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Discussion Starter · #1 ·
We have to leave about 7:30 am to Michigan State University veterinarian hospital. See what wrong with her, I pray it is not serious and easy fix. Not sure if we will have to stay over night, if not when we get home that night I let you know, If you don't hear from me we had to stay over night. My husband is going to try to get his old lap top up and running so I have PC if I need to stay over.

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Discussion Starter · #22 ·

Intersexuality ( hemaphrodite)
Bilateral Nephroliths and Mineralization of the Kidneys
AmberLeah LouLou is a 7 month old intact female Chihuahua. Her owner bought her from a breeder off of Craigslist
when she was 6 weeks old on May 1st. At that time she believed that she had a larger than normal vulva but it has
gradually increased in size since then and is now elongated and swollen. She has never gone through a heat cycle. She
also has been polydipsic, polyuric and pollakiuric since she brought her home. The owner reports that she drinks a lot
during the day. She will frequently urinate multiple times in an hour. Occasionally she will dribble when walking but
the owner has not noticed any wet spots after she lays down or on her blankets after she takes a nap. Two months ago
she collected urine from AmberLeah LouLou and brought it to her referring veterinarian for a urinalysis. They found
some blood in her urine and prescribed an antibiotic which did not improve her polyuria/polydypsia. She is an indoor
only dog that uses peepads throughout the house but has frequent accidents. She also had some hair loss, which the
owner reports that she had this at 6 weeks but that the hair loss has gotten worse over the past few months.
AmberLeah Loulou is fed Wellness puppy a mix of dry and canned about a fistful of both twice daily. She is hand fed
her food as she is a picky eater though she readily eats the 4-5 wellness puppy treats she receives daily. She is normally
on Revolution though she is two weeks overdue and they found a flea on her a couple of day s ago and gave her a flea
bath. She is up to date on her puppy vaccines though she still needs her rabies and lepto. Her parents were both 8
pounds and the breeder refuses to answer emails regarding genetic problems and if the other puppies are small. She lost
her deciduous tooth 805 last week.
On physical exam AmberLeah Loulou was bright, alert and responsive. She had a temperature of 102.0 F, her HR was
200 bpm and she was shaking. She weighed 3.07 pounds and had a BCS of 5/9. She had an enlarged and protruding
vulva about 3cm by 1 1/2cm in size. Palpation of the vulva alluded to a thin hard structure inside the vulva consistent
with an os clitoris. She also has some bilateral symmetrical hair loss over her rump, chest, ears and shoulders. She has a
mottled pattern of hair loss over her dorsum. She was very tense on abdominal palpation and her kidneys could not be
palpated. She had a retained deciduous tooth 305.
Abdominal ultrasound:
Bilateral nephroliths and/ or dystrophic mineralization of the renal diverticula

PRESENTING COMPLAINT: PU/PD and an enlarged vulva
Procedure Ref Range Units.

