Hoping to learn! Bonnie, 8-yr old Maltese (Surgical Update)

[Bonnie's Mommie]

Hi,

My name is Linda, and my darling Maltese is Bonnie. She is 8 years old and was diagnosed on Tuesday (14th) with Cushing's. I took her to the vet because I noticed she was drinking an excessive amount of water, so people have told me I caught it early, whatever that means. I am on a Maltese forum and one of our members referred me to this site. My first question is, what is meant by the initial loading phase?

I really hope to learn alot here, and I'm so glad I found this site, although I wish I never would have needed it.:(

PS - Bonnie is on Lysodren for 5 days, then off and a one hour blood test on Sunday. My vet said Lysodren instead of Trilostane because the treatment is less - once a week for maintenance versus daily with Trilostane.

[Gabrielle]

Hi Linda,

I'm new, too, and also hoping to learn. I have a fourteen-year-old beagle with Cushing's who has a moderately severe case.

Goo luck to you and Bonnie! Charlie Brown and I wish you the very, very best! :)

Gabrielle

[StarDeb55]

Hi, Linda! I would like to welcome both you & Bonnie to our group! I must warn you that we will usually play "20 questions" with new members, but that helps us to give the most appropriate feedback that we can from the group's collective experience.

Before I start questioning you about Bonnie's history, let me answer your first of many questions to come. "Loading phase" sounds like your vet wants to treat Bonnie with a drug called lysodren or mitotane. When using this drug, the loading phase is aimed a eroding enough of the adrenal cortex tissue to bring the cortisol down to more healthy levels. Healthy levels for our cushbabies are 1-5 on the post value on an ACTH or what we call a stim test. Lysodren dosage is calculated by weight of the pup in kilograms, & you want the dose to be 25-50 mg/kg. For example, if the calculated loading dose is 400 mg., you would be giving this daily, split into 2 doses. What is Bonnie's current weight?

Besides excessive drinking, does Bonnie have any other symptoms including a voracious appetite, excessive urination which usually includes accidents in the house, coat/skin issues, muscle wasting/weakness, especially in the rear end, & repeated infections. Not all pups have all symptoms, but most pups have more than one. Could you tell us what diagnostic tests were done by your vet to make the Cushing's diagnosis? Some of these tests may include an ACTH, low dose dexamethasone, high dose dexamethasone, & abdominal ultrasound. If you could post the actual results, that would help us tremendously. It's very important that adequate diagnostic testing is done to get to a confirmed Cushing's diagnosis. Cushing's is probably the most frustrating, difficult disease to diagnose as there is no single test that is 100% specific & sensitive. Also, was anything like a senior wellness or super chemistry panel done? I ask about this as most Cushpups have common abnormalities in their liver function tests. If you don't have copies of Bonnie's labwork, your vet should be happy to provide them. Most members keep a file on their babies at home as you never know when those records might come in handy, especially if you end up at a strange vet. Did your vet rule out diabetes & thyroid problems? Both of these medical problems share a lot of symptoms in common with Cushing's, so you want to make sure that these are ruled out. Is Bonnie taking any other medication or supplements? Does she have any current medical problems?

The best thing you can do for Bonnie is read & learn, as you are her voice & only advocate. On those lines, I strongly suggest you swing over to the Important Information & Resource section of the forum where you will find a huge number of links that will lead you to just about any information you might need to help both of you as you begin your Cushing's journey.

Just to give you a bright spot, my 1st Cushpup, Barkley, was successfully treated for nearly 8 years with lysodren, crossing the bridge at 15 years old.
Looking forward to hearing more.

Debbie

[StarDeb55]

Linda, I was typing as you posted that Bonnie has already started lysodren. Could you tell us what the dose is & Bonnie's current weight? Did your vet give prednisone to have on hand in case of emergency? Did your vet explain to you what to look for as signs of loading, an a low cortisol emergency from too much lysodren?

Most loading protocol states that you load for approximately 8 days or until signs are noted that loading is complete. If no signs of loading have been noted, then an ACTH is done to see exactly where the cortisol level is. If the level is not within range, you just continue loading. No pup loads in the exact same amount of time, so you can't set a specific timeframe. Some pups especially larger breeds have a tendency to load in 2-3 days, while some of the little ones like yours & mine may take 7-10 days. We also have some members whose pups have take upwards of a month to load. None of our pups have "read the book" on what they're suppose to do & how to react, that is why it's so important that you be very vigilant during the loading phase for any changes in Bonnie's behavior, even minor ones. Minor changes may very well indicate that she has loaded. If you see something that is out of the ordinary for Bonnie, you do not want to give any further lysodren, & get her stim test scheduled. Lysodren is a long acting drug, usually for about 48 hours after a dose is given, so once you give a dose you can't take it back. This also means that the ideal time for a stim is about 48 hours after the last dose of lysodren.

Debbie

PS- Most lysodren maintenance protocols call for a minimum of twice weekly dosing. A lot of vets prefer that maintenance dosing be split up into several small doses spread out over the week. The goal is to maintain the level of adrenal cortex erosion, & not allow the adrenals to regenerate.

[Bonnie's Mommie]

Hi, Linda! I would like to welcome both you & Bonnie to our group! I must warn you that we will usually play "20 questions" with new members, but that helps us to give the most appropriate feedback that we can from the group's collective experience.

Before I start questioning you about Bonnie's history, let me answer your first of many questions to come. "Loading phase" sounds like your vet wants to treat Bonnie with a drug called lysodren or mitotane. When using this drug, the loading phase is aimed a eroding enough of the adrenal cortex tissue to bring the cortisol down to more healthy levels. Healthy levels for our cushbabies are 1-5 on the post value on an ACTH or what we call a stim test. Lysodren dosage is calculated by weight of the pup in kilograms, & you want the dose to be 25-50 mg/kg. For example, if the calculated loading dose is 400 mg., you would be giving this daily, split into 2 doses. What is Bonnie's current weight?

Besides excessive drinking, does Bonnie have any other symptoms including a voracious appetite, excessive urination which usually includes accidents in the house, coat/skin issues, muscle wasting/weakness, especially in the rear end, & repeated infections. Not all pups have all symptoms, but most pups have more than one. Could you tell us what diagnostic tests were done by your vet to make the Cushing's diagnosis? Some of these tests may include an ACTH, low dose dexamethasone, high dose dexamethasone, & abdominal ultrasound. If you could post the actual results, that would help us tremendously. It's very important that adequate diagnostic testing is done to get to a confirmed Cushing's diagnosis. Cushing's is probably the most frustrating, difficult disease to diagnose as there is no single test that is 100% specific & sensitive. Also, was anything like a senior wellness or super chemistry panel done? I ask about this as most Cushpups have common abnormalities in their liver function tests. If you don't have copies of Bonnie's labwork, your vet should be happy to provide them. Most members keep a file on their babies at home as you never know when those records might come in handy, especially if you end up at a strange vet. Did your vet rule out diabetes & thyroid problems? Both of these medical problems share a lot of symptoms in common with Cushing's, so you want to make sure that these are ruled out. Is Bonnie taking any other medication or supplements? Does she have any current medical problems?

