# Can you please pray for my Zoe?



## CrystalAndZoe (Jul 11, 2006)

I just heard from Dr. Steph via email about Zoe's latest urinalysis this afternoon and am trying to process things. She told me that this time, for the first time her protein/creatine ratio is high. In her words, what this means is that we have a primary kidney issue. It's very early in the process but the test rules out a primary adrenal issue. Next step will be an ultrasound so she can visualize her kidney structure.

I'm trying to remain positive that no matter what is going on with Zoe, we are still in the very early stages. But I just feel out of control at the moment since this is a new area for me. I knew Zoe came from a BYB and genetics have not been kind to her. Zoe had Lepto when she was 2. But we again caught it so early that the first titer to get an actual diagnosis came back negative. We rechecked 3 months later after treating and there was a Lepto marker. But dang there could have been some damage that is just now manifesting itself in her senior years. 

And I'm rambling.... Sorry. I'm not myself and I'm struggling to focus on anything. I've known now for a month that Zoe could have a kidney issue and I'm not dealing well. So please say a prayer. Thanks.


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## pippersmom (May 21, 2012)

Oh Crystal I will for sure say a prayer for little Zoe. Believe me, I know the stress you are feeling right now. :grouphug:


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## aprilb (Jul 9, 2010)

I'm so sorry, Crystal...Zoe has been through a lot, but she has the best mom ever!! I know you can do this....please keep us posted...(((hugs))) Prayers coming your way..:wub:


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## Leanne (Sep 6, 2012)

Sending healing energy for Zoe and lots of prayers.


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## Lacie's Mom (Oct 11, 2006)

Crystal -- I'm so sad to hear about Zoe. I know how much you worry about her. 

I had one Lhasa that had this when she turned 11 and we did catch it very early. I remember having to change her food so that she didn't have much protein at all -- used a special kidney formula diet which she did well on. She did begin urinating a lot more often as time went on, but she did live another 4 1/2 years and did well. She was 15 1/2 when she went to The Bridge. That was about 10 years ago and I'm sure that there are more options available now and a lot more info available. Just wanted to let you know not to panic as I've been through this will a lot less available research/info and it definitely wasn't a "death sentence".

Sending prayers for sweet Zoe and hugs for you. Love you, GF.


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## maddysmom (Mar 8, 2012)

Sending Prayers for Zoe that everything will be fine!


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## CrystalAndZoe (Jul 11, 2006)

We did her yearly bloodwork and urinalysis a month ago and Dr. Steph was plotting past year results for the past 4 years...when I started keeping copies of things. Dr. Steph ran an MA along with that urinalysis, which her old vet didn't. I can't help but think we may have had a better handle on what was going on with her over a year ago if the old vet had done this. I didn't even know about a MA part of a urinalysis. Her Alk Phos and GGT are still very slightly high but not a significant change from the year before when we were treating for, lack of a better diagnosis, Cushings. She does not present like a typical Cushings dog. Her muscle tone is excellent. She's not bloated or puffy. No pot belly. 2 tests indicated Cushings but my holistic vet, Dr. Dan, was not convinced that was what she had. He always said she *may* have Cushings. My old vet was positive she did. I'm very thankful I've found Dr. Steph. She and Dr. Dan are very much on the same page. A month ago she had 1+ protein in her urine. This last one showed she had 2+. I can barely wrap my head around the fact that my Zoe may very well be in the early stages of renal failure.


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## CrystalAndZoe (Jul 11, 2006)

Lacie's Mom said:


> Crystal -- I'm so sad to hear about Zoe. I know how much you worry about her.
> 
> I had one Lhasa that had this when she turned 11 and we did catch it very early. I remember having to change her food so that she didn't have much protein at all -- used a special kidney formula diet which she did well on. She did begin urinating a lot more often as time went on, but she did live another 4 1/2 years and did well. She was 15 1/2 when she went to The Bridge. That was about 10 years ago and I'm sure that there are more options available now and a lot more info available. Just wanted to let you know not to panic as I've been through this will a lot less available research/info and it definitely wasn't a "death sentence".
> 
> Sending prayers for sweet Zoe and hugs for you. Love you, GF.


Thank you Lynn for that. This is what Dr. Dan and Dr. Steph are also telling me. At this point they don't want me to change her food as of yet. I'll probably know more after I talk to Dr. Steph later tonight. But as of a month ago, she said don't change her food. From my research, what they are now saying about a kidney diet, it's not so much the amount of protein but the phosphorus level in the food. So I've already been looking into foods low in phosphorus. I hate to change her from what she is on because there was a dramatic improvement in her body condition, energy level and muscle tone when I changed her to frozen raw. She did have a slight pot belly prior to the change in food.


