Yorkie Gidget - waiting for official diagnosis

[SharonH]

Hi there, first I would like to thank those of you responsible for this site. I found a similar site several years ago when we lost Igor the Pug to bone cancer and that forum really helped deal with the decisions and grief involved in that diagnosis.
Today our 11 yo yorkie Gidget has her ACTH test and I feel we know the outcome. She has a great deal of symptoms - the panting, excess water, cold seeking by lying on tile floor, pot belly, reluctance to jump, constant hunger.
I know our vet will prescribe mitotane aka Lysodren. He referred to mitotane as the gold standard. I know I have a lot of research to do.
Currently she is on Prion for incontinence and rimadyl for arthritis - both of which have worked quite well. She does still have the occasional accident but now I fear that is the Cushings and not simple aging.
I take comfort that so many of these symptoms disguise themselves as normal aging and that while she may have a little discomfort (cold seeking, panting) she is not in pain. She still has her feisty personality and plays with our 2 yo chihuahua. She is the happiest little beastie and so loving. I hate knowing that the side effects might diminish her a bit and know that we will once again be faced with the decision of knowing "when it's time".
ANY info or advice is welcome. If there is anything I should know immediately, I am open. I've seen a bit on milk thistle so I will ask my vet about combining that. I also worry about drug interaction - if she should stop the rimadyl and proin. We had recently bought a doggie stroller since she wanted to go on walks with the 2 chihuahuas (the other is 8) but she tired easily. We now let her walk for a bit, then put her in the stroller and she looks around happily. I'm unsure how much exercise she should get but perhaps her actions will let me know. She usually lets me know when she wants to be in or out of her stroller.
Once again, I thank you for your guidance and kindness. This agony is the price we pay for loving them so much.

Sharon

[StarDeb55]

Welcome to you & Gidget! You have given us a good start by describing the symptoms that have been troubling Gidget. What will help us even more is if you can gather up copies of all testing that has been done to make the diagnosis of cushing's, including general labwork such as a super chemistry panel or senior wellness panel. On the general labs, we would like to see the results of just the abnormals, along with the normal ranges & reporting units. Does Gidget have any other health problems? Has your vet ruled out diabetes & low thyroid? I ask about these 2 as their symptoms overlap with Cushing's. Is the ACTH the only Cushing's diagnostic test that Gidget has had? Cushing's is the most difficult canine disease to diagnose as there is no single test that is 100% accurate. It's really mandatory that you have a second test to validate either an ACTH or low dose dex test. We always suggest an abdominal ultrasound to take a look at the adrenal glands, so you can determine what type of Cushing's. The big bonus with the ultrasound is that you get a look at all of Gidget's internal organs, so you have a better idea of her overall health. If you do decide on the US, it will need to be done a high resolution machine. Most GP vets don't have this type of equipment.

Here is a link from our important information section on lysodren loading instructions. Before you start, please let us know the dose your vet has prescribed & Gidget's current weight. It's not that we are doubting your vet, but we have seen cases time & again on this forum where the treating vet has prescribed a dose of either drug that is much too high according to current guidelines. Please make sure that your vet provides you with prednisone before you start loading. This is an absolute requirement when using lysodren. Make sure your vet gives you clear instructions on what to look for that would indicate a pup is loaded, along with instructions on when prednisone might be needed

http://www.k9cushings.com/forum/showthread.php?t=181

The best thing you can do is to learn everything you can about Cushing's, becoming a knowledgable, educated owner since you are Gidget's only voice. Our important information section has tons of links that will lead you to any information you might want to explore about Cushing's.

Now, for the good news. I've successfully treated 2 pups with lysodren. My first boy was treated with lyso for nearly 8 years, crossing the bridge at 15 from causes unrelated to his Cushing's. My 2nd boy who was diagnosed at 13, so he was a senior fellow to start, was successfully treated for 2 1/2 years before he crossed the bridge due to causes unrelated to his Cushing's.

Again, welcome. Please let us know how you proceed. Lysodren loading can be pretty nerve wracking, but we will be here with you every step of the way.

