Adorable Rossi is a much-loved senior border terrier who is a familiar face at Hollybank after requiring two specialist surgeries within the space of 6 months.

In January 2023, Rossi presented to Hollybank with vomiting and a loss of appetite, which saw little improvement after initial symptomatic treatment.  Comprehensive bloods were then taken to further investigate and highlighted elevations in two of his liver enzymes, ALT and ALP.  With concerns over Rossi’s liver, an ultrasound of the abdomen was performed, which showed a gallbladder mucocele.

A mucocele is where the gallbladder becomes distended, due to a blockage in the duct, which normally allows the gallbladder to express bile into the digestive system. The liver and gallbladder work together as the liver produces the bile, which is stored and concentrated in the gallbladder.

Given the risk of a rupturing gallbladder, Rossi was stabilised overnight with fluids, pain relief and anti-vomiting medications before being referred for specialist surgery to remove it. Concurrently, samples were taken from the abnormal liver, which also showed an accumulation of copper and Rossi was therefore started on a specific low-copper diet. Despite lengthy surgery, Rossi recovered well on pain relief, antibiotics and for a short period a feeding tube was placed, to ensure nutritional support through his recovery journey.

Unfortunately for Rossi though, the mucocele was not the end of his hospital visits. After recovering well from this surgery, the owner noted an increase in his drinking and urination, which was initially put down to his new low-copper diet.

However, given his history and age, we thought it prudent to investigate further as differentials that can cause increased urination (polyuria) and increased drinking (polydipsia) can include diabetes mellitus, chronic kidney failure, high calcium (hypercalcaemia) and Cushing’s disease. Cushing’s, also known as hyperadrenocorticism, is a condition commonly seen in older dogs, where the body overproduces the steroid hormone, cortisol.

Concerned with these differentials, we embarked on full bloods and a diagnostic test to measure the levels of cortisol being produced. The test results suspected Cushing’s and also highlighted increased calcium (hypercalcaemia), which complicated our interpretation of Rossi’s problems. To help us understand these results, our visiting ultrasound specialist performed an abdominal scan and in light of the high calcium also scanned Rossi’s neck (this is where the parathyroid gland is located which is involved in Calcium regulation).

A parathyroid nodule was identified and with some additional endocrine testing this supported a diagnosis of primary hyperparathyroidism. 

Primary hyperparathyroidism is a disease where the parathyroid glands in the neck, overproduce the parathyroid hormone. This increase in parathyroid hormone is then responsible for increasing the level of calcium in the blood, causing signs of increased urination, drinking and lethargy. The most common cause of this disease is a benign tumour in the parathyroid gland. The treatment requires challenging soft tissue surgery . After a discussion with the owner, our visiting specialist soft tissue surgeon was able to remove the enlarged parathyroid nodule and a mixture of medications to control calcium levels was started post-operation.

Since this surgery in June, Rossi had another Cushing’s test, which showed he does in fact also have cushings so he has most recently started on specific medication for this as well.

Rossi has been doing extremely well supported by his loving family, with no complications from his surgeries and is back to the happy little chap, we all know and love.

Despite requiring a plethora of investigations and surgeries, we couldn’t wish for a better patient, and we are so pleased to have such an encouraging outcome for him.