My dog has high enzymes and an adrenal tumor. What are the risks?

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!

Hello. I would wait on the blood work, but it is never a bad idea to obtain a second opinion if you think it is necessary. Spaying GiGi should resolve the vaginal hyperplasia, & medications may control the symptoms associated with the adrenal tumor. If possible, the adrenal gland with the tumor can removed, but this can be a bit of a tricky surgery. This would depend on GiGi's overall health, chest x-rays to make sure the tumor has not spread to the lungs & the availability of a surgeon comfortable doing this surgery. Wait for the blood work & then talk to your vet about all your options. Thanks for using Petco Pet Education Center, formerly Petcoach.

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. Elevated liver enzymes and abnormal liver appearance on ultrasound scan does not necessary mean liver tumour or liver failure. Older dogs often have abnormal liver appearance, which is not related to any serious underlying problem. Liver enzymes level is a measure of 'damage' to liver cells but it is not directly related to prognosis. Again, older dogs often have mild elevation of liver enzymes I would think that the specialist will perform full abdominal scan and possibly take liver samples through a needle - this is commonly performed procedure in dogs with signs of liver disease. Based on the findings of the aspirate, the doctor will recommend further testing or prescribe treatment for Mars.

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.

Hi there! I'm so sorry to hear about Call being sick. From the blood values you've given me, I think the best case scenario for Call would be a gall bladder problem, such as a mucocoele (a soft "gallstone") or infection. The gall bladder can be fully surgically removed in these cases and the liver enzymes may be able to return to normal after recovery. Unfortunately, it may also be a sign of liver cancer, the most common being hepatocellular carcinoma. When the vet does his ultrasound, they will be able to tell you about what both the liver and gallbladder look like and hopefully it will give a clear answer as to what's going on. I hope this helps answer your question. I wish you the best of luck and I'll keep Call in my thoughts!

I assume when you say liver enzymes you mean ALT? There a few enzymes we look at and elevation in 1 value makes us consider different causes then elevation in another. ALT elevation is caused make liver cell injury and leakage of enzymes in to the bloodstream. As the liver sees all the blood of the body it can be quite a reactive organ. So the question is whether the liver enzyme is up because of something wrong with the liver/vessels to liver themselves (such as an infectious or inflammatory cause (hepatitis) or a shunt (more common in younger dogs)) or something the liver is responding too (toxicity, disease of over organs). Unfortunately all parts of sago palm are toxic to dogs with the seeds (nuts) being most toxic. And it can be quite challenging to know if this is the cause. If it is sago it depends on the degree of ingestion as to how severe the case is. Unfortunately the treatment for this is supportive as you have been doing. The values may continue to increase or hopefully may plateau off and remain mildly elevated or decrease again. Ultrasound will help to rule out other things going on in the abdomen, assess the liver for changes in texture (although a liver can appear normal on an ultrasound and not be functionally normal), and sometimes identify a portosystemic shunt. After the ultrasound then sampling either first by fine needle aspirate or with a biopsy (needed for many cases of hepatitis, some other issues) can be performed. Checking platelets and clotting times should be performed prior to liver sampling in patients whose livers are not normal to decrease the risk of bleeding from sampling. As shunts are more common in younger animals , if this is suspected, additional imaging may be recommended prior to sampling as ultrasound will not identify all shunts. There is also a disorder called microvascular dysplasia that can be found in the liver. This is best diagnosed by liver biopsy and the sample sent to a pathologist who specializes in liver pathology. I hope this has helped and not confused you more. It sounds like your vet has taken the appropriate steps thus far and has recommended the next best steps to try to rule out some other causes. Thank you for using Petco Pet Education Center, formerly Petcoach!

First, I would want to get to the bottom of why Zoe's ALP is so high. This may be indicative of a hormonal disease like Cushing's (overactive adrenal glands) and if she has any of the symptoms, such as increased thirst, increased urination, panting, increased appetite, or a big belly, it's worth it to consider ruling out Cushing's disease. An abdominal ultrasound may be helpful in this quest, as it will show changes to the liver as well. If you are sure the mass is benign, I'm not sure I would even remove it, unless it's bothering her. It's hard to tell based on the pictures and without something for scale, but it seems small and I would consider talking to your vet about whether it could be removed with just some local anesthetic instead of general anesthesia.