Need encouragment (Madison, 13 yr old Dachshund, Atypical Cushing's, high BP)

[Karen]

O.K.. I am overwhelmed. Been some week. Madison has Atypical Cushings. He is 13 years old, neutered, standard Dachshund. Taking flax hulls, melatonin for 8 months now. He also has hyerestriinism. I have been using milk thistle. Now I read milk thistle may effect hyperestrinism. Also his BP is now high. Started taking Vasotec last week. Second day on it he didn't want to lift his head up. Going to start again Monday, cut the dose in half. Guess I should just think positive. Hard to do somedays. Madison is a happy little guy. When off BP medicine. Doesn't urinate alot, drink much water, no pot belly. Coat didn't grow back after disc surgery April '08. That is why we started flax hulls and melatonin. Cushing's confirmed after ACTH test, ultrasound, Adrenal panel sent to University of Tennessee. Liver biopsy clear. Because Madison is so happy, Dr. told me he has to remind himself Madison is sick. I feel like he is following apart inside. Enlarged liver, elevated liver eneyzmes (sp), elevated sex hormones. Enlarged ardenal glands. Now elevated bp. Dr. doesn't want to start Lydosen (sp) yet. Thyriod O.K.. Sent to University of Michigan. T-4 a little low. They recommended not starting thyriod medicine yet. T-3 perfect. Concerned he can not tolerate BP medicine. Really concerned about everything. Thanks for listening.

Karen

[lulusmom]

Hi Karen and welcome to you and Madison.

I have two cushingoid dogs, one of which was diagnosed with pituitary dependent cushing's with elevation of all adrenal steroids/hormones. Elevated liver enzymes, enlarged liver, enlarged adrenal glands and high blood pressure are all common with cushing's so all of us have seen one or all of those diagnostic results in our dogs.

I am not sure why your vet is balking at trying Lysodren at this point. Dr. Oliver at the University of Tennessee normally recommends melatonin and flax hulls for 3 to 4 months and if no improvement, add a maintenance dose of Lysodren.

Both of my dogs are being treated with Lysodren. It is a very effective drug and side effects can be eliminated in most cases by following proper protocol. A maintenance dose is certainly less worrisome than having to go through a loading phase. My Lulu weighs less than 5lbs and Jojo is 7 lbs and I have had to load both of them more than once. They are currently on a maintenance dose that is working and they are doing great. Lulu has also been on melatonin and flax hulls for 8 or 9 months.

It would be very helpful if you could please post the results of the University of Tennessee adrenal panel. Can you also tell us if the adrenal glands are equally enlarged? Adrenal tumors are famous for excreting one or more of the adrenal steroids/hormones and high blood pressure is common, especially if the aldosterone is out of wack. Abdominal ultrasound findings for the majority of dogs with an adrenal tumor, reveals one adrenal gland larger than the other. It is possible that a dog can have tumors on both gland that cause bilateral enlargement which is more common with pituitary dependent cushing's.

My dogs give me high blood pressure but they don't have a problem with it themselves. I am therefore not well versed in hypertension but I hope that Louise will be by later to share her experience with you. I learned from Louise that diagnosing high blood pressure is not so easy and must be done under the right conditions.

I am so sorry for the reasons that brought you here but I'm glad that you found us. There is a wealth of information and collective knowledge here and nobody will hesitate to share it with you. Prepare yourself for questions and requests to post info. You will be way ahead of the game if you post as much information as possible, including results of all testing done. Be sure to include the reference ranges as well.

Glynda

P.S. You have come to the right place for a lot of encouragement and support. Once you become a member of our community, you never have to walk alone.

[Karen]

Thank you for the welcome. I really needed that. Both adrendal glands are equally enlarged. My Vet. is an Internist. He said, Lysoden treats symptoms. Madison doesn't have any, accept for hair loss outward symptoms. He said, dogs die from lysoden. He would for now, rather treat his BP with BP medicine. Madison's results are from 1/5/09. Was treated by another Vet. back then. Switched Internist one month ago. Long story.

