New member, Brutus, 11½ yr old Shih Tzu Poodle mix, considering treatment

[Brutus's Mom]

Brutus is an 11 1/2 yr old Shih Tzu/Poodle mix. About a year ago he started drinking more water and having accidents so we treated for a bladder infection. Have had no more accidents but he does drink more than he did a year ago. Then about 4 - 6 months ago I noticed his hair thinning on the tail and then not really needing to be groomed at the normal time. He then had a blood test before having his teeth cleaned and it was found that he had elevated ALT and ALKP levels. A little research and I felt he may have cushings. Since then he has had a cortisol/creat ration test.
Results
Urinary Corisol 283 nmol/L
Urinary Creatinine 5.6 nmol/L
Ratio: 51

This was a little high

Then had a Thyroid Test
Results
T4-VET 1.6 ug/dL
T3-A 77 ng/dL

This was normal

Finally had a low dose dex test

Results
Base line Cortisol 9.6 ug/dL
4 Hr Cort 6.6 ug/dL
8 Hr low Cort 11.5 ug/dL

As a result the vet said he has cushings. My question is the only symptoms at this time is hair loss and excess hunger. He drinks more than he used to but only about 18 oz per day max and he weighs 19.5 lbs.

Should I talk to the vet about starting treatment or should I wait. Also it appears it may be adrenal gland dependent cushings which drug would you treat with. I do not think I would have surgery.

Thanks for any advice

Karen

[littleone1]

Hi Karen,

Corky and I would like to welcome you and Brutus. You have found a very wonderful group of people.

Has Brutus had an ACTH stim test done? There is also a full adrenal panel that can be done. No one test is conclusive in diagnosing Cushings.

I would talk to your vet about these tests before starting treatment.

It would also help if you could post the results of any other tests and blood work that Brutus has had done. Also, please post the reference ranges.

Corky does have a right adrenal tumor, but surgery is not an option for him, as he has other medical issues. We do have a member whose furbaby did have an adrenalectomy and she is doing very well.

Others will be along who have much more experience than I do.

Terri

[gpgscott]

Hi Karen and welcome to you and Brutus,

So far it does look very much like Cushing's. Even if you are not going to consider surgery I think a good diagnosic is an abdominal ultra-sound as the Dr. will be able to image the adrenals and also the other major internal goings on.

And my suggestion concerning ACTH is to do the first one with UTK and a full adrenal panel, this will give you cortisol and five other hormones all of which can cause Cushing's symtoms.

Even though his symtoms are minor now if the further testing confirms a diagnosis of Cushing's I would begin treatment right away. The longer you wait the more damage to the pups internals and you have a breed here which is disposed to long life.

Thanks for joining, there will be many others with their welcome and comment, please check back frequently.

If you have not done so please refer to th resources area where you will find medically reviewed information on all aspects of Cushing's in dogs.

Scott

[Squirt's Mom]

Hi Karen,

Just popping in to welcome you and Brutus. Love the name for small pooch! :D One of my Danes bore that same name.

The ultrasound Scott mentioned is an absolute necessity in my eyes, especially when an adrenal tumor is suspect. The good thing about adrenal Cushing's is that surgery can often cure the condition so don't close your mind to that option just yet. Our resident ADH expert, Ken, will hopefully be along soon to share his experience with you. His Shiloh is in her 3rd year post op and doing GREAT!

So glad you are here and hope to learn more in the coming days.

Hugs,
Leslie and the girls - always

[Buffaloe]

Hi Karen,

I completely agree with Scott and Leslie about the ultrasound. I strongly believe you need to have a top quality ultrasound performed on Brutus so you know what you are dealing with. It is, by far, the best way to diagnose an adrenal tumor.

I believe the results of your LDDS test point to the definite possibility of the presence of an adrenal tumor. If one is found, your best option is surgery (adrenalectomy) if it is operable and he is deemed a good surgical candidate. Your other option is to treat with Trilostane or Lysodren. Each medication has its advantages and disadvantages. All the best to you and Brutus.

Ken