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Possible cushings?

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  • Possible cushings?

    Hi everyone - I don't frequent this part of the forum much, but I thought y'all might have some help for me. I have a 10 y/o Heeler/Jack Russell spayed female that I have had for 9 yrs. She has never been a problem regarding peeing in the house. Lately, she has been having accidents in the house in a regular, almost daily, basis. I took her to the vet last week, hoping that something would show up on BW or UA. UA showed that her urine was slightly less concentrated, but no bacteria, WBC, RBC, or glucose. BW was reported to be "good," but as I have not received a copy yet, I do not know the actual measurements. I was a vet tech, so I am very familiar with BW and such. The initial worries of UTI, kidney issues, and diabetes were ruled out with the BW and UA. Vet suggested restricting water to see if she was just polydipsia, causing the polyuria.

    Since restricting her water, I have noticed how she seems to ALWAYS be thirsty. She walks around the house looking for something to drink and is pushing my other dog out of the way when she is offered water. I've had to water him in a separate room to be sure he is drinking enough. I haven't talked to the vet about her behavior since restricting water, but I am wondering if she could possibly have Cushings. I really don't feel that the urinating in the house is behavioral. Nothing has changed in her diet or home environment in the past year. Does anyone have any other suggestions? Experience with Cushing dogs?

    I'm contacting the vet on Monday, but wanted some people to bounce my thoughts on. Thanks for reading this all!
    Last edited by bugsynskeeter; Apr. 13, 2013, 11:39 AM.
    Only two emotions belong in the saddle: One is a sense of humor. The other is patience.

  • #2
    I think, given the symptoms, that Cushings would be pretty high on the differentials. Any hair loss? It certainly wouldn't hurt to do some tests.

    Comment

    • Original Poster

      #3
      No hair loss and she is in good condition (she runs 5 miles with me 2-3x per week). She is a quiet dog in the house, so I would not have really noticed any lethargy.

      I'm familiar with cushings in horses, as well as kidney issues in relation to the PU/PD. While her BW was reported to be "good," I don't want any water restriction to cause something that is looming to get worse.
      Only two emotions belong in the saddle: One is a sense of humor. The other is patience.

      Comment


      • #4
        Water deprivation tests are very old school and can be harmful to your pet. Please call your vet asap and ask them to reinstate full water consumption.

        Was the AlkPhos high on his bloodwork? Next step would likely be an ACTH stim, or low dose dex suppression. I would also ask for a referral to an internist as I wouldnt want to go back to a vet who said to restrict water. However, thats just me.

        There are other things that can cause PU/PD but generally first rule outs include infection, diabetes, cushings and renal. Of course after those are ruled out theres a ton more causes but diagnosis is more complicated.

        Comment

        • Original Poster

          #5
          Squish - as I already mentioned, I don't have a copy of the BW as I have not been able to go get it. I was simply told that it looked "good" and everything was within parameters. I have upped how much water she is allowed to have, but I have not given her free choice back yet.

          In regards to vets, I am severely limited. I live in the middle of no where with one vet that I took her to, one vet that you would be lucky to find sober, and one vet whom is very old school. I work 6 days a week, so taking time off to even go to another vet in another area is almost impossible. As I am getting ready to make a drastic change in my current circumstances, I'm not wanting to spend too much money on a vet right now until my next stage in life is secure. I'm willing to give my dog what she needs, but money is tight right now.

          Diabetes and infection have been ruled out at this time. There was no indication of renal issue per the BW, but I know those don't normally show up until there is significant damage to the kidneys. As I said, I have been a vet tech for several years (albeit equine), so I do know a thing or two.
          Only two emotions belong in the saddle: One is a sense of humor. The other is patience.

          Comment


          • #6
            Sorry, I didnt read that she had an ACTH stim. So if that was normal, then she clearly doesnt have typical cushings.

            How did her belly palpate, any chance of abdominal mass?

            Comment


            • #7
              If her ACTH came back and everything else looked good, did they consider urinary incontinence? Not uncommon in older female dogs, especially spayed females and it's very easy and inexpensive to treat.
              A good horseman doesn't have to tell anyone...the horse already knows.

              Might be a reason, never an excuse...

              Comment

              • Original Poster

                #8
                Sorry for the confusion Squish. We did a cbc and chem panel, which i don't have a copy of yet. There has not been an acth or dex suppression test yet. That was on my plan to ask him for Monday. Is there a time frame where there is a better time to test as in horses?

                I brought her in thinking incontinence, but he said because she was choosing a spot to urinate and not leaking urine where ever she lay that it wasn't incontinence.

                I'd like to get something figured out soon...killing me cleaning my carpet so often.
                Only two emotions belong in the saddle: One is a sense of humor. The other is patience.

                Comment


                • #9
                  You don't have to worry about the seasonal stuff with the ACTH in dogs like you do in horses.

                  Even if you did, you'd be in the clear this time of year. Really anything from Jan through the end of July/early Aug is fine for horses.

                  It could be that with her age, her kidneys just aren't concentrating the urine as well as they used to. My 10YO lab drinks a lot and needs to urinate more frequently now than he used to. No issues though. We did an ACTH about 2 mos ago. We were actually more concerned about Addison's in his case due to some other symptoms but those things have resolved.

                  Still, he has to go a lot more than my younger dog and his urine is more dilute. Luckily, he doesn't drink much when I'm not home. But when I'm home, he has to go out at least every couple of hours and urinates A LOT. I usually take them out around 10-11PM and he'll urinate. Then I'm up at 4 or 5am and he'll go, eat breakfast and within 30 min be ready to urinate again. Sometimes if I don't get up early enough, there will be an accident in the basement.