Test Results:

Cortisol Result basline 44.0 Normal 2.0-56.5 Result post ACTH 235.2 Normal Range 70.6-151.2

Estradiol ng/ml Result baseline 95.0 Normal Range 23.1-65.1 Result post ACTH 95.5 Normal Range 23.3-69.4

Androstenedione ng/ml Result Baseline 2.6 Normal 0.1-3.6 Result post ACTH 31.1 Normal Range 2.4-29.0

Progesterone ng/ml Result baseline 0.47 Normal Range 0.03-0.17 Result Post ACTH 3.46 Normal Range 0.22-1.45

17 OH Progesterone ng/ml Result baseline 0.20 Normal Range 0.08-0.22 Result post ACTH 3.46 Normal Range 0.25-2.63

Aldosterone pg/ml Result baseline 134.2 Normal Range 11/-139.9 Result post ACTH 914.5 Normal range 72.9-398.5

[Harley PoMMom]

Hi Karen,

Welcome to you and Madison from me too. My Harley who is almost 13 y/o, has elevated estradiol, which is known as Hyperestrinism, altho I am not sure yet if he is true cushings...this is another story.:rolleyes:

Anyways, we are dealing with the possibility of high BP with Harley too, no meds yet, trying to figure out if he indeed has high BP or he just has the "white coat effect" BP. Louise has been a tremendous help with me with ideas on how to get his BP at the vets office with out him being so stressed, I'm sure Louise will be along to share her amazing knowledge with you.

Karen, you have definitely have come to the right place for advice, these wonderful people have helped Harley and I so much, I don't know what I'd do without them.

Regarding the Lysodren: This is from the Treatment Option Considerations Sheet from UTK.


LysodrenTM, traditional treatment for Cushing’s disease. Very effective in lowering cortisol, progesterone, androstenedione and 17-hydroxyprogesterone levels.

And here is the link:

http://www.vet.utk.edu/diagnostic/endocrinology/pdf/Treatment%20Info,%20Atypical%20Cushing's,%20revise d,%20July,%202009.pdf

Best of luck to you and Madison.
Hugs.
Lori

[Karen]

Thank you. I really appreicate all the support. Yes, both my Vet. & I have that information. Very kind of you to send it. It might be time to go to second step. Think he wanted to see if flax hulls & melatonin worked. Madison has grown some hair back.

[Karen]

Madison has been on milk thistle.

Just read below on another list:

I heard milk thistle plant extract might have estrogenic effects, dogs with hormone sensitive conditions (e.g., hyperestrinism, estrogen-producing tumors) should probably avoid milk thistle above ground parts.
Should I switch him back to Denamarin? He does have hyperestrinism.

[Squirt's Mom]

Hi Karen and welcome to you and Madison! :)

Bless your heart! Dealing with this all by yourself for this long! :( Well that is over, now. You have found the very best place for information, experience, and good old fashioned hand-holding. As Glynda said, you are no longer alone, we will be with you every step of this journey.

When my Squirt was first diagnosed (PDH) in 3/08, I was a complete basket-case! :eek::eek: Nothing made any sense, I was consumed with fear, grief, anger and guilt, and absolutely terrified of what the future held for my Sweet Bebe. But these wonderful folks here took my hand and gently led me along until I could begin to understand a bit. With that understanding came a calmness. Squirt and I would never have made it without this group.

Squirt is also Atypical but the PDH is now questionable. She had a splenic tumor removed in Sept '08 and her cortisol has returned to normal on the last two tests. She was on purified lignans (capsule) but after the last UTK panel, Dr O switched her to the hulls. Her estradiol and both progestrones were still a bit high. We have been on the hulls for about a month now and she will be retested to see if they have helped. If not, she will start a maintenance dose of Lysodren.

Based on the results for Madison, he is what is called true Cushing's, or conventional Cushing's, (because his cortisol is high) with elevated intermediate/sex hormones. If his cortisol were normal, then he would simply be Atypical but the elevated cortisol puts him in the true/conventional category. The elevated estradiol is where the hyperestrinism comes from. The estradiol can be a booger to control because it can be produced in areas of the body other than the adrenals, like the skin or other organs.

