Tuesday, November 2, 2010

Chem 20

Clover went to the vet for a fairly routine physical last week. In addition to a few suspicious lumps, he had a blood panel run.

I am happy to report that the two lumps turned out to just by lipomas - benign fatty tumors. Clover has a lipoma on his chest we looked at last year - they are generally soft, just under the skin, and relatively easy to move. The only concern with them would be if they grew large enough to interfer with the dog, such as being large enough or in a location that inhibits movement. Many vets call them "lumps" or something rather than tumors, because the word tumor often gives people the wrong idea in the case of lipomas.

Clover's two new bumps were suspicious because they were small, somewhat harder, and seemed to be further under the skin. Lindsey (my ever marvelous vet) felt them and said we should definitely aspirate them - use a needle to draw out a bit of the bump and examine what it is. After several nervous minutes, she did confirm both were simply lipomas - they were probably under a bit of connective tissue that made them feel harder. Phew.

We did do a blood draw follow up to his July 2010 elevated kidney levels. We strongly suspected it was his high-protein food, and agreed to follow up after he'd been on a lower protein food for a period of time.

When she called on Monday, she started with, "Well the good news is his kidneys look beautiful..."

Unfortunately, he had elevated liver and platelet readings. With his age, this is consistent with the early signs of Cushing's Disease. This is an adrenal disorder that affects the body's feedback system, making the brain and body miscommunicate things like hunger, thirst, or other hormone-based functions. Left unchecked, the body continues to go awry and opens up possibilities for more illness, from infections to diabetes. But, it's not uncommon in older dogs, and reasonably treatable.

Lindsey and I discussed some of the other symptoms, but they are sort of vague and easily confused with "just getting old." In Clover's case, the symptoms he has are also very reasonably explained by outside factors.

Has Clover been drinking (and peeing) more lately? Yes - but it started when my heat start running and my apartment got very dry. Has he gained weight? Yes - but it started when I switched his food. Does he seem hungry? Yes - but it started when he was getting fat so I cut back his ration. Does he seem to be panting (in his case, oinking) more than usual? Yes - but it started a few months ago when I put him on food with grain in it again, which is is clearly allergic to, and has been going away the longer he's off that food. Does he seem somewhat stuff, perhaps hesitant to jump on furniture - yes, but he had two knee surgeries in under a year, and he's certainly better than he was. Does he have a pot belly? No. Does he have skin or coat problems? No.

So it's a tough thing to call. You could say that ice cream causes drowning - after all, more people eat ice cream in summer, and more people drown in summer - but you also need to examine outside factors (more people eat ice cream when it's hot, more people swim when it's hot) to see if they do actually correlate or if they just appear to.

The other issue is Clover will have to come off his Temeril (which has prednisone in it) to test for Cushing's. The adrenal glands produce natural steroids, and prednisone is a steroid, so you can't test the natural steroid level with some other ones floating around. Since he's still detoxing from his grain allergy, and the fall pollen is still up, that's not a sensible option right now.

Lindsey's advice was to wait and see. We'll see if the eating, drinking, panting all settle down - signs that they were environmentally related - or if they stay the same or worsen. By January, the well-frozen ground and several months on the new food should have his need for Temeril to a minimum, so we might be able to get him off long enough to test and see.

I hate "wait and see." It's my absolute least favorite thing. But I guess we'll see how things look after Christmas.