                  He is house trained but he can't seem to hold it for more than about 6 hours tops these days.
                  A good horseman doesn't have to tell anyone...the horse already knows.

                  Might be a reason, never an excuse...

                  Comment


                  • #10
                    My cushings dog did not lose any hair, but instead it became much more course, like a brillo pad.

                    Originally posted by Eventer13 View Post
                    I think, given the symptoms, that Cushings would be pretty high on the differentials. Any hair loss? It certainly wouldn't hurt to do some tests.


                    ETA: I noticed the change of coat a year before my cushing dog was diagnosed, right before the peeing
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                    Comment


                    • #11
                      The ACTH stimulation test is a pretty inconclusive Cushing's diagnosis by itself. Coupled with Low Dose Dex Test and abdominal ultrasound, then it has some weight.

                      For Cushing's in dogs....the big 'red flags' are:
                      *increased water drinking and thus urination
                      *Dilute urine/low specific gravity
                      *Ravenous appetite (seriously...they can't eat fast enough!)
                      *Panting under normal circumstances when the dog wouldn't usually pant
                      *Changes in coat
                      *Hind end shakiness
                      *Loss of muscle mass which makes it look as though the dog is losing weight
                      *Increased nervousness/changes in typical behavior
                      *Distended abdomen/pot bellied (generally more advanced cases)

                      My dog's bloodwork all came back within normal limits the first two times I suspected Cushing's disease. I had to keep pushing that 'something' wasn't right. The LDDS test showed Pituitary Dependent Hyperadrenocorticism and he then went to an internist a few months later after we couldn't stabilize his cortisol with my regular vet. She then did the ultrasound that showed that his adrenals were enlarged which confirmed the diagnosis.

                      My dog also has Diabetes Insipidus which is very different from typical diabetes mellitus. It also causes the polydipsia/polyuria, so until we began to treat both concurrently, it was a mess.

                      Be sure that you're confident in any Cushing's diagnosis before you begin treatment. You do not want to treat based on a guess as lowering the cortisol too much, as I'm sure you know, has unfavorable consequences (Addison's).
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                      Comment


                      • #12
                        Please return to free access to water until you can see your vet. My dog had cushings and the vet insisted that water be in front of him even on our short office visits.

                        Comment


                        • #13
                          I agree. I think restricting water is always a bad idea and can cause all kinds of health problems.

                          Comment


                          • #14
                            OP, I see you are in KY, how far from Cincinnati? There are two referral clinics with internists in KY. I still think Cushings should still be high on the list. If you go to an internist, you should be able to get an ultrasound so they can rule out adrenal vs. pituitary Cushings. And go back to free choice water immediately.

                            Comment


                            • #15
                              I had a dog with cushings, confirmed by the dex test and acth. She never lost her hair either, but did ave a change in coat texture. She had a pot belly and her back wnd was week. She had an endless thirst, poor girl. I had a relative of hers (no, I did not breed her.)who acted the same and had all the same symptons, but his tests always came back in the normal range (He was tested three times.)
                              If it was me I would not restrict water, but that is an opinion of a non vet!

                              Comment

                              • Original Poster

                                #16
                                I've upped her water allowance, so she hadn't appeared to be searching for water like she was. But the urinating in the house is the same. We went on a walk this morning, she urinated before and after. Then i caught her peeing in the house not even an hour later! I live in a rental house, so I've been trying to keep it clean. I am spending all today cleaning carpets.

                                I live on the other side of the state from Cincy. I only make $400/week, so a specialist is really outside my budget until i get my next place set up.

                                She isn't potbellied and the vet didnt remark about anything feeling abnormal when he palpated her abdomen. Hair may be slightly coarser, but she is a heeler mix...they dont exactly have soft coats. No increase in appetite noticed. She has always a lady like eater.
                                Only two emotions belong in the saddle: One is a sense of humor. The other is patience.

                                Comment


                                • #17
                                  Maybe your dog does not have Cushings. I understand it is difficult when you live in a rental. Perhaps you can use baby gates and keep her only where there is tile. That way cleanup is easier. Or would she use a puppy pad? Maybe get her a diaper? All I know is I'd give everything and anything to have to have my Boxer back peeing all over the floor. He lived exactly the average lifespan after Cushings diagnosis -18 months....I miss that big guy and his frequent need to pee!

                                  Comment


                                  • #18
                                    I know this may sound rude, and I don't mean for it to come off this way - however, often times clients spend LESS money at specialists than they do their regular vets. Specialists know what to test for, and know what not to. They will also do their best to work within your budget and review labs and radiographs that have already been done at your regular vet.


                                    Hopefully its an easy answer!!

                                    Comment


                                    • #19
                                      I would get her fitted for a diaper or some sort of padding so when she urinates in the house it will not make a mess.

                                      Can you have her urine checked for crystals? I may have missed this in past posts if its already been mentioned I am sorry for the repeat.
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                                      Comment

                                      • Original Poster

                                        #20
                                        Thanks Squish. I just used to work at a referral equine hospital, so I'm used to seeing clients charged over $100 per ultrasound and pricey exams. As much as i love my dog, I just don't have that in the budget. Plus, until i leave my current job, i cant get away to take herto a specialist.

                                        The urinalysis did not reveal any crystals, but I won't say she doesn't have them.

                                        I've set up someplace outside for her to stay during the day and diapers were my next thought. Hopefully she will leave them on!
                                        Only two emotions belong in the saddle: One is a sense of humor. The other is patience.

                                        Comment

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