mydogsmom
04-01-2017, 03:22 AM
I have a 12 yr old golden retriever named Harriet who was first diagnosed with kidney leaking protein and hypothyroidism in August. Started treating with Soloxine, 6 mg for hypothyroidism and Benazepril 5 mg for kidneys. I kept remarking about her trembling and panting. At first vet though trembling was from the Soloxine but kept up when off it for a day or so. Trembling was never resolved although lately I see less of it. There are large skin callouses at her elbows but very few other skin problems. Panting was said by one vet to be pain. I read where Cushing's causes panting due to calcification in the lungs or the liver pushing on the diaphragm. Vet I usually see says cortisol causes her to feel hot.
2/28 urine/cortisol/creatinine test:
Urine Cortisol: 19.8
Urine Creatinine: 101.7
Urine Cortisol/Creatinine Ratio: 61 (>/= 34 hyperadrenocorticism is possible)
I felt like I was losing my dog soon after hearing Cushing's, kidneys leaking protein, and hypothyroidism and started preparing for it mentally. Vet sd costs would be high and I resolved to not treat the Cushing's because of everything else going on.
We had just lost another golden retriever in February so all this news seemed staggering. The other golden, Penny, was 12 3/4 and was being followed for anemia that kept getting worse and then suddenly could no longer use her rear legs. I believe degenerative myelopathy that wasn't diagnosed. Instead she was being followed for arthritis because of difficulty getting up and down stairs.
1/17/17 Bloodwork:
ALP 1072 (5 - 160 U/L) Notes say 9/16 ALP was 943, 10/22 was 713
ALT 126 (18 - 121 U/L)
BUN 13 (9 - 31)
Creatinine 0.6 (0.5 -1.5 mg/dL)
BUN/Creatinine Ratio: 21.7
NA/K Ratio 27 (28-37 range) Low
Hemolysis Index +++ (index of +++ may decrease ALP)
SDMA 11 (0 -14)
Both SDMA and Creatinine are within the reference interval which indicates kidney function is likely good.
T4: 3.6 (1.0 - 4.0 ug/dL) 8/23 = .8, 9/16 = 2.8, 10/22 = 1.8
For dogs on thryoid supplement, acceptable T4 concentrations generally fall within the higher end or slightly above the reference range.
WBC 11.6 (4.9 - 17.6 K/uL)
MCH 20.9 (21.9 - 26.1 pg) Low
Lymphocyte 998 (1060 - 4950/uL) Low
Protein 1+ (100 - 200 mg/dL) Negative - trace, was 4+ before Benazepril
There have been ups and downs with vomiting and diarrhea but has responded well to treatments for that. Is currently on Budesonide 1 ml per day for IBD and lymphoma. Responded well on that. Harriet's nights are really restless. She was moving after only 10 minutes. Seemed to be either hot or uncomfortable. Vet has her on 3-4 Tramadol 50 mg at bedtime and one during the day for the panting. Tramadol seems to help. Room at night can be 53 degrees and still she will be panting. A few nights back it was 64 degrees and she was really uncomfortable.
Approx. 3/6/17 I had an ultrasound done. It showed enlarged lymph nodes, slightly enlarged spleen and liver. Vet says lymphoma. I am not going to treat the lymphoma due to my dog's age, stress, chemotherapy, etc.
Having said all this...I am wavering about treating her for Cushing's. I talked to tech today and would be approx $200 for initial testing and approx $100 mo for meds. I feel bad about her panting all the time and would like to help her. Vet questions her quality of life but she is eating 1 - 1 1/2 boiled chicken breasts, about a can of dog food (was Pure Balance but got her to eat EN for now, eats treats, usually 1/2 - 1 c of dry dog food. I do have to hand feed her a lot. About a week and a half ago there was a blood clot in her urine and she wasn't eating well. Vet gave her an antibiotic shot and she was feeling better within a day. She drinks a lot of water and urinates frequently. Uses puppy pads at night or if I am out for a few hours. I felt she would be gone by 3/21 when my vet returned from a 3 week vacation and now she's still here. I honestly can't imagine that she will be with me for another 2 months though but am glad for every day. Vet says whenever she doesn't eat for two days she needs to be put down, which I agree. I don't want to keep her if she is in pain and am always trying to get a sense of that. She picks up toys, plays with them for a minute, wags her tail, goes up and down stairs both outside and inside, goes off on her own to roll on the carpet in my bedroom, and follows me around the house. Any help on whether to treat for Cushing's? Is the panting pain, hot, or difficulty breathing? Thank you ahead of time for your help. Barb
2/28 urine/cortisol/creatinine test:
Urine Cortisol: 19.8
Urine Creatinine: 101.7
Urine Cortisol/Creatinine Ratio: 61 (>/= 34 hyperadrenocorticism is possible)
I felt like I was losing my dog soon after hearing Cushing's, kidneys leaking protein, and hypothyroidism and started preparing for it mentally. Vet sd costs would be high and I resolved to not treat the Cushing's because of everything else going on.
