Dixie Doodlebug

[Dixie Doodlebug]

Hello and thank you for letting us join. I don't have a actual diagnosis but our vet suspects possible Cushings in my 14 year old Jack Russel Dixie. We are having extreme restlessness at night (we haven't slept more than 2hours at night in a week now) as soon as we get into bed and turn off the lights she begins to pant and pace and sometimes shakes. This goes on almost all night long. she sleeps hard during the day and some days seems her normal self but some days seems off..nervous even sad maybe. Sorry I'm trying to tell it without rambling or emotional breakdowns.. No potty accidents, increased potty trips (sometimes just to urinate sometimes extra poop), no real increase in appetite, no history of illness (lost her hearing towards end of 2018). Vet first suspected Dog cognitive impairment and started 100mg of trazadone for the anxiety but it hasn't made any difference but the lab work came back and he is leaning more toward something like Cushings. I'm posting the labs welcome any advice. I have a phone conference with the Vet on Sunday as he was not on shift when labs came back.
ALT 196 range 12-118
All 911 range 5-131
Bun/creatinine Ratio 29 range 4-27
Platelet count 476 range 170-400
Eosinophils 1 range 2-10

T4 <0.5 range 0.8-3.5

Urinalysis
Color yellow appearance clear
Specific gravity 1.051 range 1.015-1.05
Ph 6 range 5.5-7
Protein 2+ rage Negative

Microalbuminuria 5.2 range <2.5

[Joan2517]

Hi and welcome to the forum. Before my Gable was diagnosed, he had some episodes of the panting and trembling at night for about two years beginning in 2015, not every night, but sometimes for a few nights in a row. He would shake so much that the whole bed shook. I'm not sure if that was a sign of what was to come or not. After my Lena died in 2016, he wouldn't come upstairs to sleep anymore, he slept downstairs, so I don't know if it continued or not. He was finally diagnosed last May with Cushing's.

Posting the blood work, with the Highs and Lows, along with the reference ranges would help others more knowledgeable than I am, try to help you with figuring out what's going on with Dixie.

[labblab]

Hello, and welcome from me, too! Joan has gotten you off to a great start and as she says, we’ll await your posting of any abnormal lab values. I have to say that if Cushing’s is indeed the cause, I would expect the panting and restlessness to continue throughout the day as opposed to being limited to just the nighttime. You’ve mentioned more frequent trips to urinate — is Dixie also drinking more water, or is it just that she seems restless and want to go outside more often?

From what you’ve told us so far, I have to say that Cushing’s would not be at the top of my list of likely culprits. But let’s take a look at the lab results and also see what the vet has to say on Sunday. I do understand why he’s been considering Canine Cognitive Dysfunction, and it may remain a consideration. If so, there may be a medication other than trazadone that the vet may suggest. Coincidentally, it also has been found to ease symptoms in a certain subset of dogs who suffer from Cushing’s caused by a pituitary tumor. The medication is selegiline (brand name: Anipryl).

So let’s see those numbers, and also find out what the vet is thinking. In the meantime, we understand how upsetting all this must be for you, your husband, and also little Dixie. We’ll do our best to offer our suggestions and support while you sort things out. We’re really glad you’ve joined us, and we’ll be very anxious to learn more about your sweet girl.

Marianne

[Dixie Doodlebug]

Hello,
Thank you for welcome. I hate any of us need a group like this but so thankful to have a place to come that other people understand.

[Dixie Doodlebug]

Hello and thank you for the welcome. She does seem to drink a bit more water than my other dogs but not every day. The only time she pants during the day is after a potty trip and I know that is because she got hot but she doesn't pace around like she does at night. I'm not sure if I'm missing something from the shear exhaustion but I can't figure out how to post the results.

[labblab]

The best way to show us the results is to directly type them in a reply. You only need to list results that are marked as being outside the normal range for that particular value — either too high or too low. We also need the normal range for that value so that we can see how how “off” the value really is. Here’s an example (I just made up the numbers and the range):

ALT: 200 (normal 50-150)

Hope this helps!
Marianne

[Dixie Doodlebug]

Hi ok I think I edited my original post and added the labwork

[labblab]

Thanks so much for adding the labwork. I now understand why your vet is considering Cushing’s, but some question marks remain. Every single one of the abnormalities in Dixie’s bloodwork can be caused by Cushing’s. However, her urine is quite concentrated, and that would be unusual for Cushing’s. Dogs with Cushing’s typically exhibit abnormally dilute urine with a low (rather than high) specific gravity. So that does make me scratch my head.

The presence of the protein and albumin in her urine could be associated with Cushing’s, but it also might just be due to age-related changes in her kidneys.

Has Dixie’s urine been cultured to see whether she may be suffering from a urinary tract infection? That could certainly make her feel restless and wanting to frequently try to urinate. You might also request a particular blood test, the SDMA, that gives a more precise assessment of kidney function.

