Raw green tripe?

[Ray]

Hi,
I hope someone can help with my query. My dog is being tested for Cushing's but is not diagnosed yet. He is mostly raw fed. Is raw green tripe a no-no? I'm reading conflicting advice online. He has raised liver enzymes so I have reduced the fattier content of his diet replacing it with more white fish and chicken but he is still having the raw green tripe that he loves. If anyone has advice/experience of tripe and dogs with Cushing's it would be most appreciated as I'm really confused at the moment. TIA

[Squirt's Mom]

Hi and welcome to you and your baby!

The key with diet and Cushing's is LOW FAT. Nothing else really matters but that is critical because our cush babies are prone to pancreatitis which can be fatal...and fats feed pancreatic flares so low fat is critical for our babies. What you need to know then is the fat content of not only the tripe but it along with everything your baby eats. Fat content for our babies needs to be somewhere around 10-15% if my memory holds.

Can you tell us about your baby? What prompted the cush testing in the first place? What tests have been done? Which are planned? It will help a great deal if you will get copies of the actual test results, not the invoice, and post those results here. That will help us help you. Also, the more you can tell us about your baby the better. All his health history, any meds he is on, etc.

I'm glad you found us and look forward to learning more soon!
Hugs,
Leslie and the gang

[flynnandian]

i have always fed my cushing dogs raw green tripe. i don't know if you feed the tripe in big pieces or minced out of commercial frozen rolls?
when you cut the tripe yourself, throw away the white fatty parts and just feed the green stuff.
it is very healthy food. lots of probiotics etc.
white fish and lean chicken or turkey are ok too.
but don't forget to feed bones and organs too to complete the raw diet.
[or a calcium powder and added vitamins.]
all my dogs are raw fed from day one till they die.

[Ray]

Thank you both for your replies, much appreciated.
I don't have the actual tests results here but will try to explain what's been happening.
10yr old gsd/husky cross commenced on Rimadyl about 6 months ago for arthritis in his knee (cruciate surgery nearly 2yrs ago).
After 3 months liver/kidney function test showed ALT had risen to 215. Rimadyl was stopped, retest showed ALT was now 258. Hepatosyl Plus commenced, retest & bile acid study followed. Results showed ALT now 1387, ALP & GGT now also affected. T4/TSH normal, urine showed 2+ protein, specific gravity ok (1.042 I think she said). It was decided to test for Leptospirosis, more so to rule it out. Results were negative but lab (IDEXX) reported high levels of red blood cells in the urine. After vet/IDEXX consulted on this it was decided to repeat urine test. In-house test was fine & lab test showed no blood in urine so the original high red blood cell result was put down to a testing error. Clotting results ok.
Abdominal ultrasound showed the liver was enlarged & darker in colour, no obvious abnormality to pancreas or gall bladder detected.
Liver biopsy discussed but vet decided to carry out endocrine testing prior to surgery. Urine creatinine/cortisol ratio affected (sorry don't have levels here) so we are now booked for ACTH stimulation tests on Thursday.
Over last few months dog has had an increased appetite but has lost weight & muscle, looks skinny now. He does not have the pot belly, is not drinking excessively but he is panting a lot, especially at night. When the raised liver enzymes were detected I reduced the fat content in his diet replacing most of the fatty meat & fish with white fish & more chicken, eggs & cottage cheese. He still has raw green tripe, both minced & chunks (pre frozen). I used to feed two meals per day that consisted of raw meat & bone, small amount of veg & grain free kibble. He now has 3/4 small meals per day & very little kibble. Flynnandian I'm concerned about giving too much organ meat due to his liver problem & the fat content. Am I being overcautious here?
After consultation with the vet he has been started on codeine for the arthritis as we felt it wasn't fair to withhold pain relief at this point.

Sorry if that reads a bit confusing, hope it makes sense.

[Squirt's Mom]

With those liver values, Cushing's would be the last thing I would be pursuing. I would be wanting to know what was wrong with that liver! Elevations in the ALP are very common in cush pups, up to the 1000s+ often but elevations that high in the ALT with the GGT and AST rising as well are alarming to me.

[flynnandian]

if you feed your dog mainly BARF, you have to feed ""the complete animal" raw meat, organs, bones etc. some extra veggies are ok.
http://www.aplaceforpaws.com/blog/raw-food-liver-disease-dogs
like leslie said; those liver numbers don't sound like cushing's disease to me too.
i hope the vet and you are able to find out what is really wrong with your dog.

