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brittneylbell
08-28-2016, 12:58 PM
Tinker Bell
11 years old, female, Yorkshire terrier mix
Weight: 7.6-8 lbs

Thank you for allowing us to be a part of this site.
Her CPK number has been trending up since May of this year. Tinker Bell despite lab work has overall been healthy until recently.

Significant History:

May 2014
It was found May 2nd 2014 that her liver enzymes were elevated. Prior to this they were known to be within the normal range. She had an ultrasound and bile acid studies at this time. Both were negative. Since that time we have followed lab work every few months, closely monitoring for changes but labs have been about the same. At this time she was put on Hills L/D and denamarin.
She had lab work done at this time prior to a dental cleaning. We did have her teeth cleaned in August 2014 and she coughed for about 2 months after being intubated for this.

March 2016
In the beginning of March of 2016, it was noticed that she lifted her left front arm when running. She was also collapsing when walking around and losing traction inside on hardwood floors. We took her to see a holistic vet. It was thought that she had a muscle injury. We began physical therapy and laser treatments and she improved greatly. We are still doing daily physical therapy. She now walks about 2 miles per day and swims every evening. She appears to us to be stronger and is now running occasionally during her walk time.

May 2016
May 10th 2016, she became acutely ill with pancreatitis. In the weeks leading up to this, her appetite slowed. We consulted a nutritionist who formulated a diet with low fat and low protein, she ate this specific diet for one day before becoming very ill. She received 3 days of IV antibiotics and was sent home on 10 days of oral metronidazole.

August 2016
Her appetite again has slowed. Friday evening, August 5th she pooped. The poop was a normal color and consistency, but we noticed a few tiny bright red blood specks around her tail area afterward. We took her to the vet the next morning, Saturday August 6th and she was put on another 10 day course of metronidazole to treat possible colitis which she is currently on now. She has had no further abnormal poops. The doctor also noted that her anal glands were full and expressed those.

Monday August 8th she did not eat (she later decided to eat when we got back home), so we called and took her in to be seen. Lab work was rechecked at this time. We had planned to check labs in 2-3 weeks anyhow but would not have taken her in had she eaten breakfast. I received the results Tuesday August 9th, her CPK is trending upward to 3200. We are really surprised that this is the case based on what we are seeing during her physical therapy and her increasing tolerance for exercise.

Thursday August 11th- she was seen by internal medicine and Neurology at the university vet hospital. She tested negative for Protozoa, myasthenia gravis, masticatory myositis, received X-rays and another ultrasound. The only new finding was sludging in the gallbladder and she was started on a month of clindamycin. The decision was made to retest labs and check a few other things.

Wednesday August 25th- we rechecked a chemistry at the university and her CPK was 2300. ANA was negative, urine myoglobin was negative. No diagnosis. Neurology and internal medicine told us that she was a mystery.

Food:
As of May 2016 Royal canin low fat GI dry, Hill's i/d low fat canned (just picked this up to try on 8/9/16)
We have to heat, fan, dry, wet, play games, and guess what texture she wants each meal.

From May 2014 - May 2016, she was eating Hills L/D dry. She was never a picky eater until she started on this diet.

December 2012-May 2014- she was eating purina pro plan

Prior to this she was eating nutro lamb and rice and she was a good eater.

Medications: VSL #3- 1/2 capsule daily, denamarin tablet once daily, clindamycin for one month

Activity/Mobility: She walks 1 mile in the AM, 1 mile PM. She swims in the tub most evenings. We allow her to walk up the stairs. She does not struggle with activities. She does have some frontal (and overall) muscle atrophy. Her back legs bow in, her front legs angle out. This is not new for her. She does occasionally do what we call "peg-leg" her left front leg when walking. She walks strong, does not fall, does not collapse now (see below under March 2016).
During the day while we are working, she mostly sleeps. We watch her on a camera.

Squirt's Mom
08-28-2016, 01:20 PM
MODERATOR NOTE: Your post has been manually approved so that members can start responding to you. Please check your email, possibly your spam / junk folder, for a message from k9cushings. You will need to reply to that email so that your post go directly to the board and are not delayed waiting for approval. If you have already received and responded to the confirmatory email, please be patient. Your registration will be finalized shortly.

I also moved your post to the Discussion section from the How To section - this is where members talk about their babies. ;) In addition, I deleted the duplicate post.

Glad to have you join us from the Facebook group! I am Leslie Hays Richards on FB and you will find Glynda, who sent you to K9C, under the user name of lulusmom here at K9C.

Thanks and welcome!

Harley PoMMom
08-28-2016, 03:38 PM
Hi and welcome to you and Tinker Bell!

I have manually approved your membership so now all your posts will be seen right away. Also, please just disregard the validation email that was sent to you from k9cushings. ;)

I am sorry that you and your sweet girl are going through this troubling time with worrisome creatine kinase levels. You have definitely left no stones unturned and I commend your diligence in pursuing a diagnosis for your dear girl.

Muscle injury is one common reason for elevated creatine kinase levels however it looks like this has been ruled out. Sometimes acute pancreatitis can cause an increased activity level in the creatine kinase, has she recovered from her pancreatitis episode? The only other medical reasons that I can think of that would cause high creatine kinase levels are a heart issue or an endocrine disorder such as hypothyroidism or Cushing's.

I agree with the IMS in that Tinker Bell's case sure is a mystery and I do hope you find the answer that will help your precious girl.

Hugs, Lori

lulusmom
08-28-2016, 11:10 PM
Hi Brittany and welcome to you and Tinker Bell.

I'm super glad you joined us and I apologize that you had trouble posting labs here. I've saved all of them from the fb group and have attached them below. For our members here, I'd just like to say that based on the information Brittany has shared with me and others on facebook, I personally don't see anything that convinces me that Tinker Bell has cushing's. Some facebookers suggested a full thyroid panel and full UTK adrenal panel but I disagree as neither symptoms nor labs are indicative of cushing's or low thyroid. Internal medicine specialist and neurologist don't know what is causing the high CPK. Tinker Bell is currently on denamarin for the mild elevation in ALT and AST.

I am sure others will be by to share their experience and opinions.

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Allison
09-02-2016, 06:11 PM
Brittany, hi.

Welcome to the forum! I admire your diligence and attention to detail in documenting Tinker Bell's health issues. Pancreatisis isn't fun, nor are mystery ailments. We're going through the latter right now with our poodle. I'm sorry that I don't have any answers for you, but hope someone here in the Cushings community can help.