Need some Input

[aliceluther]

My little Yorkie who is struggling with a liver mass that has grown in the last eight months has exhibited many signs of Cushing's disease. I will find out the test results today but feel confident it is Cushing's. Has anyone had any experience with neurological issues? My Yorkie is shaking all the time like she is cold. I have seen unusual displays by her and fear it's neurological. This morning her little body did three jolts, then her head turned sideways abruptly three times. My other dogs were barking at a service person in my backyard. Normally, she does too but today, she ran like she was scared and urine seeped out. She has weakness in all four legs. She's not herself, just wants to sit on my lap and does not play with my Maltese at all like she used to. Has anyone out there treated their pup with acupuncture and supplements? Please help - I'm a depressed nervous wreck.

[Squirt's Mom]

Hi and welcome to you and your sweet baby,

What you are describing fits liver disease which can mimic Cushign's. If I were you I would focus on the liver and not Cushing's at this point. Cushing's is a very slowly progressing condition while it is critical to get liver disease diagnosed and treatment started if possible ASAP. Here is an excerpt and a link for you (I have to run right now but will be back later and am sure others will be along soon as well) -


Signs that a dog has liver disease can vary and include loss of appetite, vomiting, stomach ulceration, diarrhea, seizures or other neurologic problems, fever, blood clotting problems, jaundice (a yellow tinge noticeable in the skin, mucous membranes, and eyes), fluid collection in the abdomen, excessive urination and thirst, changes in liver size, and weight loss. Gastrointestinal bleeding can be seen in animals with liver disease due to ulcers or problems with blood clotting.

https://www.merckvetmanual.com/dog-owners/digestive-disorders-of-dogs/disorders-of-the-liver-and-gallbladder-in-dogs

Hugs,
Leslie

[labblab]

I agree with Leslie 100%. I’d really focus on the liver mass right now. A big complication with the two diagnostic blood tests for Cushing’s is that they are vulnerable to giving “false positives” when a dog is suffering from serious health problems other than Cushing’s. So even if the Cushing’s test comes back positive, I’d have to wonder whether or not the liver mass is truly the underlying problem. Are there abnormalities in your dog’s bloodwork associated with the liver?

I’m guessing you’re having ongoing imaging of some sort to monitor the liver mass, but has your vet suggested a liver biopsy? If it were me, I’d defer any Cushing’s treatment until you have more information about the true nature of that mass.

I’m so sorry she is doing so poorly. As Leslie has noted, liver problems can cause seizures, and that does sound as though that may be what your baby is experiencing. If you can, please do tell us more about her overall health history, and especially about any diagnostics related to her liver.

Marianne

[lulusmom]

Hi, Alice, and a belated welcome to your little Yorkie.

I have the same questions and requests made by Marianne. I would also be interested in seeing the abnormal blood and urine values with normal reference ranges. Aside for the symptoms you have shared, what symptoms associated with cushing's are you seeing that you believe are being caused by cushing's? i.e. excessive drinking peeing, voracious appetite, pot belly, panting, etc. Based on the information you have shared so far, there are any number of possible causes, such as liver disease, pituitary or other brain tumor, hypoparathyroidism and a pinched nerve in the neck. If your Yorkie is not already under the care of a board certified internal medicine specialist, I highly recommend that you consider asking your gp vet for a referral. I look forward to hearing a lot more about your girl's medical history.

Glynda

[aliceluther]

Thank you to all of you for your comments! Here's a brief history on Gigi. On April 21, 2018 (by accident for something else) she was given an ultrasound. It revealed a liver mass in her right dorsel that was 2.3 x 1.7 cm. I retested it on June 19, 2018 and we were thrilled there had been no change. They suggested retesting six months to a year later. All bloodwork had been normal. Bloodwork done on October 29, 2018 showed an ALT of 175. I put her on Sam-e and milk thistle and retested 30 days later and it had dropped to 132. I started to notice an abnormal amount of water she was drinking and accidents in the house. In November, while eating, she fell on her side. I thought it was a seizure but when I picked her up, she began eating again. I thought maybe she had lost her balance. The water consumption continued and her appetite was ferocious. In December when my husband picked her up out of bed to go potty, she fell over on her side, he picked her up and she did it again. Had trouble standing up but after a brief time she snapped out of it and began walking. Bloodwork done January 30, 2019 showed an ALT of 210 and ALK of 332. Did a urinalysis on her February 7 and urine creatinine was 51.3 and urine protein was 819!!! I panicked after those readings and took her for an emergency ultrasound.The horrible news was the liver mass was now 70 x 50cm. They put her on Enalapril to try to reduce protein loss. Met with an Internist on Monday Feb. 11. He does not want to a biopsy because he says they come with risks and said surgery is not recommended because of where the mass is located. They can't remove it all and says it will grow back and said she could die from the surgery because of her size. A Cushings test was done and he told me last night it does indicate Cushing's. He wants to put her on Trilostane. I have read that dogs with liver disease should not take this but he seems to think it won't be a problem. Last night in bed, Gigi had a full blown seizure with legs kicking and it lasted about 1 - 2 minutes. We have never seen that before. She is still eating and drinking. Water consumption is not crazy but she's been spending most of the time on my lap. I'm taking her to a holistic vet this afternoon who does acupuncture. Should I see another internist? Should I try that medicine? I'm so desperate because I think she's going down pretty fast and I don't know what to do.

[Squirt's Mom]

There is no way in you know where that I would give that baby Trilostane or any other drug for Cushing's. NONE. I would absolutely forget about Cushing's and start pushing to find out all I could about what could be done for the liver. If there truly is nothing, then love her and dote on her as long as you can but please do not treat Cushing's. Both drugs used to treat Cushing's are very powerful and it is an unspoken rule that you not give either of them to a sick dog...and your baby is sick. So if she were mine, I would just forget about Cushing's and ignore any vet who said to treat Cushing's. Focus on the liver only and do everything you can to help that organ. One thing I would do is find a surgeon and talk to them about surgery for her - not an IMS. The surgeon is the one who will know the most about whether surgery is an option or not. Even if the IMS or GP vet has performed surgeries on livers before...the one who specialized in surgery is the one you want to talk to. That's my 2 cents worth.

Know we are with you all the way no matter what!
Hugs
Leslie