Debbie

[SharonH]

Debbie, thank you so much. I will be getting the lab reports back in a day or so. This is wonderful information - I want to be sure to ask all the right questions so that we are confident in our decisions. At this time, we're still gathering the info although our vet seems to feel hypothyroid is a possibility and we will know more on that soon. I had seen the info on prednisone and will be asking him about that as well as options for after hours. We do live close to an emergency hospital which will help me relax on nights and weekends if we do begin Lysodren loading. Both of us work during the day so Gidget and the chi's, Peanut and Taco, are home alone with access to a doggie door, several rooms and plentiful water. I know monitoring is key and will consult with our vet if it advisable to leave her unsupervised for close to 8 hours.

Thank you for the info on your little angels. Realistically, I knew Gidget at close to 12 was slowing down, it was not a reality out there. We also lost our special Shorkie Wolfgang unexpectedly a year ago due to a post surgical complication after a back injury and hate the thought of losing our Gidget prematurely as well. Knowing that Lysodren can work gives me hope that we can give her more quality time with us. Google can be our friend and our enemy and Lysodren can sound pretty scary.

I can't say thank you enough. Maybe I'll just do TY! :)

MODERATOR NOTE: Please check your email for a message from k9cushings. You will need to reply to this email so that your posts are not delayed. Thanks!

[labblab]

Sharon, your membership has now been approved, so there should be no more problems with your posts being immediately visible on the forum.

Marianne

[Bo's Mom]

Sharon,
Welcome to you and Gidget. I just have to say that you have found the most wonderful and knowledgeable group of people here who can all say that they have "been there" with things you will be facing with a cush pup. Please don't ever hesitate to ask....I know I haven't and it has given me the knowledge that I needed to know that my Bo's cushings was not being treated correctly and it has found us in a world of ups and downs with getting him on a maintenance dose. So, I had to switch vets.
Again...welcome to you!!

[SharonH]

Thank you Belinda Rose - yes the compassion and support I saw while reading other posts is amazing. It's a special group of people who can reach out and help others in need. I do trust my vet but he will be getting many questions from me because I am very proactive and our dogs are our "kids". I will check back once I have some official news - we hope to have labs back by Thursday. Gidget is still her feisty little self - and I have promised her that I will do everything I can to help her.

[jmac]

Hi Sharon,
I just wanted to belatedly welcome you to the site. You have definitely found a wonderful place of caring, helpful, and knowledgeable people! We will do whatever we can to support you and Gidget as you go through this process. I see that you are waiting to share test results, which will help a lot. I am glad to hear that Gidget is still feeling pretty good and showing you she is happy. That is what is most important, right?! :) Again, welcome to the site, and please let us know what we can do to help!

Julie & Hannah

[SharonH]

Well, sadly we have an official diagnosis. I will get all her numbers on Friday. Thankfully, my vet has Cushings experience and we communicate well. We discussed an ultrasound and have not made a decision. Ultimately, we're not sure US will change anything. His experience is very positive with Lysodren and he always includes prednisone. The good part of this is we are 2 minutes from our vet, 6 minutes from emergency vet and due to vacation and holiday, my husband will be home next Wed-Sun to watch her during the critical induction period. I can even bring her to work with me Mon-Tues to watch her.

In the abstract, I figured at 11-12 YO, I figured we had a few years left. Now of course, we know pretty much exactly what we have. We know every day will be precious.

I'll be making a list of questions for him - I know I will ask him about milk thistle. I thought I read somewhere not to mix rimadyl and lysodren but he was not aware of that.

Thank you again for the link above, I will be checking it thoroughly when off work. And thank you in advance for all the guidance and support.

[Squirt's Mom]

Hi Sharon,

Welcome to you and Gidget! :)

How well I remember when my Squirt was diagnosed with Cushing's. I thought my world was ending. That was in March of '08. Four years later, she is going strong for old broad of 14! :D I know you have heard the 2-year myth and I want you to know deep in your soul it is just that - a myth. At 11- 12 your sweet girl can have many more years - good, quality years - by your side. Cushing's is not a death sentence. Our babies, an we :p, can and do live full, happy lives with Cushing's. In fact, our babies are probably some of the best cared for in the world - we are very diligent, devoted parents. And, I dare say, if the subjects of that 2-year myth study were like us and our babies, the conclusion would have been vastly different. ;)

An ultrasound saved Squirt's life in '08. They found a tumor on her spleen and had it not been removed, it would have ruptured. Not only was her life saved by finding that tumor, her diagnosis was changed as result, too. After the tumor was removed, her cortisol returned to normal and remained within normal range until last summer. Had I started treatment without the U/S, not only would I have put her at risk with the treatment itself, she would have died when the spleen ruptured. Our case is not typical but I always try to share it to let folks know how valuable an ultrasound can be not only in helping diagnose Cushing's but in finding problems in other areas that may be much more critical than Cushing's. ;)

Including prednisone along with Lysodren is not standard practice but some vets approach it this way. Here is a link to directions on Lysodren loading and monitoring from a well respected endrocrinologist, Dr. Edward Feldman, as well as some tips from our members who have been where you are -

http://www.k9cushings.com/forum/showthread.php?t=181

You will do just fine! :) Someone is online here just about 24/7 so any time you have a question or need to panic "out loud" :D, we will be here.