Melatonin can help lower the cortisol as well as the other hormones, but Lyso will do a better job on the cortisol. Please note - Trilostane is not an option for Madison. Trilo will cause the intermediate/sex hormones to elevate while it lowers the cortisol so it is a two edged sword when dealing with hormones other than cortisol. Lyso is the only viable option for Madison.

Lysodren does not kill dogs. What causes problems is vets that don't follow long established protocols for diagnosing, administering and monitoring, who don't educate the parents on what to look for that indicates a problem, who don't give prednisone to use in emergencies and parents who can't or won't be as diligent as required when using any drug as powerful as Lyso and Trilo.

What Lyso does is erode the outer layer of the adrenals so they can't continuously release so much cortisol. Once the erosion has reached the correct level (via what is called loading), then a maintenance dose is given to keep the adrenals in that state. If it were me, I would skip the loading phase and go to a maintenance dose for Madison. This is often what works for pups that have all six hormones out of whack.

His aldosterone is incredibly high and that could be impacting the blood pressure and his heart because this hormone plays a major role in regulating the electrolytes in the body. When electrolytes get out of balance, the whole body is negatively effected. Lyso will help bring aldosterone back down which could lower his BP. If his electrolytes have not been checked lately, I would have that done asap.

I wish I could help with the BP more, but that is all I know about it. The infamous Louise can tell you a great deal about it, tho. (If she mentions a blender, don't panic until you know what she's blending. :eek::p )

No some questions - Does Madison have any other health issues not mentioned? Is he on any other meds, herbs, supplements, etc.? What tests were done to diagnose the Cushing's and could you post the results in chronological order including the units of measurement and normal ranges? Could you give us the thyroid results? Was the lack of hair regrowth what prompted the Cushing's testing to start? Has he had any other signs along the way? How much does he weigh? What doses of melatonin and hulls is he taking and how often? Is the melatonin a rapid/time release/extended form? What diet is he on? Have you had enough questions for now? :p

I am so glad you found us and hope to learn much more about you and Madison soon.

Keep your chin up, sweetie. I know exactly how you feel and it is tough at times to be positive. But keep telling yourself that Cushing's does not mean he is on death row. It simply means some things need to be changed and with the love you have for Madison I know you can handle whatever needs to be done. Plus, you now have us to help. :)

Check out the Resource section for some great info and read the threads here to see how others are dealing with their pups. Ask any questions you have and we will do our best to help you understand. If we don't know, we will research together and share what we have learned.

Hugs,
Leslie and the girls

K9C Resource section:
http://www.k9cushings.com/forum/forumdisplay.php?f=10

Atypical Cushing’s*
(Estradiol, Androstenedione, 17-Hydroxyprogesterone, Progesterone and Aldosterone – an elevation in one, all, or any combination of these hormones, without elevated cortisol.)

http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=485128&sk=&date=&pageID=1

Thyroid info
http://www.thyroid-info.com/articles/dog-hypo.htm

free T4 by equilibrium dialysis*
info about the thyroid tests (including free T4 by equilibrium dialysis) on the lbah site.
http://www.lbah.com/canine/hypot4.htm

Dr. Jean Dodds
http://www.itsfortheanimals.com/BEHAVIOR-THYROID.HTM
http://itsfortheanimals.com/THYROID-ARTICLES.HTM

[MiniSchnauzerMom]

Hi Karen,

Welcome to you and Madison from me too! Regarding canine blood pressure, the best I can do is share what I've encountered with my Munchie. I hope something I've posted will be helpful to you.

First let me say that if Madison does indeed have high blood pressure it is something that needs to be addressed and treated. I suggest you express your concerns about his fatigue after taking the Vasotec with your vet prior to altering his dosage. If you have already done this, forget I mentioned it. :D The bp meds really zonked Munchie out. After checking with the specialist at the time and getting the ok, I gave it to him in the evening instead of the morning and that did help. You might want to ask your vet about this too. Although Munchie's high bp diagnosis was incorrect, being on a low dose of the meds did not harm him. I have no experience with Atypical or aldosterone and its effects on blood pressure so I'm not much help there.

