My ultimate goal is to improve the quality of life for my 10

My ultimate goal is to improve the quality of life for my 10 year old Pit-bull, Sadie.
That is hard to say out loud because selfishly, I would like to increase her lifespan, as well. After experiencing an increased level of ALK Phosphatase and ALT (SGPT) over a period of a year, I felt compelled to get a second opinion on how I could lower that and/ or how to make her comfortable with it. (ALK reference range should be at 10-150 U/L - has been: 102, 407, 531 consequently. ALT (SGPT) reference range should be 5-107 U/L - has been: 70, 65, 68, 128,186, 141 consequently.) Presently she is on:
     Amoxicillin - 400 mg, 2 times a day
     Metronnidazole -250 mg 3 times a day
     Thyroxine - .07mg -1 ¼ tablets daily
     S-Adenosyl-225 -2 times a day
     Restor-A-Flex (extra strength) -1 tablet daily
     Aspirin -325 mg -1-2 tablets a day, as needed for arthritis pain

I took her to a second Vet that is recommending an ACTH Test for Cushing's disease and/or an Ultrasound to look for tumors. I am concerned because what I have been researching, states that a canine with severe arthritis (which my dog has in her knees due to an injury as a puppy) may suffer worse if diagnosed and treated for Cushing's Disease, due to heavy doses of cortisone they are giving themselves. Again, I am after quality of life for my dog. Is there truth to this? I also have a cash flow problem (after being layed off and now, self-employed with my husband's business) so an estimate of $659 to $759 for just the diagnosis is concerning. Her cholesterol is good (189 - reference is 112 -328 mg/dL) as is her BUN (15- reference range is 7-27 mg/dL.) She has ALWAYS   been thirsty, hungry and heavy (75 lbs) but she is NOT having any accidents, loosing hair or experiencing diabetes (Glucose is low, 56 - reference range is 60-125 mg/dL). Her somewhat NEW symptoms have been - excess panting (in heat or stress), a hard potbelly and she does have lumps in the skin which my first Vet told me was fatty deposits, similar to love handles. She has been off again and on again with diarrhea for a few weeks but I have been feeding her boiled chicken and rice, mixed with Hill's prescription l/d food for liver failure (2 cups a day total) and they have all made her stool normal . Is a Urine Cortisol/Creatinine Ratio test enough in her case, to rule out the Cushing's disease? With the information I have provided you, what would you recommend?

Optional Information:
Age: 9; Female; Breed: Pitbull

Already Tried:
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Customer (name blocked for privacy)

Hi,

I'm sorry that your dog is experiencing difficulties. Dogs with clinical signs such as drinking more than normal, peeing more than normal, a pot-bellied appearance, chronic urinary tract infections, chornic skin infections and an elevated ALP may in fact have Cushing's disease. An elevated ALT does NOT indicate cushings in any way. ALP is a liver enzyme, but in Cushing's disease, it is a false elevation. By this I mean that there is a similar enzyme in the body that mimics ALP. In a Cushing's dog, the ALP is elevated, but it isn't the true ALP. So, you should only see ALP, not ALT. However, you can have elevations in all liver enzymes in Cushing's, it's just not characteristic. Have I confused you yet?

As far as lowering liver enzymes, there are several things you can do. I would add Milk Thistle and Artichoke to your dog's regimen. They both have been shown to lower liver enzymes and protect the liver cells.

If I were advising you as my client, I would be concerned that your dog has Cushings. This will shorten his life span and decrease quality of life. The test of choice is not a urine cortisol-creatinine. A negative test means he definitely doesn't have Cushings -- but a positive test is not diagnostic (there are to many false positives). The test of choice initially is a Low Dose Dexamethasone Suppression test. It is much LESS expensive than an ACTH stim test and is very diagnostic.

The issue is that Cushings disease is treatable by a medication that is a bit pricey for the first 10 days. The maintenance dose is much less expensive. If the Low Dose Dex test is diagnostic, an abdominal ultrasound is a waste of money if you wouldn't do surgery. All that does is tell you if it is a pituitary tumor or an adrenal tumor (85% are pituitary). The treatment is the same if a very expensive ($1500 surgery) is not an option.

So, my best advice is to do the Low Dose Dex test -- treat the dog if it has Cushings. Even with arthritis, the steroids the dog secretes have far more bad side effects than good. We have better ways of treating arthritis than steroids.

Please let me know if you need more information. I hope this is helpful.

I share your concerns and am glad you have sought out help. I strive to provide you with excellent service. If this information has been helpful to you, please Accept! Bonuses are ALWAYS APPRECIATED.

Cushing's Disease

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