I'm glad you found us and look forward to learning more about the both of you as time passes.

Hugs,
Leslie and the gang

[SharonH]

Thank you Leslie. I haven't completely ruled out the US. I plan on studying up. Our vet is open to the option - he said his experience with it has been that it doesn't change anything other offering surgical options. We will have the prednisone as an emergency - I don't believe he plans on using it only having it available to us if necessary.

[StarDeb55]

Sharon, I want to clarify what your vet wants to do when you start loading. Is he intending that you give prednisone concurrently with the lysodren? If this is the case, it goes against standard loading protocols. When you are giving pred concurrently, you are simply replacing the cortisol that the lysodren is trying to limit the production of by eroding a certain amount of the adrenal cortex. Concurrent use of pred can easily mask the signs of loading which frequently can be very subtle. For instance, the dog who eats their meals at warp speed, never looks up, & their bowl is so clean you could eat out of it, now, pauses briefly while eating. That simple pause could easily be a sign of being loading. The dog who would rip your hand off to get a treat, now, walks away from a treat when you offer one. These are just a couple of examples. We have seen more than one instance of concurrent use of pred masking the signs of loading, lysodren is still being given, & the pup is pushed into an Addisonian crisis. I don't want to scare you, but concurrent use of pred is just not standard protocol.

Debbie

[SharonH]

Hi Debbie, no he is not doing that. I had read that I should have prednisone handy in an emergency and I asked him if he would indeed have it available for us. I wanted to make sure that I had access to it if she showed side effects that required it. Hope this clarifies.

[Squirt's Mom]

ahhh... very good! Way to go, Mom! :D I feel much better now. ;)

[StarDeb55]

BIG SIGH OF RELIEF, from me, too!

Debbie

[SharonH]

I have a couple of questions (getting ahead of myself but I want to be prepared.) I know I'll be asking the vet but would love opinions from those who have been there.

If I want to give Gidget milk thistle, it's my understanding that I should wait until after the loading is done and she is stabilized so that if there are side effects we concentrate only on lysodren - that she shouldn't start 2 different things at once.

Currently she takes rimadyl (arthritis) and proin (incontinence). She's never had issues with them and both work. Now of course, I wonder if both of those issues are Cushings related and not age related. I can't seem to find good information on drug interactions. I thought I read somewhere not to mix lysodren and rimadyl but my vet didn't seem aware of it.

We are on vacation in about 6 weeks and will be in Cabo which is sketchy for cell and email service. The place we board our dogs is wonderful and I never worry about them there - it's very interactive, no cages, great supervision. BUT the last 2 times they've been a little lax on giving Gidget her meds. I spoke with the manager today to ask if they have cushings experience and explained my concerns about Gidget receiving her meds - that before it wasn't horrible if they goofed up a little but NOW it could be life threatening and serious consequences. They do have access to vets and I know they are major dog lovers. But I'm wondering if I should board Gidget at the vet since we are so early in her treatment. I hate that she would be caged for 8 days but she would be at the very place that would know what to do immediately. I've also planned on asking them what they think - they may know of an ideal place for her to be too. Unfortunately, we don't really have family or friends here who could watch her in a home environment.

[Squirt's Mom]

Hi Sharon,

If you were close, I'd be happy to watch to watch that sweet girl while ya'll are away! I'm in ARK just in case. ;)

As for where to leave her otherwise :p, follow your gut. If there is the least doubt in your gut that the boarder may not be diligent enough, ask the vet to watch her. It may even be possible that one of the techs would take her home with them at nite - I've known that to happen before. ;)

Arthritis often becomes more of an issue once treatment starts so when it is a known condition prior to starting treatment, you want to stay on top of it. Cortisol is a natural anti-inflammatory so while it is running rampant in the body prior to treatment, it is in effect "treating" the inflammation of arthritis. As treatment lowers the cortisol back down to normal levels, the inflammation can become worse.