The best thing you can do for Bonnie is read & learn, as you are her voice & only advocate. On those lines, I strongly suggest you swing over to the Important Information & Resource section of the forum where you will find a huge number of links that will lead you to just about any information you might need to help both of you as you begin your Cushing's journey.

Just to give you a bright spot, my 1st Cushpup, Barkley, was successfully treated for nearly 8 years with lysodren, crossing the bridge at 15 years old.
Looking forward to hearing more.

Debbie

Hi Debbie - I'm happy to play 20 questions at this point! Bonnie weighs just under 9 pounds, and she's taking 125 mg Lysodren once a day for 5 days, then off, and back to the vet for an hour's long blood test(s), where I will also have them check her blood pressure (suggestion from a vet on my Maltese forum). Her ONLY symptom is the excessive drinking and subsequent urinating, but always on her pads (she's pad trained). No hair loss, no increase in appetite, in fact she's been a little fussy with her food lately.

The tests results that are abnormal are:
(first round of tests)
ALT (SGPT) 159
BUN/Creatinine 31

(second round of tests)
Urinalysis
Specific Gravity 1.053
Protein 2+
Blood 1+
RBS 4-10

I was told that this is NOT degenerative, is that correct? By that I mean, will - eventually - her hair start to fall out, her appetite become voracious, etc.

Thank you for your help. As you can probably tell, I'm very new to this, as she was just diagnosed on Wednesday, but I'm trying to learn all I can.

Linda

[frijole]

Welcome from me too! My schnauzer Haley has been treated with lysodren for nearly 3 yrs now so there is hope! She's 15 1/2! Since you are loading but no one told you what it meant :p here is a real helpful list of tips and info on loading and using lysodren. I printed it and read it daily to calm my nerves. Using the drug can really help your dog on the path to wellness but it is a chemo drug and you must understand it.

Read and ask us lots of questions... don't be shy. You are your dog's voice and we are just here to help. Glad you found us! Kim

http://www.k9cushings.com/forum/showthread.php?t=181

[Bonnie's Mommie]

Linda, I was typing as you posted that Bonnie has already started lysodren. Could you tell us what the dose is & Bonnie's current weight? Did your vet give prednisone to have on hand in case of emergency? Did your vet explain to you what to look for as signs of loading, an a low cortisol emergency from too much lysodren?

Most loading protocol states that you load for approximately 8 days. If no signs of loading have been noted, then an ACTH is done to see exactly where the cortisol level is. If the level is not within range, you just continue loading. No pup loads in the exact same amount of time, so you can't set a specific timeframe. Some pups especially larger breeds have a tendency to load in 2-3 days, while some of the little ones like yours & mine may take 7-10 days. We also have some members whose pups have take upwards of a month to load. None of our pups have "read the book" on what they're suppose to do & how to react, that is why it's so important that you be very vigilant during the loading phase for any changes in Bonnie's behavior, even minor ones. Minor changes may very well indicate that she has loaded. If you see something that is out of the ordinary for Bonnie, you do not want to give any further lysodren, & get her stim test scheduled. Lysodren is a long acting drug, usually for about 48 hours after a dose is given, so once you give a dose you can't take it back. This also means that the ideal time for a stim is about 48 hours after the last dose of lysodren.

Debbie

PS- Most lysodren maintenance protocols call for a minimum of twice weekly dosing. A lot of vets prefer that maintenance dosing be split up into several small doses spread out over the week. The goal is to maintain the level of adrenal cortex erosion, & not allow the adrenals to regenerate.

No, Debbie, he didn't give me prednisone. He told me to look for vomiting and diarrhea, neither of which Bonnie has, and she's now on her third day of Lysodren. She's a tough little broad. :) I get the impression that the blood he's going to take on Sunday (6th day of this protocol) will determine if the Lysodren is working, and then we will go to the next step, which I guess is maintenance, right?

[Bonnie's Mommie]

Welcome from me too! My schnauzer Haley has been treated with lysodren for nearly 3 yrs now so there is hope! She's 15 1/2! Since you are loading but no one told you what it meant :p here is a real helpful list of tips and info on loading and using lysodren. I printed it and read it daily to calm my nerves. Using the drug can really help your dog on the path to wellness but it is a chemo drug and you must understand it.

Read and ask us lots of questions... don't be shy. You are your dog's voice and we are just here to help. Glad you found us! Kim

http://www.k9cushings.com/forum/showthread.php?t=181

Thank you very much, Kim!

[frijole]

Linda, were there any other tests done by your vet to diagnose cushings? The urine test can rule it out but not confirm it. The blood panel can lead to additional testings but not diagnose cushings.. Was there a test called ACTH or LDDS?

You mentioned your dog's appetite had lessened... that is a sign to stop the drug. Please let us know about the tests.... we want to make sure your dog has cushings. We see hundreds of cases annually and it can be tough to diagnose.. and it takes more than one test. Thank you. Kim

[Bonnie's Mommie]

Linda, were there any other tests done by your vet to diagnose cushings? The urine test can rule it out but not confirm it. The blood panel can lead to additional testings but not diagnose cushings.. Was there a test called ACTH or LDDS?

You mentioned your dog's appetite had lessened... that is a sign to stop the drug. Please let us know about the tests.... we want to make sure your dog has cushings. We see hundreds of cases annually and it can be tough to diagnose.. and it takes more than one test. Thank you. Kim

Actually, her appetite had lessened BEFORE we started the drug, maybe two weeks ago.

There is a part of the results that say "interpretation of ACTH stimulation test", but it doesn't seem to be specific to Bonnie, just gives numbers for 'normal response to ACTH'. I'll ask him tomorrow, thanks.

This is such a fog for me, I'm so very happy I found this site. I see I've got a lot to learn, and I'm glad to do it for my little squirt.

[StarDeb55]

Linda, I am very concerned based on the test results you have posted. None of these tests can diagnose Cushing's, they may hint at Cushing's. Bonnie's test results don't even hint at Cushing's. First of all, the great majority of Cushpup's can't concentrate their urine, meaning they have a very low specific gravity, usually less than 1.010. An elevation in the SGPT which is one of several liver function tests, can be due to a huge number of things other than Cushing's. The most common liver function test that is elevated which will lead a vet to suspect Cushing's is the alkaline phosphatase. Elevations in this liver enzyme are usually pretty dramatic, even in the several thousands. As both Kim & I have already mentioned, the Cushing's diagnostic testing includes the following low dose dexamethasone (LDDS), ACTH, high dose dex (HDDS), & frequently, an abdominal ultrasound. Were any of these tests done?

Debbie

PS- One other VERY IMPORTANT thing when it comes to making a Cushing's diagnosis, symptoms. Strong symptoms are a very important part of making the diagnosis. If excessive drinking was the only symptom Bonnie has, most vets will not treat based on just this symptom. Excessive thirst can be caused by diabetes, & thyroid as I mentioned. Were these 2 things ruled out?

[frijole]

Actually, her appetite had lessened BEFORE we started the drug, maybe two weeks ago.