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## Snowball Pie's Mommi (Oct 16, 2008)

I am so sorry, Crystal. It's so hard when our fluff babies are not well.

You are a wonderful and devoted mommy to your fluff babies ... so, I have faith, that somehow, things will work out for Zoe. 

Prayers and hugs for you and your sweet, sweet Zoe.


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## Snowbody (Jan 3, 2009)

Crystal - I'm so sorry. I don't know anything about kidney issues but if I know anything it's that you will leave no stone unturned to figure out what will help Zoe. Sounds like you've got two vets working on this and that you'll be able to devise a plan. Just try to take deep breaths and regroup. It's been info no one wants to hear about their beloved Maltese but you know what miracles have taken place with love, care and the right medical (holistic or traditional) help. Sending hugs to you all.:grouphug:


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## edelweiss (Apr 23, 2010)

Crystal&Zoe said:


> Thank you Lynn for that. This is what Dr. Dan and Dr. Steph are also telling me. At this point they don't want me to change her food as of yet. I'll probably know more after I talk to Dr. Steph later tonight. But as of a month ago, she said don't change her food. From my research, what they are now saying about a kidney diet, it's not so much the amount of protein but the phosphorus level in the food. So I've already been looking into foods low in phosphorus. I hate to change her from what she is on because there was a dramatic improvement in her body condition, energy level and muscle tone when I changed her to frozen raw. She did have a slight pot belly prior to the change in food.


Crystal, I think this has always been true in relation to kidney issues---at least it is a known fact in Europe. 
I do hope you get to the bottom of this & that Zoe will be back on the track to wellness! :wub:


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## maggieh (Dec 16, 2007)

Sending you a huge hug! Zoe still has a lot of life ahead of her!


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## wkomorow (Aug 26, 2011)

Crystal,

I know how worried you must be, but let's hope that it is in the early stages of whatever it might be and it can be corrected with a change in diet. Hoping for the best.


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## edelweiss (Apr 23, 2010)

Crystal, this isn't a new article---but easily read and very informative:
Chronic Renal Failure


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## educ8m (May 19, 2010)

Crystal, sending prayers for dear Zoe. It sounds like you are getting some excellent care from your vets. I know that doesn't keep you from worrying, though.


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## Grace'sMom (Feb 22, 2012)

Special prayers for sweet Zoe...


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## michellerobison (Dec 17, 2009)

We'll all keep Zoe in our hearts and prayers and you too. We all love our fluffs so much. Please keep us posted on Zoe. Lots of love and hugs!


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## ladodd (Jan 8, 2012)

Crystal, I know how much you love your sweet pups and you take fabulous care of them. I remember very well how stressful an illness with them is on all involved. I will pray for your precious Zoe and for you to have the peace of mind that this will be controlled.


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## Cassievt (Apr 24, 2013)

Christel, I will be keep you and Zoe in my prayers. She has the best mom and she knows it and can feel your love. 


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## jmm (Nov 23, 2004)

Prot:Crea doesn't tell about adrenal function. Did they do a Cortisol:Crea ratio? 

Has she been tested for Atypical Cushing's with an adrenal panel to UT? This panel gives you a TON of information and UT will consult on treatments. 

Adrenal issues can present with kidney dysfunction which typically resolves with properly addressing the underlying problem. For example, dogs with Addison's often have high BUN and Crea when they first present to the vet. Once the Addison's is controlled, the kidney values return to normal. 

I would want to be sure of who is doing the ultrasound. I always go to a BOARD CERTIFIED veterinary radiologist. If anyone else does the study I get it reviewed by a BOARD CERTIFIED veterinary radiologist. I would definitely want the size, shape, and echogenicity of the adrenals noted, not just the kidneys.


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## CrystalAndZoe (Jul 11, 2006)

jmm said:


> Prot:Crea doesn't tell about adrenal function. Did they do a Cortisol:Crea ratio?
> 
> Has she been tested for Atypical Cushing's with an adrenal panel to UT? This panel gives you a TON of information and UT will consult on treatments.
> 
> ...


Thank you Jackie. This was something that Dr. Dan also said. That he wanted them to get a good look at the adrenals as well. He has always thought we were dealing with more of an adrenal issue. Although with her last blood panel and urinalysis, he too is leaning towards a kidney issue.


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## Ladysmom (Oct 19, 2004)

I am so sorry, Crystal. I know how scary it is when your senior dog develops serious health issues. Hopefuly this can be managed with the correct diet and supplements. If anyone can do that, you can!


