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Ask Dr. Michael Salkin Your Own Question

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 26192
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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My question is about my dog who is approximately 10-12 years

Resolved Question:

Hello my question is about my dog who is approximately 10-12 years old. He has a variety of symptoms and the possible diagnosis of a brain tumour.
I am not keen to take him for a scan because part of his problem is anxiety and he gets particularly stressed in the car and he would have to travel for several hours to be seen. in addition at his age I don't think it would alter his treatment.
So I wondered if you could consider his symptoms and give me your thoughts about his condition.
His symptoms started with excessive drinking and urinating, he was tested for all the usual suspects (Cushings, diabetes, etc) and all results have been normal other than the suggestion that he was dehydrated which appeared strange as he was drinking at least 4 large bowls of water per day and his urine was tested and was very dilute. He started to have an urgency to get out following a meal, he would go straight to the door and bark in a bit of a panic and he also began to move off before he had finished peeing.
He also had an increase in his appetite and would wake us as early as possible and be unsettled and very agitated until he was fed. Once fed he could then settle down and relax.
He then started to have a delay in responding to noise. I would say his name or 'biscuit' and he would show no response whatsoever as if he hadn't heard anything and then a few seconds later would turn to me and look as if to say did you shout me.
In addition to this he was becoming very anxious, panting a lot and agitated and found it difficult to settle. He would pace the garden or house looking for something to bark at.
He has a hip problem (possibly congenital) so we wondered if his anxiety/agitation was due to pain so he was started on Metacam. The result of this was quite a surprise as it improved the symptoms discussed above other than the anxiety. However i found if I gave it to him at night he was more settled in the morning and would sleep on a bit longer and not need to get up for food immediately as before. The thought then was that the anti-inflammatory properties may have been reducing the swelling of a tumour.
He then started to shake his head a lot and I knew it was different to an ear infection as he had a few in the past. His ears were clean and not smelly. I took him for a check up and they were fine. A couple of days later he went almost completely deaf over night and his head shaking has stopped. (although has started a little again in thefts few days)
His agitation continues to increase and recently he was prescribed Xanax to help with this.
He has also become aggressive to others dogs which is very unusual for him, he had been a very calm dog who spent time helping other dogs with issues.
I feel that some of his original symptoms are creeping back in. He is drinking a bit more and has the urgency to get out after a meal and walking away before peeing. Although they are not nearly as bad as they were prior to the Metacam.
I have a medical background so I had a look at the anatomy and function of the dog brain and it seems as if all his symptoms would fit within the hypothalamus and pons area of the brain which do look in the diagram quite close to each.
I know you can't give a definitive answer but I wondered if you hd any thoughts with regards ***** ***** likelihood that it is a tumour.
Thanks for you help
Submitted: 9 months ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 9 months ago.

You're quite perceptive. A hypothalamic tumor should always be on the differential diagnosis list for a polydipsic, polyuric, and polyphagic geriatric particularly if you've ruled out the common villains such as diabetes mellitus and Cushing's. I would like to confirm that that's the case, however. Can you upload a copy of his test results to our conversation? I understand that you might not have a copy at home but his vet can give you one which you can scan into your computer and then give me the file link or you can photograph the pages and upload them by using the paperclip icon (if you can see that icon) or by using an external app such as dropbox.com/

Please note that atypical Cushing's remains a possibility if a sex hormone panel (progesterone, 17-hydroxyprogesterone, estradiol, androstenedione, testosterone) hasn't been performed. Excesses in these hormones also can cause cushingoid symptoms.

Customer: replied 9 months ago.
Thank you for your answer I will get the information for you hopefully tomorrow. Can I ask just out of interest if it was atypical Cushing's would it improve with the addition of Metacam. Thank you again for your help.
Expert:  Dr. Michael Salkin replied 9 months ago.

Perhaps. The sex hormone-related Cushing's will be found secondary to an adrenal tumor (particularly adenocarcinomas) and a nonsteroidal antiinflammatory drug might have a chemotherapeutic effect on such a tumor. Piroxicam is the NSAID we're most aware of having such an effect and meloxicam is in the same class of drugs. You're quite welcome. I can't set a follow-up in this venue so please return to our conversation - even after rating - with the additional information at your convenience. You can bookmark this page for ease of return.

Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 26192
Experience: University of California at Davis graduate veterinarian with 44 years of experience.
Dr. Michael Salkin and other Dog Specialists are ready to help you
Expert:  Dr. Michael Salkin replied 9 months ago.

Thank you for your kind accept. I appreciate it.

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