There is a part of the results that say "interpretation of ACTH stimulation test", but it doesn't seem to be specific to Bonnie, just gives numbers for 'normal response to ACTH'. I'll ask him tomorrow, thanks.

This is such a fog for me, I'm so very happy I found this site. I see I've got a lot to learn, and I'm glad to do it for my little squirt.

Bonnie, I continue to wonder if your dog even has cushings. The numbers you posted are not what is normal with cushings dogs. This could be great news for you except the drug would be potentially harmful so I am trying to understand a bit more before recommending that you cease giving it.

Don't worry about being in a fog... I have so been there! This group helped me save my dog's life because my first vet made a mistake in dosing. It happens because this can be a tricky disease.

It is protocol to always prescribe prednisone to have on hand when a dog is loading with lysodren. You only use it in emergencies. You need to have in case the dog gets too much lysodren. I am surprised you don't have it on hand. It is given to raise cortisol in case your dog gets too much lysodren.

Deb who commented a while ago about your lab results is a lab tech with many years experience. Just wanted you to know you can trust her!

I don't mean to scare you --- I'm just trying to understand and to help you help Bonnie. Kim

[frijole]

Oops.. I forgot.. that paper where you said it wasn't specific to Bonnie but mentioned the acth.. normally there are two numbers on it. They are usually labeled Pre and Post.

Example: Pre 4.4 Post 31.2

Do you see any numbers on it?

I am asking because this is a cushings test that measures cortisol. Thanks! Kim

[StarDeb55]

Linda, I'm in total agreement with what Kim is telling you. If an ACTH is the only test that was done to make the diagnosis, this may be very risky to treat based on a single test. As I said, no single test is 100% specific & sensitive for Cushing's. If Bonnie did have an elevated result on her ACTH, IMHO, I would want an abdominal ultrasound done to take a look at her adrenal glands which will help determine what type of Cushing's is present. Also, if this is the only test that has been done, I would stop the lysodren until you can discuss this in detail with your vet. Cushing's is a very slowly progressing disease, so you have plenty of time to make absolutely sure of the diagnosis. It takes Cushing's months & months, if not years, to do the damage to a pup's internal organs from the overproduction of cortisol. The other thing is the prednisone, this is not a maybe on a vet's part to provide you with this during loading, it's CRITICAL. If a low cortisol emergency should occur, having pred immediately available can save a pup's life. I have been through Cushing's with 2 pups, now, & I absolutely make sure that I have prednisone available at all times.

Debbie

[Bonnie's Mommie]

Wow, now I certainly have a lot more questions. Okay, found the other results:
Cortisol Pre is 2.3
Cortisol 2 is 2.2

[AlisonandMia]

Wow, now I certainly have a lot more questions. Okay, found the other results:
Cortisol Pre is 2.3
Cortisol 2 is 2.2

What test is would that be? Was that an ACTH stimulation test? How long did it take to run the test - did she have to be there all day or only for a couple of hours?

Alison

[zoesmom]

Whoooooaaaa.....that acth was done to diagnose cushings????? Because those are NOT results that indicate cushings. Pretty much the opposite. I'm not sure what addison's disease would show on an acth test. But those numbers are way too low, even for a NORMAL dog.

Cushings dogs should have a post acth (2nd) number above 22. ug/dl. That's 22, not 2.2 for sure. Normal dogs should have somewhere between 8 and 17. ug/dl.

Your Bonnie is way below that. Addison's is where the dog doesn' t have enough natural cortisol in their systems, and when a cushings dog is being treated and their cortisol falls below 1.0 froom too much medicine (or 1.5 or 2 sometimes for dogs being treated with the specific drug trilostane), then that is usually an indication that they have gone 'addisonian' as we say around here. I'm wondering if your dog may be borderline addisonian. I believe the symptoms can be similar.

Maybe others here will know what the range is for identifying a dog with addison's. It too is treatable, so not to worry. But to put an addisonian dog on cushings medicine would surely be disastrous - likely even fatal. Have you found our info section and done any reading there, yet. Look on the home page. Sue

PS - are you sure that that was an acth stim test? Not a LDDS (low dose dex suppression test.) The LDDS takes 8 hours, nbut IT would have 3 numbers. How long was your Bonnie in for the test? PLUS.....An ACTH test should stimulate the dog's body to produce MORE cortisol, too, so it makes me wonder what Bonnie's cortisol levels were running BEFORE the test - assuming that was an ACTH test that she got. It could have been much lower, in which case she's almost certainly addison's. Not only that but the second number went DOWN, which is the opposite of what should be happening with a stim test.

PPS - I just reread your first post and it sounds like she's already started on lysodren???? If that's true, I'd strongly suggest you stop it at once, until this is all sorted out! Did your vet happen to give you any prednisone before you started her on lysodren? She might be needing some. And when was the ACTH test done? Before you started the lysodren, I presume - not after, right?

[StarDeb55]

Linda, if these numbers are indeed an ACTH, PLEASE STOP THE LYSODREN NOW! They by far & away not consistent with Cushing's. They are very low, but I think there borderline for Addison's. I just took a look at the IDEXX lab test result interpretation for Addison's & they say either a Pre or Post value on the ACTH of less than 2.0. As Alison has asked, how long was Bonnie at the vet when this test was done? That will give us a good idea as to what test was probably done.

Debbie

[zoesmom]

Not to alarm you but if your dog starts getting weak, wobbly, lethargic, not eating, vomiting, diarrhea and generally sick, she will need immediate attention to raise her cortisol levels. That's why I asked if you had been given any prednisone. That is the quick antidote, but in Bonnie's case, she'll definitely need to be seen and treated at once, because of her initial low cortisol. She may even need more than prednisone. I think we're all extra concerned here and are hoping you'll be back online soon. Sue

[frijole]

Bonnie,

If the two numbers you posted are from the acth test like Sue said, this is not a cushings diagnosis. As she or someone else said, treating cushings does not have to happen right away. I would cease giving the lysodren until all this is sorted out. Something is not ringing right.

Perhaps we are missing something but the fact that no prednisone was given to me is really alarming as it is a must. I know you are new to this and don't know us ... I remember being in the exact same situation... so I can only promise you that we are not new to this and because we read here daily for many years while we are not vets we have seen far more cases than most vets.

I repeat that a dog that does not have cushings should not be given lysodren. It is designed to intentionally reduce the adrenals so that cortisol (which causes cushings) is reduced. Your dog's test results that you posted would indicate cortisol was already too low. That is why stopping the drug is important.

Please don't worry about asking us any questions because we all were new at one point.

There is a ton of information if you are up to it in our resources section. This comes from international sources and experts in the field. The first link is for beginners. :D The second talks about testing and lysodren.

Thinking of you.. Kim

http://www.k9cushings.com/forum/showthread.php?t=180

http://www.k9cushings.com/forum/showthread.php?t=217

[Bonnie's Mommie]

Thank you all so much. I'm very worried right now. Am going to stop the Lysodren today. When I take Bonnie in on Sunday for her blood test I am going to ask the vet to re-evaluate her test results. I have been going to this vet for almost 8 years and have had no reason in the past to question him or anyone in his office, but this really has me shaken up.