AmberLeah was referred for abnormal vulvar conformation and increase water intake and urination. Given the
diagnostics previously performed our differential included: underlying systemic disease causing pu/pd like behavior
(endocrine, liver, renal), urinary tract infection or vaginitis, and possible exterior genital abnormalities cause by
inappropriate androgen secretion. This over exposure is usually due to the fetus being exposed to excess androgens,
otherwise known as sex hormones, during development. Much less commonly it can occur to due self release of
androgens from the adrenal glands or sex organs. This type of change would be described a hermaphroditism (or a mix of
both female and male reproductive organs) now termed intersexuality.
Diagnostics today showed no major abnormalities on bloodwork or urinalysis that would easily explain her increased
thirst and urination or physical changes. There was a mild increase in calcium, hypercalcemia can cause Pu/pd to occur
but often at much higher values. Abdominal ultrasound revealed small renal nephroliths and cystic mineralization. This
could be due to underlying renal disease or cyclic increases in this hypercalcemia causing mineralization. Her specific
gravity indicated that she was able to concentrate urine well and that no indication of infection was noted. In terms of her
increased thirst and urination we would recommend performing an ionized calcium (which is a truer reflection of the
calcium circulating in the body).
In terms of her sex organs no obvious abnormalities which seen on abdominal ultrasound. The ovaries were both
visualized, and her uterus was present. Ultrasound is a sensitive medium but there is still some chance that
abnormalities were visualized. If AmberLeah is truly a hermaphrodite (Intersexual changes) then a normal appearing
reproductive tract could be seen with changes to tissue type being more microscopic. We recommend that AmberLeah
LouLou have an exploratory laparotomy (abdominal explore) and be spayed at MSU. At that time we would also like to
perform a vaginal exam consider running some further endocrinological tests to find the source of the excess androgens,
otherwise known as sex hormones, that are resulting in the increase in vulvar size. We may use human gonadotropin
hormone to stimulate androgen release, then we will measure her hormone levels after this to determine if her adrenal
gland is secreting excess androgens or other endocrine hormones. If Amberleah undergoes a spay then she should live a
normal life span to little with no side effects from her conformational changes. Occasionally there is a small piece of
cartilage or bone present in the clitoris of the female dog (like an os penis) that has to be reduced or removed to help
with recurrent urinary signs. This would be address far after her spay.
AmberLeah Loulou's excessive urination and drinking may be due to an anatomic abnormality due to her
pseudohermaphroditic condition, or due to early renal disease. It will be important to submit an ionized calcium level
and consider further endocrine testing. It would be our recommendation to return to MSU and drop Amberleah off with
the internal medicine department to finish her medical work up, then transfer her to soft tissue surgery the next day for
her abdominal explore and spay. Please let us know what date might be convenient for us to pursue this care.
Thank you for bringing AmberLeah LouLou to MSU VTH. She was a wonderful patient.

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Discussion Starter · #27 ·
After her first exam I had to leave her there for 5 hours, so i went to mall and got something to eat, I am on a strict diet because of Candida, I can only eat raw. vegetables and chicken, fish, nothing even with hint of sugar, yeast, egg, dairy, Well I was very bad, don't tell my husband, lol, but I got bananas foster french toast, with lots of caramel sauce. It was so good. but feel very guilty now...
There was so many people with cats and dogs with cancer so sad. many of them old in 15 years of age, do you think an animal that old if you would put thousands of dollars to saving them to give you just few more years. I am not sure. I guess it all depends.

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Discussion Starter · #28 ·
I was one who thought of this. Hopefully the removal of the reproductive organs will help with the urination problem. Kidney disease is usually controlable when it is not of a progressive type. If this is from androgen hormones, the vet will 'search' for remants of the testes when he spays her. Good luck. Did you make an appointment? Sue
Susan I want to Thank you so very much for thinking it my be boy/ girl problem. So very great full, God Bless you friend.

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Discussion Starter · #31 · (Edited)
I know a little of what you are going through. Quigley has kidney issues and is on a protein free diet. I have to take Quigley to UGA (University of Georgia). Our visits at UGA sound much like yours. Drop him off go to town for a while then go back to the school get the report and course of action when I pick him up. He had 2 surgeries there (not for his kidneys) and had ICU care each time. $$$ well spent. I do not regret a penny. I thank God I had the $$ to do it. If we did not have the money then we would do the best we could afford. Each person has to do whats best for them emotionally and financially.

Oh ya the Genetic department came down and got Blood sample and they will do it for FREE!!!

As far as the french toast. Hope it did not make you more ill. And good for you! I bet it was amazing!
So far the bill was $700.00 have no idea yet what the next visit will Cost. Christmas will be very little this year and I told my husband that my present for my Birthday and Christmas. it is hard as my husband just got back to work after losing his job for 11 months, still playing catch up. I don't work as I have lots medical issues my self.

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Discussion Starter · #36 ·
I am so glad you have a diagnosis :) my instincts were right :)
If I was you I would speak to your vet, give them the report and explain how you feel that they have let you down and due to their incompetence you have to fork out a lot of money to enable You to get a proper diagnosis and care for your pet. As her vet they have a duty of care to her, personally I don't feel they have given you that.

I am glad it is not hugely serious and can be treated. When I thought she could be a hermaphrodite I did some research into it and it's quite common. I find the entire thing fascinating!!

I believe that you were given amberleah to help her, she is a very special girl with a special mum who will see her through this. I think she is under the best care possible.

