always hair loss and fragile skin? - Kaspar has passed

[rea56]

HI everyone - great forum full of great helpful info but even more fantastic - very helpful and informative nice people who have love our fur babies :)

i have a question - do dogs with cushings ALWAYS have Hair Loss (or and coat/fur)vand poor (fragile) skin?

:confused:

thank you
Rea

[VetStudent]

My dog didn't show the hair loss signs. I don't think all dogs show that, but I would just go with an ACTH test to make sure. My dog Max had high levels of alk phos and cholesterol (classic blood work signs for a Cushing's dog) and the vet felt it wasn't necessary to conduct an ACTH test because he was in the last 2 years of his life when the signs became apparent.

However, looking back, I wish I had done the test even though I am almost certain he had Cushing's because it would have given me peace of mind on how to treat him and what was going on at the time.

[mytil]

Hi and welcome to our site.

Not every dog experiences hair loss symptoms of Cushing's; but a majority do.

The elastic tissue under the skin is affected, leading to thinner skin; specifically around the trunk of the body. Owners often see darkening of the skin as well.

Feel free to tell us more about any other symptoms and testing you and your pup are going through right now.

Terry

[Squirt's Mom]

Hi and welcome! :)

And then there are those pups who after starting treatment do what is called "blowing their coat" - and if you think shedding is bad! :eek: A pup who blows their coat may lose the majority of their hair and then regrow an altogether different new coat. Can you imagine a Boston with a curly red coat? :p

[rea56]

hi again -thx for info mytil , VetStudent , Squirt's Mom :)

sorry - i am all over the shop – the reason I asked is by my ‘baby’ Kaspar (Samoyed 10yrs old) is showing all physical signs of cushings except hair loss and thin/fragile skin – but it could just be liver problems :(

and vet said it (cushings) was low in his list due to this (hair/skin) not being present (and some other things)

Kaspar is in liver failure (as per his blood tests – ultrasound)– and when we look back (hubbie and me) I am thinking he has been deteriorating for awhile (he has been back to vet several times for things cropping up which now leads me to the liver and cushings(maybe)

does cushings lead to liver failure?:confused:

drinking buckets of water, heaps of peeing, extended tummy, excessive panting, wobbly ‘legs’ , really excessive dribbling, hot, generally unhappy – all happened in glaring starkness in last week… very fast. He collapsed last Friday morning whilst having his breakfast – hence vet asap

We can ‘cope’ with the liver failure if we have to, but I want to check all possibilities – if liver is failing – why and can we stop it ?

We are scheduling another (better) ultrasound (hopefully next week at a vet uni) plus a ct scan plus biopsy… ultrasound at clinic showed Very Big liver – it’s very hard, he has pain when it is pushed at (vet did it) and hence his tummy huge. Ultrasound also showed a big black mass – not sure if dead liver (cells) or a tumor – vet not sure…

he seems a bit better today - some days seems better (or worse) than others - indeed some times of the days it is up and down...

Anyways – was hoping to find something to help or explain it – he is my ‘baby’ fluffy despite being 10 and I think I am coping by researching! (google can be good – but also exhausting)

Any further thoughts would be most appreciated… cushings or not related… Thx all
oh and - he's on tramal for pain, and last gulcose test was 4.4 :)

Results:
Haematology all good,
Endocrinology T4 total … <10
Immunoserology – canine pancreas – 136 ug/L (<=200) …. Ref: <=200ug/L is normal
Here is his biochemistry
Report H or L reference
Sodium 151 mmol/L 139-153
Potassium 6.2 H mmol/L 3.9-5.9
Chloride 116 mmol/L 101-118
Bicarbonate 17 mmol/L 12-26
NA:K ratio 24.4 L 26.0-35.0
Anion Gap 24.2 mmol/L 14.0-32.0
Glucose,FL.OX 2.9 L mmol/L 3.3-6.8
Glucose, serum 0.0 L mmol/L 3.3-6.8
Urea 3.9 mmol/L 2.5-10.0
Creatinine 0.07 mmol/L 0.05-0.15
Calcium 2.6 mmol/L 1.9-2.9
Phosphate 3.9 H mmol/L 0.8-2.1
CA:P ratio 0.7 L 1.9-2.9
Protein-total 73 52-80
Albumin 32 g/L 23-40
Globulin 41 g/L 25-45
A:G ratio 0.8 0.6-1.4
Bilirubin,total 4 Umol/L 0-7
ALP 597 H IU/L 1-150
ALP steroid isoenzyme 5 IU/L
AST 228 H IU/L 10-80
ALT 1355 H IU/L 16-90
CK 915 H IU/L 73-510
Cholesterol 2.9 L mmol/L 3.5-9.0
Amylase 1611 H IU/L 333-1500
Lipase 496 IU/L 77-750
Gamma GT 6 IU/L 0-9

