New here, looking for help

[Dukie]

I suspect my dog may have been misdiagnosed.... He’s a 13yr old Boxer. Since May 2018 he has been diagnosed with arthritis, Pancreatitis, and just 2 weeks ago diagnosed with Chronic Kidney Failure. He has always been in great health up until May. His symptoms are as follows:

1. Excessive thirst/urination
2. Slight pot belly
3. Intermittent weakness in back legs
4. Thinning hair/ hair loss in patches on his back
5. Cataract in one eye
6. Allergies/runny nose
7. Elevated (high-normal to high) Crea and Bun
8. Grumbling and groaning (think maybe tummy pain)
9. Dry heaving
10. Idiopathic head tremors
11. Siezures
12. Tremors in back legs while sleeping
13. Low RBC
14. High GLOB and Cholesterol
15. WBC in low-normal range
16. No lost weight even with calorie reduction

I could be wrong, as I am not veterinarian, but CKF does not account for ALL of these symptoms.

Duke has been on a “kidney diet” and Enalapril for 2 weeks now and after a day or so the excessive urination/ thirst stopped. Which my vet told me wouldnt happen at all with CKF dogs. But I have read that it does clear up almost immediately in Cushing’s dogs. So what do y’all think, could CKF be the actual diagnosis, or would he more likely have Cushing’s?

[Harley PoMMom]

Hi and welcome to you and Duke!

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...thanks!

To me, Duke's symptoms are more inline with CKD, pancreatitis and his arthritis, than Cushing's. The increased drinking/urinating in dogs with Cushing's doesn't improve until treatment, usually with Trilostane or Lysodren, has been initiated for at least 2 weeks. Also, dogs with Cushing's generally have high elevations in the ALK Phos, mild increases in the ALT, blood glucose, high blood cholesterol concentration, and usually low or normal BUN level. And on the complete blood count (CBC) dogs with Cushing's syndrome have what is called a "stress leukogram," which refers to a specific white blood cell distribution in the blood. This includes a high total white blood cell count with increased numbers of neutrophils and monocytes and decreased numbers of lymphocytes and eosinophils.

How was the CKF and pancreatitis confirmed? Was an ultrasound performed? Commonly, high blood pressure is found in dog's with kidney disease, was Duke checked for this?

I sure am sorry for the reasons that brought you here but so glad you found us and we will help in any way we can. Please do not hesitate to ask all the question you want and we will do our best to answer them.

Hugs, Lori

[Squirt's Mom]

Hi! Welcome to you and your baby boy! :)

Ready to play 20 Questions? :D

Some of the signs you have listed are certainly in keeping with canine Cushing's and it is not unheard of for kidney disease to confused with Cushing's because they do share signs. However, Enalapril and a kidney diet would not have brought about the changes you saw in drinking and urination in a cush pup. So let's start with those questions -

Has your baby been tested for Cushing's - tests called the LDDS, HDDS, or ACTH?

Were the only abnormal values on the chem test the CREA, BUN, CHOL, and GLOB?

Was his GLUC normal?

All the liver values are normal (ALP {or ALKP}, GGT, AST, ALT)?

Has he had an abdominal ultrasound? If so, were any abnormalities noted on the adrenal glands or liver?

Has he had a kidney specific test called the SDMA? (The SDMA will tell us much more about the kidney health than the BUN and/or CREA)

You mention his weight and pot belly but not his appetite - is it extreme to one end or the other (ravenous - no appetite)? What about the neutrophils and monocytes - were they within normal range?

What medications is he currently taking other than the Enalapril - ie anything for allergies, seizures, etc?

If he has NOT had the SDMA that is the first thing I would ask for followed by an abdominal ultrasound (not Xray, ultrasound), an ACTH and LDDS. Those tests will give a much clearer picture of both the kidney situation as well as offer some insight to whether he may have Cushing's. One thing to keep in mind concerning the tests for Cushing's - when other non-adrenal illnesses are present, like, CKF, those illnesses can cause false results on the testing - ie they can indicate a pup has Cushing's when they really don't and vice versa. So it is best to do a thorough job in the testing if at all possible - which is why I recommended the ultrasound, ACTH and LDDS. Combined they can give a much clearer picture than one test alone.

And a caution - do NOT start treatment for Cushing's using Vetoryl (Trilostane) or Lysodren (Mitotane) without doing the testing for Cushing's. Those are powerful drugs and should never be given without testing to support the presence of the disease. Cushing's shares signs and lab results with many, many other diseases and conditions so we must do our best to as sure as possible our babies do actually have the disease before we start treatment. We have seen vets give one drug or the other to dogs based solely on abnormal liver values with harsh results because the pup never had Cushing's to start with. So do the testing to get a clearer idea of the kidney situation with the SDMA then followed by the tests for Cushing's IF the SDMA is within normal range.

