Bella, 11 y/o shihtzu - considering diagnostics

[bmschiotis91]

Good morning, so glad I found this forum!
My ten year old mix (probably husky/border collie/gsd) had a senior panel done. It came back with all values normal except the ALK Phos around 525-550 (I don’t remember which, just that it was mid 500s). Normal would have been below 150.

My vet said it could be Cushing’s or possibly related to arthritis. He has had both his CCLs repaired, as well as one meniscus surgery. Thyroid levels fine.

We did the cortisol:creatinine test with a result of 37. >34 is out of range.

The vet said we could do the test for Cushing’’s- the one where they draw blood, inject something, then retest in an hour or so, or we could retest in a month.

I’m sure the anxiety will get to me and I’ll do the test.

Eating/drinking seems normal, no panting. He is overweight and I’’m working on that. The only symptom I see is he is sometimes slowing down on walks. Other times not. Not as active as he used to be when out in the yard. He will sometimes stand near the treat jar.

Just wondering if anyone’s dog was diagnosed with Cushing’s with numbers like this?

While a diagnosis of Cushing’s is no walk in the park, part of me hopes it is because I’m reading that high alk phos is present in dogs with bone cancer. No limping or swelling, though, so that’s good. Plus, I would want to do any warranted Cushing’s treatment sooner rather than later if he needs it at this stage.

My vet uses western and holistic treatments. My dog is raw fed.

Thanks for any help!!

Hi I have an 11 year old shihtzu who had similar results in her liver enzyme on her senior blood work. Another vet called back and recommended we check for Cushing's with an ultrasound and I have been freaking and googling for hours ever since. I was wondering what came of your case? My baby girl Bella panted a lot but it was summer, and she has gained 2 pounds so I have noticed weight her in belly area. She does no eat more than usual (she eats once a day and picks at the dry food once a day), she drinks normal and pees normally. She does have sebaceous cyst on her back but those are common in her breed. She is very active, runs outside and active when indoors. I am so worried and don't know what to do. I asked for my primary vet to call me back but thanks to you and Lori I have other questions to ask about her blood work. Thanks for your time and I hope your baby boy is doing ok. Isn't it insane how much we love them? Wouldn't have it any other way.

[labblab]

Hello, and welcome to you and Bella! You’ll see that I’ve made a copy of your reply posted elsewhere in order to begin a thread that’s your very own. This way, it’ll be easier for our members to reply to you directly.

It’s certainly true that there are a lot of similarities in your situation with this other new member, and I’m hopeful that we’ll soon get a status update from them, too. In the meantime, all the info that was posted on that thread seems quite relevant to Bella’s situation, as well. Elevated ALKP is indeed consistent with Cushing’s, but it can be caused by other conditions, as well. At this point, since Bella doesn’t exhibit other Cushing’s symptoms aside from panting and some weight gain, I don’t know how aggressively I’d immediately launch into additional diagnostics.

As you’re already planning to do, I believe the first step is to check with your vet about the presence of any other laboratory abnormalities. If present, I can’t argue with the value of advancing to a specialized cortisol test, and depending on outcome, then on to an abdominal ultrasound. But in the absence of classic observable classic Cushing’s symptoms, I think many specialists would hold off on actually instituting treatment at this point, regardless. This is because, with a few exceptions, treatment is geared largely to relieving symptoms. If no observable symptoms are present, a treatment path of value becomes questionable.

Here are some exceptions. If it’s found that a dog suffers from an adrenal tumor rather than a pituitary tumor, surgery can offer a complete cure and prevent any further problems from developing. Also, depending upon a dog’s age and expected normal lifespan, halting slow chronic internal changes may be deemed more or less of a priority. For instance, if there’s already evidence that elevated cortisol is causing high blood pressure or the presence of protein being leaked from the kidneys into the urine, then you do want to lower the cortisol in order to protect against further organ and internal damage that those conditions can cause.

Coming back full circle, the most important thing for you to know is that you should feel free to take whatever time you need to investigate your options. Cushing’s is typically a very slowly advancing condition. If nothing else is amiss in Bella’s lab profile right now, you may want to hold off on any additional diagnostics at the moment, and just recheck her basic blood profile again in a month or two in order to see if anything has changed. Either way, please do let us know what you find out when you have the chance to talk directly with your vet.

And once again, welcome!
Marianne

[Squirt's Mom]

Just popping in to welcome you and Bella! I look forward to learning more about your sweet girl!
Hugs,
Leslie

[Mmp01]

Hi Marianne,
I just updated on my thread (finally remembered my password so I could write something!).

I hope to take Zeus for his blood work soon. His sister is due for hers so I need to get that done, as well. Her liver level was high last year (not sure which one) but started to come down once I started her on thyroid meds.

Zeus’ thyroid seemed to be fine. However, I had a dog a few years ago whose thyroid levels were also fine. I sent his results to Dr. Jean Dodd and she said he absolutely needed thyroid medicine. I may do the same with Zeus if my vet tells me low thyroid could cause high ALK phos. Wouldn’t that be a nice, easy fix?

I like this “ignorance is bliss” phase but know I will have to get the testing done soon. That will send me into that anxiety ridden waiting stage. Lol.

Let us know what’s going. This is one disease I know nothing about so we’re in this stage together.