To answer your question about the tests - Bonnie was at the vet for 8 hours. That's when they did the pre and post tests.

[AlisonandMia]

If Bonnie was in for an 8 hour test then that was probably a Low Dose Dexamethasone Suppression test (often abbreviated to LDDST or LDDS Test).

There are usually 3 sets of numbers, a pre number and then a four hour number and an eight hour number. If those two numbers you posted are from an LDDS test then that is not as worrying as it would be if it was from an ACTH stim test.

However the fact that Bonnie only has one symptom of Cushing's - that is frequent urination and excess drinking and that she was diagnosed with just that one test is a worry. There are many, many reasons for excess urination and drinking besides Cushing's and her urinalysis was not entirely normal which could point to something else. The LDDS test is a test that can give what is called a false positive (that is it can say the dog has the disease when it doesn't) if there is any other illness present or even if the dog is stressed out being at the vets. For this reason I think that there is still a reasonable doubt as to whether Bonnie really does have Cushing's and for that reason you would be wise to stop the Lysodren dosing for the time being. If she does indeed have Cushing's then there is no harm in holding off on the treatment for the time being until you can be totally sure of the diagnosis - but on the other hand if she doesn't have Cushing's then treatment with Lysodren could be very dangerous indeed.

Alison

[StarDeb55]

As Alison has already said, this certainly sounds like a low dose dex test. Could you please recheck the report & see if there are 3 values listed? One should be listed as a baseline or pre which is the cortisol value before the injection was given, a 4 hour value which is the cortisol level 4 hours after the injection, & then an 8 hour value. Please repost the results including which value is baseline, 4 hour, & 8 hour.

Debbie

[Bonnie's Mommie]

Thanks, ladies. I feel a little better. There was a low dose dex test run but stupid me left all the paperwork at home today. I did stop the Lysodren and as one of you stated, since it lasts in her bloodstream for 48 hours, it will still be present at the time of her test on Sunday. Believe me, I will have a laundry list of questions for that vet appt.

I will post the other test results when I get home tonight. I feel like a bad mom - I should know how to read basic test results and I obviously overlooked some of the numbers.:confused:

Thank you again - this site is a godsend.

[gpgscott]

I will post the other test results when I get home tonight. I feel like a bad mom - I should know how to read basic test results and I obviously overlooked some of the numbers.:confused:

Thank you again - this site is a godsend.

You are not a bad mom you are just a mom following instructions trying to help your pup and also educating yourself at the same time. I would call that a good mom:)

If the numbers posted are from an LDDS, they could indicate Cushing's as you want the two post numbers to be below 1.4 ug/dl at both the 4 and 8 hour marks and prefereably both should be less than 1.0. But it is impossible to say for sure without seeing all three numbers. If the number you are identifing as pre is indeed the pre number it is suspiciously low.

I agree with the others that I would not continue treatment until I knew there was more than one lab confirming Cushing's and even with mutiple labs it would be difficult to convince me to commence treatment with consumption of water being the only sympt. I would be very suspcious of kidney issues and diabetes.

Scott

Looking forward to more test results, stoping the Lysodren when in any doubt is much better than continuing to administer it.

[Bonnie's Mommie]

Linda, I am very concerned based on the test results you have posted. None of these tests can diagnose Cushing's, they may hint at Cushing's. Bonnie's test results don't even hint at Cushing's. First of all, the great majority of Cushpup's can't concentrate their urine, meaning they have a very low specific gravity, usually less than 1.010. An elevation in the SGPT which is one of several liver function tests, can be due to a huge number of things other than Cushing's. The most common liver function test that is elevated which will lead a vet to suspect Cushing's is the alkaline phosphatase. Elevations in this liver enzyme are usually pretty dramatic, even in the several thousands. As both Kim & I have already mentioned, the Cushing's diagnostic testing includes the following low dose dexamethasone (LDDS), ACTH, high dose dex (HDDS), & frequently, an abdominal ultrasound. Were any of these tests done?

Debbie

PS- One other VERY IMPORTANT thing when it comes to making a Cushing's diagnosis, symptoms. Strong symptoms are a very important part of making the diagnosis. If excessive drinking was the only symptom Bonnie has, most vets will not treat based on just this symptom. Excessive thirst can be caused by diabetes, & thyroid as I mentioned. Were these 2 things ruled out?

Hi Debbie - forgot to answer you - yes, diabetes was ruled out. Thyroid was not mentioned, however.

[frijole]

Hi again! Checking in during lunch... glad you got the messages and withheld just to be safe.

Trust me, we were all lost the first week. Could you start at the beginning and tell us what symptoms made you take Bonnie to the vet and started the testing? The more info the better. Tell us the story.

Thanks!
Kim

[zoesmom]

Whew...I feel better knowing you've stopped the lysodren. Always better safe than sorry. Both cushings drugs are serious medicines and it's crucial to have a definitive diagnosis of cushings before using either one.

If Bonnie was in for eight hours, that is most likely the LDDS. I suggest you make a specific list of questions before you see the vet and that would be the first one to ask. If it was an LDDS test, the next thing is to figure out if there were actually 3 numbers, rather than 2. If there are only two, you need to find out exactly which ones those were. The baseline (done at the outset and before any suppression drugs were given) - then normally, they'd give the suppression drug to the patient and wait 4 hours to do another blood draw (that would be the second number); then after 4 more hours, they'd do the last blood draw (basically at 8 hours and that would be the third number). Without knowing which numbers you posted (pre, 4 hr, 8 hr) it's hard to tell exactly what they mean. But certainly, no lysodren is still in order. Also, it won't make much sense to go ahead with Sunday's test if Bonnie only took a couple of doses and then three more days go by. It's not a cheap test so don't throw your money away on Sunday. If this proves to truly be cushings, you would restart the lysodren and load with a daily dose for anywhere from 2 to maybe 10 or 12 days. Each dog is different and the fact that your vet said 5 days is sorta a red flag. Some dogs can load in 2 or 3 and if Bonnie were like that and continued on the lysodren for five days, that too could be a big problem. Especially since the drug keeps doing its work for a couple days after the last pill. What ought to be done in loading is to watch for the early signs of lessening of appetite and water consumption. Those can be very subtle signs and easily missed. It might be simply turning up their nose at a treat. Or leaving a few morsels of food in their bowls at mealtime. I'm also wondering why loading would have begun when your dog's appetite seemed to fallen off even before the lysodren. That would not be the ideal time to start a loading. Anyway, at the first hint of appetite and water reduction, an owner would then stop the lysodren and wait a day or so and then get the ACTH stim test to see if the cushings is under control (that would be a one or two hour vet visit and the results would have only a pre number and a post number. If loading is complete, then you would expect to see that post number be slightly above the pre-number and in the 1 - 5. ug/dl range. That's the goal for a dog on lyosdren. If the ACTH is in that range, then you'd begin maintenance. Those are the basics. One thing you can do is read up in our resource section and then when you go to the vet, pose some questions on these things that you already know the answer to, and see if your vet seems to know them all. Believe it or not, there are a lot of gp vets out there who don't have a good handle on how to diagnose and treat cushings. They just don't see enough cases.