I'm glad you found us and look forward to learning more as time passes. Please read the information found in our Helpful Resource section as well as some of the threads on this forum. Feel free to ask any questions you may have -we will do our best to answer.

Hugs,
Leslie

https://www.k9cushings.com/forum/forumdisplay.php?10-Helpful-Resources-for-Owners-of-Cushing-s-Dogs

[Dukie]

I appreciate yÂ’all taking the time to answer. IÂ’m trying to research as much as possible and ask questions where I can. Duke may very well just have CKF, but I always have to question if its the right diagnosis and if heÂ’s getting the right/ best treatment. Perhaps IÂ’m just driving myself nuts with it all lol... I guess whatÂ’s throwing me is that my vet said the excessive thirst/urination would not get better, but so far itÂ’s the only symptoms the Enalapril has cleared up completely. And the hair loss is coming back.

The pancreatitis was confirmed through X-ray, blood tests and CT scan. Arthritis was also seen in the X-ray at this time (May 2018).

CKF was diagnosed thru presentation of symptoms and blood tests (Jan 2019).

Nuerological issues have not been tested or treated. Vet said that itÂ’s probably something in the front of the brain and that the meds for it may hurt the kidneys. He didnÂ’t see any point in treating yet and said to come back if the siezures become more frequent. Duke does not have Grand Mal type siezures, he arches his back, goes stiff, cries then goes limp. Usually only last 30-90 seconds.

He has not had any additional testing. He will have more bloodwork in a couple weeks so Im curious how that turns out.

Appetite... well I wouldnÂ’t say itÂ’s ravenous but he is always looking for food and begging when I have food! ItÂ’s always been normal for him to want and ask for food constantly.

As far as meds, he is only on the Enalapril at this time. Food wise, heÂ’s on HillÂ’s k/d kidney diet with his Dasuquin chews (supplement) for arthritis.

https://photos.app.goo.gl/ogfh4YTE9iZvmJWDA I hope these photos can be shared and come through ok, Im new to this kind of stuff lol

Again, I appreciate yÂ’all taking the time to reply and answer questions!

[Harley PoMMom]

I appreciate yÂ’all taking the time to answer. IÂ’m trying to research as much as possible and ask questions where I can. Duke may very well just have CKF, but I always have to question if its the right diagnosis and if heÂ’s getting the right/ best treatment. Perhaps IÂ’m just driving myself nuts with it all lol... I guess whatÂ’s throwing me is that my vet said the excessive thirst/urination would not get better, but so far itÂ’s the only symptoms the Enalapril has cleared up completely. And the hair loss is coming back.

I commend you on educating yourself, your being a wonderful advocate for your sweet boy!


The pancreatitis was confirmed through X-ray, blood tests and CT scan. Arthritis was also seen in the X-ray at this time (May 2018).

My boy, Harley, had pancreatitis which was diagnosed with an ultrasound and later confirmed with a Spec cPL test. We were never able to get his Spec cPL numbers in the normal range, that pancreas sure is a fickle organ which makes the pancreatitis hard to get control of.


CKF was diagnosed thru presentation of symptoms and blood tests (Jan 2019).

Were the symptoms and blood work results that you noted in your previous post the ones that made the vet believe Duke has CKF?


Nuerological issues have not been tested or treated. Vet said that itÂ’s probably something in the front of the brain and that the meds for it may hurt the kidneys. He didnÂ’t see any point in treating yet and said to come back if the siezures become more frequent. Duke does not have Grand Mal type siezures, he arches his back, goes stiff, cries then goes limp. Usually only last 30-90 seconds.

Seizures can be a side effect of CKF because the kidneys aren't able to filter the toxins out and they build up in the blood. Seizures can also be seen in dogs with the pituitary type of Cushing's because over time the tumor can enlarge.


He has not had any additional testing. He will have more bloodwork in a couple weeks so Im curious how that turns out.

I will be anxiously waiting with you for those results and will be praying for improvement.


Appetite... well I wouldnÂ’t say itÂ’s ravenous but he is always looking for food and begging when I have food! ItÂ’s always been normal for him to want and ask for food constantly.

An appetite in a dog with kidney disease is a really good sign that treatment is working!


As far as meds, he is only on the Enalapril at this time. Food wise, heÂ’s on HillÂ’s k/d kidney diet with his Dasuquin chews (supplement) for arthritis.

If you don't mind sharing, what is his dose of Enalapril?


https://photos.app.goo.gl/ogfh4YTE9iZvmJWDA I hope these photos can be shared and come through ok, Im new to this kind of stuff lol

Again, I appreciate yÂ’all taking the time to reply and answer questions!