Rimadyl is an NSAID and that class of drug is not the best for our cush babies. NSAIDS are hard on the body in the first place and doubly hard on a cush body. Members here have used them but most use things like Adequan, Dasuquin, Duralactin. Fish oils and certain herbs/supplements can also help. There are foods that have anti-inflammatory properties and some that can aggravate inflammation - like white potatoes. (Love them and suffer every time I eat them! :rolleyes:) Several here have had great luck with acupuncture and hydro-therapy, too. We will be glad to share with you things we have tried and answer any questions you may have about diet, supplements, etc. that may help Gidget.

You are right about starting multiple new things at once, especially when one of those things is a drug like Lyso. At the beginning, you will need to be able to tell when the least little thing is different with Gidget - her behaviors will tell you a great deal about how she is handling the Lyso and how well it is working. So to add something else into the mix could present a problem if she were to develop an issue - what was the cause? which do you stop? is this a crisis or not? Let her body adjust to the Lyso, to the lowered cortisol, to the changes that may be required for her arthritis, then when you are both comfortable with these changes, you can start looking at things like Milk Thistle and diet changes. ;)

You are doing a great job of preparing yourself and educating yourself. :) Keep up the good work!

Hugs,
Leslie and the gang

[SharonH]

Have labs:
ACTH
Sample 1: 9.3
Sample 2: 24.4

Blood work - there were lots that are in normal ranges. I am posting the ones that are not as well as what the range should be.

Alk Phosphatase 388 (5-131)
BUN/Creatinine Ratio 30 (4-27)
Calcium 11.6 (8.9-11.4)
Triglyceride 637 (29-291)
MCH 28.3 (19-28)
Platelet count 451 (170-400)

We start lysodren tonight and her next stim will be July 9 if all goes smoothly. Just found out a friend has an Aussie shepherd with cushings and it has been managed for 4 years. I'm starting to get past the initial panic and fear - we can do this. Whatever time I can help give Gidget will be a gift - we know now she has probably had this for awhile but as so many do, we attributed it to normal aging. So I am trying to adjust my thinking that this diagnosis is actually a good thing because treating it will give her longer life and better quality of life while being untreated would have hastened the process.

[lulusmom]

Hi Sharon and a belated welcome to the forum.

I am trying like crazy to get caught up with all the threads and yours was the next in line. You'll soon figure out that brevity is not my strong suit but hey, I mean well. :D My questions and comments are in blue text below, within the body of your posts. Before you get started, I would suggest you get comfortable, get a cup of tea and some aspirin for when your head starts hurting. :D


I know our vet will prescribe mitotane aka Lysodren. He referred to mitotane as the gold standard.

Lysodren used to be the gold standard because up until a few years ago, it was the only effective treatment available. Since Vetoryl's approval by the FDA, it's use has continued to increase and at this point, I believe Vetoryl is probably the gold standard.

Currently she is on Prion for incontinence and rimadyl for arthritis - both of which have worked quite well. She does still have the occasional accident but now I fear that is the Cushings and not simple aging.

When did Gidget become incontinent? When was she diagnosed with arthritis? Was she limping or having trouble getting up without a lot of pain? A dog with cushing's has an abundance of circulating cortisol in their blood and cortisol is the body's natural steroidal anti-inflammatory. In other words, cushdogs self medicate so an NSAID like Rimadyl shouldn't be necessary until treatment reduces cortisol to a therapeutic level. Dogs who are overtly symptomatic have been cushingoid for a very long time so if Gidget does have cushing's, she has been self medicating for quite a while.

She is the happiest little beastie and so loving. I hate knowing that the side effects might diminish her a bit and know that we will once again be faced with the decision of knowing "when it's time".

Others may have already mentioned this to you but side effects can be minimized and usually eliminated if the vet follows proper protocol and the pet owner is educated and vigilant in monitoring their dog. It is when one of these elements is missing that a dog is more likely to experience ill effects.

ANY info or advice is welcome. If there is anything I should know immediately, I am open.