You did not mention whether Madison was stressed when he originally received the elevated bp diagnosis. Did the doctor just take one measurement and base the diagnosis on that reading? Vasotec is an ACE Inhibitor. Possibly there is a specific reason/health concern and that is why your vet prescribed an ACE Inhibitor. If not, perhaps a different bp med could be used. You may want to discuss this with your vet also. My Munchie took Norvasc, which is a calcium channel blocker. This may not be appropriate for your Madison though.

Last, but not least, I copied part of my post to Lori for you. This is what Munchie's doctor does to get accurate readings.


Regarding the bp - different vets or different specialists all seem to have their own ideas/techniques. This is what they do w/Munch who was originally misdiagnosed and has an extreme case of the white coat problem. Maybe your doc would consider using this technique w/Harley? They use one of those bp machines that periodically inflates, records, deflates and then automatically takes another reading. Currently he is taken into a room and a tech holds him for awhile. They allow calm down time and several measurements are taken. On other occasions he sat in a room w/me and this was done. Mind, you - it has been determined that Munch has excellent bp. His doc discovered that if she remains in the room he is extremely stressed and his bp elevates but when she would leave all his readings were normal. When she'd walk back into the room his bp would spike to 200.

I certainly understand that feeling of being overwhelmed. We're here to listen and you're not alone!! Give Madison some extra hugs and pets from me.

Louise

[Karen]

Thank you all for sharing your knowlege and encouragement. It is much needed.

Madison bp was taken on 2 different days. Once with the Vet.. Madison in his lap. He walked Madison around outside took it again. When Madison reacted so badly to Vasotec. We took him off. Took Madison back for recheck. This time Madison was on my lap, Vet was not in the room. BP still high. Will ask about different blood pressure medicine. Thank you.

Madison takes 3mg melatonin 2 x a day. 1/2 tsp. flax hulls once a day. Was on milk thistle until today. Read a post on another list stated it can cause hyperestrinism. Since he already has it. I need to research it more. Since Denamarin has a different form of milk thistle might try that again. Madison went for dental cleaning. His liver enzymes were high. No symptoms at all. I have had Vets. ask if I am sure he has Cushing's. 2 months later he had disc surgery. Hair didn't grow back. Started losing hair around neck. Took Madison to internist. She confirmed Cushings. With ACTH. 1 hr cortisol 29.0 ug/dl normal 10-20. Cortisol Baseline 4.6 normal 1.0-5.0, Protein/Creat Ratio 0.210, normal less then 1. She also put Madison on thyriod medicine 3mcg 2 x's a time. After results from University of Michigan. They wanted to retest ACHT in August, after speaking with Dr. Oliver. About 3 months later Madison starting itching, losing hair, and smelled (really, really) bad. Called his Vet. she thought he had seborrhea (sp). Wanted me to shampoo with Pyoben. It didn't work. He really smelled bad. Was losing weight like crazy. Decided to take Madison in to see her. She got upset, she said didn't do skin. Retested his thyriod. He was now Hyperthyriod. Long story short. Went to new internist about 2 months ago. He had Madison's test results. Lab results in Dec. stated Madison was not hypothyriod. Since he has been off. No itching, smell gone, hair growing back. O.K. Madison also takes Nordic Natural fish oil. I cook chicken, oatmeal and veggie diet for him. His weight is 26 lbs.. Madison is a standard dachshund. Also on cosequin for arthritis, calcium carbonate, no salt supplement since I home cook. Dr. Pitcarin's health powder for home cooking. Madison still doesn't have Cushings syptoms. Except for hair loss. Which is now growing back since he stopped thyriod medicine. Might have block benefit of melatonin.

I understand. Thought Atypical meant he didn't have syptoms. Hope I answered all questions. If not please let me know. Any input appreciated.

