What a Bittersweet week...Cushing's disease??

[Wylie's Mom]

Hi Amanda - I know we've been PMing, but thought I'd also lend any support you need here as well.

In your last PM, you mentioned the possibility of Atypical Cushings - and this is exactly what my Wylie has. This type of Cushings can take longer to diagnose bc the only lab in the country that does this kind of blood testing is at the U of Tennessee. Dr. Jack Oliver is the leading canine Cushings/endocrinology vet in the U.S. (if not the world).

Has your vet done an ACTH Stim test yet, or LDDS? That's a first step, even before the ultrasound, or on the same day preferably (since she would have to stay for 1/2 day for the Stim test anyway - they usually do an ultrasound then as well).

Now, for atypical -- the stim tests are borderline or inconclusive, but still suspicious. It is at that point that blood has to be sent (make sure they keep some of the blood from the pre-stim in case it needs to be sent to Dr. Oliver) to UofTenn for the Atypical testing. Here is one of the forms your vet can use to submit.

These are treatment options for Atypical Cushings, about which Dr. Oliver will advise after seeing which sex-steroid is the root of the problem.

Here is a link to UofTenn's endocrinology.

This is my fave Cushings overiew.

This is a yahoo group for Cushings; I don't post there, but I def recommend joining bc the archives are AMAZING, especially for Atypicals. There is a ton of info there, so try not to get too overwhelmed. I had a long learning curve in really understanding Cushings, and this is typical of other pet owners who are dealing w/ Cushings. It's a very complex disease (both diagnostically and in treatment), so it takes a while for things to move forward.

I've probably overwhelmed you enough already. But, I have many more Cushings sites I could give you...but the ones I've posted are the ones I ended up using the most (and still use).

There is another member I've been PMing with whose kiddo may also have Cushings, so I hope she too sees your thread. I'll PM her and point her here.

Best of luck, and your baby is in my thoughts.

[shodanusmc]

I am pulling for you guys. I am no expert on the disease, but he is in the best of hands with you. It sucks when our pets get hurt or a disease. Hang tough.

[luv_my_yorkies]

Wylie'sMom...I really appreciate the information you provided and am happy to have such a knowledgeable person to turn to if he does, indeed, get the diagnosis of Cushing's...either typical or atypical.

The only test my vet has done was a Bile Acid test for liver function after her finding what she felt was an enlarged liver for his size. On tuesday we get an ultrasound and will go from there. However, if the radiologist does suspect Cushing's, Hubby and I have decided to search for a vet that is much more familiar with the disease. I really didn't feel comfortable about the way she casually mentioned he may have it, and then I learned the potential severity of the disease through my own online research. Also, I found that they got the results of the bile acid test this morning, but I have to wait until the doctor is in on tuesday for her to read them to me. I may be overracting, but this is a scary time for me, and I am thankful for all the support here!

[Wylie's Mom]

Originally Posted by luv_my_yorkies

Wylie'sMom...I really appreciate the information you provided and am happy to have such a knowledgeable person to turn to if he does, indeed, get the diagnosis of Cushing's...either typical or atypical.

The only test my vet has done was a Bile Acid test for liver function after her finding what she felt was an enlarged liver for his size. On tuesday we get an ultrasound and will go from there. However, if the radiologist does suspect Cushing's, Hubby and I have decided to search for a vet that is much more familiar with the disease. I really didn't feel comfortable about the way she casually mentioned he may have it, and then I learned the potential severity of the disease through my own online research. Also, I found that they got the results of the bile acid test this morning, but I have to wait until the doctor is in on tuesday for her to read them to me. I may be overracting, but this is a scary time for me, and I am thankful for all the support here!

I def agree on going to a specialist. Usually, you'd go see an Internist for Cushings diagnosis. On that yahoo group, there is a list of Vets whose practice includes Cushings.

Just fyi, the adrenals can look completely normal on ultrasound, and yet still have Cushings (either adrenal based or pituitary). So, this is why an ACTH or LDDS is so important, even if an ultrasound is normal.

Just to back up a bit, before any of the above tests...most vets (if they even suspect Cushings) will do a Urine Cortisol-Creatinine Ratio Test -- as this test is cheapest (relatively, in Cushings), simplest, and points to whether or not further testing for Cushings is even needed.

I know, so confusing!

Is your vet open today? You could always stop by and say you need a copy of your pet's records ....just sayin'.

[ladyjane]

Originally Posted by Wylie's Mom

I def agree on going to a specialist. Usually, you'd go see an Internist for Cushings diagnosis. On that yahoo group, there is a list of Vets whose practice includes Cushings.

Just fyi, the adrenals can look completely normal on ultrasound, and yet still have Cushings (either adrenal based or pituitary). So, this is why an ACTH or LDDS is so important, even if an ultrasound is normal.

Just to back up a bit, before any of the above tests...most vets (if they even suspect Cushings) will do a Urine Cortisol-Creatinine Ratio Test -- as this test is cheapest (relatively, in Cushings), simplest, and points to whether or not further testing for Cushings is even needed.

I know, so confusing!

