My dog's high ALP after anal gland rupture: Is it Cushing's or pain?

Cushing's or Hyperadrenocorticism is a fairly common endocrine disease in dogs. It can be caused by a bit of overactive tissue in the brain (in the pituitary gland, which is the master ruler of hormone secretion in the body) or a mass in an adrenal gland (sits by the kidneys, secretes hormones as directed by the pituitary gland). Basically what happens is an excess of a hormone in the body, usually a steroid called cortisol, if it is traditional Cushing's. This then causes some symptoms in the pet, blood work changes, and sometimes other changes like high blood pressure. I suspect based on the value that you report that this was a liver enzyme elevation call ALP. This very commonly occurs in pets that have Cushings, but is not specific for Cushing's and elevation can be caused by other disease processes. This value does not correlate with severity of disease as many dogs have a high value. It sounds like your vet is on the right track by recommending an ultrasound to look at the adrenal glands and also the rest of the abdominal organs to rule out other disease processes. Ultimately Cushing's Disease has to be diagnosed by some sort of endocrine testing which your vet may recommend as well. Treatment if then based on what type of Cushing's disease is present. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

I'm sorry that Miller is not feeling well. We certainly see an increase in ALKP as an early sign of Cushing's disease, but ALT is not as commonly elevated. I am attaching a handout with more information about Cushing's disease below. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1551 The most common test that we will use to diagnose Cushing's disease is called a Low Dose Dexamethasone Suppression Test. I am attaching a handout below that discusses the specific tests we use for Cushing's disease. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=636 However, an abdominal ultrasound is also an excellent test to evaluate the adrenal glands to look for evidence of Cushing's disease. So, I would discuss with your veterinarian if they would recommend doing further blood testing first or an abdominal ultrasound. That answer will likely depend on what Miler's lab work looks like when it is rechecked in 2 weeks. Good luck! I hope that was helpful and you can figure out what is going on with Miller. Thanks for using PetCoach.

It's hard to get a full picture of a pets condition without a hands on exam, but the things that concern me with this bloodwork are the glucose level, the ALKP and the elevated WBC count. Unfortunately, in these cases, more veterinary care is the only option. Your pet may have Cushing's disease (adrenal gland disorder), diabetes and an infection somewhere. These cases can get complicated and require follow up testing, likely medications that need to be controlled and adjusted once a diagnosis has been made. There really isn't any way of moving on with your pets care until you have a working diagnosis and these results point to a few possibilities. Perhaps you can see if your vet accepts Care Credit and utilize that for financial assistance.

Hi there and thank you for using Petco Pet Education Center, formerly Petcoach to address your concern. Unfortunately ALP is such a vague value and does not tell us much in the way of specific diseases that it is not a very useful value. In older dogs with a high ALP, this may be a normal finding not related to any disease. Cushing's disease can cause an elevated ALP along with many other causes. If the ALP continues to rise or does not resolve, I would consider testing for Cushing's disease and have an abdominal ultrasound performed. Bronchitis and a tooth infection generally would not cause an increase in this value in my experience. I hope this helps! Please let me know if you have any other questions or concerns and I would be more than happy to help you further.

Hi there and thank you for using pet coach to address your concern. The ALP is quite high but this also depends on their reference ranges there. The symptoms you are describing could be consistent with a condition called hyperadrenocorticism (Cushing's disease) which is when there is excessive steroid production in the body due to a pituitary tumor or adrenal gland mass. There is treatment for the disease but it needs to be confirmed first. If you want to know for sure, testing such as an ACTH or low dose dexamethasone test should be performed. You can try using melatonin and flaxseed lignans to treat cushings disease naturally. I have had some cases respond to this treatment but not 100%. Also, I see that cre is 18. If this is creatinine, this is very high. Again, this depends on the machines reference range, calibration and unit of measure. Creatinine elevates typically with renal disease, which could also explain the increased thirst. If you attach a picture and repost to the forum here, it may help us better guide you. I hope this helps! You can visit a website called lignansforlife.net and order the holistic medications that I spoke of earlier. Please let me know if you have any other questions or concerns and I would be more than happy to help you further.

An enlarged liver is unfortunately one of the common side effects of Cushing's disease so it is not unusual that Ginger's liver appeared enlarged. Her urine concentration is very low (normal for a dog is 1.040) but again, this can be attributed to her Cushing's disease as well (because she is probably drinking more water and therefore causing her urine to be more dilute). In Ginger's case I would be worried about Diabetes and possibly cancer as well. I know it can be frustrating (and expensive) to keep doing more tests, especially when you aren't getting clear answers as to what is going on. I would recommend talking to your vet about costs/additional testing versus palliative care/keeping her comfortable for the time being. It may also be worth beginning treatment for her Cushing's disease because it could help allieviate some of her symptoms. Good luck. Please let us know if you have more questions/concerns.

Further testing including abdominal ultrasound are appropriate at this point. If this testing was or will be done, the results of a fine needle aspirate of the liver will help direct the course of treatment. If you have further questions, please feel free to request a consult with an expert where more questions can be asked and diagnostic data can be provided.