Will be anxiously waiting to hear from you...... Sue

PS - will see if I can find my favorite explanation of how to interpret the specific numbers of an LDDS test and postthem for you here.

[zoesmom]

Here it is. It sounds complicated when you read it, but if you just write down the numbers and then go thru the instructions step by step, it will make more sense. As you can see, with just those two numbers, it's hard to interpret what's going on with the LDDS test. So we need to know what those two numbers were from (pre, 4 or 8 hr. readings). Normally a cush dog will suppress (have a lower number than the baseline) at four hours and will show some escape from suppression (rising number) at 8 hours. If you're still confused, the people here can help you understand what Bonnie's numbers mean - once we get their timing straightened out. If there is still some doubt, it might be worthwhile to have an abdominal ultrasound done next. Sue

Low Dose Dexamethasone Test (LDDS)
The protocol utilized for this test is obtaining plasma samples
for cortisol before and 4 and 8 hours after I.V. administration
of 0.01 mg/kg dexamethasone. The 8-hour plasma cortisol
is used as a screening test for hyperadrenocorticism, with
concentrations >1.4 μg/dl being consistent with (not confirming)
the diagnosis of Cushing's syndrome. This test is relatively
sensitive and specific, but not perfect. Approximately
90% of dogs with Cushing's syndrome have an 8 hour postdexamethasone
plasma cortisol concentration >1.4 μg/dl
and another 6 to 8% have values of 0.9 - 1.3 μg/dl. The
results of a low dose test can also aid in discriminating PDH
from ACT, using three criteria: 1) an 8 hour plasma cortisol
>1.4 μg/dl but <50% of the basal value; 2) a 4 hour plasma
cortisol concentration <1.0 μg/dl; and 3) a 4 hour plasma
cortisol concentration <50% of the basal value. If a dog has
Cushing's and it meets any of these three criteria, it most likely
has PDH. Approximately 65% of dogs with naturally
occurring PDH demonstrate suppression, as defined by these
three criteria. A dog with Cushing's that fails to meet any of
these three criteria could have either PDH or ACT. However,
if it has two relatively equal sized adrenals on abdominal
ultrasonography, it most likely has PDH.

ACTH Stimulation (NO LONGER RECOMMENDED) [note: for diagnosing, that is....still the test to use to monitor a dog on treatment, tho)
The ACTH stimulation test has been popular for decades in
veterinary medicine. It is simple to complete and takes little
time. The other significant feature regarding results of an
ACTH stimulation test is that this is the only study which reliably
demonstrates the effect of o,p' DDD on the adrenal cortex.
Thus, some veterinarians want results of an ACTH stimulation
test, prior to initiating o,p' DDD therapy, because the
results are used as “baseline” information to objectively
monitor effects of o,p' DDD. Regardless of the protocol chosen,
it must be appreciated that 20 - 30% of dogs with
Cushing's syndrome have test results within the reference
range (in our laboratory: post ACTH plasma cortisol concentrations
of 6 to 17 μg/dl). An additional 20 - 30% of dogs
with Cushing's have test results described as “borderline”
(plasma cortisol concentrations >17 but <22 μg/dl).
Therefore, the test is not considered sensitive but is relatively
specific, i.e., those dogs with plasma cortisol concentrations
>22 μg/dl frequently have Cushing's. However, specificity
of an exaggerated response to ACTH is also not perfect.
Therefore, test results should never be interpreted without
knowing results of history, physical examination, and routine
data base testing. There are no features of ACTH stimulation
test result that allow discrimination between PDH and
ACT. As ACTH has become more and more expensive, this
test is losing popularity. .... In our opinion,
the lack of sensitivity of the ACTH stimulation test makes
it a test that the profession should abandon. The situations in
which ACTH stimulation testing would be indicated include
monitoring therapy for naturally occurring hyperadrenocorticism,
to aid in the diagnosis of iatrogenic Cushing's syndrome,
and as the “gold standard” for the diagnosis of naturally
occurring hypoadrenocorticism (addison's disease)

Urine Cortisol: Creatinine Ratio (UC:CR)
The urine UC:CR ratio is easily performed (simply have the
owner collect and deliver urine to the hospital and submit
it to the laboratory) and, therefore, it is usually less expensive
than other screening tests. Most dogs (~97%) with naturally
occurring Cushing's syndrome have an abnormal
result (the test is sensitive) but a significant percentage of
dogs with polyuria / polydipsia due to other conditions and
those with non-endocrine illness also have abnormal
results (the test is not specific). It has been suggested that
the UC:CR be routinely performed only on urine collected
by an owner at home, rather than having it collected inhospital.
Since this protocol eliminates travel or hospital
stress from altering test results, it seems reasonable to follow
this concept. We do not utilize this test with the same
degree of confidence with which we use the low dose dexamethasone
screening test. However, a normal result is
quite uncommon in a dog with Cushing's syndrome while
an abnormal result could be used to prompt further testing.
Therefore, this test can be used as a prompt to recommend
abdominal ultrasonography and a low dose dexamethasone
test to an owner.

[Harley PoMMom]

UC:CR


Yes. The same would apply when looking at urine cortisols in the initial diagnosis of Cushings. Ideally 3 morning pooled urine samples collected by the owner at home and refrigerated.
Dave


Urine cortisols can be a problem. Many studies have shown that the only way to accurately gauge urine cortisol levels is to obtain the first morning voided urine sample on 3 consecutive days and then pooling the urine to run a UCCR. When done in this fashion it is likely an accurate test. Otherwise there is likely too much day to day variation to make a single random cortisol very helpful.

Dave Bruyette DVM DACVIM


I didn't know about this protocol for the UCCR until 2 weeks after I had my other pom. tested with this test. :eek::(

Lori

[Bonnie's Mommie]

Hi again - here are the tests that were given:
Cystocentesis Bladder
Urinalysis (AD)
Urine Culture/Sensitivity (AD)
Dexam. Suppression Low Dose
Cortisol Pre/Post X 2 (AD)

The Cortisol (2 Samples)
Tube Labeled 6HR
Tube Labeled 8HR
Cortisol Pre 2.3
Cortisol 2 2.2

I'm going ahead with the blood test on Sunday, and am going to have her blood pressure checked at that time. I'm also taking her to a Cushing's specialist on Wednesday for a second opinion!

Thank you all for your continued help.
Linda

[StarDeb55]

Linda, a baseline result should have been drawn prior to the injection. The other 2 values are compared to the baseline to see if there is any escape of suppression. Most guides to interpret low dose results state that if the 4 hr. sample is greater than 1.5 & greater than 50% of baseline, & the same with the 8 hour result, it would be consistent with Cushing's, but you're not able to determine what type. For the results to be consistent with PDH, the 4 hr. is >1.5 & <50% of baseline, while the 8 hour is greater than 1.5, but <50% of baseline. So I think you can see without that baseline value, there is no way to tell for sure that these results are consistent with Cushing's.