Is your vet open today? You could always stop by and say you need a copy of your pet's records ....just sayin'.

One of my fosters had been diagnosed with Cushings before he came to me. My vet, based on the lab studies, did not believe it was Cushings. She did the above testing and it ended up to be pseudo cushings aka alopecia x. I was told the same thing about the ultrasound not being a good diagnostic tool.

[luv_my_yorkies]

I must agree here, and am only doing the ultrasound as a possible "least invasive" step in our journey to find what is truly ailing Valentino. I am actually researching different veterinarians right now in hopes that I can find someone close to consult. As I said, I am starting to see that this is not my vet's expertise and have found that you shouldn't go against gut feelings when you get them, especially when it is dealing with the health of a (very) loved one...

[ladyjane]

There is nothing invasive about the other tests. A vet would have to explain to me why I was spending money for an ultrasound...is it because he is looking for something else perhaps? And...just saying that perhaps looking at the kidneys would be a good idea?

[ladyjane]

Oh I just noticed your avatar...how adorable!!! Kissing pups!

[luv_my_yorkies]

This is precisely the reason I am happy to be a member here with such informed and caring people...looks like I need to call my vet and get some answers as to why a full abdominal ultrasound is the next proposed step. Hmmmm....

[ladyjane]

Originally Posted by luv_my_yorkies

This is precisely the reason I am happy to be a member here with such informed and caring people...looks like I need to call my vet and get some answers as to why a full abdominal ultrasound is the next proposed step. Hmmmm....

There could be a very good reason! But...always good to ask

[Patti]

With Maya they did the ultrasound and the first ACTH stim test the same day. The ultrasound showed nothing. If I remember correctly, if there had been a tumor they could do surgery but I may be confused. It is very important to have a specialist involved in the care of a Cushing's dog. My vet referred me as it was out of their realm of expertise. I hope you can get some answers.

[luv_my_yorkies]

So, after what feels like hours of research, I was able to review some information on the ACVIM ( American College of Veterinary Internal Medicine ) and actually come away feeling a bit more at ease. It seems that we are in good hands on tuesday's appointment as I was able to find some great info about the radiologist we are going to see. I was also able to find a good list of board certified small animal internists available at Penn Veterinary Hospital. So, we are well on our way...I am starting to feel more at ease that Tino will get some great care. I really appreciate all of you and will keep you posted. Right now, I am going to give my sweet boy a pup massage and snuggle him and his sister, Lolita until they make me stop

[ladyjane]

Originally Posted by luv_my_yorkies

So, after what feels like hours of research, I was able to review some information on the ACVIM ( American College of Veterinary Internal Medicine ) and actually come away feeling a bit more at ease. It seems that we are in good hands on tuesday's appointment as I was able to find some great info about the radiologist we are going to see. I was also able to find a good list of board certified small animal internists available at Penn Veterinary Hospital. So, we are well on our way...I am starting to feel more at ease that Tino will get some great care. I really appreciate all of you and will keep you posted. Right now, I am going to give my sweet boy a pup massage and snuggle him and his sister, Lolita until they make me stop

Penn is awesome! I am glad that you are feeling a bit more relaxed about all of it.

[SweetPea Dain]

Hi Amanda,

I just wanted to let you know that my Sweet Pea was diagnosed with Cushing's disease today. She has two massive pituitary dependent tumors in her brain and a completely ruptured left ligament in her left rear leg and partial in her right. The vet is researching radiation treatments but thanks to Ann, I am going to have our vet contact the doctor in Tenn. tomorrow and see if we can get some help. Sweet Pea is only 5 1/2 years old which the vet said must be hereditary because you hardly ever see it in a dog so young. We have had the ACTH test, x-rays and ultra sound done so far. They are recommending we have a MRI done ($1,250!!!) in order to know exactly where to do the radiation. I hope you find some help for your precious baby and ya'll will both be in my prayers.

[luv_my_yorkies]

Originally Posted by SweetPea Dain

Hi Amanda,

I just wanted to let you know that my Sweet Pea was diagnosed with Cushing's disease today. She has two massive pituitary dependent tumors in her brain and a completely ruptured left ligament in her left rear leg and partial in her right. The vet is researching radiation treatments but thanks to Ann, I am going to have our vet contact the doctor in Tenn. tomorrow and see if we can get some help. Sweet Pea is only 5 1/2 years old which the vet said must be hereditary because you hardly ever see it in a dog so young. We have had the ACTH test, x-rays and ultra sound done so far. They are recommending we have a MRI done ($1,250!!!) in order to know exactly where to do the radiation. I hope you find some help for your precious baby and ya'll will both be in my prayers.

I am so, so sorry to hear this news and extend my thoughts to you and your baby, Sweet Pea. We have our ultrasound appointment tomorrow afternoon and I am filled with nervous energy. I am trying really hard to be brave because I know these little ones definitely can sense our emotions, and Tino is such a sensitive little guy. I too believe that if Valentino does have Cushing's, it has to be a dormant hereditary condition. So, if those are the cards we are dealt, we will do the best we can to help him. Again, thank you for sharing...and we appreciate your prayers!