These are just my first thoughts this morning. Hopefully, some other folks will also chime in as the day goes on, and I’ll also return as I think about things further.

Marianne

[Harley PoMMom]

Hi and a belated welcome from me as well!

I totally agree with Marianne, cushdogs rarely have a high specific gravity such as your girl does. The protein loss found in the urine, I believe, should be checked into by having an UPC test performed which entails getting an urine sample preferably by Cystocentesis. High blood pressure has been associated with protein loss in the urine. Has Dixie's blood pressure been checked recently?

I'm sorry for the reasons that brought you here but so glad you found us and we will help in any way we can.

Lori

[Dixie Doodlebug]

I have been heartbroken since I got the lab work and saw issues with the urinalysis. We lost our beloved Max schnauzer in 2016 from renal failure and I don't think my heart can handle watching another beloved baby go through it. The urinalysis was part of the geriatric package at my vet but I don't know if they will culture it or if I will need to take her back in for them to get another sample for cultures. I will also ask about the SDMA. I really wish that when I ask for a full work up they would just go ahead and test for everything possible to keep her from having to go in so many times as it stresses her horribly. She hates going to the vet. Thank you for your help.

[Dixie Doodlebug]

I have been heartbroken since I got the lab work and saw issues with the urinalysis. We lost our beloved Max schnauzer in 2016 from renal failure and I don't think my heart can handle watching another beloved baby go through it. The urinalysis was part of the geriatric package at my vet but I don't know if they will culture it or if I will need to take her back in for them to get another sample for cultures. They did get the sample by cystocentesis. I really wish that when I ask for a full work up they would just go ahead and test for everything possible to keep her from having to go in so many times as it stresses her horribly. She hates going to the vet. They did not check her blood pressure but I will have them do it.
Thank you for your help.

[labblab]

It may well be that no evidence of infection showed up in the urinalysis, since you’re not reporting abnormal levels of white blood cells or bacteria as part of the results. So the vet may not have seen a purpose in moving forward with a culture. When urine is very dilute in dogs, sometimes those abnormalities don’t show up on the urinalysis and it’s worthwhile to run a culture, anyway, when symptoms of a UTI are present. But in Dixie’s case, since her urine was well concentrated, the vet may think that an infection is unlikely given her results. I think it would be worth asking him about, though, to get his opinion.

The SDMA may actually have been included in the blood panel that was run. It’s included now on my dog’s annual panel. Check back and see if you find it anywhere on the labsheet.

Also, I sure understand why these abnormalities are so worrying to you. But being optimistic, bear in mind that given Dixie’s age, some degree of kidney dysfunction may not be all that unexpected or truly sinister. It’s certainly important to explore the significance of the labs and to begin any treatment that might be warranted. But whatever’s going on may not actually progress all that rapidly.

Marianne

[Dixie Doodlebug]

Hello all,
She had her LDDS test on Monday, blood pressure check, and ultrasound. Blood pressure was ok and the ultrasound showed nothing alarming. LDDS test results came back yesterday and she is positive for pituatary Cushing's. I will post the labs and info from ultrasound once I receive the results. They will be starting her on Vetoryl and mentioned a starting dose of 20 - 30 mg once daily. I've read many horror stories from being started at too high of a dose. Does this sound like a good starting dose for Dixie Doodlebug she weighed 24 lbs this visit and is a Jack Russell that is 14 years old. She was also started on denamarin for liver support.

[labblab]

Thanks so much for this update on Dixie, and we’ll definitely be anxious to see the actual testing results. When you say that nothing alarming was seen on the ultrasound, I’m assuming you mean that no tumors or suspicious masses were seen. This would rule out Cushing’s caused by an adrenal tumor. However, enlargement of both adrenal glands is characteristic of pituitary Cushing’s. So if Dixie’s adrenal glands were not enlarged at all, this would be another puzzling aspect to her diagnosis, in addition to her concentrated urine.

However, if the Cushing’s diagnosis is indeed accurate and you are going to begin treatment, I’d personally opt to start with 20 mg. of Vetoryl. Even though her weight falls between 20-30 pounds, I’d want to start at the lower end of the formula of 1 mg. per pound, and then work upward if a higher dose appears to be called for. Our experience here is that unwanted side effects may be minimized by starting low and working upwards over time, rather than vice versa.

Anyway, it’s good to see you back here, and we’ll await further info!
Marianne

[Dixie Doodlebug]

Hi Marianne
On the nothing alarming with the ultrasound he just meant no bladder or kidney stones, spleen, heart, lungs, and other organs are alright and no tumors or masses.
I wish I could post a pic of the labs and test but I will type them in (Ultrasound report is very long because he was very thorough also did some x-rays)
Cortisol sample one 2.2 ref range 1-5
Cortisol sample two Dex 0.8 ref range 0-1.4
Cortisol sample three Dex 1.7 ref range 0-1.4

Thank you for your help