It was Easter Sunday, March 23, and it had been a rough day. By this point, I had researched so many topics on Sadie’s symptoms and I noticed a trend: with each effort to help her, she only grew worse. Why? What would cause this? I was in no way denying that Sadie’s body had cancer cells, but I had done some research on the adrenal glands and started learning about Addison’s Disease. The “crisis” so many of these dogs experience sounded so much like Sadie’s experience with her last chemo (cytoxan) pill, that I now wanted Sadie’s adrenal glands tested. One of the main factors in making sure there were no adrenal problems was that due to her chronic allergies, there were many seasons in her life where she had steroid shots. From the time she was a small pup, she was given a monthly injection for years. When she was in our care, I used a shot as a very last resort, because I had been warned they could overwork the adrenals. I much preferred to give her benadryl, but the key was prevention. For example, we would know the approximate season when her allergies would flare up, so if we gave her preventative doses of benadryl in the days before the bloom, sometimes she wouldn’t have to get a shot. Sometimes it got so bad that we had no other choice. But I was never happy about it.
I made the mistake of asking for the ACTH test “to check for Addison’s.” I was so ignorant about it all, but I should have just asked for the adrenals to be checked. Wouldn’t you know it? Her test on March 25 came back positive for the opposite of Addison’s – Cushing’s Syndrome (Pre-Cortisol: 21.7; Post: 41.6)! I didn’t really know much about it, but the doctor said we would have to disregard the results for this reason: you never get tested looking for one issue and receive the opposite diagnosis. It’s not good medical practice to do so. She even told me, “You don’t want this to be Cushing’s. You have to give your dog chemo-like meds and follow a strict regimen. There are many ups and downs. You don’t want it to be Cushing’s.” I kept thinking, “But I’m ignorant; I’m the one who brought it up! Couldn’t I have made a mistake in asking what to look for?” Still, I know I’m not a medical doctor, and would have to defer to the vet’s experience. We did not pursue Cushing’s, but I will post similarities between Sadie’s symptoms over the last 2 years of her life and Cushinoid dogs (many things that are typical of old age can also be caused by Cushing's):
1) She had a ravenous appetite (until she went anorexic).
2) In 2003, she gained several pounds (was up to 23 pounds); this was while we were out of the country. We had her on Hills W/D and rationed her food, and she stabilized. (Good weight for her was 18 lbs.) In the last year ½ prior to her illness, she actually lost 2 pounds.
3) Whenever people would say she was skinny (in her healthy years), we’d just say, “look at her belly!” Her nickname was the “pot-bellied pig”.
4) She had funny sleep patterns and her “happy hour” was between 3 and 4 am.
5) In 2004, she had bladder stones & surgery.
6) Her hair was thinning a bit, and her skin was very sensitive over the last year and a half. In fact, she was so sensitive that that groomers would refuse to take her because she bit them if she was in pain. She was not able to walk stairs or jump on furniture as well in her older years.
7) She had numerous “old age warts,” and quite a number of them were removed during the final dental surgery.
8) Her drinking habits were odd: sometimes she would go hours without drinking, but whenever she drank…..it was like a horse! Bless her heart, she almost always had a coughing spell after drinking (due to her enlarged heart).
9) She had protein deposits on her eyes.
10) For at least the past several months, her Albumin was low.
11) She had severe muscle wasting. Before she was sick, she did feel “bony,” but just thought she was getting older. She continued to malabsorb some of her food even with the feeding tube, due to the protein loss.
12) She was diagnosed as being hypothyroid in the last months of her life.
13) She rarely had an easy recovery from surgery.
14) She had High Platelet Counts.
I made the mistake of asking for the ACTH test “to check for Addison’s.” I was so ignorant about it all, but I should have just asked for the adrenals to be checked. Wouldn’t you know it? Her test on March 25 came back positive for the opposite of Addison’s – Cushing’s Syndrome (Pre-Cortisol: 21.7; Post: 41.6)! I didn’t really know much about it, but the doctor said we would have to disregard the results for this reason: you never get tested looking for one issue and receive the opposite diagnosis. It’s not good medical practice to do so. She even told me, “You don’t want this to be Cushing’s. You have to give your dog chemo-like meds and follow a strict regimen. There are many ups and downs. You don’t want it to be Cushing’s.” I kept thinking, “But I’m ignorant; I’m the one who brought it up! Couldn’t I have made a mistake in asking what to look for?” Still, I know I’m not a medical doctor, and would have to defer to the vet’s experience. We did not pursue Cushing’s, but I will post similarities between Sadie’s symptoms over the last 2 years of her life and Cushinoid dogs (many things that are typical of old age can also be caused by Cushing's):
1) She had a ravenous appetite (until she went anorexic).
