Dogs » Cushings confusion ?

Katrina1982

This question is related to: Benjie the Dog

Age:6
Gender:Male
Breed:Labrador / Beagle cross
Neutered:Yes
Weight:20kg
Vaccination History:Fully vaccinated
Fed On:Arden Grange light calorie chicken and rice
Kept:In my home

Cushings confusion ?

Hello may I ask for a second opinion/clarification please. My dog is an 11 year old Labrador/Beagle cross and suspected cushings disease patient. Its all come about from a dental procedure which flagged up some fatty substance in his chest, so an abdominal xray was done. This showed 1 enlarged liver lobe, which was biopsied and shown as none cancerous. His liver enzymes are raised and his urine cortisol level was 74 so they did an ACTH test. That has come back perfectly normal. Now hes booked in for a LDDS test. He has some but not all of the physical symptoms and his urine has been quite dilute for a while. I dont understand why some of his results/symptoms are positive and some are negative for Cushings. Is this normal to have such a mixture when making a diagnosis ? Thank you.

18/3/19

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Martina Stuart

I am not able to give specific advice without access to full clinical records and that is not the aim of this site, however The short answer to your question is no it is not unusual to have some tests “positive and some negative. There are so many variables that affect cortisol and acth base levels such as time of day, diet, water intake, time since food, stress levels exercise etc. This is why final confirmation is dependant on the dynamic tests.
It is interesting to note that the possible presence of hormonal imbalance cane to light on routine examinations prior to treatment of a dental problem. Dental disease is often accompanied by less than perfect kidney function.
You do not indicate what signs of Cushings disease he is demonstrating but if he is drinking more than usual and also passing nore urine then if it has not already been done then provided and only provided that his blood urea levels are normal then a water deprivation test is simple easy and safe to see perform and will tell you if his kidney function and urine control are functioning normally which is unlikely when a dog is clinically affected by Cushings disease. Do not restrict his water intake without first assessing his urine specific gravity and blood urea levels to do so would be dangerous.
I suggest that you talk to the vets currently treating him and maybe indicate that you are thinking about requesting a referral or second opinion.

18/3/19

Katrina1982

I adopted him aged 4 and got him neutered straight away but ever since he struggled to keep weight off and looked like a pot bellied pig. His skin is covered in lumps which I believe are sebaceous cysts and for years his submandibular glands have been enlarged. He's always ravenous and will eat anything that he can lay his paws on. A couple of years ago he got quite acutely ill and was hospitalised for 2 days diagnosed with a toxic insult to the kidneys. I assumed he had eaten something poisonous given his history of scavenging but after a few weeks of repeated blood and urine tests they found a terrible Ecoli infection. Since then he's had episodes of dilute urine. I then started him swimming to lose weight so he would be fit for a dental as he started making a stertor sound intermittently and his glands were still enlarged. I got him from 22kg down to 17kg and it was during the dental they xrayed his chest to investigate the noisy breathing and saw the fatty stuff and thought his heart was enlarged. An ultrasound was done but showed his heart normal but one liver lobe enlarged, that was biopsied and came back negative. He has arden Grange dry kibble and naturediet wet meat and I give him a multivitamin, a cbd capsule and a Hawthorn tablet daily

18/3/19

Katrina1982

I should add that during the dental they found loads of green gooey mucus at the back of his mouth. That turned out to contact Ecoli too.

18/3/19

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