FS 11 yo Cockapoo

Significant past medical history:

Multi-year history of allergic dermatitis and recurrent seasonal otitis currently on RC PD diet

2014 Cruciate surgery left knee

2015 Probable partial cruciate tear right knee O elected conservative tx. Currently on Gabapentin,Dasaquin and acupuncture at home. Nsaids avoided given variable borderline high SDMA results. BUN, Cr normal.

2/19: O reported exercise intolerance and weight gain. Full blood panel normal with exception of Thyroid and mildly elevated Cholesterol.

Total t4 0.4 (1-4)

Free T4 (ng/dl) < 0.3 (0.6-3.7)

Free T4 (pmol/L) 3.9 (7.7-47.6)

cTSH 0.43 (0.05-0.42)

Started on Thyoid supplementation at 0.02 mg/kg. O reported significant hyperactivity so halved dosage and recheck of T4 2 weeks later 4-6 hrs post pill 1.6 (1-4). O reports vast improvement in activity levels as well as some loss of weight. Was moderatley overweight.

 O has reported PU/PD and urinary accidents in house off and on over last year. Repeated urinalysis showed great swings in specific gravity from 1.008 to 1.036. Most recently on 3/28/19 morning sp. Gravity 1.030. Multiple urine cultures negative. No proteinuria ever seen.

Recent blood pressure 137 average of 5 Dopler readings.

Repeated cbc/biochem panels over last year have been normal with exception of boderline sdma and Cholesterol which varied between 422 to 519 (131-345 mg/dl). Alk Phos always WNL

 Ultrasound performed yesterday along with ACTH stimulation

ACTH Pre: 6.6 Post 15.1

Other than PU/PD O thinks the dog is doing great!

Videos show L adrenal mass and normal R adrenal as well as hyperechoic liver nodule.