We had just lost another golden retriever in February so all this news seemed staggering. The other golden, Penny, was 12 3/4 and was being followed for anemia that kept getting worse and then suddenly could no longer use her rear legs. I believe degenerative myelopathy that wasn't diagnosed. Instead she was being followed for arthritis because of difficulty getting up and down stairs.
1/17/17 Bloodwork:
ALP 1072 (5 - 160 U/L) Notes say 9/16 ALP was 943, 10/22 was 713
ALT 126 (18 - 121 U/L)
BUN 13 (9 - 31)
Creatinine 0.6 (0.5 -1.5 mg/dL)
BUN/Creatinine Ratio: 21.7
NA/K Ratio 27 (28-37 range) Low
Hemolysis Index +++ (index of +++ may decrease ALP)
SDMA 11 (0 -14)
Both SDMA and Creatinine are within the reference interval which indicates kidney function is likely good.
T4: 3.6 (1.0 - 4.0 ug/dL) 8/23 = .8, 9/16 = 2.8, 10/22 = 1.8
For dogs on thryoid supplement, acceptable T4 concentrations generally fall within the higher end or slightly above the reference range.
WBC 11.6 (4.9 - 17.6 K/uL)
MCH 20.9 (21.9 - 26.1 pg) Low
Lymphocyte 998 (1060 - 4950/uL) Low
Protein 1+ (100 - 200 mg/dL) Negative - trace, was 4+ before Benazepril
There have been ups and downs with vomiting and diarrhea but has responded well to treatments for that. Is currently on Budesonide 1 ml per day for IBD and lymphoma. Responded well on that. Harriet's nights are really restless. She was moving after only 10 minutes. Seemed to be either hot or uncomfortable. Vet has her on 3-4 Tramadol 50 mg at bedtime and one during the day for the panting. Tramadol seems to help. Room at night can be 53 degrees and still she will be panting. A few nights back it was 64 degrees and she was really uncomfortable.
Approx. 3/6/17 I had an ultrasound done. It showed enlarged lymph nodes, slightly enlarged spleen and liver. Vet says lymphoma. I am not going to treat the lymphoma due to my dog's age, stress, chemotherapy, etc.
Having said all this...I am wavering about treating her for Cushing's. I talked to tech today and would be approx $200 for initial testing and approx $100 mo for meds. I feel bad about her panting all the time and would like to help her. Vet questions her quality of life but she is eating 1 - 1 1/2 boiled chicken breasts, about a can of dog food (was Pure Balance but got her to eat EN for now, eats treats, usually 1/2 - 1 c of dry dog food. I do have to hand feed her a lot. About a week and a half ago there was a blood clot in her urine and she wasn't eating well. Vet gave her an antibiotic shot and she was feeling better within a day. She drinks a lot of water and urinates frequently. Uses puppy pads at night or if I am out for a few hours. I felt she would be gone by 3/21 when my vet returned from a 3 week vacation and now she's still here. I honestly can't imagine that she will be with me for another 2 months though but am glad for every day. Vet says whenever she doesn't eat for two days she needs to be put down, which I agree. I don't want to keep her if she is in pain and am always trying to get a sense of that. She picks up toys, plays with them for a minute, wags her tail, goes up and down stairs both outside and inside, goes off on her own to roll on the carpet in my bedroom, and follows me around the house. Any help on whether to treat for Cushing's? Is the panting pain, hot, or difficulty breathing? Thank you ahead of time for your help. Barb