Report from idexx labs says significant hepatopathy with hepatocellular leakage – and ongoing thoughts…

[rea56]

opps - the Report H or L reference mean
the lab report stated H (high) L low - reference is the numbers at the end of the line

[Squirt's Mom]

Personally I would forget about Cushing's right now and concentrate on the liver and his BG. These two values made me wonder why he didn't pursue further diabetes possibilities -


Glucose,FL.OX 2.9 L mmol/L 3.3-6.8
Glucose, serum 0.0 L mmol/L 3.3-6.8

Was the urine tested for diabetes?

These values tell me there is definitely something making the liver very unhappy -


ALP 597 H IU/L 1-150
AST 228 H IU/L 10-80
ALT 1355 H IU/L 16-90

Unfortunately, if, IF, he does have liver disease these drugs used to treat Cushing's may be contraindicated meaning he can't take them. So for now, put Cushing's on the back burner (and don't let the vet push you into expense cush tests) and check out the liver and BG thoroughly first. ;)

I'm glad you found us and hope to learn more soon!
Hugs,
Leslie and the gang

[labblab]

I'm afraid I have to agree that primary liver failure looks to be the biggest risk right now, perhaps more likely caused by a tumor than anything else. The advanced liver diagnostics you have scheduled for next week should really help clarify the path forward.

As far as the glucose level, it looks to me as though the issue is actually the opposite of diabetes -- it is abnormally low. I do not know what is meant by "Glucose FL.OX," but it seems that a serum Glucose of 0.0 is very troubling.


Hypoglycemia (low blood glucose) is a complication of end stage liver failure due to the livers central role in carbohydrate metabolism. Normal blood glucose levels are maintained by the healthy liver during normal fasting states.

So let's see what the ultrasound/biopsy show us next week. I think that will really be the best way to judge whether the symptoms and abnormalities are compatible with a tumor vs. some other disease process.

Definitely, please keep us updated!
Marianne

[Squirt's Mom]

Marianne is absolutely correct. That is a hyPOglycemic response, not hyPERglycemic or diabetic. I knew that when I saw those values but the old synapses stopped firing. :o

[rea56]

Thx Marianne and Leslie
yeap vet said same, its not diabetes as gluc opposite (he was tested)

you both have helped me feel better (sic) about getting the vet uni stuff done, some are telling me to just make Kaspar comfortable and wait !!! for what - for him to die... :(

vet also said glucose very troubling and lab test said almost contradictory to some of other results
we have honey on hand for low glucose collapse and vet on emergency phone :(

really appreciate the help , and also pointing my addled brain in right direction (look after liver/glucose first) - i was getting 'bogged down' with info...

will update after vet uni results
Rea
(ps Kaspar had a ruff night but is brighter this morning - seems its just me who is worn out and buggered!)

[judymaggie]

Hi! I wanted to give you a good reference page with regard to hypoglycemia:

http://www.canine-epilepsy-guardian-angels.com/hypoglycemia.htm

Don't panic when seeing all the references to seizures -- the page is part of a canine seizure website that I have used in the past. There are lots of good tips here.

[molly muffin]

Hello and welcome from me too.

Well of course you are worn out. This is a lot to take in and I'm sure the research is exhausting too. We all tend to do that as soon as we get any kind of diagnose.