My biggest piece of advice is don't place blind faith in your vet and educate yourself so you don't have to. Based on the information you have provided so far, I wouldn't completely trust your vet but then, I'm twice burned by gp vets and so are a lot of other members. Others have also mentioned that confirming a diagnosis based on an acth stimulation test, with no validating or differentiating tests, is not the norm. Unfortunately, your vet never determined the form of cushing's Gidget has. The majority of dogs with cushing's have a pituitary tumor so chances are Gidget is in the majority. However, if Gidget happens to be in the minority and has an adrenal tumor, you need to understand that adrenal tumors are highly resistant to lysodren and much stronger doses are required. These doses are so strong that you are almost guaranteed to see some ill effects so prednisone is usually prescribed concurrently. In my opinion, if Gidget has an adrenal tumor, Vetoryl would be a much better choice of treatment.

If Gidget were to have an adrenal tumor and was a good surgical candidate, would you be open to a surgery that is a complete cure? How much does Gidget weigh and what loading dose has your vet prescribed?

The good news is that my worries about a proper diagnosis would be much worse if your vet had prescribed Vetoryl. Normal dogs don't really respond to Lysodren so the dog usually will never load. On the other hand, if you give a dog with normal cortisol Vetoryl, there is a very good chance, the dog will start to experience bad side effects rather quickly.

I've seen a bit on milk thistle so I will ask my vet about combining that. I also worry about drug interaction - if she should stop the rimadyl and proin.

If your vet is absolutely certain that Gidget has arthritis, then chances are she's going to need something to alleviate the pain, especially when cortisol begins to drop. If her problems are not arthritis but rather muscle wasting due to the catabolic effect of cortisol, then you should see improvement as cortisol drops and muscle mass is built up.

Dogs with cushing's have dilute urine and low specific gravity. If your vet did a complete urine analysis, including a culture, and has ruled out cushing's and a UTI as the cause for Gidget's incontinence, then chances are she'll continue to be incontinent. If it were me, I'd probably discontinue both meds until Gidget is stabilized on treatment.


Well, sadly we have an official diagnosis. I will get all her numbers on Friday. Thankfully, my vet has Cushings experience and we communicate well. We discussed an ultrasound and have not made a decision. Ultimately, we're not sure US will change anything.

It very well could change things, including but not limited to the first choice and/or most appropriate treatment.

His experience is very positive with Lysodren and he always includes prednisone. The good part of this is we are 2 minutes from our vet, 6 minutes from emergency vet and due to vacation and holiday, my husband will be home next Wed-Sun to watch her during the critical induction period. I can even bring her to work with me Mon-Tues to watch her.

I'm really glad to hear that you are committed to being super vigilant during the loading phase. Did your vet explain what to watch for and what to do if you notice signs of low cortisol? Be sure to print out the Lysodren loading instructions and keep them handy.

In the abstract, I figured at 11-12 YO, I figured we had a few years left. Now of course, we know pretty much exactly what we have. We know every day will be precious.

There are a lot worse diagnoses than cushing's and certainly not many that are as expensive. The old wallet certainly takes a beating but on the up side, once stabilized, your precious girl can live out her life expectancy with a good quality of life.

I'll be making a list of questions for him - I know I will ask him about milk thistle.

Milk thistle is a great thing but most often it won’t make a difference in bringing down alkaline phosphatase. This is a liver enzyme that is triggered by cortisol's effect on the liver. Cortisol doesn't kill liver cells but rather increases the workload on the liver to convert amino acids to glycogen. Because there is so much cortisol in the blood, the liver is over-accumulating glycogen, which is the reason why most cushdogs have an enlarged liver. Milk thistle and other liver supplements won't reduce the glycogen but it will help keep the liver healthier while the dog is being stabilized on treatment. Some cushdogs will see liver enzymes return to normal but others may have mild elevations for the rest of the their lives.



We are on vacation in about 6 weeks and will be in Cabo which is sketchy for cell and email service. I'm wondering if I should board Gidget at the vet since we are so early in her treatment. I hate that she would be caged for 8 days but she would be at the very place that would know what to do immediately. I've also planned on asking them what they think - they may know of an ideal place for her to be too. Unfortunately, we don't really have family or friends here who could watch her in a home environment.

I know what a bummer it is not having family or friends who you trust to not screw up the medication regimen. I think that Gidget will be fine in either the boarding facility or the vet's office. If all goes well, she should be on her maintenance dose so she will only be getting two to three doses a week. The beautify of Lysodren is that if one day is missed, it's no big deal. As long as you give the whole weekly maintenance dose within the week, things should be fine.

