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Does my dog have cushing's?

Species: Dog
Breed: Lab
Age: 8-11 years
Hi Dr. Marie,

I took my almost 10 y/o lab to the vet because she has been waking me up at night with her panting. I let her out to urinate, but I don't feel like she really has to go as she lolly- gags around the yard. Another problem she developed is occasional incontinence. It seems she will leak a little urine after a walk or if she is relaxed.

She has arthritis in all legs and also walks with a limp. She is only taking cosequin right now for that. She also has a history of seasonal allergies-yeast infection in her paws and ears. Chronic ear infections since a puppy. No other skin issues. She also has a few lypomas.

Despite all of these issues, she is great! She loves her walks, normal appetite, can't tell if she is drinking more water than usual and don't think she is urinating more. She can probably lose about 5 lbs but otherwise her physique and coat look great.

My vet ran a senior blood test on her. Every value came back normal except Alk phosphatase (256). Last year it was 139. He also ran a uc:ur =13. The vet wants to proceed on with an ultrasound, x-ray and hormone test. If Roxy truly has Cushings, with her lab values, do you think she should be put on medication? Do you think her panting can be caused from arthritis pain? I feel like this year she has slowed down a bit but she still LOVES her walks! Do you think it is reasonable to start her on arthritis medication before doing all of the Cushings tests? Is there an arthritis medication you can recommend?

Thanks for your time and any input.

Marie


Online vet, Dr. Marie

Dr. Marie replied:

Hi Marie,

An alkaline phosphatase level of 256 is not terribly high. Similarly, a cortisol-creatinine ratio of 13 is not extremely high either. In my books, this means that cushing's is not a likely diagnosis. However, given that Roxy is panting and is an older dog, it's not a bad idea to test for cushing's just to be sure. You may find that she has mild cushing's, in which case I would likely wait for now and monitor things and perhaps put her on medicine in the future. Cushing's is an expensive disease to treat.

On the other hand, I have some owners in situations like this who choose not to test for Cushing's because they would be unlikely to treat (due to the cost). If this were my case I would still recommend testing just so you know what to expect.

There are many other possible reasons for panting. Yes, arthritis pain is possible. In some cases like this I will use a two to three week trial of a non steroidal anti-inflammatory drug like Previcox, Metacam or Rimadyl (or there are others) and see if the panting improves.

If the panting gets worse you could ask your vet about the possibility of laryngeal paralysis. This condition is common in labs.

There are other possibilities. As dogs get older we worry about all sorts of issues and an ultrasound may help to uncover hidden things like cancers or liver problems or other issues.

I hope things work out ok!

Dr. Marie



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thank you very much Dr. Marie! Which test do you think would be best for Roxy- the LDDD or ACTH? I read somewhere that one is more sensitive than the other...with her possibly having a mild case of Cushings, which will accurately detect it?


Thanks again,
Marie


Online vet, Dr. Marie

Dr. Marie replied:

I'm so sorry for the delay in getting back to you.

Every vet has a different protocol for how they test for Cushing's. Personally I use the LDDS (low dose dexamethasone suppression) test as a screening test, but I know other vets who prefer the ACTH first.

Both are similar in cost. Your vet will be the best to advise you on which test should be done.

Dr. Marie.



Customer reply:

Thanks again! Have a great weekend!


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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.