Karen

[lulusmom]

Hi Karen,

Did your vet do a high dose dexamethasone suppression test (HDDST) or an endogenous acth stim test on Madison to make an absolute determination as to whether the cushing's is pituitary or adrenal based? Given the facts surrounding Madison's case, a functional adrenal tumor is quite possible for the following reasons:

1. A dog with one or both of the two most common adrenal tumors, adenoma and adenocarcinoma, may have minimal to no clinical signs associated with cushing's.
2. Dachshunds are one of the top four or five breeds that are over-represented in their predisposition to adrenal tumors.
3. Functional adrenal tumors cause hypersecretion of aldosterone (hyperaldosteronism) which is the primary culprit for hypertension.
Madison's is off the charts.
4. Adrenal tumors are not always visible on ultrasound. Even though Madison's adrenals were bilaterally enlarged, some dogs have been known to have both pituitary and adrenal cushing's which would show enlargement of both glands, as would a dog with two adrenal tumors.

You may want to talk to your IM about making a definitive diagnosis as to pituitary or adrenal cushing's via an HDDST or endogenous acth. I would definitely not treat as long as no symptoms are apparent regardless of whether the ultimate diagnosis is PDH. If either the HDDST or endogenous acth results are indicative of an adrenal tumor, I would definitely keep an eye on the adrenals by repeating the ultrasound every 60 to 90 days.

Glynda

[Harley PoMMom]

Hi Karen,

Regarding the high liver enzymes, Harley's ALP is 1289, which usually and I stress usually all cushpups have high ALP numbers, the one I keep an eye on is his ALT, what is Madison's ALT?

I've discussed using Denamarin with Harley's vet and she told me that this is a very good product...so I just got it in the mail and tomorrow we are going to start using it. I am using Marin right now, and after reading the insert of the Denamarin it says you can use both the Marin and Denamarin...but they have to be 12 hours apart.

Hugs.
Lori

[ventilate]

Hi and welcome from me and mine;
I have 2 giant schnauzers one, my female is cushnoid, had Diabetes insipidus and hypothyroid, my male is early cardiomyopathy and is hypertensive. The Vet believes it is from his kidneys. If there is a stenosis in the renal vasculature it can cause systemic hypertension. Kenai my dog is currently on sotolol for irregular heartbeats, enalipril which is vasotec 25 mg 2 times per day and his pressure was still high so he added norvasc aka amlodapine (sp) 10 mg in the Am and 5 mg PM. so takes 6 pills in the AM and 5 PM all related to his Bp and when we go to the vets sometimes it is still high, like 220s systolic. He had some dental surg and once he was slightly sedated they checked his BP and it was good.
I do not like your IMS saying that lysodren kills dogs. Cushings kills dogs, treating cushings saves dogs. Nike has been treated for what will be 3 years last march and doing great, she is 12.5 years old and is a large breed who has way outlived her life expectancy, thanks to lysodren.
Good luck and let us know how things go.
Sharon

[Karen]

I will ask his Vet. about this. None of those test have been done. He needs to have more test. See if melatonin & flax hull are helping. Just had an ultrasound last month.

[Karen]

Just noticed. Dr. Oliver's comments, All values are increased at stim, and the high aldosterone value may indicate the presence of a primary adrenal tumor. Don't remember hearing that before. Never had either of the test you mentioned. Madison had another ultrasound last month. I do remember his last Dr. saying, if he starts having seizures, we take the tumor out. Always wondered what she meant. Guess his new Vet. thinks I know this. Maybe, that is why he is so opposed to using Lydosen. Is an adrendal tumor removable? I thought if a dog has high coritsone levels Lydosen was use to bring it down.

[Harley PoMMom]

Hi Karen,

Usually vets do whats called a CBC and a Chemistry blood tests on dogs before anything else. This chemistry blood test will have long list of things that were done...ALP, ALT, Bun, Glucose...etc. The CBC has to do with the blood...RBC, WBC, etc...


Is an adrendal tumor removable? Yes, they are, altho I am no medical expert, we do have a member here whose pup just went thru this successfully, and here is the link to their thread:

Little Katrina Has An Adrenal Tumor (surgery July 28)

http://www.k9cushings.com/forum/showthread.php?t=640

Hugs.
Lori

[SaxLady]

Thank you Lorie! I was just about to answer Karen regarding adrenal tumor removal.
Candy

[Karen]

I am in shock about the possibily of an adrendal tumor. Just when I was getting use to the word Cushing's. Wondering if that is why the new Vet. has concerns about treating cortisone level's. He really thinks the last Vet told me. I think my BP went up. Read some of the suggested posts. She went to Akron, I go to a Vet. in Akron. She most live near me. Madison's CBC is normal. Blood test done last week. All blood work normal. Ultra sound done again last month. No tumor seen. Vet. is off tomorrow, will call him Tuesday. For now I have to restart BP medicine tomorrow. Lower dose. Stress, stress, stress.

