Lou, 5 year old Jack Russell Mix, SoCal

[CushyLou]

Hi friends,

Wednesday I took Lou in for a heartworm check, and shared what I thought were separation anxiety symptoms. My husband is recently deployed, and my mom is staying with me to help with my toddler. I thought he was acting odd with my mom pining over the baby. We had a blood panel and urine run on him after the vet asked the perfect storm of eyebrow raising questions.

Symptoms: peeing in the house, slowly increasing duration of panting, crazy appetite, wiping out his water dish

Friday I received the following abnormalities in his labs to suggest Cushing's:

High albumin at 4.5
Low ALT at 5
Very high Alk Phosphatase at 330
High BUN:Cretinine ratio at 36
High magnesium at 2.6
Very high triglyceride at 1628
High MCH at 28.5
Low specific gravity of urine

Today was his 8 hour low dex test....I plan to hear in 1 to 2 days.

My concern is his rapid symptoms as far as from Friday to last night, he's panting constantly and laying alone on the floor. He's also snapped at my daughter and his fur sister, in which neither were provoked. :confused:

Edit: He is now 29 lbs, the most he's ever been.

[LauraA]

Hi Cushy Lou, sorry to hear about your boy. My girl had a rapid onset of symptoms as well which is not usually the norm. She had a bout of pancreatitis (which Cush dogs are prone as I found out). Within 24 hours of stopping the antibiotics she was was a mess. She was panting, wetting herself, starving - all the classic Cushing symptoms in fact. Over the weeks she lost any control of her bladder. It was such a sudden decline we really thought her time was up. Once we got through all the testing and got a diagnosis she started Vetoryl and hasn't looked back. It made a huge difference for her. In hindsight we can now see she had some early signs of Cushing some 18 months before but we just put it down to old age and tests at that stage didn't show anything unusual.

Hang in there, and once you get those test results of the Low Dex test post them here and the members will help give you some direction as what to do next.

[CushyLou]

His test wasn't even 24 hours ago and I got the call this a.m. that it is pituitary Cushings. I don't have the numbers, but will make a trip soon to grab them. He's 29 lbs and will be on Vetoryl 30mg once a day. We talked about side effects, when to call, and when/where ER visit is warranted.

Our vet encouraged me to call around to Costco, WalMart, etc, and if I shop online to be sure it is Vet Vipps certified. We are not Wal-Mart supporters, so online it is! Valleyvet.com was 51.00 vs. Costco at 73, and 1800petmeds in the 90s. That's so much money saved. I hope he doesn't have adverse effects when we start him, it should be a week before I receive them.

[Harley PoMMom]

Hi and welcome to you and Lou!

Cushing's symptoms do not come on suddenly. Cushing's is a slow progressing disease, some dogs go undiagnosed for years and since the majority of dog's with Cushing's are senior the symptoms associated with it are usually attributed to old age.

For those values you listed could you edit your post and add the reference ranges and their units of measurement, thanks!

Cushing's is one the most difficult diseases to get a confirmed diagnosis for, and unfortunately it is often misdiagnosed. There are other conditions that have overlapping symptoms with Cushing's, such as hypothyroidism and diabetes. Did your vet rule these out? Is Lou taking any other herbs/supplements/medications? Was an urinalysis done, and if so, could you post those findings too?

Another challenging aspect of Cushing's is that there is no test that is 100% accurate in identifying the disease, and that is why symptoms are a huge part of a diagnosis for Cushing's. The symptoms that are commonly seen in a dog with Cushing's are: excessive drinking and peeing, I mean peeing rivers and drinking buckets upon buckets of water; voracious appetite, they are like little hoover vacuum cleaners looking for any crumb they can find; panting; loss or thinning of coat; skin issues; muscle wasting; muscle weakness, especially in the hind quarters; exercise intolerant; difficulty or unable to go up steps or jump on furniture.

As for the dose of Vetoryl, Dechra, the makers of Vetoryl, have since revised their starting dosing protocol and now recommend that treatment should be initiated at 1 mg per pound of a dog's weight. Here's the link to where this information can be found: http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf.