Hopefully the further test will tell you more but I agree the liver is top priority. As to whether or not anything can be done to stop or to slow it down... I don't think you'll know till the results are in from the further testing. It all rather depends on what is causing the liver problems and how advanced it is. The usual option is to have an mass removed if that is possible and if it hasn't spread. So many factors, so for now keep him as comfortable as possible and then see what the specialist says at the uni.

Hang in there.

[rea56]

Thx Judy and Molly's mum
Judy - the ref is great thx :) also great info on diet and supplements (all in one place - i have been all over gathering,gathering info - geeze)

Molly's mum - yeah - we do that don't we ? research - or at least i do, most of my friends whom are not the same with their pets - i think i am alittle too stressed and 'what the heck are you doing - leave it to the vet' - thing !

anyways - there is great support here, and that is very comforting, esp. becuase you 'girls' have been there, seen it or talk about it - all great for newbie to this whole new horrible world...

will keep every one posted - still don't have appointment at vet uni yet :mad: so am going to vet today and see what's up (even though i all ready did that yesterday !) - feels like they think we have plenty of time... well... isn't his liver in failure of some sort ?

deep breath - thx again

[rea56]

opps - sorry Sharlene (Molly's mum ) :p

[molly muffin]

:) :) that's okay I answer to either, sharlene, mollys mum, molly muffin, you name it. :)

My specialist actually likes it that I have done research and we can have a discussion that is more throwing ideas back and forth to do what is best for our molly. She tells me her thoughts and I tell her mine and that works for us. Nothing wrong with research in my book, as you and only you are the advocate for your furbaby.

[Squirt's Mom]

Dedicated cush parent = researching fool! :D

I think we all become obsessed with understanding what is happening to our babies...then during that process we learn there ARE ways we can help them...then there is MORE research! :p

Dedicated cush parent = researching fool! :D:p:D:p

[Harley PoMMom]

With the elevations in the ALT and AST I do believe there is something going on with his liver. Has the vet mentioned having a bile acid test done to check the function of the liver?

[rea56]

HI all, well finally we got an appointment for vet uni 9am monday ...
i rang them to ask some questions :) and they said they had him in for a 'full liver workup' but no ultrasound or ct scan :mad: geeze

anyways they are going to 'book' them in - so hope so, because the liver workup was just bloods! :eek:

one wonders what my vet surgery said :confused:

so, fingercrossed, we'll spend the day there on Monday, get some results, and see our vet on Tuesday (they were a bit surprised i wanted to stay - told me to go have coffee or something!)

hubbie is a bit freakie about the cost ($1250.00 for ct, $250 ultrasound - rest - unknown) payment on day

i just said we'll use the emergancy fund (luckily it is 'up' due to possible holiday forthcoming) thank heavens for my 'squirrel' fund...:)

do these costs sound similar to anyone? not that we wouldn't get them done, just surprised me a bit - i had an mri done on my back and it was only $500.00 but no anesthetic

anyways - Kaspar a bit 'sad' this morning, didn't even eat all his first breakkie chow but he did seem to have a better night , so maybe he's just tried...

hanging in there - research research research

from 6am in country nsw - australia :)
rea

[rea56]

Hi Harley, yeap i think they are doing that on monday - thx :)

[rea56]

hi again
has anyone had any experience/heard of Rick and Cindy at doglivershunt?
thx
rea

[labblab]

I really do not know the answer to this, so hopefully other folks will have thoughts to add. But I am just wondering about the need/benefit for doing both an ultrasound and a CT scan. Has your vet specifically advised you to have both types of imaging done? I am just wondering whether you mightn't be able to opt for the ultrasound first, and then only proceed to the CT if the experts there at the university think there would be an added benefit.

Also, did they say anything about a possible liver biopsy, or will that perhaps just depend on what the imaging shows...

Marianne

[Renee]

I opted for the CT in place of the ultrasound. I'm not sure I would do both (seems a bit of a waste), but if you have the funds -- I do believe the CT is a sharper, more precise tool, although some may argue it's not necessary. My vet and I have referred back to my pug's CT imaging more that once though. Given the choice over, I would still choose the CT.

[rea56]

Hi Renee and Marianne - thx

sorry - i think it should be just ct scan, as mentioned better than ultrasound and....