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## vinhle68 (Mar 19, 2012)

Sending positive vibes and prayers to Zoe & Mommy!


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## jmm (Nov 23, 2004)

I strongly suggest talking about the adrenal panel. It really helped us with diagnosing Roo and finding safe treatments to help him. Simple Melatonin treatment helped resolve his Atypical Cushing's. He even has hair! LOL


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## Maglily (Feb 3, 2009)

Oh Crystal I am so sorry you have this worry about Zoe. I do know that she is in the best of hands though and you will get her the help she needs. Hang in there. If this is the same as CRF, that's what Lily had (and Maggie before her), I found out about Lily at age 11 and she was with me for over 6 years after that. She had her special diet and supplements and blood work 2 x a year showing she was holding her own.


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## sherry (Jan 4, 2013)

Crystal, I'm so sorry to hear this news of Zoe. Hugs and Prayers!


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## Summergirl73 (Sep 18, 2011)

Just wanted you to know that we will be keeping you in prayers. You are an amazing lady and a great Mom. I have no doubt that you will get the absolute best care for Zoe. Big hugs and much love.


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## BeautifulMaltese (Dec 4, 2013)

I am so sorry and am sending prayers. My own Zoe was diagnosed a year before she passed with Cushings and I opted for melatonin/flaxseed lignan course of treatment to manage the symptoms as I felt the meds they wanted to put her on were to severe. She did well, and honestly we can't be sure what ultimately caused her passing as both of her parents died very young. From what I understand, depending on the type, they can be treated and live comfortably in most situations. I was very suspicious with my Zoe that her tumor was cancerous and spread, which is what my vet thought ( I couldn't bring myself to autopsy). I know what you are going through but so many dogs are successfully treated and live comfortably. You are obviously very well informed on health issues where it concerns your dog so you will guide your vet to the best course of treatment. I pays to be informed and do your research ! Will look forward to updates and keeping my fingers crossed !


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## CrystalAndZoe (Jul 11, 2006)

jmm said:


> I strongly suggest talking about the adrenal panel. It really helped us with diagnosing Roo and finding safe treatments to help him. Simple Melatonin treatment helped resolve his Atypical Cushing's. He even has hair! LOL


Dr. Dan put Zoe on Melatonin about a year ago. As for the Cortisol:Crea Ratio, I don't know if that was done at this last urinalysis or not. She ran a few things in house that we got the results on right away. But she sent it out and I have had to wait much longer than normal for the results. I've not received a copy of it yet. Dr. Steph emailed me later last night saying she would be in touch with me later. Don't know how much later is...but I'm hoping it's not Monday or Tuesday. But it probably will be. And I understand. She needs her days off too.


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## mamapajamas (Apr 12, 2009)

Crystal, I am so sorry to hear about Zoe. I know she will respond well to treatment and recover. She has such a great mommy to love and care for her. Prayers are coming your way, for both you and for Zoe.


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## shellbeme (Mar 1, 2011)

Praying for you both.


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## Bailey&Me (Mar 8, 2010)

Sorry to hear this, Crystal. I don't know anything about kidney issues but it sounds like if it that, then it's been caught very early so hopefully that means it can be managed. With a team of wonderful vets and you as her mom, I know Zoe will be okay. Sending you a hug and prayers.


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## Maidto2Maltese (Oct 19, 2004)

Ahhh Crystal, I'm so sorry you have this concern about your little Zoe! Be assured I'll be praying for her.


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## KAG (Jun 1, 2006)

Aww, Crystal. I'll be lighting bunches of candles for you and your beautiful girl. If not today, tomorrow for sure.
Xoxoxoxo


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## Lacie's Mom (Oct 11, 2006)

Cyrstal -- just thinking about you and Zoe and sending lots more prayers and hugs your way.


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## Ann Mother (Dec 18, 2013)

Prayers for you & Zoe


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## mfa (Oct 5, 2009)

Sending prayers for beautiful Zoe. Hugs, Crystal.


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## SA_GC (Oct 14, 2013)

Sorry to hear about your troubles. We will be sending you good vibes for a positive outcome.


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## Tanner's Mom (May 27, 2005)

Prayers for little Zoe.


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## donnad (Aug 22, 2006)

Sending prayers and good thoughts for Zoe.