Debbie

PS- I'm so sorry, I have misread your post. I seem to be doing that lately, must be old age setting in. Anyway, you have, indeed posted a baseline result of 2.3, & what appears to be an 8 hour result of 2.2. You are still missing one value which should be the one done at 4 hours.

[frijole]

Linda, now that you have read about cushings and the different potential symptoms... does Bonnie have any of these? Still trying to wrap my head around what got the testing started.. Thanks, Kim

[Bonnie's Mommie]

Linda, now that you have read about cushings and the different potential symptoms... does Bonnie have any of these? Still trying to wrap my head around what got the testing started.. Thanks, Kim

Kim, the testing started when I noticed that she was drinking an excessive amount of water. When I took her in the first time, the vet immediately tested for and ruled out diabetes, but said that it could be renal, liver or Cushing's. Her first blood tests showed a high liver enzyme, and that's what prompted the next round of tests, meaning the 8 hour tests. So far, she's only shown the water drinking symptom.

[StarDeb55]

Linda, as I mentioned in one of my first posts, you only have a single liver value that is elevated, the ALT. This could be caused by a number of things including Cushing's. It is extremely common for cushpup to show substantial elevations in the alkaline phosphatase, ALT, & cholesterol which are all considered to be liver function tests. The most common abnormality that will cause a vet to be suspicious of Cushing's is a severely elevated alk phos. Strong symptoms are very much a part of making the diagnosis, & right now, Bonnie does not have that. Excessive drinking, & a single abnormal liver enzyme wouldn't be considered strong symptoms by most vets. It's possible that you may have caught Cushing's early. If that is the case, IMHO, I would hold off treating until Bonnie becomes more symptomatic. I think going to a specialist is an excellent idea as they certainly should be able to get this sorted out for you.

Do you have a hard copy of the LDDS result? If so, could you please double check it, looking for that 3rd number that we're still missing which I believe should be a 4 hour result.

Debbie

[zoesmom]

Hmmm.....those LDDS results are a real mystery. Looks like the pre (or baseline is 2.3). And the 2.2 is one of the post-numbers. Wonder why they noted a 6 hr and an 8 hr sample, tho, but only show one number? Plus, why didn't they do the draws at 4 hrs and 8 hrs. That alone warrants a question for the vet.

In any case, if the 2.2 is one of the post numbers, it's definitely greater than 1.4 and probably indicative of cushings - although that isn't the ideal way to do the LDDS - with just one post draw. But even if it was a 6 hr. draw or an 8 hr. draw, the fact that the number was still above the 1.4 probably means cushings. But as the others have said, it doesn't help determine which kind of cushings.

If it was done properly - with all 3 draws and the last two done at 4 & 8 hours, you might have gotten an idea about which kind of cushings it is. Is that something you would would want to know? Most people like to know that because PDH is only treated with medicine. ADH (adrenal based cushings & much more rare) is often curable with surgery. Even if an owner doesn't want to go the surgery route, ADH dogs treated with lysodren usually take longer to load and require a higher dose. So, IMO, it helps to know which kind of cushings you are dealing with. The ultrasound would be the best way to confirm that. ADH dogs have, on an u/s, adrenals that are not equal - one is apt to be much bigger. PDH dogs usually have adrenals that are normal or enlarged - but equal in size, either way.

As far as the ACTH on Sunday, my guess is that it won't show that Bonnie is loaded. But it will be interesting to see exactly what her cortisol level is now. The problem is that with two days of lysodren, you won't know where her cortisol started (how high it was initially.)

What the others are saying about lack of symptoms is also something to discuss with the vet. Many vets won't begin tx until there are more symptoms occurring. My concern with continuing loading (assuming the LDDS is truly positive) is that you said her appetite wasn't up to par lately. That can make loading much trickier. Especially if there's some other health reason for her losing her appetite.

All in all, I think the appt with the specialist is the best idea at this point. Sue/Zoe

[Bonnie's Mommie]

Just thought I'd update you nice people. I took Bonnie to the Animal Medical Center to see a Cushing's specialist. She was misdiagnosed, as you hinted. She's going to have an ultrasound on Tuesday, because SOMETHING is wrong. The new vet thought it could be a very mild case of pancreatitis, but it's definitely NOT Cushing's.

Thank you for putting doubt in my mind!

[frijole]

Thanks for coming back to tell us! We become attached quickly. :p I also am glad that you got enough doubt from our sincere concerns to go to a specialist and get that 2nd opinion. Congrats because you could have just saved your dog's life. Big pat on your back from us. Feel free to keep us posted on how its going with others tests... we have old dogs and lots of experience. :D Hugs to dear Bonnie. Kim

[StarDeb55]

Linda, I'm so glad for both Bonnie & you that it's not Cushing's! I wish we could say that you are the very first parent that this has happened to when you find us, but unfortunately, you aren't. Cushing's is a very frustrating & difficult disease to diagnose as there isn't one single test that is 100% specific & sensitive. This is why we strongly encourage new members to learn all you can, ask questions of your vet, & first & foremost make sure you have a "Cushing's savy" vet on your team. None of us are vets, but there are more Cushing's case histories in this group than most GP vets will probably see in their career. This group has probably seen it all when it comes to diagnosing Cushing's, & we're here to share our experiences, to try to help other parents avoid some of the problems/pitfalls that have happened to us.

Debbie

PS- Please keep us updated on what the specialist finds on Bonnie's ultrasound.

[Harley PoMMom]

Hi Linda,

I am very happy for the both of you too.


The new vet thought it could be a very mild case of pancreatitis
Susy, one of the very nice and knowledgeable moderators posted a link about pancreatitis in another members thread, it is very informative, so I thought I would post it for you.

http://www.dogaware.com/wdjpancreatitis.html

Best of luck to you and Bonnie.
Lori

[gpgscott]

Thanks for the note Linda,

Pancreatitus is a serious issue as well and hoping the new Dr. gets a read on it it quickly and gets Bonnie and you some relief.

Even if it is not Cushing's please consider yourself part of this family, we want to know and help where we can.

Scott

[Bonnie's Mommie]

Really sad update, but this is a direct result of me being talked into
a second opinion. Email from my new vet:
Hello,
I just got an email from the radiologist about Bonnie's ultrasound.
Unfortunately, he found a mass on Bonnie's liver.

It is difficult to tell based on ultrasound whether this mass is a malignant (cancerous) tumor or a benign tumor. Furthermore, it is difficult to tell how this may relate to Bonnie's increased thirst and urinations. Liver problems can cause increased thirst and urinations, but this certainly should not have responded to lysodren. So, it's possible that this mass was an incidental finding, that was not causing her any problems at this point.

The medical recommendation at this time would be to have this mass removed, with surgery, and submitted for biopsy. The most common type of primary liver tumors in dogs, hepatocellular carcinoma, can sometimes be cured byt complete surgical removal. Other types of liver tumors, though, can be more aggressive. It will really be difficult to determine the nature of this mass without performing a surgical biopsy.

I'm sorry to share this news with you over email. I will be back at work in approximately 3 weeks, and would be happy to speak to you about this when I get back. If you are interested in pursuing surgery with Bonnie, I would recommend making a consultation appointment with one of our soft tissue surgeons. There are 2 surgeons I would strongly recommend

I am calling tomorrow morning to make the consult appt. And this would have never been found because my first vet didn't want to do an ultrasound.

