Dog with polydypsia, hyperphagia and polyuria after surgery

[DobermanMom]

My 6.5 y/o Doberman had major surgery at the end of October (10/30) to remove a grapefruist sized cyst compressing his bladder. The surgeon also removed his spleen, “tacked” his stomach and neutered him.

Right after the surgery, or at least when the pain meds were stopped he started to drink LOTS of water and pee a lot. His appetite increased, but this wasnÂ’t as obvious at the beginning as the drinking. He also became irritable. Kind of listless. Intermitent bouts of vommiting.

On 12/20 visited primary care vet (surgeon denied any possible surgical cause). CBC with electrolytes done. Normal except slightly elevated ALT 156 (range 10-125) and Biliruben 1.0 (range 0.0-0.9). Dog had gained 18+ pounds since the surgery. Normal healthy weight for him is around 100lbs.

T4 low normal 1.5 (range 1-4) started on thyroid meds. Some decrease in thirst and seemingly happier at first, but got worse again.


2/7 discontinued HillÂ’s light dry food as a precaution due to recall of other HillÂ’s products for Vit D toxicity.
2/8 returned to vet. Weight 120, T4 very high 7 (range 1-4). T4 being reduced and discontinued. Urinalysis normal.
2/9 LDDST attempted but vet miscalculated and gave overdose of dex..
2/12 LDDST being done today. Weight 116.8


Relevant hx- no hx of long-term steroid use, MRI of brain and neck 2/2018 bc of dog attack, no notable findings. 9/2018 CT of abdomen no findings related tp adrenal glands. No hx of excess drinking peeing or eating prior to surgery.

Thoughts?

[Squirt's Mom]

HI and welcome to you and your baby boy,

Personally I wouldn't waste my time nor money on the LDDS. Cushing's doesn't come on as result of surgery nor does it come on quickly. It is a very slowly progressing condition taking years to become evident in most dogs. Instead I would spend that money taking him to an IMS - Internal Medicine Specialist - asap and let them to an assessment. They have much more knowledge than most GP vets plus have no vested interest in proving this is not related to a surgery they performed. ;) Request a copy of all his medical records and take them with you. Meantime keep a very close eye on him. Have they ruled out Vit D poisoning from the Hill's?

I'm glad you found us and look forward to learning more soon.
Hugs,
Leslie

[DobermanMom]

Thank you, my thoughts about the Cushing’s too. Test already in progress though just because the surgeon mentioned it too. Surgery was done at a specialty vet who told us to go back to the regular vet.

Vet wanted $190 for Vit D test, which is more than the Cushing’s test. CBC blood work and urine don’t show obvious signs of toxicity. So will do that if LDDS comes back normal. Probably will do it at another facility.

[Squirt's Mom]

The LDDS, while considered the gold-standard for Cushing's testing, is also notorious for false-positives if any other condition is present so the results of the LDDS may not be entirely reliable if something else is going on with your sweet boy. Just fyi for you to keep in mind. If he hasn't had an abdominal ultrasound recently I would want that done for sure.

Let us know how he is doing when you can!
Hugs
Leslie

[DobermanMom]

Thank you, good to know! When the results come back will update. He had an xray 2/8 and an ultrasound in August prior to the CT scan and the surgery. I really think something went wrong with the surgery, but everyone keeps telling me that’s not the problem. So I am ruling out everything else and then will double-down on that concern. I am working 60 hr weeks to pay back the surgery and I still can’t cover all of my bills. I am still behind and only did the surgery bc he was a healthy dog with a discrete surgical issue and now all the vets who told me he was healthy and would be even better after the surgery are trying to tell me he has an endocrine disorder that magically showed up right after the surgery but had nothing to do with the surgery.

My instincts are that he is in pain.

[DobermanMom]

The LDDS, while considered the gold-standard for Cushing's testing, is also notorious for false-positives if any other condition is present so the results of the LDDS may not be entirely reliable if something else is going on with your sweet boy. Just fyi for you to keep in mind. If he hasn't had an abdominal ultrasound recently I would want that done for sure.

Let us know how he is doing when you can!
Hugs
Leslie

Apparently the test showed a low resting cortisol level of 0.2 so now the vet is convinced it is AddisonÂ’s and wants to do a $400 test for that, but because they gave an overdose of dex a couple of days before they also acknowledge that could be the reason. Updated CBC/electrolyte panel done 2/17 shows the ALT and Bilirubin back to normal but Potassium high. Sodium was normal. Potassium has never been high before and I donÂ’t know that the result was accurate. Given how many mistakes this place has made recentky I think it coupd be because of mishandling the blood sample. I am now out $1500 in vet bills after the surgery and everyone says this canÂ’t have anything to do with the surgery even though the symptoms all started 1-3 weeks after surgery. AddisonÂ’s doesnÂ’t track with his symptoms in the way CushingÂ’s did and I am going to decline the ACTH test.