[Harley PoMMom]

Was the ultrasound done on a high resolution machine? Most GP's don't have them. I have to take Harley to the Univ. Of Penn. in Philadelphia, PA., a 2 hour drive for me and Harley, to get his U/S done.

I know this is alot to take in and this is quite stressful, but remember, we are here for you...you are not alone.

Hugs.
Lori

[lulusmom]

Hi Karen,

Please don't jump to conclusions and don't doubt why your IM has chosen not to treat with the conventional drugs like Lysodren and Trilostane. It is ill advised to treat a dog that is asymptomatic so your IM is doing the right thing. It was not my intention to scare you but rather provide you with information that perhaps you weren't aware of.

If a dog with an adrenal tumor is otherwise healthy, surgery is the first choice as it is a permanent cure. This is one of the most risky surgeries done on dogs so it is important to have a board certified surgeon that has done a lot of them. If surgery is not an option, then Lysodren would be the best choice of treatment but only if the dog is displaying overt symptoms. It sounds like your IM is doing everything right but as I said previously, I personally would want to rule out the possibility of an adrenal tumor.

I am not sure what your prior vet meant that if Madison were to start having seizures, the tumor would have to come out. Here in the states only adrenal tumors are surgically removed. Pituitary tumors are not so I am wondering if your prior vet knew something that you don't. Any way to find out?

Glynda

[Karen]

No way to ask her. We didn't part on the best of terms. I have written a letter to the hospital adminstrator about her actions and mistreatment of Madison. Maybe shock is a better word this morning.

Guess everyone has their own thoughts on treatment. I thought since he is producing cortisone which is now effecting bp we should consider it. He didn't have high bp when adrendal panel was done.

[Squirt's Mom]

Hi Karen,

When I first started learning about Cushing's, I wanted Squirt to have an adrenal tumor VS a pituitary one because the adrenal form can be cured via surgery. But she does not have ADH so if there is a tumor on her pituitary, the possibility of a cure is remote. In The Netherlands they have been removing pituitary tumors for some time but only recently has this procedure started being done in the US. One of our members here has the first pup to undergo this surgery here.

I am still concerned about Madison's aldosterone level and the effect it has on the electrolyte balance. His levels are out of this world high and could very well be causing the BP issues if the acid base (electrolytes) are out of whack. The electrolytes include potassium which is a vital mineral in heart health. I hope you will have his electrolytes checked soon and often until that aldosterone level comes back down. I am more inclined to believe this is what is affecting the BP VS the cortisol.

Hang in there!
Hugs,
Leslie and the girls

[lulusmom]

I understand about parting ways on bad terms with your vet. I parted ways on bad terms with two gp vets, not because they were mean to my dog but because they never admitted that they were way over their head in diagnosing the root cause of my first cushdog. As a result she went undiagnosed for at least a year with worsening symptoms. An internal medicine specialist took one look at her and said, "Cushing's" and I said huh? I had never heard of Cushing's and it obviously neither had the two gp vets.

I do agree with Leslie and believe that Madison's high bp is a result of the elevated aldosterone. Thinking back to Sharon's post regarding Kenai's hypertension, are Madison's kidney values normal?

Glynda

[Karen]

His kidney's are in great shape for now. Wondering if flax hulls can bring that high level down. Amazing his previous Vet. never mentioned adrendal tumor.

[SaxLady]

Hi Karen and welcome!
You might want to see Dr. Lynn Turner at Metropolitan Veterinary Hospital in Akron for a second opinion. She is a board certified internal medicine doctor and one of her main specialties is endocrinology/Cushings. Dr Turner is very thorough and follows through on every aspect of a pets care. Unlike many doctors, she follows up with phone calls herself. Very important as well is her compassionate, loving nature. I left Katrina's first internal medicine doctor because I knew more than she about Cushings and adrenal tumors. Katrina's surgery was done by the surgeon doctor Turner recommended. There was a choice of several surgeons.
Hoping for the best for you and Madison!
Candy and Katrina

[Harley PoMMom]

Hi Karen,

I thought I would add this very informative quote from our "oracle" Glynda, she so thoughtfully explained to us how the melatonin and the flaxhulls work.


