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Mugsy
08-06-2016, 12:45 PM
Mugsy is a 9 year old lhaso apso. Some hip problems with pain. Brought him to vet 7/20 and went home with the NSAID Carprofen. 4 days later would not eat. Then 24 hours no pooh. Change in behavior evident lethargic etc. Took him to emergency clinic Sunday. Did xray, blood tests etc. Found elevated levels indicative of diabetes but not foundational to symptons. Thought obstruction but found none in xray yet could not be ruled out. Plan the vet told me was stay overnight and prepare for surgery to obstruction. Plan was 4500.00. At that point a host of questions developed i took him home. Tuesday i brought him back to same place. This time after testing they are focusing on pancreatitis and gastritus. At this point I quietly thought these are symptons and not the cause. But he needed fluids and rest as he had not eatin in 3 days. He does still drink water. So this plan was to stay for plan b IV fluids and meds. Meds are metronidazole 250 1/2 2 times a day, clavamox 125mg every 12 hours, Cerenia vomiting, Famotidine, carafate, mirtazipine.

The rotated vet who arrived at 6 am called me at 8 am stating concern Mugsy, who we brought in at 130 am, wasnt eating yet. He recommended ultrasound not a part of our quote for 410.00. I agreed since that was not done yet. Our quote was for 48 hours of iv meds fluid another blood test for 1200.00. There was the low range and a high range was 1900 but that included additional xrays and other procedure which we denied since the were just done 36 hours earlier and not benchmark worthy in my opinion.

That brings us to 30 hours after placement in his 48 hours stay. The clinic called and said the high quote was exceeded by 23.00 already. I questioned as to why? The low quote being 1200 adding the ultra sound at 410.00 would put us at 1610 still leaving 300.00. In addition since we have not reached the final 16 hours of clinical stay or about another 400.oo we are about 700 over quote. Needless to say i picked him up about 12 hours short of 48 hours and paid over high range. I share this not to complain so much to say be prepared. I dont like the alot of what occurred but fully understand how complicated endocrine disagnosis may become.

Now Mugsy course of treatment will be in my hands while not closing the door on any of these providers just in case. I did not leave in bad terms with them. I paid!

Mugsy did come home and ran right to his bowl to eat. First time in 5 days. His first movement started tarry but finished normal and healthy looking. The oral meds he now takes are clearly not as good as the iv. He has what i describe as an oragutan butt quite swollen red and bothering him. Likely due to diarihea. When he farts he runs. Probably sore but with his hair cut maybe a noise he is unfamilar with. I went to primary vet and he gave him Quadritrop and applied it twice didnt seem to relief him. May have hightened swelling. After researchin Quad indications are should not be used as it is a steriod application and will wait until cushings is determined. Cushings is a steroid over production disease. Now applying zinc free A & D it does appear to be helping. Also could be high cortison levels associated to cushings. The ultrasound does have an indication of attachments on the adgland at kidney.

We are balancing the desire to give mugsy a couple more years with not offending vets knowledge and paradigms (of course cost are important too). The track we are on includes vets guidance reccomendations and testing. The next step is to stabilize him and do more bloodtest on Monday. After that within a week do the tests to determine cushings.

I have all the records including xray and ultrasounds. Cushing is not easy to diagnose as the sympton could be many conditions. As in mugsy case they wanted to go to surgery for an obstruction and if i had the money probably would. Let me ad it is still possible carprofen contributed to the amplified symptons of whatever maybe the underlining issue. Obstruction has very likely been ruled out so surgery would have been hopeful but painful when proven unneccassary relating to obstruction potential.

Thanks for reading and if approved maybe I could post all his records here. Let me add after i took him to the vet on sunday and they told me surgery for 4500.00 i dug a hole in the back yard and as of now it was only filled with tears. Hopefully it stays that way for a few more years!

Because I am big fingervon a smart phone i will edit this for spelling and content confusion.

judymaggie
08-06-2016, 06:40 PM
Hi and welcome to you and Mugsy! It sounds like both of you have had a rough couple of weeks. We will do our best to help you as you try to figure out what is going on with Mugsy.

It would help if you could tell us the symptoms that Mugsy has been exhibiting that has led you (and/or your vet) to think that Mugsy has Cushing's. With regard to all the tests that Mugsy has had, 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. Was an urinalysis done and what were those findings? Please also provide the wording of the results on the ultrasound. You mentioned something about the kidneys but I didn't understand what you meant.

Others will be along with more insight (and probably more questions :D).

Squirt's Mom
08-07-2016, 08:52 AM
Hi and welcome to you and Mugsy!

From best I can tell, your sweet baby has several things going on along with suspected Cushing's. Here is one very important factor to keep in mind when considering testing for Cushing's tomorrow - cortisol, which is the enemy in Cushing's, will rise NATURALLY in response to any stress, internal or external. The tests for Cushing's can tell us if the cortisol is elevated but not why. This helps make Cushing's one of, if not THE, most difficult canine conditions to diagnose and why several tests are usually better than one to make that determination. The diagnostic phase is as much a process of ruling out other causes for the elevation in cortisol as it is anything. So with this in mind, I would hold off on any testing for Cushing's until the diarrhea, stress from the apparent obstruction (?), and any other issues he is currently dealing with are behind him.

As Judy requested, it would help us a great deal if you would post the abnormal values on the lab work he has had done so far, including all the comments on the ultrasound. Just the abnormal values - too high and too low - are all we need to see from the lab work.

To help keep you busy this morning so you aren't thinking too much, let's take that shovel and fill that hole in backyard up again, ok? Plant a bush or something in it. Let's set our minds on finding out what's going on with your sweet boy then helping him feel better before we even start to think of needing holes. ;)

Hugs,
Leslie and the gang