There is something wrong with Blomma

FinnishLapphund

FinnishLapphund

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Not expecting anyone to be able to offer an epiphany, I only wanted to write it down, and get it a little bit off my chest.
Blomma is 12, spayed (so no uterus = not pyometra), and less than 3 weeks ago she started to drink more water. She has gone from drinking up to max around 1 litre per day (the same as Jonna, and Beata), to drinking around 2½, 3 litres per day.

Spent yesterday at the veterinarian clinic, did an 8 hours Cushing test, her blood was also tested for Diabetes, and had the usual liver, kidney values tested. And we went out and collected an urine sample after they had done the first of that days blood samples.

The veterinarian called earlier today, and there is no Cushing, no Diabetes, all her values are normal, the only not normal thing they found was that her urine is very diluted. Which of course isn't strange considering how much she's currently drinking.

The veterinarian is now not sure what can be causing her thirst. To find out if her body for some reason no longer is able to concentrate urine as it used to, from 18.00 this evening we're now testing to see if she can go 12 hours without water (and food). If it goes well, 06.00 tomorrow morning I will take her out for a urine sample, give her food and water afterwards, and take the sample to the veterinarian when they open.

But if she wakes me up desperately searching for water in the middle of the night/show signs of dehydration, I have to stop the test, give her water, and we will have to do the whole thing again, but for only 10 hours. And if that also doesn't work 8 hours...

Apparently there is a medication we maybe can try, which hopefully could help her concentrate her urine better again, if that is what is causing the thirst. But what if they find that she doesn't have any problem with concentrating her urine?

She have started her Autumn shedding a little before the other two, so the veterinarian said they might also want to eliminate that her thirst isn't an unusual symptom of a problem with her thyroid gland. Besides these two things, it didn't seem as if the veterinarian had any more ideas about what the problem could be/how to solve the problem.

So here I sit, waiting. Trying not to worry on beforehand, but still having nagging thoughts in the back of my head, wondering what the cause could be.

By the way, all 3 dogs was fed a portion with food and water each at around 17.50. For Jonna, and Beata that water should be enough for them to not be thirsty until tomorrow. Water bowl removed 18.00.
Berta the cat is a bit confused about why her water bowl isn't where it should be. Even though she normally likes to try to drink from watering cans, buckets, glasses, cups etc, put her + water bowl on the kitchen table, and suddenly she's a bit sceptical.

Thanks for reading, hugs or similar would be appreciated.
Updates will follow when I have any.

Blomma
 
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I would say some sort of kidney failure on the symptoms, but the blood tests should have shown that??!!

Sending huge ‘get well soon’ vibes to Blomma, thinking of you FL xxxx I will anxiously wait for updates xxx
 
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More of a lurker than a poster but just wanted to chuck Addison's Disease out there as a possibility. I'll let you google it rather than trying to go through it as it's quite complex and symptoms can be variable and can come and go. Hope you get some answers soon.
 
cauda equina

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Humans can get a thing called diabetes insipidus. It's nothing to do with sugar; you pee loads because a hormone called antidiuretic hormone (made in the brain, tells the kidneys to hang onto water) is lacking. I guess that's what your vet is thinking of. It's treatable as a synthetic form of the hormone is avaiable.
Sending hugs to you both xx
 
fankino04

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Sounds similar to my girl, vets think Cushing's but she's had 2 tests that weren't conclusive but apparently it can be really difficult to trigger a positive response, her signs are excessive drinking and panting, increased hunger, her coat isn't growing back from when she was shaved for a liver ultrasound, slight tremors (may or may not be associated), reluctance to exercise, Alp liver enzymes at 1500 instead of 100. This all started last winter, just got her referred to a specialist and she is in on Monday for ultrasound on her adrenals. Thankfully in herself she is still quite happy and perky. Hope you get answers quicker x
 
FinnishLapphund

FinnishLapphund

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No real info yet really, they went out for a pee at 20.10, she walked by where the water bowl usually stands a few times during the evening, otherwise calm. Took the morning pee sample at 06.05. When she stopped peeing, it was only about 1 cm left before she would have flooded the Chinese takeaway container I used to collect the sample in.
She's only a medium sized dog, I really can't remember ever having gotten such a large urine sample from any of my dogs previously through the years.

Now I can only wait for an answer from the veterinarian.

PaintPonies said:
More of a lurker than a poster but just wanted to chuck Addison's Disease out there as a possibility. I'll let you google it rather than trying to go through it as it's quite complex and symptoms can be variable and can come and go. Hope you get some answers soon.
Click to expand...

Thank you for not lurking. I hadn't thought about that some of the symptoms for Cushings, and Addisons are the same. But she doesn't have any of the other Addisons symptoms, and as far as I can tell from my google searches, the ACTH + cortisol levels test they do for suspected Cushings, is the same as they do for suspected Addisons. So the tests we did on Monday would have shown if she had either Cushings, or Addisons, if she had had either of them.

cauda equina said:
Humans can get a thing called diabetes insipidus. It's nothing to do with sugar; you pee loads because a hormone called antidiuretic hormone (made in the brain, tells the kidneys to hang onto water) is lacking. I guess that's what your vet is thinking of. It's treatable as a synthetic form of the hormone is avaiable.
Sending hugs to you both xx
Click to expand...

Not sure I've heard of that before, but having googled it, it seems that it is the test we have done today. Now it makes sense why the veterinarian was so adamant about that I had to stop the water deprivation if Blomma became worried/had problems, because the info I found said that even though a water deprivation test is needed to diagnose Diabetes insipidus, it also said that depriving water can lead to death for someone with the condition. (ETA If not being careful.)