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## Matilda's mommy (Jun 1, 2005)

Crystal, I have been praying for Zoe and for you, I know how hard it is to wait to find out just what is going on with Zoe, honey remember God is in control, with all the prayers going up, he hears us, he know your heart, he knows the fears you are feeling, he's right beside you. I am waiting to hear good results from your vet, hang in there dear friend, we are all here for you. Here's one of my favorite scriptures, boy do I hang on it 

PROVERBS 3: 5-6
TRUST IN THE LORD WITH ALL YOUR HEART, LEAN NOT ON YOUR OWN UNDERSTANDINGS, IN ALL WAYS ACKNOWLEDGE HIM AND HE WILL DIRECT THY PATH


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## pippersmom (May 21, 2012)

Still saying prayers for little Zoe.


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## Chardy (Oct 30, 2008)

Matilda's mommy said:


> Crystal, I have been praying for Zoe and for you, I know how hard it is to wait to find out just what is going on with Zoe, honey remember God is in control, with all the prayers going up, he hears us, he know your heart, he knows the fears you are feeling, he's right beside you. I am waiting to hear good results from your vet, hang in there dear friend, we are all here for you. Here's one of my favorite scriptures, boy do I hang on it
> 
> PROVERBS 3: 5-6
> TRUST IN THE LORD WITH ALL YOUR HEART, LEAN NOT ON YOUR OWN UNDERSTANDINGS, IN ALL WAYS ACKNOWLEDGE HIM AND HE WILL DIRECT THY PATH


One of my favorite scriptures as well, and I am sending all the same thoughts to you Crystal.


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## maltese manica (Nov 6, 2012)

Praying for your sweet little one!


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## Matilda's mommy (Jun 1, 2005)

just checkin in


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## Cassievt (Apr 24, 2013)

How are you doing Chrystal ? Thinking of you.


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## gigigirlz (Jun 18, 2007)

Crystal...I am just now seeing this.....praying for Zoe.......


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## michellerobison (Dec 17, 2009)

Checking in on Zoe before I go to bed. I hope and pray both of you are doing well... Sending lots of love from all of us:wub:


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## CrystalAndZoe (Jul 11, 2006)

Thanks everyone. Still nothing new to report. She's scheduled for her ultrasound on Monday. I keep telling myself to snap out of it because I do want to find things early and that's why I do yearly blood work and urinalysis. It's just crummy that _sometimes_, even when catching things early, you can't prevent it or reverse the condition. Dr. Steph called me yesterday and she tried to reassure me that we are catching things in the very very early stages and she's hopeful we can manage whatever this is for a long time. So I'm trying to rest in that. And I'm trying really hard to not think about it. Not sure if that is the right thing to do or not. But those first few days I was obsessively reading and researching. So now I'm just trying to enjoy the fact that we have had sunshine these past couple of days and temperatures up into the 40's. Feels like Spring and the birds are singing. And Zoe is acting happy and like she's feeling good and loving the change in weather.

Thank you so much to everyone who has responded, checked in and prayed for me and my Zoe. It means so much and does truly help. I think it hit especially hard because Zoe chose my dad as her person. And she really mourned and grieved when he passed away. And dad fell on 2/14 and passed away early the next morning. And I find out about Zoe on Valentines Day.... *sigh* ... I truly do not like Valentine's Day.


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## Snowball Pie's Mommi (Oct 16, 2008)

Crystal, I will be thinking positive thoughts and saying prayers that Zoe's ultrasound goes well on Monday.

I totally understand your concerns ... and, sometimes it is hard to try and stop worrying, especially when we know something is not quite right with our precious fluff babies.

It does sound like Dr. Steph is a wonderful doctor who is on the right track in helping you and Sweet Zoe. That is such a blessing ... and, I hope a comfort to you. 

I, like you, am trying to enjoy the sunshine and warmer days. Today it is in the high 50's. But, still I worry, too. I wanted to get Snowball out for that walk for his birthday today. However, although the sun is out and we finally have a warm day ... the snow is melting and I don't trust him picking up or licking the salt left over on the sidewalks from the past snowstorms. 

I, too, love seeing and hearing the birds sing! A sign of Spring, for sure. And, I do think the freezing weather has been hard on some of our fluff babies ... especially the ones who are a little bit older.

I am so sorry Valentine's Day is not a happy day for you. My wish for you is that a Valentine's Day in the future will bring you much joy and happiness. I think your father, whom I am sure is in heaven, would want that for you.

Crystal, we all know that you are the best mommy to all of your fluffs. And, I have faith that Zoe is going to live a long and happy life because of you.

Sending you and Zoe much love and many hugs.:wub::wub:


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## Alexa (Aug 6, 2009)

Praying for sweet Zoe and sending lots of positive thoughts the way to you, Crystal!