I'm not seeing your photos in your post but you can upload them to an album that you can create in your profile, here are directions to do that:
As a member, you can create Albums of images that are linked to your public profile. Albums can be created by visiting the User Control Panel, and clicking on the 'Photos & Albums' link, and then clicking on 'Add Album'.

Each album can have a title ('Joe's Holiday to Nepal'), a description ('A bunch of photos from my recent adventure') and can be of three different types: Public, Private or Profile.

Public albums can be viewed by anyone
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Profile albums are viewable only by you. However, you can use the images to customize your public profile (info)

How do I upload photos?

Once you've created an album you can upload images to it. Simply view the album and click on 'Upload Photos'.

You'll have the option to give each photo a caption, and to set one image as the Album cover, which will be displayed on the public profile. To delete an album or edit the title, description or album type, click on 'Edit Album'. To delete an image, or to edit a caption or change the album cover, click on 'Edit Photos'.

All members who have access to your album images can comment on them, in a similar way to Visitor Messages (more info). You can delete any image comments from your albums, and report inappropriate messages to moderators.

When you have uploaded a photo, you can place it in your posts by using the BB code text that is displayed below the image when you view it at full size.

I also wanted to provide a link to a Yahoo K9Kidney site that I joined when my dog got diagnosed with kidney disease:
https://groups.yahoo.com/neo/groups/K9KIDNEYS/info;_ylc=X3oDMTJkdGZxbHU5BF9TAzk3MzU5NzE0BGdycElk AzQzNDA1OQRncnBzcElkAzE3MDczNzc5NTMEc2VjA3Z0bARzbG sDdmdocARzdGltZQMxNTQ3OTU5NjIz

Please keep us updated!

Lori

[Dukie]

Were the symptoms and blood work results that you noted in your previous post the ones that made the vet believe Duke has CKF?

He was diagnosed based of the blood tests and symptoms of increased thirst/urination. I had told my vey about the siezures, which he didnt seem to think were related. Some of the other symptoms they already knew about from seeing him in May.


I will be anxiously waiting with you for those results and will be praying for improvement.

Thank you! ��


An appetite in a dog with kidney disease is a really good sign that treatment is working!

Thankfully, the only thing that has changed his appetite was the kidney diet the vet first gave us. He did NOT like that stuff!



If you don't mind sharing, what is his dose of Enalapril?

His dose is 20 mg twice a day


[QUOTE=Harley PoMMom;209151]I'm not seeing your photos in your post but you can upload them to an album that you can create in your profile...

Thank you again! I have added an album to my profile, it should be public. Been a pain doing it on my phone and for some reason I cant copy the BB code... will try to hand write it in at the bottom of this post as a test, see if that works.


I also wanted to provide a link to a Yahoo K9Kidney site that I joined when my dog got diagnosed with kidney disease

Great! I will check that out too.

https://www.k9cushings.com/forum/attachment.php?attachmentid=8534&d=1548000047
https://www.k9cushings.com/forum/attachment.php?attachmentid=8535&d=1548000062
https://www.k9cushings.com/forum/attachment.php?attachmentid=8531&d=1548000006https://www.k9cushings.com/forum/attachment.php?attachmentid=8532&d=1548000020https://www.k9cushings.com/forum/attachment.php?attachmentid=8533&d=1548000035

[Harley PoMMom]

Do you have copies of Duke's blood panel results before the pancreatitis episode? I'm curious to see if Duke's creatinine levels have been trending upward or if the elevation in the creatinine was caused from the pancreatitis.

Honestly, in my layman's opinion, Duke's blood work results are indicative of pancreatitis and not Cushing's. Cushdogs generally have high elevations in the ALP because 80-90% of dogs have a cortisol induced isoenzymes and in a dog with Cushing's the chances of a very high ALP is very commonly seen, and even with treatment for Cushing's that high ALP may never return to normal, unlike in Duke's case where his ALP did come down within the normal limits.

How is Duke doing today?

Lori

[Dukie]

Unfortunately I dont have any prior bloodwork for Duke. He has good days and bad days, today is a good one. His bad days he grumbles a lot and doesnt want to do much. Still eats and drinks fine. He’s responded well to a change in his diet (less fat, phos) and does ok with his joint supplement for arthritis. Nuerological symptoms seem to get worse though. Siezures becoming more frequent, had 2 over the weekend. His last one was Jan 7th, prior to that was the beginning of Dec. I just feel lost at the moment, if Im doing the right thing for him. Hoping we can find out more when he goes back for testing.

[Harley PoMMom]

For the seizures, Cannabidiol (CBD) oil may help.