[SharonH]

We have something in common - brevity is not my best quality either. Although this post may be short since I am winding down my work day and anxious to get home.

A few answers for you - Gidget's arthritis was detected maybe 3-4 years ago at her regular exam when he tested her hips. It was more in her jumping ability, no real limping. Once on the med, improvement was immediate. The incontinence started about a year ago and the Proin also worked immediately, pretty low dose but can't recall exact amount. I do question now whether that is Cushings related. She will still have the odd accident - generally when sleeping or napping in one spot without moving. Her urine is very dilute and I do recall a thorough urinalysis and culture.

I do have quite detailed instructions from them on the loading and also have the instructions from this website. They complement each other well - no conflicting information.

I get what you are saying about blind faith. He's pretty egoless when it comes to recommending specialists or opinions when needed. I've got to put some initial trust in this. You know that old phrase "when it rains it pours". That's what I'm up against. Not getting into too many details but I have a lot of extremely stressful issues going on all at once. The only way I can handle all of them without losing it is to compartmentalize, trust some experts, keep moving forward and not lose focus. I may not make the same decisions as others but I've got to try to make the best for our situation. The vet and I had a lengthy talk about options. Please don't feel if I don't choose some of the suggestions here that they are not valued.

Thank you for so much for all the insight. Leaving my office now so I can get home to the 3 dogs and the husband. :)

[molly muffin]

Hi Sharon,

We've just been diagnosed too. Anxiety with a capital A.

I hope everything is going well with Gidget's treatment. You just started right?

Crossing fingers and toes for you.

[SharonH]

Thank you - my best to Molly. We lost our beloved shih tzu/yorkie Wolfgang a little over a year ago to post surgical complications from a back injury. What kind of mix is Molly? Wolfie was an amazing boy.

Gidget has just had 2 doses so far. So far so good. We had her shaved yesterday for grooming and that helped her with her panting a bit. Hey every little bit helps. Walked her and the chi's this morning before it got too hot. Of course her walk is more in her stroller! She loves it.

[molly muffin]

We think she is mixed with Lhasa Apso. She has quite of few of their temperment characteristics. Choosey about making friends, thinks she is the only alarm system for the entire neighborhood. LOL

Oh I love Yorkies, they are just beautiful little dogs. Okay, I'm partial to most dogs., Come to think of it, cats, horses, I'm pretty much good with all warm blooded creatures. :)

Oh I bet the shaving helped. Molly got clipped yesterday too. Just too bloody hot here right now.

Molly has to have her own glass of water (Not a bowl) when sitting out by the pool (she doesn't like the whole swimming idea one bit). So that is what we are doing most of the weekend I think.

So glad that the treatments are going well so far. Yea! :)

[SharonH]

I hope everyone with a cush pup gets results like we have. Gidget has completed her Lysodran loading stage. She had zero side effects and was the same feisty and loving girl she has always been. She had her 2nd stim test yesterday and she passed with flying colors. Her numbers were all in the normal range both pre and post and we now start the maintenance phase of 2x per week. Her next stim will be in 3 months.

We will still watch closely for any changes. With 3 dogs, I know the personnel at our vet's quite well after all these years and one told me they have a lot of cushdogs there so I feel she is in good hands. That doesn't mean I will be relinguishing my education but knowing that she is not some rarity and that the practice is experienced with ongoing treatment provides some comfort.

[lulusmom]

Hi Sharon,

I'm glad to hear that Gidget is doing well aced the loading and her cortisol is where it needs to be. Can you please post the actual results of the last acth stimulation test? The fact that you said that Gidget's cortisol was within normal range concerns me. I haven't updated my own thread yet but I'm going to share my update because it relates to my concern for Gidget.

I got a message from the new gp vet yesterday and she told me that Lulu's post stim number of 8.4 is within normal range so everything is perfect and no medication is necessary. I haven't called her back yet but I will and I'll explain, like I've explained to two other gp vets that you can't use the normal lab reference ranges for a cushdog and that Lulu's post stim number needs to be within 1 and 5 ug/dl. If Gidget's post stimulated cortisol is higher than 5, she's not where she needs to be either.

Hopefully, you and I aren't in the same place with our girls. I'll be looking forward to seeing the stim test numbers.

Glynda

[molly muffin]

That is good news hopefully for Gidget. It does make you feel better to know that the vet is familiar with cushings and all the possibilities that go along with it.

Hope that you can get Lulu where she needs to be too Glynda.