes, so was given Metronidazole. Tested again and still high liver enzymes. In retrospect, the Metro did nothing for her and was surprised (again in retrospect) that it was prescribed. The fever/infection was probably knocked out by the initial Amoxicillin and/or certainly the Ciprofloxacin. There was been no re-occurance of fever since but her liver enzymes remain high, actually getting worse. Here is a table of her liver enzyme test results.
Normals>> 0-7 23-212 10-100
GGT (U/L) ALKP (U/L) ALT (U/L)
10/16/2012 0 354 133
7/23/2014 13 2000 375
8/9/2014 16 1792 546
8/26/2014 7 1781 250
9/6/2014 12 1736 226
9/16/2014 22 2000 334
Xrays showed no growths or abnormalites other than a slightly enlarged liver. Xrays and ultrasounds showed no bile stones and no detectable bile sludge. Ultrasound and needle biopsy showed normal bladder, spleen, stomach, bowels, gall bladder, kidneys, and adrenal glands. The liver was still slightly enlarged and a little paler than normal. No tumors seen. Slides of the aspirate (needle biopsy) looked like vacuolar degeneration (or vacuolar hepatopathy) which often occurs in Cushing’s or pancreatic issues.
So on to the Cushing’s test. First was the urinalysis. Cortisol = 5.9 ug/dL, creatnine = 17/1 mg/dL. According the urinalysis, it stated hyperadrenocorticism (Cushing’s) was highly unlikely.
A follow-up Cushing’s blood test (dex suppression) was performed. Her cortisol baseline = 3.3 ug/dL, post dex 4hr = 2.0 ug/dL, post dex 8hr = 1.5 ug/dL. I was told that if either the 4 or 8 hour numbers are less than half the baseline, then it’s a positive test for Cushing’s. But the 4 hr is not half and the 8 hr is borderline. Coupled with the urinalysis, the diagnosis was no Cushing’s.
Some side notes. She has some of the symptoms of Cushing’s including drinking more, increased hunger, and panting. But no hair loss, pot belly, obesity. Other info…she’s been tested for heart worm, Lyme, E. canis, and something called A. ph. All negative.
So the diagnosis is ? Right now, she will occasionally pant excessively but no drooling. I having been giving her Denamarin daily which seems to be wonder drug. And she will be starting Science Diet L/D next week. I will do that for a month, then test for the enzymes again.
Sorry for the long drawn out post. It’s probably not Cushing’s or if it is, it's very early in its progression. I will report back the liver enzyme test results in a month. But in the meantime, if any have any ideas about what might be going on, I’d appreciate the comments. Maybe there is a doggie liver forum as great as this Cushing’s forum you could direct me to. If the enzyme results don’t improve, I’m considering taking her to Cornell which is relative close to me and suppose to have an excellent vetrinary school. Right now my local vets are totally perplexed.