Alexandra


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## Snowbody (Jan 3, 2009)

Checking back, Crystal. Glad that Zoe's been feeling well with the weather being better. Lifts all our spirits. Will be praying for her Monday. I've been going through a health issue myself and see my, um...losing count...fifth doctor on Monday too. Would do anything for answers. :mellow:


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## Maglily (Feb 3, 2009)

I know this is on your mind, hoping you're doing ok and things go well on Monday. 

Sue...hope you are ok too. : (


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## Matilda's mommy (Jun 1, 2005)

JUST WANT YOU TO KNOW YOU AND ZOE ARE ON MY HEART, rayer: I HOPE YOU HAVE A WONDERFUL WEEKEND CRYSTAL


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## hoaloha (Jan 27, 2012)

Crystal, I'm just seeing this now.  I hope that Zoe's ultrasound will give answers soon and that things will be manageable based on the results. A urine protein:creatinine ratio is used to determine the extent of proteinuria (how much protein is spilling over into the urine). Your kidneys can have abnormal function without being renal "failure" just yet. Was her isolated serum creatinine level high? Did they check for microalbuminuria? I know it's easier said than done, but I do hope you remain positive. Please keep us posted... :hug:


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## vinhle68 (Mar 19, 2012)

Crystal&Zoe said:


> Thanks everyone. Still nothing new to report. She's scheduled for her ultrasound on Monday. I keep telling myself to snap out of it because I do want to find things early and that's why I do yearly blood work and urinalysis. It's just crummy that _sometimes_, even when catching things early, you can't prevent it or reverse the condition. Dr. Steph called me yesterday and she tried to reassure me that we are catching things in the very very early stages and she's hopeful we can manage whatever this is for a long time. So I'm trying to rest in that. And I'm trying really hard to not think about it. Not sure if that is the right thing to do or not. But those first few days I was obsessively reading and researching. So now I'm just trying to enjoy the fact that we have had sunshine these past couple of days and temperatures up into the 40's. Feels like Spring and the birds are singing. And Zoe is acting happy and like she's feeling good and loving the change in weather.
> 
> Thank you so much to everyone who has responded, checked in and prayed for me and my Zoe. It means so much and does truly help. I think it hit especially hard because Zoe chose my dad as her person. And she really mourned and grieved when he passed away. And dad fell on 2/14 and passed away early the next morning. And I find out about Zoe on Valentines Day.... *sigh* ... I truly do not like Valentine's Day.


Hi Crystal

I am very sorry to hear of the loss of your great Dad! My condolences to you and your family during this grieving time. I am sure he is at peace in heaven. I am also glad ot hear that Zoe's is feeling much better. You and Zoe's will continue to be in our prayers.


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## CrystalAndZoe (Jul 11, 2006)

hoaloha said:


> Crystal, I'm just seeing this now.  I hope that Zoe's ultrasound will give answers soon and that things will be manageable based on the results. A urine protein:creatinine ratio is used to determine the extent of proteinuria (how much protein is spilling over into the urine). Your kidneys can have abnormal function without being renal "failure" just yet. Was her isolated serum creatinine level high? Did they check for microalbuminuria? I know it's easier said than done, but I do hope you remain positive. Please keep us posted... :hug:


She did run the MA back with her first urinalysis when there was protein in her urine. And then she did a 2nd urinalysis a month later which also included the MA just to make sure the first one wasn't a fluke. The protein amount was higher a month later. I don't have a copy of her test results yet so I can't tell you what her isolated serum creatinine level is but will check on Monday when I get a copy.

I'm happy that Dr. Steph wants me to be there with her when she is having her ultrasound. I told her that if she felt Zoe would do better without me, that was totally ok with me. But she said she has observed me with my dogs and knows that Zoe will be more cooperative with me there and since we don't want to aggravate her back (IVDD), she prefers that I'm there with her. So this week we've been working on having her roll on her back and staying there for longer periods of time for treats and praise. Hope it pays off.


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## Maglily (Feb 3, 2009)

Sounds like a plan Crystal I'm sure that practise will help.


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## CrystalAndZoe (Jul 11, 2006)

*Update: Ultra Sound is done*

Well the ultrasound did not reveal any masses or cysts. The kidneys are a good size. No obvious scar tissue. So we still don't know what is causing the protein to spill over. But at least we know it's not as serious as it could have been. Dr. Steph thought it a good idea to recheck her thyroid at this point. 

Even though we don't have any real answers yet, through process of elimination we know what it isn't.

Oh Marisa, her isolated serum creatinine is normal.