[Ray]

I know, the blood results are very alarming hence the need to do a liver biopsy. In ruling out other conditions we have this creatinine/cortisol urine result that is pointing to Cushing's so we have to pursue it before surgery.
Thanks for your advice. ACTH tests are being done on Thursday (earliest appointments I could get!). I will let you know either way

[molly muffin]

The thing is that if there is something else going on, such as with the liver, then the cortisol is likely to raised. It is the body's natural response when it doesn't feel good. So, a high creatinine/cortisol wouldn't be surprising, nor would a high ACTH. That wouldn't necessarily mean that it is cushings though, it could mean that his body is self medicating to feel better.

Cushings is Very hard to diagnose when anything else is going on especially.

[Ray]

Thank you molly muffin. That has set me thinking.
So if the ACTH indicates Cushing's will he then need the dexamethasone suppression test also? Would the two different tests be needed for them to diagnose Cushing's & begin treatment?
I'm just trying to get it all straight in my head before the next round of tests! I think the vet would prefer to do the laparoscopic procedure for the liver biopsy. She told me they don't always get a conclusive answer from a biopsy done by fine needle aspirate as it's such a small amount of tissue they recover.
I know we have to carry on testing to rule out Cushing's but I feel like we are putting him through a lot & might still end up needing to do the biopsy.
Feeling frustrated, seems to be taking forever to get a diagnosis. I do realise though that if it is more sinister than Cushing's his prognosis is very poor so I suppose the delay in the biopsy probably isn't that significant?

[Squirt's Mom]

My Squirt tested positive for PDH, the pituitary form of Cushing's, based on five tests - LDDS, HDDS, ACTH, UTK panel, and abdominal ultrasounds (2). After the second US I was told about a tumor on her spleen. Once that tumor and half her spleen were removed, her cortisol returned to normal and remained that way for several years.

The tests were ALL false-positives due to the stress that tumor was causing her system. Elevated cortisol is the *normal* reaction to any stressor, internal or external. A dog who is terrified of going to the vet will register with elevated cortisol simply from the stress of the vet visit - however it is not Cushing's causing the elevation but rather a natural response.

If I were you, I would pursue the liver and forget about Cushing's until everything else has been ruled out...and with those liver values a solid look at that organ would be paramount to me. ;) Diagnosing Cushing's is as much a process of ruling out other causes for the elevated cortisol as it is testing specifically for cortisol.

[Ray]

Thank you Squirt's Mom, I appreciate your advice :)
I think I will try to get a consultation at the vets before Thursday when he is having his ACTH.

[molly muffin]

What about a liver function testing. Is ther anything they could do,with that?

[Ray]

He's had several molly muffin that's where all this started (he was on Rimadyl for arthritis in his knee so periodic LFT's were carried out).
I'm going to discuss things with the vet tomorrow before the ACTH, have already told them I'm not sure I wish to proceed. We may just do repeat LFT's & see where we go from there.
I wish we hadn't done the creatinine/cortisol urine test now (advice from the lab Idexx) & had just opted for the biopsy. We might've had a diagnosis now.

[molly muffin]

How are things going? did you decide on a next step?
Rimadyl can be hard on the liver too, so that might have affected the LFT's too.

[Ray]

Hi molly muffin, well the vet convinced me we needed to rule out Cushing's before the biopsy so he had the ACTH test & repeat LFT's on Thursday, just waiting for the results now.
I wasn't keen on him being on Rimadyl & actually it didn't seem to do that much for his arthritis (it was well out of his system though when the liver enzymes rose drastically). He's now on Codeine - not sure about that either but he has to have something. His poor knee is quite arthritic & he is showing signs of arthritis in his lower spine & elbows. Having said that he still loves his walks & likes a bit of daft play, bless him.
Will post the results when we get them :)

[molly muffin]

We'll be watching for the results.

[Ray]

Well as expected really the ACTH simulation test did not indicate Cushing's.
We were encouraged by his liver function results, both ALT & ALP showing some improvement:) He is to stay on Hepatosyl (& codeine for his arthritis) & have a full blood panel done in two months unless he is poorly in the meantime of course. We have decided not to proceed with the laparascopic liver biopsy & investigative surgery as we are agreed that it may not be in his best interests. We are all enjoying a bit of normal life at the moment with (hopefully) no vet visits for a good while!
Thank you guys for responding to my posts & offering advice. Much appreciated! :)

[molly muffin]

Definitely enjoy the normalcy. :) It's precious. LOL

Glad to hear the liver is responding well.

I know my IMS has mentioned we could do a liver biopsy on my dog but she isn't keen on it and neither am I, so we aren't going to do one either.

Let us know how things are going. and Yay no cushings!!!

[Ray]

Thank you, yes it is lovely to have that window of normality! :)
Hope Molly is doing ok, enjoy your little furry friend :)