The key to successful treatment is an experienced vet and an educated pet owner. Adverse side effects are usually only seen when the proper protocols are not being followed.

We have a wealth of information regarding Cushing's in our Resource thread, which does include articles written by some of the most renown veterinarians that specialize in endocrinology such as David Bruyette, Mark Peterson, and Edward Feldman. Here's a link to our Resource thread: Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10) Please know we will help in any way we can, and do not hesitate to ask all the questions you want.

Hugs, Lori

[CushyLou]

Hello again, I finally got a hold of the initial test results to get us into the 8 hour test. Here is the follow up!


Superchem Panel

Test/Result/Normal Range Values

Total Protein 7.2 5.0-7.4 g/dL
Albumin 4.5HIGH 2.7-4.4 g/dL
Globulin 2.7 1.6-3.6 g/dL A/G Ratio 1.7 0.8-2.0
AST (SGOT) 36 15-66 IU/L
ALT (SGPT) 5LOW 12-118 IU/L
(Result Verified)
Alk Phosphatase 330HIGH 5-131 IU/L
GGT 2 1-12 IU/L
Total Bilirubin 0.2 0.1-0.3 mg/dL
BUN 18 6-31 mg/dL
Creatinine 0.5 0.5-1.6 mg/dL
BUN/Creatinine Ratio 36HIGH 4-27
Phosphorus 4.3 2.5-6.0 mg/dL
Glucose 96 70-138 mg/dL
Calcium 10.8 8.9-11.4 mg/dL
Magnesium 2.6HIGH 1.5-2.5 mEq/L
Sodium 145 139-154 mEq/L
Potassium 4.7 3.6-5.5 mEq/L
Na/K Ratio 31 27-38
Chloride 110 102-120 mEq/L
Cholesterol 274 92-324 mg/dL
Triglyceride 1628HIGH 29-291 mg/dL
(Result Verified)
Amylase 549 290-1125 IU/L
Lipase 198 77-695 IU/L
CPK 146 59-895 IU/L

CBC

Test/Result/Normal Range Values

WBC 12.1 4.0-15.5 103/mL
RBC 6.6 4.8-9.3 106/mL
HGB 18.8 12.1-20.3 g/dL
HCT 50 36-60 % MCV 76 58-79 fL
MCH 28.5HIGH 19-28 pg
MCHC 38 30-38 g/dL
Platelet Count 353 170-400 103/mL
Platelet Est Adequate
Neutrophils 62 60-77 %
Bands 0 0-3 %
Lymphocytes 26 12-30 %
Monocytes 6 3-10 %
Eosinophils 5 2-10 %
Basophils 1 0-1 %
Absolute Neutrophils 7502 2060-10600 /mL
Absolute Lymphocytes 3146 690-4500 /mL
Absolute Monocytes 726 0-840 /mL
Absolute Eosinophils 605 0-1200 /mL
Absolute Basophils 121 0-150 /mL
Total T4
T4 1.6 0.8-3.5 mg/dL
Free T4 (Equilibrium Dialysis)
Free T4 Equilibrium Dialysis 15.1 8-40 pmol/L
Add-On Urinalysis
Collection Method
Cystocentesis
Color Yellow
Appearance Cloudy
Specific Gravity 1.014LOW 1.015-1.050 pH 7 5.5-7.0
Protein Negative
Glucose-Strip Negative
Ketones Negative
Bilirubin Negative
Occult Blood 1+
WBC None
RBC 4-10
Casts/LPF None Seen
Crystals None Seen
Bacteria None Seen
Squamous Epithelia 0-1

He was followed up with the 8 hour test.....5 days later.

Cortisol Serial 3 (DEX)

Time 1 0H

Time 2 4H

Time 3 8H

Cortisol Sample 1 2.4 1.0-5.0 mg/dL

Cortisol Sample 2 Dex 1.2 0.0-1.4 mg/dL

Cortisol Sample 3 Dex 2HIGH 0.0-1.4 mg/dL

He is 29 lbs and started Vetoryl 30 mg this morning. He will get his 3 week follow up test to see how it's treating his system.