- we have had an ultrasound done at the vet surgery - small machine - couldn't see stuff clearly - but saw huge liver, and big black spot/thing in or near it??

i'll try to sort it on monday thx(they're not open today)

Biopsy was mentioned - so if ct shows something i am lead to believe biopsy will be done ... not sure though - seems to me 'everyone is a bit too laid back for me...!'

we live 1 1/2 hr from vet uni, so although not far in driving terms, a long way for Kaspar in car... he never travels well...

should i just request biopsy whilst he is there and being tested? less anesthetic the better is my thoughts - if need it do it then !

i know its invasive, but results could be worth it ?

geeze - there i go again... if/what/when/should/huh?
:)

[molly muffin]

I wouldn't do both, since you are thinking of a biopsy, i'd go with the ct, and forgo the ultrasound.

Find out if they are thinking of a biopsy if ct shows they need it and then find out about the after care for that too.

Nope, I don't know and have never heard of the liver website you mentioned. I think before going down any roads like that you should find out exactly what is going on medically with Kasper.

It seems to be that they are nutrition researchers meaning that they are not themselves in the field but they research other peoples research and have devised what they consider to be a diet plan/supplement for dogs with liver problems. I'd find out their credentials first and what makes them a specialist in this area.

I know! I am so leery of online things that I like to have backup information. I guess just we've seen too many using cushings as a get rich scheme and paid for testimonials that I am a skeptic first. I can be convinced but I like to know who I am dealing with. The university will also have nutrition dieticians that can devise a diet, if you want to do home cooking and supplements to support the liver. Many use that and there are some reputable ones online that we have some experience with. (there was just a thread about this actually). So, some possibilities, but first the testing to see whats what.

Hang in there!!! You are doing great, in what is not an easy situation.

[rea56]

Thx Molly's mum - sound advice:) re both ct/biopsy - and other

where does my reasoning go - that i get myself so confused?

geeze - never thought about after care of biopsy :(

anyways - i'll sit on it all until monday, and still research of course, and see what we end up with

tar
rea

[molly muffin]

Also, now I don't know, but I just read on another thread, that there are 4 types of liver biopsy possibilities, so I guess you would also want to find out exactly How they plan to do the biopsy, and what it entails. (along with the after care option)

it's okay, not even surprising to confuse yourself. Emotions all over the place, worried, too much information and too little information. Nothing is ever simple it seems, so you just focus on what you know, what you need to know and how to get there. Baby steps.

[rea56]

Hi All
thanks for your help and support
we put Kaspar to sleep at home Monday 5.20pm
:(
my big baby fluffy of 10 yrs is now in no pain,and runs free with Kramar, Kozie and Missy

loved forever, never forgotten , hugs in my heart
xx
rea
heartbroken in oz

[judymaggie]

Rea -- I am so sorry for your loss. Hopefully, the memories of all your good times with Kaspar will help you through this difficult time. Run free, sweet Kaspar!

[Harley PoMMom]

Oh Rea,

I am so terribly sorry for your loss of dear Kaspar, and my heart goes out to you. Please know we are here for you and understand your pain at this most difficult time.

His name has now been added to our special memorial thread of honor -- always to be remembered and always to be treasured.

With Heartfelt Sympathy, Lori

[molly muffin]

oh no Rea. I am so sorry. He was a big beautiful, fluffy boy. I know your heart is broken. :(

My sincerest condolences to you and your family.

[doxiesrock912]

Rea, my sincere condolences on your loss of Kasper. He'll meet many others on the other side of the bridge. His avatar picture is gorgeous! All of that fur!

[mytil]

Oh Rea, I am so very sorry for your loss of sweet Kaspar. My heart is with you.

Always in loving memory of your big beautiful fluffy boy.
Terry

[Dixie'sMom]

I am so sorry for your loss. Kasper is so beautiful and now he is healthy and running free at the bridge. You'll see your beautiful boy again one day. Until then, I will be praying for comfort and peace for you and your family.

[pansywags]

Rea, I am so sorry to hear you had to say goodbye to your beautiful Kaspar. So many of us here share your grief. Please know that you are in my thoughts.