Seems to be a rare condition, with 3 possible options. If it is caused by the brain no longer producing enough of the AD hormone you mentioned, there is a medicine available. If it is caused by a cancer tumour in the brain, the prognosis didn't sound good. Or if it is the kidneys that have stopped responding to the ADH, there is a medicine which together with a special diet might help.
At least with the first and last option, the outcome didn't sound too hopeless.

Thank you so much for mentioning it. Not fun to read that it might be brain cancer involved, but I will probably understand better what the veterinarian is talking about when she calls with the test result, thanks to your reply.

fankino04 said:
Sounds similar to my girl, vets think Cushing's but she's had 2 tests that weren't conclusive but apparently it can be really difficult to trigger a positive response, her signs are excessive drinking and panting, increased hunger, her coat isn't growing back from when she was shaved for a liver ultrasound, slight tremors (may or may not be associated), reluctance to exercise, Alp liver enzymes at 1500 instead of 100. This all started last winter, just got her referred to a specialist and she is in on Monday for ultrasound on her adrenals. Thankfully in herself she is still quite happy and perky. Hope you get answers quicker x
Click to expand...

As I understood it there was no inconclusiveness with Blomma's blood tests last Monday, the ACTH + cortisol test results was completely normal, and her liver (+ kidney) values are also completely normal. With those results, and her lack other Cushing symptoms, from my layman point of view, it seems more likely that there is another cause to her problems, than that she has a difficult to diagnose type of Cushings. But always worth remembering, in case they don't find anything else.

Hope you finally get an answer about your dog's problems, from next Monday's tests. I've read that about 30% of Cushings cases are ACTH-independent, which I presume can lead to the not conclusive test results your dog have had.
But I'm still sitting here just shaking my head over that your dog's problem started last Winter, and all these months later, you still don't know for certain what the problem is. That is a long time to spend in a limbo, worrying about what is wrong. Fingers crossed we both get answers soon.
 
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fankino04

fankino04

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As I understood it there was no inconclusiveness with Blomma's blood tests last Monday, the ACTH + cortisol test results was completely normal, and her liver (+ kidney) values are also completely normal. With those results, and her lack other Cushing symptoms, from my layman point of view, it seems more likely that there is another cause to her problems, than that she has a difficult to diagnose type of Cushings. But always worth remembering, in case they don't find anything else.

Hope you finally get an answer about your dog's problems, from next Monday's tests. I've read that about 30% of Cushings cases are ACTH-independent, which I presume can lead to the not conclusive test results your dog have had.
But I'm still sitting here just shaking my head over that your dog's problem started last Winter, and all these months later, you still don't know for certain what the problem is. That is a long time to spend in a limbo, worrying about what is wrong. Fingers crossed we both get answers soon.[/QUOTE]
It feels like it has been going on forever! We pretty much had to put it all on hold during covid as she wasn't sick enough (thankfully still doesn't appear ill except the over heating and excessive drinking) to be an emergency. Then when they were back to doing routine things they did the other Cushing's test but no trigger, they sent her case notes to a medicine specialist to look at (whatever that is) but then I had an issue with them over something else so changed vets and they have booked her straight in for an ultrasound with a specialist so hopefully will know more on Monday. Hope you get some positive answers today and it's easily treatable x
 
EventingMum

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Our first JRT ended up with diabetes insipidus and he responded well to medication. I have a horse that had similar symptoms and he was diagnosed with polydipsia, one of the symptoms being he couldn't concentrate urine and drank a lot. I have no knowledge of it in dogs but understand they can get it - part of his treatment was to increase his salt intake even though he was fit and competing and on electrolytes at the time.
 
FinnishLapphund

FinnishLapphund

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The veterinarian had spent the day doing surgery, so called after 18 o'clock. The test result made her certain that it is Diabetes insipidus, and since the kidney test result where perfectly normal, she's convinced the problem is in the brain, but doesn't seem to think that it is a tumour.
So Blomma will need medication, if we can get the dosage correct, she will be on it for the rest of her life.

There is no medication developed especially for dogs with the condition, without she will get the same medicine as humans. Apparently the condition really is rare. Rare enough for it to only be 1 pharmacy in the whole of Sweden's second largest city that have any packages in their store. All others needs to order them to their customers, and even the one pharmacy who have them, have them listed as only a few available.
They close at 22, but their customer service, where you can phone and check so they still really have any packages left, closed at 18.

I decided to still go there on my bike, took over 40 minutes each way. They had 1 package! We've started the medication this evening, after some cutting pills in pieces, and counting hours back and forth.

Because of course she can't simply have one whole pill, she needs 3/4. And the medication should not be given too close to feeding times, the first week 3 times per day, preferably around at the same time from when she last ate/before her next meal, and due to 15 year old Jonna's liver, my dogs now gets fed 4 times per day... o_O

Hence the counting hours back and forth, but I've figured out a schedule. And after 1 week, we need to do a new water deprivation test, take a new urine sample, and depending on the result, the veterinarian thinks we should probably be able to lower the dose to maybe 2 times per day.

Hopefully the medication works, and it isn't a tumour involved. Time will tell. At least they've already figured out what the problem is. Judging by the tone in her voice, and her words, I have a feeling the veterinarian was a little surprised herself that it really was Diabetes insipidus.

Thank you so much for all the replies.
 
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I'm glad that you have an answer. I hope that Blomma is feeling better now that she will be getting medicine and hopefully she improves quickly so that you have less counting! Best wishes to you both
 
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