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joeyisboss
12-29-2015, 07:52 PM
Hello. I am currently fostering a 10.5 lb dog named Joey. I believe he is a mix of chihuahua, beagle and pug. I estimate his age at 12-14 years. This is all a guess, of course.

Joey has been with me for about 8 months. He is fixed but he marks. He is mostly mellow but will have sudden episodes of aggression, usually directed at another dog, mostly my large male goldendoodle. He sometimes bites but he has very few teeth so the large dog usually doesn't notice. We call these episodes his "get off my lawn" moments.

Recently I have started noticing that he is drinking more water, going to the water bowl as much as 2 or 3 times an hour and often emptying the small dog water bowl. He also has started begging for a 3rd meal before bedtime, on top of the 2 meals he typically eats per day. He does have a pot belly and he does show weakness in his rear legs, often having difficulty jumping on the furniture. When we go for walks he rides in the dog stroller with my hospice dog (right left pda heart defect, yes, I am a magnet for dogs with rare medical conditions). He loves to go for a stroll.

When I found several large (bigger than my thumb) bald spots on his back I took him to the vet. The vet found that his last blood work, done last February when he had 19 teeth removed, showed slightly elevated cortisol. We did another full panel of blood work which came back totally normal, including the cortisol! The vet believes that this plus his symptoms points to atypical Cushings. The diagnostic test for this will cost $500. That is with the rescue discount; I live in a very high cost of living area.

As an alternative to the test, the vet would like me to start Joey on 40-100 mg of flax seed hull lignans and 3 mg of melatonin per day. Then observe for 6 weeks and see if symptoms improve.

I am meeting with the members of the rescue this weekend who make decisions about medical expenses to discuss how to proceed. Can anybody share advice/experience/recommendations with the diagnostic tests and advise whether it is best to do the tests immediately or try the supplements?

Either way, Joey's status will be changed to "medical needs" and he will stay with me. Which he probably would have anyway as dogs that mark and bite are not generally considered desirable by potential adopters.

Harley PoMMom
12-30-2015, 12:59 AM
Hi and welcome to you and Joey!

Bless you for taking Joey into your loving care and giving him a forever home.

If you could get copies of all the tests that were done on Joey and post those abnormal values here that would be a great help to us. With respect to the blood chemistry and complete blood count (CBC), you need only post the highs and lows and please include the normal reference ranges. It sounds like an ACTH stimulation test was performed on Joey to check his cortisol level, and we would love to see those results too. Were other non-adrenal illnesses ruled out such as diabetes and any thyroid problem? Does Joey have diluted urine along with a low specific gravity? Does Joey have any underlying illness that he is taking medication for, and if so, what is it and what is the medication?

Melatonin along with lignans are the preferred treatment for Atypical Cushing's. The Melatonin should be just the plain stuff, not rapid release or extended release. And there are two different kinds of lignans that are recommended: one is Flax hull (SDG) lignans; and the other is lignan that is derived from the Norwegian Spruce tree (HMR lignan). You can find all this information in our Resource sub-forum with this link: http://www.k9cushings.com/forum/showthread.php?t=198

As you mentioned the test used to diagnose Atypical Cushing's is expensive so if Joey were my dog I would try the lignans and melatonin first, however it does take at least 6 months to see improvement with this type of treatment.

I sorry for the reasons that brought you here but glad you found us and we will help in any way we can.

Hugs, Lori

joeyisboss
12-30-2015, 05:51 PM
Thanks for your reply. I called the vet and got the results of the blood work that was done on Monday. The results are as follows:

Total Protein 6.6 (5.0-7.4) g/dl
Albumin 4.0 (2.7-4.4) g/dl
Globulin 2.6 (1.6-3.6) g/dl
A/G Ratio 1.5 (0.8-2.0)
AST (SGOT) 37 (15-66) IU/L
ALT (SGPT) 47 (12-118) IU/L
Alk Phoshpatase 64 (5-131) IU/L
GGT 8 (1-12) IU/L
Total Bilrubin 0.1 (0.1-0.3) mg/dL
BUN 13 (6-31) mg/dL
Creatinine 0.6 (0.5-1.6) mg/dL
BUN/Creatinine ratio 22 (4-27)
Phosphorous 4.3 (2.5-6.0) mg/dL
Glucose 102 (70-138) mg/dL
Calcium 9.5 (3.9-11.4) mg/dL
Magnesium 2.1 (1.5-2.5) mEq/L
Sodium 148 (139-154) mEq/L
Potassium 4.9 (3.6-5.5) mEq/L
Na/K Ratio 30 (27-38
Chloride 113 (102-120) mEq/L
Cholesterol 151 (92-324) mg/dL
Triglyceride 81 (29-291) mg/dL
Amyiase 995 (290-1125) IU/L
PrecisionPSL 39 (24-140 U/L
Comment: Pancreatis is unlikely, but a normal PrecisionPSL result does not completely exclude pancreatitis as a cause for gastrointestinal signs
CPK 370 (59-395) IU/L
Comment: Hemolysis 2+ No significant interference
WBC 11.5 (4.0-15.5) 103/ul
RBC 7.1 (4.8-9.3) 106/uL
HGB 16.7 (12.1-20.3) g/cL
HCT 51 (36-60) %
MCH 23.7 (19-28) pg
MCV 73 (58-79) fL
MCHC 33 (30-38) g/dL
Platelet Count 575(HIGH) (170-400) 105/ul
Platelet Est Increased
Differential Absolute %
Neutrophils 7130 62 (2060-10600) /ul
Bands 0
Lymphocytes 2530 22 (690-4500) /ul
Monocystes(HIGH) 1495 13 (0-840) /ul
Eosinophils 345 3 (0-1200) /ul
Basophils 0 0 (0-150) /ul

Add-on Total T4 0.9 (0.8-3.5) ug/dL
Comment: The Total T4 is less than 1.0 mcg/dl A Free-T4 by equilibrium dialysis may be helpful in supporting the diagnosis of hypothyroidism in patients demonstrating clinical signs compatible with hypothyroidism. Please use test code 7589 for this additional testing.

When I spoke to the vet he stated that these results ruled out diabets, cancer and liver failure. He did not mention thyroid. Unfortunately I had to leave a meeting to take his call so my time was limited.

I do not believe Joey's urine is dilute. He marks and when I clean up with a paper towel his urine appears to be a normal yellow color.

He does not have any illnesses or take any meds. He did get in the middle of a fight that a visiting former foster dog started with one of my cats and sustained several cat scratch wounds so he did receive a shot of antibiotics to prevent infection at the same time his blood was drawn.

Thanks again for looking at this. I am interested in any feedback you or anybody else can provide.

Julie

joeyisboss
12-30-2015, 06:02 PM
This is Joey:

https://lh3.googleusercontent.com/-VF05UoMB0EA/VoRURZzyOMI/AAAAAAAAdp4/k0TwnzxE9UE/s426/20150514_133848.jpg

molly muffin
12-30-2015, 07:45 PM
Hello and welcome. Awww, Joey is cutie.

The blood work actually looks very good, and with the only thing high being the platlets and moncystes, which actually could have been a bit high due to the cat scratches, it sounds like he is in good shape. You might want to just have the thyroid looked at a bit more due to his behavior but that certainly could be due to sex hormones, which the lignans and flax seed would treat.

I ordered mine from Lignans For Life http://www.lignans.net/ You can also get them from amazon for example.

It wouldn't hurt to give them a go, and see how he does, re-evaluate as the vet said.