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## Matilda's mommy (Jun 1, 2005)

Crystal I have been praying for Zoe and you, sounds like good news so far. I'll continue praying


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## Ann Mother (Dec 18, 2013)

In humans a urine creatinine level has to be a 24 hour urine sample to be correct. Increased creatinine if not kidney caused can be caused by a high meat diet,muscle breakdown or muscle loss, and such medicines like antibiotic cefoxitin,cimetidine, cisplatin. I'm sure your dog has already been checked for diabetes. But if blood creatinine level not abnormal then probably not kidney. So try not to worry until you have too. The one thing we spend more time on is worry and it does nothing but causes stress. But then easier said than done. My father used to tell my mother not to worry because he did enough of that for both of them.



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## aprilb (Jul 9, 2010)

Crystal&Zoe said:


> Well the ultrasound did not reveal any masses or cysts. The kidneys are a good size. No obvious scar tissue. So we still don't know what is causing the protein to spill over. But at least we know it's not as serious as it could have been. Dr. Steph thought it a good idea to recheck her thyroid at this point.
> 
> Even though we don't have any real answers yet, through process of elimination we know what it isn't.
> 
> Oh Marisa, her isolated serum creatinine is normal.


I am so glad to hear that Zoe's kidneys are normal! Does she eat a high protein diet? Remember that her body will use the protein it needs, and the rest will be excreted in the urine...just a thought..:thumbsup:


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## CrystalAndZoe (Jul 11, 2006)

Trying to do as brief of a history as possible for those not understanding why we still aren’t 100% sure what Zoe has. And it’s not very brief. I certainly do not expect everyone to read this. But if anyone has gone through something similar, you may have some good info for me. And it may be helpful for someone else who may have a fluff go through something similar. About 2 years and maybe 4 months ago, I sold my house and my parent’s house and we purchased something we could all live in and I could help out with Dad. Right when we moved Zoe started to lick the kitchen floor before and after meals for over an hour. Even in the middle of the day we could find her out there for maybe 30 minute stretches. And she started to drink large volumes of water. Mostly we noticed it in the evenings when there was more activity going on. But during the day she would go almost the entire day without drinking. Unless someone came home or a visitor came to the door. She would excitedly greet them and then go drink a ton of water. And of course she would then have to pee more. Behavioral or health issue? So I took her to my then vet Dr. Visser (Dr. V) for a full blood panel and urinalysis. All numbers were within normal limits. So I was told it was most likely behavioral due to all the changes. And it made sense to me. Zoe went from leaving my house every morning to going out to G’ma and G’pa’s house and running in all excited to greet them, having 3 acres of yard to run in and explore off leash with a creek running through it and fields around it. The wildlife and smells were heaven to my little wanna be farm dog where she was encouraged by G’pa to bark at squirrels and chase them. Then we moved and she stayed home when I left. Sure G’ma and G’pa were there. But no excited greetings or going away in the car. And she had to go outside on a leash. And had to start working on ‘inside voice’ instead of getting to bark her fool head off when she saw something. It was also at this time that she was getting grouchier and I asked for a Thyroid test as well to be sent to Dr. Dodds. Dr. V. thought she was being nice and sent everything to her regular lab to save me money. She was insistent that the numbers were smack dab in the middle of the normal range and there was no reason to send it to Dr. Dodds. It was also at that time that her IVDD got really bad and she was in a lot of pain. She had been on Metacam, Buprenorphine and then finally Prednisone to keep her comfortable. That’s when I did research and found the holistic approach to managing her pain and inflammation. But it also made sense why she was grouchier if she was in chronic pain. So I didn’t insist on redoing the thyroid test. Then Dad past away very unexpectedly within just a couple of months and the night it happened was a nightmare and all 3 dogs were beyond stressed to have the ambulance come in the middle of the night, and for everyone in the house to leave and be left alone in the middle of the night. Zoe refused to leave Dad’s side and I had to move her off the bed and put her and the other 2 in another room so they didn’t get stepped on or slip outside as they were wheeling him out. And there was major stress in the house for over a year after that with my mom dealing with the loss of dad and her fears/anxieties. Fast forward to not quite a year later and symptoms/behavior have stayed the same with the noticeable change of her hair thinning and some dry scaly skin on her tummy. We did our annual full blood work up and urinalysis and this time it showed her Alk Phos was slightly high at 310 and her GGT slightly high at 14. Nothing alarming. In fact, most traditional vets would not be too concerned is my understanding but with her hair thinning and the dry, scaly skin on her tummy, Dr. V was suspecting Cushings. Everything else was perfect. But she did not do the MA with the urinalysis. We started out initially with the urine cortisol:creatinine ratio. After that she did the dex suppression, which I’m told can have false positives with stress and other diseases such as kidney disease. We never did the ACTH Stim Test. This is where Dr. V and Dr. Dan (my holistic vet that I found during this time) argued. He was suggesting the Stim Test next and she said it wasn’t necessary, because she was certain Zoe had pituitary cushings. He wasn’t convinced and wanted to run the ACTH Stim Test. I didn’t know he wanted her to have the ACTH Stim Test. It was never suggested to me that I remember. I knew there was disagreement between the two, but I didn’t know she was refusing to send him test results. And I still wasn’t at a place where I was thinking clearly. It was during this time that I didn’t have a vet that I felt I could trust and was searching for a new one. I finally found Dr. Steph several months ago, who I really love. During this past year is when my sister temporarily moved in with us during her divorce. She and my mom do not get along so there was again some considerable stress and tension in the house for awhile. And her definition of temporary and mine were apparently not the same. *sigh* But for the most part it’s gotten better so I can’t say there is any more tension/stress in the house then anyone else’s. Well…before when it was just me and the fluffs there really was no tension. And so we again, not quite a year later, ran a full blood work up and urinalysis. This time Dr. Steph also did the MA with the urinalysis. Her Alk Phos and GGT have remained almost the same, within just a point or 2 of each other. But this is when she for the first time had protein in her urine and her BUN/Creatinine Ratio was slightly high at 30, normal range being between 4-27. So again, nothing alarmingly high. Her MA was 8.2 the first time and went down to 7.3 a month later. Reference range says <2.5. So I messaged Dr. Dan after the ultrasound with Dr. Steph and told him what she said. And they are both a little stumped at this point. She is doing another Thyroid test and sending it to Dr. Dodds. I myself have not seen the Dex Supression test but did get Dr. V to finally send it to Dr. Steph and Dr. Dan. This is what Dr. Dan messaged back to me when I told him I was getting confused with some conflicting information, most likely because I was telling people that Zoe had the Stim test when she didn’t. I was going from memory and got confused between the two: 



