New at this - need advice

[Carole]

My vet suspects that my 10-year-old rescue beagle, Toby, has Cushings. His blood work was last done in May, 2012. All values were within normal ranges except for ALKP, which was 401 U/L; normal is 23 to 212 and LIPA, which was 5737 U/L;normal range is 200 to 1800. An LDDS test was done last week. Here are the results:

SNAPshot Dx

CORT 1.2 ug/dl
8 hour post low dose dex
Both 4 and 8 hour < 1 ug/dl - Normal
Both 4 and 8 hour = 1-1.5ug/dl - Inconclusive; repeat in 6-8 wks
Both 4 and 8 hour > 1.5 ug/dl and > 50% of baseline -
Consistent with Cushing's; do HDDST to ruke out adrenal tumor
4 hour < 1.5 ug/dl or < 50% of baseline and 8 hour > 1.5 ug/dl
and > 50% of baseline - Consistent with PDH
4 hour < 1.5 ug/dl or < 50% of baseline and 8 hour > 1.5 ug/dl
and < 50% of baseline - Consistent with PDH
4 hour > 1.5 ug/dl or > 50% of baseline and 8 hour > 1.5 ug/dl
and < 50% of baseline - Consistent with PDH
Another attached page says:
CORT <0.5 ug/dl
4 hour post low dose dex

I would be grateful for your interpretation, advice. Toby is scheduled for an ACTH Stimulation tomorrow morning. I am also going to ask for a UCCR test. Toby is a beagle and has always had a ravenous appetite. He is overweight but has had no recent weight gain. His skin and coat are actually thick and beautiful. His blood pressure is normal. He does seem to pant a lot, but mostly when there is food around. He also has rear-end weakness, but that is probably due to some neck herniation; he was attacked and shaken by a large lab about 4 years ago. I give him tramadol daily for pain. He was not neutered until the age of 7 when we adopted him. Just an FYI, Toby had a mast cell tumor removed from the sheath of his penis two weeks ago. Pathology report said it was a grade 2, was completely excised with very good margins. He is recovering nicely, and my vet told us the prognosis is good. I don't know if that would have any bearing of the diagnosis or treatment for Cushings. I would be very grateful for any advice. I love Toby very much. I will post the results from the ACTH test as soon as I have them.
Thanks so much,
Carole

[jmac]

Hi Carole and welcome to you and Toby!

I am sorry for the circumstances that brought you to us, but so glad you found us! Thanks for all of the information you provided about Toby. Others will be along soon to offer their input and advice, and probably to ask more questions.

Did you bring Toby to the vet because of bothersome or worrisome Cushing's-like symptoms, or did your vet discover this through routine blood work?

You have found a wonderful place with knowledgeable, kind, caring, helpful people. We will be here to support you with whatever you need, so please don't hesitate to ask questions. There is a lot of information that might be helpful to you in the "Helpful Resources for Owners of Cushing's Dogs" on the main page.

We look forward to hearing more about Toby!

Julie & Hannah

[frijole]

Carole, First off - cushings isn't a death sentence so don't worry about that. Secondly, there is no rush at all to treat it. It is often misdiagnosed so you are wise to do multiple tests like you are. If there is still doubt an ultrasound is very helpful.

The alk phos reading really isn't very high. Lots of things can cause the liver enzymes to be elevated and alot of cush dogs have readings between 1000 and even over 2000 so 450 is really not high.

I cannot help you with the test results from the ldds because of the way it formatted - I can't tell what the 3 numbers are. YOu typed up the whole report which includes how to read the numbers. We need 3 numbers, the first is the pre number and then the reading at 4 hrs and the last is the reading at 8 hrs. Perhaps you can find them on the report and just type them?

I can't tell from your post why your vet is suspecting cushings - your dog's breed is known for its appetite ;) and you didn't mention frequent urination or drinking gallons of water or any typical cushings symptoms. Can you tell us more?

Thanks! Kim