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Tandem’s Story- Finding a Diagnosis
By Lisa Schmit, PhD, CCFT, CPMP
In The Zone Agility 

I am sharing Tandem’s story in hopes that it will help an owner, friend, trainer, and/or a health care professional find a diagnosis and treatment and to show how important it is to have many people on your dog’s health care team. PLEASE SHARE 

In January 2020, Tandem was very constipated. My vet did a rectal exam and said Tandem had really hard stool which could be bone/ toy or something else. She performed an enema. This went on for a few weeks with a few enemas before finally doing an ultrasound which found two perineal hernias. On January 30, Tandem had surgery to repair hernias and was neutered. I was unaware that older adult intact males are prone to enlarged prostate which can lead to hernias. So of course, I feel guilty. I feel guilty for leaving him intact; I feel guilty for not knowing that enlarged prostrates are common in intact males; I feel guilty for not demanding an ultrasound right away. Thankfully, he recovered quickly. I went back to training agility with him and even trialed him in the middle of March. Then in April, things started to change. His coat was really crappy regardless of good food and supplements. He started having a hard time getting up so I started giving him Previcox hoping that would help. This was when COVID hit and we were in a stay at home order. After about a week, I went to the vet to get bloodwork and Xrays done and made appointment with my local chiropractor (I have many chiropractors). Bloodwork came back with issues: BUN and Creatine were high as were Phosphorus, Potassium, and Albumin which all lead to kidney disease. Thankfully, he was not dehydrated, heart sounded good and at this point he was still eating fine. X-rays showed some arthritis in his back. He saw his local chiropractor whom is also a vet. She was very concerned with his kidneys as well. She told me to completely stop Previcox as NSAIDS can cause Kidney issues! So I stopped pain meds and changed his diet. I feed raw and apparently, I feed a really high Phosphorus diet. So I had to change his diet. I cooked ground beef, pasta and sweet potatoes as well as other stuff. I quit feeding bone, yogurt, eggs, and cottage cheese. I added a phosphorus binding supplement. Vet gave me Gabapentin and a muscle relaxer. These drugs caused him to be lethargic. He was not feeling any better. The pain seemed to be on the right side more but I attributed this to an old injury. He was having an even harder time getting up and was more scrunched up in his back. Two weeks later back to the vet for more Xrays and bloodwork. Bloodwork looked a little better. BUN and Creatine went down so it seemed like we were on the correct path for kidneys, but he still was in pain and increasing having a hard time getting up and moving. At this point, it was the consensus of his health care team (vet, chiro vet and another chiro) he had arthritis in his back and keep watching the kidneys. Over the next 3 weeks, I ordered an Assissi Lounge bed for him. I quit the muscle relaxers and reduced the gabapentin as I think that was making things worse. He did do a little better off of drugs as he wasn’t as lethargic, but still not getting any better. He was seen by chiropractor again and we tried acupuncture. That night, he was really shaking so we did not try acupuncture again. Rechecked bloodwork, and while BUN was still high, it had gone down. Creatine was within normal ranged now, but Sodium still lower and getting lower each time, Now the Amylase is high as well as the total bilirubin. But seems like the kidneys are feeling better so nothing was said about these values. Over the next 3 weeks, he was getting worse. He was drinking a lot, peeing a lot, shaking sometimes, losing so much muscle everywhere including his head, having a hard time getting up, not wanting to eat, losing weight……. At this point, I am considering putting him to sleep. I can’t let him live like this. He is miserable. Back to my vet I go to see if there is anything else we can do. More bloodwork, urinalysis, checked his hernias and his teeth. Hernias, teeth and urinalysis look good. Bloodwork – Sodium is low and has consistently gone down and Amylase is higher. My vet sends me home with another pain med to try. I send bloodwork to two of my chiropractors and both are concerned with his pancreas now. Thankfully, my local chiropractor discussed Tandem’s bloodwork with another vet and he immediately said check for Addison’s Disease. At the same time, my friend also said check for Addison’s Disease. Once I read about Addison’s Disease, I was sure that is what Tandem has. The good news is that it is TREATABLE. I was praying he had Addison’s Disease. My chiro vet orders the Addison’s Disease test. Her vet’s office is about hour and half from me (that is why she is not my normal vet). But a week goes by and the damn test doesn’t arrive … I am waiting and poor Tandem is getting worse. He will hardly eat; he is in pain and wasting away. So I call my vet to see if they have the test and while they didn’t have it on hand, they would order it. OK so whoever got it in first was where I was going. My vet received the test the next day! So on June 18th Tandem is tested for Addison’s Disease. By this time, I had read about Addison’s Disease and know the treatment is usually Prednisone and maybe a monthly shot. Well, it was Thursday evening by the time they finished the test, so test went out Friday and then the darn weekend. So we had to wait again. But I did talk my vet into giving Tandem Prednisone. At this point, even if he didn’t have Addison’s Disease it could help with him pain. After giving him the first dose of Pred, he felt better. By the next day, he was SOOO MUCH BETTER. The prednisone helped him sooooo MUCH !!!! His eyes were brighter, he had an easier time getting up, he was happier and didn’t look in pain. He still is not eating much. Eight days later we finally get the positive test results for Addison’s Disease and he gets a shot of percorten. Within a day of this shot, he is feeling even better and is eating better almost back to normal.  

So now what? He will be on daily Prednisone and monthly Percorten shot for the rest of his life. He will get his electrolytes tested next week and again in 2 weeks before his next shot. We will play around with his dosing to try to get it is as low as possible to reduce side effects. The only side effect I see right now from the drugs is he is panting more and I am happy to say he is hungry and eating normal again.  

Now that he is feeling better, he can start a conditioning program to try to rebuild the muscles he lost during this ordeal. I started out doing an assessment (measurements, postural analysis, Range of Motion etc) to see where he is at and have a baseline so I can track his progress. If you are interested in keeping track of his progress and learning more about Addison’s please join Tandem’s facebook page: 

https://www.facebook.com/groups/TandemlivingwithAddison’s Disease/

With his new medications, good nutrition and supplements (now that he will eat it), I am hopeful that he can return to full function and activity and more importantly live pain free and happy!!!

I wholeheartedly Thank Dr Linda Harmon (DVM, CVSMT), Dr Katie King (DC) and Robin Carberry for their support through this. If it weren’t for you awesome ladies, Tandem might not be here today. So please if your dog is getting worse or you can’t find a diagnosis, keep looking; seek a 2nd opinion, see a chiropractor; talk to friends. 

Lisa Schmit, PhD, Certified Canine Fitness Trainer, Certified Pet Massage Practitioner,
Bobbie Lyons K9FitTeam
inthezoneagility@gmail.com www.inthezoneagility.com 
ITZ online school: inthezonedogtraining.teachable.com
Youtube Channel: https://www.youtube.com/c/lisaschmitinthezone
ITZ business facebook page: https://www.facebook.com/inthezoneagility/  
ITZ facebook group: https://www.facebook.com/groups/IntheZoneAgility/ 
Newsletter: http://eepurl.com/dNZpcM
Tandem Living with Addisons Facebook Group: 
https://www.facebook.com/groups/Tandemlivingwithaddisons/