Good luck with her treatment
I told the doctors at MSU why am I the one who gets the sick dogs, I just put my Pomeranian Sissy down after trying so hard to save her. The vets says she see it a lot the ones who love their baby's so much are the one who get the sick ones, and the one who don't really care for their pets get healthy ones, she says God gave her to me because He know Ill help her. I agree...

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Discussion Starter · #42 ·
Biochemistry profile:
Hemolysis Normal [Normal]
Lipemia Normal [Normal]
Icterus Normal [Normal]
Tot Protein 6.7 [6.0-7.4] g/dL
RBC 8.20 H [6.10-8.10] x10.e6/uL
Hgb 18.7 [14.0-19.3] g/dL
Hct 54.3 [41.0-55.0] %
HCT Spun 55 [40-55] %
MCV 66.2 [62.0-71.0] fL
MCH 22.9 [22.0-25.0] pg
MCHC 34.5 [33.0-36.0] g/dL
CHCM 34.2 [33.5-36.4] g/dL
RDW 12.5 [11.0-13.0] %
HDW 1.45 [1.39-1.91] g/dL
Platelet 361 [155-393] x10.e3/uL
MPV 8.7 [7.5-14.0] fL
WBC 12.10 H[5.90-11.60]x10.e3/uL
Diff Type Manual
Seg Neut # Manual 10.65 H [4.00-8.20] x10.e3/uL
Band Neut # Manual 0.00 [0.00-0.10] x10.e3/uL
Lymphocyte # Manual 0.97 [0.80-3.60] x10.e3/uL
Monocyte # Manual 0.24 [0.00-0.90] x10.e3/uL
Eosinophil # Manual 0.24 [0.00-1.50] x10.e3/uL
Basophil # Manual 0.00 x10.e3/uL
Seg Neut Pct Manual 88 %
Band Neut Pct Manual 0 %
Lymphocyte Pct Manual 8 %
Monocyte Pct Manual 2 %
Eosinophil Pct Manual 2 %
Basophil Pct Manual 0 %
Reactive Lymphs Present
Platelet Clump Present
Platelet Comment See Below
Procedure Ref Range Units
Lipemia Chem Normal
Icterus Chem Normal
Hemolysis Chem Slight
Urea Nitrogen 16 [5-34] mg/dL
Creatinine 0.5 L [0.7-2.0] mg/dL
Sodium 145 [143-149] mmol/L
Potassium 5.0 [3.4-5.2] mmol/L
Chloride 111 [107-116] mmol/L
TCO2 22 [18-24] mmol/L
Na/K Ratio 29.0 [28.0-45.0]
Anion Gap 17.0 [12.0-22.0] mmol/L
Osmolarity Calc 301.5 [297.0-312.0] mOs/L
Calcium 11.0 H [9.4-10.9] mg/dL
Phosphorus 4.2 [2.1-4.6] mg/dL
Magnesium 1.9 [1.5-2.4] mg/dL
Iron 128 [61-226] ug/dL
Total Protein 5.6 [5.6-7.5] g/dL
Albumin 3.8 [2.8-4.0] g/dL
Amylase 583 [234-1,038] U/L
Total Bili 0.2 [0.1-0.4] mg/dL
Direct Bili 0.1 [0.0-0.1] mg/dL
Indirect Bili 0.1 [0.1-0.4] mg/dL
ALP 51 [13-107] U/L
ALT 24 [14-102] U/L
AST 27 [19-34] U/L
CK 124 [33-152] U/L
Chol 182 [124-343] mg/dL

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Discussion Starter · #43 ·
The Dr at MSU just called, Amberleah other test just got back and every thing is OK. She has no concentration her urine so kidney working fine. So they said just the spay will be OK, but want it at msu because of her genital problem, Oh my goodness they said it's 2 thousand dollars. I haven't told my husband yet, he is going to blow a top.

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Discussion Starter · #47 ·
Looking at her labs, they look good. She looks a touch dehydrated and her neutrophils (white blood cells) are a bit elevated, but that could be from stress. All in all, a good lab report.
Plus she wasn't aloud to eat since 11pm night before. So it was long time with out food or water..