“The dex supression is positive but I was not convinced because of the amount of stress Zoe was under at that time.


The other issue is that she does have primary kidney disease.


SO - does she have Cushing's? Maybe, but in her case it would be extremely difficult to diagnose.


According to the dex suppression yes she has pituitary Cushing's.


According to her kidney tests she for sure has kidney disease.


Zoe has a lot of symptoms of Cushing's and I am treating her for an elevated cortisol. However her biggest issue at this point is the beginning stages of kidney failure”


So at this point he is in agreement with Dr. Steph in rechecking her thyroid. We are also doubling her probiotic. I’m told that dogs with kidney disease need high probiotic doses to keep the BUN low, specifically these strains are best for dogs with kidney issues: Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium longum. It helps lower the extra Nitrogen from getting into the system. Both Dr. Dan and Dr. Steph are assuring me these numbers are not caused by a high meat diet or too high of protein diet. He said if she were his dog, he would also probably run the Stim test, realizing that he could be just throwing away good money, but at least he would have done every test possible to figure this out. But at this point it’s not truly necessary since what he has her on is what he would have her on if she does truly have Cushings. Dr. Steph has not suggesting the Stim test at this point either. And Dr. Dan is telling me that once we get the results from the Thyroid test, we may up the herbal supplement dosage he has her on for Cushings. If that doesn’t seem to help, then it’s time to go to the traditional treatment which I’m supposing means we would do the Stim test. She had started out responding beautifully to the holistic treatment for Cushings. So I guess in summary, she has primary kidney disease most likely caused by Lepto and a hormonal imbalance most likely due to stress but possibly due to Cushing's which has been under somewhat control by Chinese herbs; but we don’t know for sure yet because she has primary kidney disease and has been stressed. She has a minimal loss of muscle strength which could be caused by losing protein in the urine. If she has Cushing's it would also be caused by the increased cortisol. However we already know for sure she has an elevated cortisol. SO - kidney disease and elevated cortisol is her problem.


Clear as mud, right?


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## Maglily (Feb 3, 2009)

Hi Crystal , I don't have any info to help and I wish I could do more.
Lily held her own for a long time (having CRF), which may or may not be what Zoe has, but your first sentence says, you aren't 100% sure of what she has. Which could be a good thing. I'm glad things are under control with regard to the holistic approach and Cushings symptoms. Do you know what the next step is? perhaps methods to help with her stress will help everything overall and wait for the thyroid test results. when do you expect those?


