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View Full Version : Heather, my 11 yr old Brittany just diagnosed with Cushings - have questions



dbellman
05-05-2012, 12:09 AM
We adopted Heather, a Brittany, 1 year ago and she is now 11. She recently had a routine senior blood panel done which was suggestive of Cushing. Results included: Alk Phosphatase (1791). Other values out of norm were GGT (55), cholesterol (424) Triglyceride (2328) and platelet count (521), Lymphcytes, and specific gravity of urine were low. There were no overt symptoms of Cushings. We followed up with Low Dose Dexamethasone Suppression which showed Cushings but was inconclusive as to type. Initial Cortisol was 4.1 and 4 hr value was 3.5 and at 8 hrs 5.0. Next came the High Dose Dexsamethasone Suppression Test. Initial cortisol 4.5. There was some suppression; 2.4 at 4 hrs and 3.0 at 8 hrs. Vet indicated that suppression needed to be 50% or greater, so whether it is pituitary or adrenal still remains a mystery.

Being retired with fixed income does come into play as we continue along this path of discovery. Abdominal ultrasound and/or endogenous ACTH concentration are both quite expensive, but may need to be done. In the meantime, where do we go from here?

Heather is active, healthy and to look at her one would not think there was anything wrong. The vet echoes this observation when he sees her. The only symptoms she shows are looking for food every time we go to the park and searching our floors for any scrap of food (could also be her Brittany nose). She had hair shaved for a procedure and that is very slow to grow back. If we hadn't had the routine blood test, I would be oblivious to the fact that she has Cushings.

I hate to begin treatment with drugs which have significant side effects on a happy and seemingly healthy dog. Vet pretty much agrees with me at this point. I would appreciate any thoughts regarding getting a specific diagnosis of which type of Cushings; future treatment; as well as thoughts in regard to with holding medication until more symptoms appear. I apologize for the length of this discourse but also thank you for any insights you can provide.

Harley PoMMom
05-05-2012, 01:12 AM
Hi Heather,

Welcome to you and Brittany! So sorry for the reasons that brought you here but glad you found us as we will help in any way we can.

Cushing's is a slow progressing disease and since Brittany does not show any overt symptoms I would agree with your vet not to treat at this time.

It is true that an ultrasound can be a very useful tool as if the Cushing's is from a tumor on the adrenal gland, with surgery the Cushing's can be cured. If surgery is not an option than one can use either of the medicines, Trilostane/Vetoryl or Lysodren/Mitotane to help control the elevated cortisol.

If it were me, I would not do any other Cushing's tests as of right now until Brittany displays more obvious clinical signs such as excessive drinking/urinating, hair-loss...etc, because strong symptoms do play a huge part in making a Cushing's diagnosis.

Does Brittany have any other health issues? Is she taking any other medicines/supplements/herbs?

Please know we are here for you and Brittany so do not hesitate to ask any and all questions.

Love and hugs,
Lori

lulusmom
05-05-2012, 03:40 AM
Hi and welcome to you and Heather.

I agree with Lori about not pursuing additional testing at this time, given that Heather is not showing overt symptoms. You didn't include the reference ranges for the values you posted and it would be great if you could do that for us. I am particularly interested in the reference range for the triglycerides. 2328 would be considered a severe elevation based on lab work I've seen for other dogs here. You asked where you should go from here and I'd say that if the triglycerides are as high as I think they are, you need to address this issue now. Was Heather fasted for this test? Did your vet recommend that you put Heather on a low fat diet and did s/he check Heather's blood pressure?

The urine specific gravity is used to assess renal function to determine if the kidneys are concentrating the urine. Dogs with cushing's usually lose the ability to concentrate their urine and you can expect to see a low usg. I see that Heather's usg was low but you didn't mention that she was drinking and peeing a lot more than usual. Is she and is she having any accidents in the house?

Glynda