Geeze, Les, you might as well ask why the earth is round. :D You cannot believe how many times I've read the UTK info on this and how many times I've accessed the dictionary to try to understand all the big words. One big word begat another big word and so on and so on until my eyes roll back into my head and I start cussing. There is no way that I could ever explain the actual process by which those six adrenal hormones magically appear but I'll try to give you a quick and dirty that I hope you can understand. So here goes nothing.

Aromatase is an enzyme that is involved in the production of estrogen. It acts by catalyses (big word – look it up) the conversion of testosterone to estradiol, which is an estrogen by the way. Aromatase enzyme is located in the estrogen producing cells in the adrenal glands, ovaries, placenta, testicles, fat tissue and the brain. Note to self: Lysodren only targets the adrenals so it has no effect if the estradiol is being produced in the latter five areas of the body. Melatonin, a naturally occurring hormone in the body that we cushdog parents buy in a bottle, is an aromatase inhibitor. UTK always recommends Melatonin and phytoestrogen treatment when estradiol is elevated. [Phytoestrogens, sometimes called "dietary estrogens", are a diverse group of naturally occurring non steroidal plant compounds that, because of their structural similarity with estradiol (17-β-estradiol), have the ability to cause estrogenic or/and antiestrogenic effects] Lignans, found in the flaxseed, has the highest concentration of phytoestrogen found in plants. Lignans is also an aromatase inhibitor and with its phytoestrogenic activity, competes with estradiol for tissue estrogen receptors. So the quick answer to your question is if estradiol is elevated, UTK recommends both Melatonin and Lignans

21 hydroxylase is an enzyme which is involved in the biosythesis of aldosterone and cortisol. Melatonin inhibits the 21 hydroxylase enzyme.

3-beta-HSD is an enzyme which catalyses the synthesis of progesterone from pregnenolone, 17-hydroxyprogesterone from 17-hydroxypregnenolone, and androstenedione from dehydropiandrosterone in the adrenal gland. Note: the synthesis of all six adrenal steroids requires 3beta HSD. Melatonin and lignans inhibit 3-beta-HSD

So there ya go.

Glynda

Hugs.
Lori

[Karen]

Dr. Turner was Madison Vet.. She is the one that didn't mention the possibility of an adrendal tumor. Never called me with results. Her Vet Tech & Secretary called. Also the Vet. that put Madison on thyriod medicine that he didn't need. Who did the surgery for you?

Karen

[SaxLady]

Karen,
I was very shocked to hear of your experience with doctor Turner! I would expect it from a certain other doctor there, whom I will not name publically. Dr. Padgett was the surgeon for Katrina's adrenalectomy.
Candy

[SaxLady]

Hi again Karen,
I looked back at your posts, trying to sort out what doctor did what. Rather difficult because there were no specific names, just "he" or "she". Would you be willing to tell us what tests each doctor did and their recommendations for treatment and followup?
Candy

[Karen]

Dr. Turner did all test. Flax seed & melatonin was recommended. By her. New internist is a male. He found Madison's high BP. Added Vasotec.

[Karen]

Dr. Turner did Madison's test in December '08. Vet tech & secretary called with results and recommendations. Follow up was supposed to be in July '09. New Vet. did another blood test, ultra sound 7/09, and BP check this month. Liver biopsy done because Madison billirubin was elevated due to thyriod medicine he received and didn't need. Madison was too hyperthyriod to check BP first visit. Since you live near me. Would be happy to name, names using private email option on this list. Just didn't think I should do it here.

[SaxLady]

Trying to sort all this out. You wrote that no tumor was found on ultrasound. Did doctor Turner have the ultrasound done? If she knew there was no tumor it seems that she followed doctor Oliver's recommendations. Wondering very much what happened exactly causing you to leave her.