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Discussion Starter · #49 ·
You might talk to the vet's at MSU and discuss the cost and your concern. Let them know you are on a budget and maybe they can recommend a vet that can do the procedure for less money. If MSU is like UGA it's a learning vet school with the student's on rotation. There are vet's out there that went to school there and are very capable of performing the surgery she needs. Although having the surgery at the school has it's benefits because it is a school they have all the best equipment right there on hand that they will need. I really don't think Quigley would have made it through his first surgery had he not been at UGA. He had a hard time processing the anthestia. It was touch and go for a couple of days. They had all the equipment they needed to get him through the tough parts. My home vet just was not set up for his needs. My vet is a great vet who knows his limitations.
Thank you for information, I will cal them tomorrow, I haven't told my husband yet have to wait for good time.

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Discussion Starter · #53 ·
When I was 8 years old my aunt took in a stray cat that showed up at her door one day, my aunt had never liked cats and my dad laughed at her and asked if she had lost her mind. After a good 10 minutes of teasing my aunt said no in fact she had not lost her mind and that all though she isn't exactly thrilled that she now has a cat she knew that some one she loved sent her that cat for a reason so she will just have to love the cat and be thankful for the gift. My dad also laughed at that but gave her a hug and kissed me goodbye, my aunt was also my babysitter. I asked who sent her the cat and could she ask them to send me a dog (I had been begging my parents to let me have a dog). She told me that when people pass away they never really leave us they watch over us and they send animals to us. A bunny that hops up to you in the park might be a loved one just saying hi, they might send a big eyed puppy to help mend a broken heart, or a matted cat in obvious need of some tlc for a distraction from a tough time. You might need them or they might be the ones that need you but always be kind to the animals because they are a gift of love. My aunt was always a little kooky but I think she absolutely right about this one. Sorry this was so long but I felt like I had to share it. Amberleah is lucky to have you, I'm sure things will work out some how just have faith and patience.
What a great story, Thank you for sharing. Amberleah and I are perfect match for each other and she is a gift from God above.

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Discussion Starter · #55 ·
How is Amberleah? Will she be able to get her expensive operation? How soon does it have to be? Is there a way that maybe you could set up an account somehow so people could donate to her operation?
I am going to start one on my fb and have my husbands pay pal account to try to raise the money. Or go open a saving with her pay pal just for her. I try to open one with first giving but it has to be a registered organization. Do you know of a company that lets you set up that kind of thing?

They said she can have it the 1st of the year it wont hurt her, only thing she will go through her 1st heat cycle.
She might get some UTI as she rub her self on ground when she goes because she is so big. She pee's on Puppy pad and I am changing them a lot.

Thank you for asking. :cool:

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Discussion Starter · #58 · (Edited)
Doctor reply

I am still SO annoyed that your home town vet told you repeatedly that it was nothing to worry about!!! I would copy off her diagnosis you got from MSU and send it to them. That is really inexcusable IMO.
I e-mailed her and told her. She e-mailed me back, I am very upset MSU sent her records even after I told them Not to. here is here e-mail back, so funny.

I did get the report from MSU. When I last saw her, the vulva was not that large. ( OH YES IT WAS ) The picture you sent certainly was enlarged greatly and was a problem. It never looked like that when I saw her. Things do progress. They do think that it could possibly be an adrenal gland problem, like I told you. I don't understand why she went to Oncology instead of Internal Medicine, though. ( She went to Internal just sign in with Oncology) You should follow up with their recommendations. I am sorry you feel we did not take care of her problem. I would have ended up sending you to MSU in the end, so at least she is being seen by the experts.
Dr. Kauffman

Am I able to post the collection on here Or is it against rules? .

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Discussion Starter · #63 ·
The link will probably get removed; as you're not allowed to post fundraising things or ask for money/donations on here. I had my link to Chipin removed even when the actual account was closed and couldn't accept money anyway LOL but I understand the rules.
That said, I will check out FB and cross-post for you!
I didn't put the chipon link on here I put my fb link that had it on there. Is that OK?

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Discussion Starter · #66 ·
I'm glad you got to do the chipin! I will donate when I get some money from my family first thing. Do you mind if I share your the info with some people from my facebook? I have some friends who love animals and might want to donate, if the information is too personal I understand.
Thank you so much, Yes I would love it if you shared it. I think I have the event link as Public. Ill check.
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