[Harley PoMMom]

Linda,

Thank God that YOU persued a second opinion and got the ultrasound done on Bonnie.

Will hope and pray the tumor is benign and be cured by complete surgical removal.

Please let us know how you make out with your consultation appointment.

Best of luck to you and Bonnie. You both are in my thoughts and prayers.

Hugs.
Lori

[gpgscott]

Thanks for letting us know Linda,

Please post us with your progress.

Best to you and Bonnie.

Scott

[Roxee's Dad]

Hi Linda,
Sorry I haven't posted to you before but you have recvd so much excellent advice that I had nothing to add. Happy that you have a diagnosis and just wanted to let you know that you and Bonnie are in my thoughts and prayers for a successful surgery and quick recovery.

I do hope you will continue to keep us up to date.

[Squirt's Mom]

Hi Linda,

Oh, man! Did your post bring back memories not that far in the past!

Squirt had an ultrasound in May of '08. Then after her UTK panel, Dr O suggested another one, so we did. I was told after the second one, that there was a tumor on her spleen that was present on the FIRST one FOUR months earlier but the IMS at that time didn't feel the need to mention it ANYWHERE! :eek: OMG!! I was scared to death and LIVID!!! :mad::eek::mad::eek::mad: The first IMS that let that tumor go unmentioned had moved by the time we had the second one done and she better be glad...I would not have been responsible mentally for what I would have done to her if I could have gotten my hands on her! :o If that tumor had ruptured during those four months, as they are prone to do, my Sweet Bebe may not be here today.

I am sooooo glad you forced the issue of the ultrasound! Now you know why I personally feel so very strongly about having them done! I fully understand what a terrifying time this is for you but you are already on the right path by making an appt for a consult. Take someone with you to the appt, take a recorder, take notes - whatever you need to do to be sure you remember what is said. When my emotions are in an uproar, my brain goes to mush and I can't absorb diddly! So I need things to help me. My vets are used to me and my notebooks by now! :p

Linda, know that we are here for you. Even if you just need to vent, we are here. Several of us have had to face these scary side trips and we understand how you feel. I could never have made it through Squirt's surgery without these wonderful folks. So don't suffer alone, please.

Let us know how things are progressing and what you decide to do.
Hugs,
Leslie and the girls

[Bonnie's Mommie]

Thank you everyone, for your advice and comments. (I put Bonnie in my avatar so you can see who I'm talking about, lol)

I'm taking her for the first surgical consultation this afternoon, and am hoping to get a copy of the ultrasound because I want to send it to a liver specialist at Cornell, in hopes that she can refer me to another surgeon here in NYC. Just for a second opinion, because I believe I'm at the best place in town, the Animal Medical Center. After the first go-round, with the misdiagnosis of Cushing's, I want to always get a second opinion now.

I can't tell you what I'd like to say to that first vet...I'm sure you can imagine!

[Squirt's Mom]

Yep, Linda, I can well imagine what you would like to say! I did say those things, but to a tree in the back yard... :o:p I felt better after, tho! ;) Of course, that was just one more nutty incident for my neighbors to take note of... :D They quit asking questions a while back and now I just get funny looks!

I love the avatar of Bonnie! Maybe you can post some more pics of her in your album for us to see. She is such a doll!

Keep your chin up!
Hugs,
Leslie and the girls

[frijole]

First off... that photo is soooooooooo adorable. I just want to hug and kiss little Bonnie. So precious.

Am grateful you got the 2nd opinion. There is a reason for everything and it sounds like you already have a backup to your backup plan so you are set to move forward and getting cute little Bonnie on the road to clean health.

Thanks for keeping us updated... we get attached quickly. :p Good luck!

Kim

[lulusmom]

Hi Bonnie,

I've been following your thread but didn't feel the need to post as the others had all the bases covered. So I'd like to give you a great big belated welcome and a well deserved congratulations for being a great advocate for Bonnie. Many of us have had a bad experience with our gp vet and the only thing that stopped me from drop kicking my old gp vet's butt into tomorrow was my mom. She said that if I made a scene, she'd hurt me and I believed her. She was 79 years old back then but even after a half a century, I remembered the sting of her iron hand. :D:D

Please keep us posted on Bonnie's progress.

Glynda

P.S. I'm so glad that you put Bonnie's adorable face up for all of us to see and go aaaawwww. She is absolutely huggable and I am sure that both of my Maltese boys, Buster and Jasper, would think she is quite the hottie. :D:D

[Bonnie's Mommie]

Well, here is the update:

We saw the surgeon today. She's doing the surgery on Tuesday to remove the mass and start the biopsy process. Bonnie will be there overnight, at least. Then no jumping or exertion for a few weeks, which means when I go to work I'll have to leave her in the bedroom so she can't jump on or off the couch. The mass is about the size of a marble. It's on the left side of the liver, which is much better than being on the right side. They took a chest x-ray to see if there were any other masses, in her lungs - thank goodness there weren't. The surgeon said that there may be another liver disease, however, which could be causing the other symptoms, since this mass, they don't believe, would cause them.

The specialist, who is on her honeymoon, is emailing me like crazy, keeping updated both from me and the surgeon.

Thank you all for the warm welcomes and all the wonderful support you have shown this very nervous mom. I'll update you on Tuesday.

xoxo

[acushdogsmom]

First of all, Bonnie is absolutely adorable! What a cutie pie! :D

I haven't read through your whole thread, but if your Surgeon and the Internist are at AMC in New York, as far as I know, it is considered to be a top-notch facility and I'm sure that you and Bonnie are in the very best of hands there.

We've had several members here in the past whose dogs were treated long-term by Internal Medicine Specialists at AMC and they all had great things to say about AMC and about the Specialists there whom they had on their dogs' cases.

http://www.amcny.org/

I'm really glad that you found us, too, and please keep updating as often as you can.

[Harley PoMMom]

Hi Linda,

We will be praying for you and Bonnie like crazy.

Would you consider putting Bonnie in a crate after her surgery to recuperate while you are at work, alot of dogs like the security of the crate. This way you know there is no jumping or exertion going on. Just a thought.


The specialist, who is on her honeymoon, is emailing me like crazy, keeping updated both from me and the surgeon.
Now that's a special specialist. :D A women of course. :p

Yes, yes, please keep us updated and best of luck to you and Bonnie.

You both are in my thoughts and prayers.
Hugs. Lori

[Bonnie's Mommie]

Hi Linda,

We will be praying for you and Bonnie like crazy.

Would you consider putting Bonnie in a crate after her surgery to recuperate while you are at work, alot of dogs like the security of the crate. This way you know there is no jumping or exertion going on. Just a thought.

Now that's a special specialist. :D A women of course. :p

Yes, yes, please keep us updated and best of luck to you and Bonnie.

You both are in my thoughts and prayers.
Hugs. Lori

Hi Lori - I thought of a crate or an expen, but I think she'll be just as safe in the bedroom, and she knows the lay of the land there. As long as she can't jump. She'll have to be on her best behavior when her sitter comes in, too!

