Cushing’s, Hypothyroidism, and Boomer
A little over a year ago, Boomer was diagnosed with a rare form of liver disease – the cells swell up and burst. No effective medication available. So I assumed his lower energy and increased thirst were due to his liver condition, and tried to accept the changing version of normal.
Last week, found a small dark mass on the outer side of his lower lip where it becomes hairless. Because of his past oral melanoma, I took him to the vet ASAP. Not fluid-filled. Reasonable potential for melanoma but uncertain until removed and tested.
Because of liver issue, hesitant to use anaesthetic. Vet said he could do local freezing and conscious sedation (I don’t know if I heard that correctly) to remove but only if liver hadn’t become significantly worse. He ran blood tests. Liver is worse. When my vet did a biopsy a year ago, ALP was 500. It’s 1900 now. And now he also has hypothyroidism. Other symptoms I thought were due to liver could now be due to the pituitary (Cushing’s disease). Or not. Or both. A lot of confounding factors.
I know ALP can elevate for many reasons but Boomer has a chronic, untreatable liver condition. If he also has Cushing’s, it’s contributing to the liver readings.
Test for Cushing’s, if negative, we continue treating thyroid. If positive, could be false positive but would be treated to see if thyroid returns to normal. If false positive, treatment & testing cycle will be for nothing. If true positive, treatment will deal with cortisol due to Cushing’s (I think) but about 10% chance thyroid would still need treatment albeit at a lower dosage. To assess the effectiveness of both treatments and set the correct levels, I assume Boomer would need to repeat both tests at least one or two more times before we check again in a year (my vet said six months, but in this case, he thought a year would be fine – I couldn’t help wondering why he thought that). If no test and it’s Cushing’s, it’ll affect everything and add to the mix of, well, everything. We’d continue to treat the thyroid at increasing dosages.
Meanwhile, the small mass on Boomer’s lower lip might or might not be affecting his organs but now we’ll never know for sure, and his liver continues to lose function no matter what else we do or don’t do.
On top of that, he’s even bumpier than before, some of them quite big. I used to have them aspirated as they appeared but now with his liver, no way to remove any because of risk of using anaesthetic. None impede his movements nor seem to be causing any discomfort, so at least I don’t have to make a decision there.
It was a long phone conversation when my vet phoned with the test results. I took notes but obviously not enough. The brain processes only so much as you pretend to be practical.
Phoning the insurance company today to verify what they’ll cover.