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## CrystalAndZoe (Jul 11, 2006)

Maglily said:


> Hi Crystal , I don't have any info to help and I wish I could do more.
> Lily held her own for a long time (having CRF), which may or may not be what Zoe has, but your first sentence says, you aren't 100% sure of what she has. Which could be a good thing. I'm glad things are under control with regard to the holistic approach and Cushings symptoms. Do you know what the next step is? perhaps methods to help with her stress will help everything overall and wait for the thyroid test results. when do you expect those?


Her thyroid draw was sent to Dr. Dodd's on Tuesday. So hopefully yet this week.

For the most part things are settled in the house so the extreme stress from those first couple of years is no longer much of an issue. Most of Zoe's stress anymore comes from bad genetics with her temperament. Sadly, she is simply a genetically unbalanced little dog. And we are addressing those with holistic supplements as well as with chews, puzzle toys, new tricks and exercise. However this past couple of months we just can't get out to walk. Sidewalks are not clear and it's all pretty much ice. I'm trying to find a treadmill that goes down to 1-2 mph.


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## hoaloha (Jan 27, 2012)

If she has cushing's, she can be having microalbuminuria secondary to cushing's. The microalbuminuria may improve once cortisol levels normalize. It may be worthwhile to treat as presumptive cushing's and monitor how things are going. Just depends on you and if the extra testing is going to change what you're doing. It's not easy but I know you will do what you feel is best for sweet Zoe. :hug:


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## lydiatug (Feb 21, 2012)

I'm so sorry you're having to go thru all this, but glad you're finding at least some answers and the herbs somewhat helpful. I found they were helpful with Lexie's spinal issues as well. Unfortunately we no longer have any holistic vets in our area, just my luck, we lost a great one when she left town.

The only thing I can add is regarding the treadmill, as I walk mine on it all the time. I don't know how most of them are, but mine goes up in tenths. It also goes slower if you walk with her (drag from your weight). Bayleigh is pretty active, so we typically walk at 2.5 (any slower and she bumps her feet on the front hood). Mine is very old, and has the extra wide deck, making it easy for me to get a little exercise along with the pups.

Hopefully things will settle down a bit for you with some answers. Hang in there, and know we're all praying for you both...hugs!


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## Maglily (Feb 3, 2009)

Crystal&Zoe said:


> Her thyroid draw was sent to Dr. Dodd's on Tuesday. So hopefully yet this week.
> 
> For the most part things are settled in the house so the extreme stress from those first couple of years is no longer much of an issue. Most of Zoe's stress anymore comes from bad genetics with her temperament. Sadly, she is simply a genetically unbalanced little dog. And we are addressing those with holistic supplements as well as with chews, puzzle toys, new tricks and exercise. However this past couple of months we just can't get out to walk. Sidewalks are not clear and it's all pretty much ice. I'm trying to find a treadmill that goes down to 1-2 mph.



Well that's good, hopefully this week. Aw I see what you mean now about stress and her temperament....it does sound like you have a good handle on how to minimize it. You know that is good advice for anyone to enrich their pups lives as much as possible, less stress overall is beneficial for general health. Walks are out of the question here too, the best I could do is make a path in the yard, although my gate is frozen open this winter so we haven't even been out. The treadmill is a good idea too. Jodi's pal Benny uses a treadmill, his mom has to spell out 'treadmill' because he get s excited when he hears the word. Take care my dear, I wish I could help you more or come by and lend a hand.


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## Lacie's Mom (Oct 11, 2006)

Crystal -- I read this over 3 times and the first thing I thought was Thyroid, then Cushings, then Kidney Failure and finally Diabetes. Some of the symptoms seem to relate to each of these but all of the symptoms together don't seem to add up to one single diagnosis. I'm sure you're perplexed.

All I can say is "good luck". Sending lots of prayers for you and Zoe and lots of hugs too.


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## Ann Mother (Dec 18, 2013)

Good luck. My brother got his dog a treadmill made especially for dogs.


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## aprilb (Jul 9, 2010)

Bless your heart, Crystal...this IS difficult to figure to out, for sure..:smilie_tischkante:  I agree with Lynn at this point...not sure what is going on...:blink: I do hope you get things figured out....((hugs)) Hang in there...knowing you, this puzzle will be solved..:wub:


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## Dixie's Mama (Mar 19, 2008)

Crystal I feel so bad for all you have been going through. No wonder your head is spinning! 
I will be praying for dear, sweet Zoe. You know how I love her. :tender:


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## eiksaa (Jun 8, 2012)

Lots of good thoughts for little Zoe. 


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