[Harley PoMMom]

Well it certainly sounds like Bonnie's Mommy has everything covered. :D

Definitely keep us updated and please, post whenever you want to, you are part of our family! I know the days before Bonnie's surgery are probably going to make you more nervous. So remember we are here for you.

Hugs to you and Bonnie.
Lori

[fivebichons]

Hello Linda,

I'm an 'old timer' here that pops in every now and then. I saw that little white head and I just couldn't resist! It looks like you and precious Bonnie are right on track. It's amazing what they can do these days. Did someone say a 'honeymoon' would ever keep someone from checking on a flufferbutt? :p

We are sending positive thoughts and prayers from our house to yours. You are in the right place. Lots of hugs and kisses for Bonnie!

Heidi, Robin, Marco & Sophie
...and Friskie, Lucky, Cheri and Snicky from heaven...

[StarDeb55]

Linda, I want to wish you & Bonnie the best of luck! I will be keeping my fingers crossed that the liver mass is nothing to worry about, but it's best to get the thing out of there. I am another firm believer in the value of an abdominal ultrasound. When Harley had his, we discovered that he has a pre-existing gall bladder problem which includes a dilated common bile duct. He was seriously ill last Sept, spending 3 days at the vet's on IV fluids. If it hadn't have been for that ultrasound, my vet might not have had any idea what the source of the problem was as all of Harleys labwork was normal.

Debbie

[gpgscott]

Very best of luck Linda.

Scott

[MiniSchnauzerMom]

Hi Linda,

I've followed Bonnie's thread but this is my first post to you. Just wanted to let you know that I, too, will be thinking positive thoughts and saying a little prayer for Bonnie's successful surgery and rapid recovery next week. And by the way....what a little sweetie pie!! Looking at her face makes me want to "gently" tweak those fuzzy little cheeks.

Louise

[Bonnie's Mommie]

Just a quick update - I changed the surgery date from Tuesday to Thursday, so I can pick her up on Friday and be with her Saturday, Sunday and Monday post surgery (yes I have OFF on Mondays!!)

[MiniSchnauzerMom]

Just a quick update - I changed the surgery date from Tuesday to Thursday, so I can pick her up on Friday and be with her Saturday, Sunday and Monday post surgery (yes I have OFF on Mondays!!)

Sounds like a good plan!

Take care,
Louise

[Bonnie's Mommie]

Hi everyone - Bonnie had her surgery yesterday and is now home.:D A little groggy and a litte worse for wear, but I'm very happy she's home. The entire mass was removed and the biopsy results should be back middle to end of next week. Her scar is pretty scary, but I've been telling her that she is a warrior, and that is just a battle scar, lol.

[Harley PoMMom]

Hi Linda,

So happy Bonnie's home and they were able to remove the entire mass, that's great news!

Will be looking for your update for the biopsy results, and on how Bonnie is doing too, thanks for letting us know.

Love and hugs.
Lori

[frijole]

Wonderful news! Thanks for keeping us posted. Give that bundle of joy a big hug and kiss for me. Kim

[MiniSchnauzerMom]

Hi Linda,

Glad Bonnie's surgery went well and that she is home in familiar, comfortable surroundings to start her recovery process. Will be watching your updates on Bonnie and saying a little prayer that the biopsy results will be benign.

Add some extra hugs and kisses for your little sweetie pie Bonnie from me too! :D

Louise

[SaxLady]

Hi Linda,
Bonnie must be doing quite well to be at home already. She is a sweet little girl! So cute! Sending good healing vibes for her.
Hugs to you both!
Candy, Katrina, Joe and Heidi

[4Mikeydog]

Hi Linda,

Just catching up on your thread. So glad to hear that Bonnie is home and recovering.
We are praying for her continued recovery and benign biopsy results!

Dorothy and Mikey

[Squirt's Mom]

Hi Linda,

I am so happy to read that Bonnie is home and doing so well! I pray her recovery will be swift and uneventful.

Hugs,
Leslie and the girls

[Bonnie's Mommie]

Hi everyone! Great news - the mass is benign!! Hoorah! Bonnie is recovering nicely although her appetite is still down (as it was 4 weeks before her surgery) and she's still drinking a lot of water, so her NEW vet will want to do more testing but I'm thrilled that the biopsy came back benign!!

Thank you all for your kind thoughts.

Linda and Bonnie

[Harley PoMMom]

Oh Linda,

That is great, great news indeed. So happy for you and Bonnie.

You will let us know what tests the NEW? vet wants to run...right? and please keep the updates coming.

Boonie is just so adorable. :) and I'm glad she's recovering nicely.

Love and hugs.
Lori

[Bonnie's Mommie]

Oh Linda,

That is great, great news indeed. So happy for you and Bonnie.

You will let us know what tests the NEW? vet wants to run...right? and please keep the updates coming.

Boonie is just so adorable. :) and I'm glad she's recovering nicely.

Love and hugs.
Lori

Thanks, Lori. Yes, the NEW vet after my previous one misdiagnosed Bonnie with Cushings and got snippy with me for asking too many questions. The new vet is an internal medicine vet with a specialty in Cushing's, and although Bonnie doesn't have it, she said she would treat Bonnie as her 'regular' vet.

[MiniSchnauzerMom]

Great news - the mass is benign!!




:D :D :D Fantastic news...congratulations!!!!:D :D :D

Louise

[Squirt's Mom]

Hi Linda,

Such good news that the tumor is benign!! :D:D I know how relieved you were when you got that news.

Hugs,
Leslie and the girls

[Harley PoMMom]

Hi Linda,

I was just reading your thread and saw this post , was Bonnie ever checked for a UTI, (urinary tract infection), with her having blood in her urine and her drinking alot she might have an UTI...Just a thought.



The tests results that are abnormal are:
(first round of tests)
ALT (SGPT) 159
BUN/Creatinine 31

(second round of tests)
Urinalysis
Specific Gravity 1.053
Protein 2+
Blood 1+
RBS 4-10


Linda

Love and hugs.
Lori

[Bonnie's Mommie]

Lori - she wasn't checked for a UTI that I know of. Her new vet wasn't too concerned with the Specific Gravity being high, she rather expected that because of the excessive urination, but she never mentioned a UTI. We're going back for a post op check up with the surgeon and also seeing her new vet, so I'll ask then.

Thanks!

[4Mikeydog]

Hi Linda,

We are sooo happy to hear good news about Bonnie :D:D:D
We wish her continued improvement and healing!!
We are absolutely thrilled for both of you!

Dorothy and Mikey

[Harley PoMMom]

Hi Linda,

Was just wondering how Bonnie is doing, it's been a while since you've posted :( me worried. Her surgery was over a month ago so I am hoping everything is going well. Let us know when you can.


Lori - she wasn't checked for a UTI that I know of. Her new vet wasn't too concerned with the Specific Gravity being high, she rather expected that because of the excessive urination, but she never mentioned a UTI. We're going back for a post op check up with the surgeon and also seeing her new vet, so I'll ask then.

Thanks!

Love and hugs.
Lori