New member - Next step questions

[lasgsd]

Mauser is a 12 yr old German Shepherd. Raw fed since 8 weeks of age (when I purchased him) and given only 1 DHLPP vaccine (by breeder). He has had his Rabies every 3 years.

Main symptom started last fall - panting. Thought it might be heart issues so went down that road first. Then noticed his increase in drinking so we switched directions. Moved during all this and then Covid so had trouble finding a new vet.

Blood work finally done on 6/22 and his ALP was 171. Other abnormal results were HGB, HCT, MCV, and MHC all high while LYM was low. Now he is showing signs of being weak in the rear end. Not sure if this is his age or more Cusings symptoms.

My question is - money is tight right and he has a growth on his foot that needs to be surgically removed now so I'm trying to figure out what is the best next steps that I can afford. More tests? Go right to treatment/medications?

Any suggestion are welcome!!

Here is Mauser in his younger days ...

http://www.rawdogranch.com/images/stories/animals/current/Mauser/20141011.jpg

[labblab]

Awwwww, what a handsome boy — welcome to you both! I’m afraid I must be brief in this first reply, but based on the info this far, my suggestion would be to go ahead and proceed with the surgery on his foot prior to pursuing any more Cushing’s diagnostics. Please be aware I’m not a vet, but it sounds as though the foot growth is of more immediate concern. Additionally, systemic illnesses/infections/stresses other than Cushing’s can skew the diagnostic Cushing’s blood tests, increasing the risk of “false positives.”

So if Mauser were my own, I’d likely wait until he’s recovered from the foot surgery before moving forward. I do think you’d need to test him further before starting Cushing’s treatment since his overt symptoms thus far might be largely attributable to aging. Since the prescription medications are powerful and do carry risks of side effects, I think you’d both want and need to pursue further confirmation of an actual Cushing’s diagnosis if you find that his problems continue or worsen after the surgery. You’ve not given us the normal range for his ALP, but I’m guessing it’s only mildly elevated and that could be caused by something other than Cushing’s. Likewise, if his red blood counts were only mildly higher, he may have just been dehydrated. And although Cushing’s can indeed lower the number of lymphocytes, other infections or bodily stresses can, too — which brings me back to the presence of the foot growth.

So I really do think you’d be well served to first get that taken care of, and then you can revisit the question of Cushing’s. It’s typically a disease that proceeds slowly, and you want to try to eliminate any other confounding variables before pursuing active testing. However, please do feel free to ask additional questions or to talk over your available options as you work to arrive at a decision that feels best to you.

Once again, we’re really glad you’ve found us!
Marianne

[lasgsd]

Marianne - thanks for the welcome and the info!!

The growth on the foot has been there for quite awhile. My previous vet said since it had stopped growing and wasn't causing any problems to just leave it. But now it is breaking up and oozing so I worry about infection. I think you are right - foot first. :)

As for his levels. The normal range for ALP is 20 - 150; his was 171. I've seen others that were WAY higher so maybe it's not too bad?

Other values:

HGB range 8 - 15; his was 17.5
HCT range 24 - 45; his was 58.1
MCV range 39 - 55; his was 72
MCH range 12.5 - 17.5; his was 21.7
LYM range 1.5 - 7; his was .82

[labblab]

Hi again! Yes, that ALP elevation is really minimal in terms of what we typically see with Cushpups. Sometimes the elevation will even be in the “thousands.” As far as the other blood counts, I really don’t know how to judge the significance of those elevations — I think your vet will be the best guide on those. But all in all, I still think that your best bet is to go ahead and take care of Mauser’s foot, and leave the Cushing’s on the back burner for the moment. We’ll remain interested to hear updates, though!

Marianne