2) In 2003, she gained several pounds (was up to 23 pounds); this was while we were out of the country. We had her on Hills W/D and rationed her food, and she stabilized. (Good weight for her was 18 lbs.) In the last year ½ prior to her illness, she actually lost 2 pounds.
3) Whenever people would say she was skinny (in her healthy years), we’d just say, “look at her belly!” Her nickname was the “pot-bellied pig”.
4) She had funny sleep patterns and her “happy hour” was between 3 and 4 am.
5) In 2004, she had bladder stones & surgery.
6) Her hair was thinning a bit, and her skin was very sensitive over the last year and a half. In fact, she was so sensitive that that groomers would refuse to take her because she bit them if she was in pain. She was not able to walk stairs or jump on furniture as well in her older years.
7) She had numerous “old age warts,” and quite a number of them were removed during the final dental surgery.
8) Her drinking habits were odd: sometimes she would go hours without drinking, but whenever she drank…..it was like a horse! Bless her heart, she almost always had a coughing spell after drinking (due to her enlarged heart).
9) She had protein deposits on her eyes.
10) For at least the past several months, her Albumin was low.
11) She had severe muscle wasting. Before she was sick, she did feel “bony,” but just thought she was getting older. She continued to malabsorb some of her food even with the feeding tube, due to the protein loss.
12) She was diagnosed as being hypothyroid in the last months of her life.
13) She rarely had an easy recovery from surgery.
14) She had High Platelet Counts.
15) She had High Monocytes.
16) She had High Neutrophils.
17) She had Protein Loss.
Other abnormalities from Sadie’s labs that day were: Hemoglobin 9.2 (low), Hematocrit 27.8 (low), WBC 36.6 (high), MCV 4.33 (low), Platelets 554 (high), Neutrophils 28,548 (high), Bands 1098 (high), Monocytes 4026 (high), slight Polychromasia, moderate Dohle bodies, slight toxic granulation, few Howell Jolly bodies, BUN 63 (high), Total Protein 4.5 (low), Albumin 1.6 (low), Calcium 7.7 (low), and Chloride 97 (low). A lot of things were abnormal. Her WBC was way too high, so we tried a broader class of antibiotic, Cephalexin. If I had it to do over, Sadie would have received IV antibiotics at this point. I also wish we had given her something for her Hematocrit then! A dog with anemia has very little energy. Another help at this point would have been Hetastarch for the protein/albumin issues. If I had only known! I was doing the best I could with the knowledge I possessed.
What we could discern at this point was that Sadie was battling an infection. The possibility also existed that Sadie’s lymphoma was a leukemic form. We’d have to give these antibiotics a few days and then go from there. In the meantime, there was a conference we were set to attend in the mountains. There was no way we were going to leave our baby, so I suggested we take Sadie with us and see if it perked her up. I knew it was a risk, but nothing seemed to have helped at this point, hard as we were trying. We told her we were going “to the cabin” and she knew what that meant. On March 31, we set out on our trip, hoping it would make a difference!
Other abnormalities from Sadie’s labs that day were: Hemoglobin 9.2 (low), Hematocrit 27.8 (low), WBC 36.6 (high), MCV 4.33 (low), Platelets 554 (high), Neutrophils 28,548 (high), Bands 1098 (high), Monocytes 4026 (high), slight Polychromasia, moderate Dohle bodies, slight toxic granulation, few Howell Jolly bodies, BUN 63 (high), Total Protein 4.5 (low), Albumin 1.6 (low), Calcium 7.7 (low), and Chloride 97 (low). A lot of things were abnormal. Her WBC was way too high, so we tried a broader class of antibiotic, Cephalexin. If I had it to do over, Sadie would have received IV antibiotics at this point. I also wish we had given her something for her Hematocrit then! A dog with anemia has very little energy. Another help at this point would have been Hetastarch for the protein/albumin issues. If I had only known! I was doing the best I could with the knowledge I possessed.
What we could discern at this point was that Sadie was battling an infection. The possibility also existed that Sadie’s lymphoma was a leukemic form. We’d have to give these antibiotics a few days and then go from there. In the meantime, there was a conference we were set to attend in the mountains. There was no way we were going to leave our baby, so I suggested we take Sadie with us and see if it perked her up. I knew it was a risk, but nothing seemed to have helped at this point, hard as we were trying. We told her we were going “to the cabin” and she knew what that meant. On March 31, we set out on our trip, hoping it would make a difference!
