Cooper

[Cooper]

I am new here although I have been a member of the diabetes forum for awhile. Cooper is a 9 year old min pin diagnosed with diabetes last March. She also suffers from pancreatitis and can have a lot of anxiety. At the suggestion of our vet we just did the initial urine test for Cushings and her cortisol came back elevated. Her next suggestion is the ACHT/stem test.

My vet feels that the reason her diabetes has been hard to regulate because she could possibly have Cushings. I am so confused about this disease. She has been through so much I hate the thought of her having one more thing.

Is there anything I should know before we proceed with the next test? I thought I read somewhere that you have to test 3 times before it can be confirmed that she has Cushings?

[frijole]

Glad you found us and welcome. I'm a bit confused because you said Cooper's cortisol level was high and therefore you are going to do the acth test. It's the acth test that measures if cortisol is high. What testing was done that told you the cortisol is elevated?

Absolutely multiple tests are normally done as it is very hard to diagnose cushing's - and even more so in a diabetic dog. I will warn you that you might need to work with a specialist unless your vet is very very experienced. It will save you time and money in the end trust me.

Another option is to do an abdominal ultrasound to take a look at the organs - you can tell by the adrenal glands often what form of cushings, if any you are dealing with. Also sometimes cortisol is high due to other illnesses and/or tumors that are on organs seen by the ultrasound.

Tell us more about Cooper. Does she have any cushings like symptoms which are ravenous appetite and thirst, frequent urination (although I know this is common with diabetics), round tummy, hair loss, skin issues, hind leg weakness?

Also know that the pancreatitis could be causing cortisol to be high as the body is fighting an illness. I would cure that prior to doing an acth test just to be safe. Are you giving a special diet for the tummy issues?

I hope this helps a bit. OThers no doubt will chime in. Kim

[Cooper]

Thank you for the quick response! We started with a urine test which showed the elevated levels. A lot of her symptoms are the same with her diabetes. We have had difficulty regulating her diabetes and our vet felt it was a good idea to test for Cushings. She has a pot belly, fur loss (her little stump of a tail is almost bare!). One night last week we woke up to find she had drank her whole bowl of water and had peed in several places in the house. We took her to the vet and her bg 4 hours after eating was 185 which is good for her.

She's at the Er vet a lot because of pancreatitis and the last time we were there they recommended she be tested for Cushings as well I guess from her appearance and history .

My vet has been absolutely wonderful. She has been very knowledgeable with the diabetes and seems to be with the Cushings although I know nothing about it yet.

Cooper is not a very cooperative patient. It still takes 2 people to give her her shot and she Absolutely refuses to let us home test her.

She eats chicken, hamburg, rice, cottage cheese and wd dog food. She is on 5 units of insulin twice a day and takes 5mg of Pepcid ac twice a day. When she gets really anxious we can give her 1/4 of a torbutrol.

Thank you for your help!

Mary

[labblab]

Dear Mary,

Hello and welcome to you and Cooper. Thanks so much for this additional information. Based on what you've told us, it does seem to me as though it is reasonable to investigate a Cushing's diagnosis, and I agree with your vet that the ACTH is the preferable diagnostic blood test. As you already know, one of the hard parts is properly diagnosing Cushing's in the midst of other ongoing health issues. And even though the ACTH can render a "false positive" in that situation, it is less likely to do so than is the LDDS (which is the other diagnostic blood test of choice). In Cooper's case, it sounds as though it is really the symptom profile that is raising the red flag and even though the ACTH is not perfect, it is probably the best you can do in this situation in terms of blood testing. And no, it does not need to be repeated three times. Perhaps you are thinking about the urine test that Cooper has already had performed -- some vets recommend pooling a urine sample from three successive mornings when the test is performed, rather than relying on a single sample alone.

As Kim has suggested, an abdominal ultrasound can also be a helpful tool. However, just as is the case with the ACTH, the adrenal glands can appear to be enlarged in the presence of other cortisol-stimulating illnesses, too. But a big "plus" re: an ultrasound is that it can give you helpful information about the status of other internal organs, too, including the pancreas. And this info might be helpful, especially in light of the history of pancreatitis.

But first things first, and I do think the ACTH stimulation test makes sense as the next step in the diagnostic process. Please do keep us updated, OK?

Marianne

[Jenny & Judi in MN]

Hi Mary: welcome over here. I might have mixed you up on the 3 tests. this is what I meant:

1. initial test to determine if she has cushings

2. if treatment is started, test after "loading" to see how she is doing

3. 3-6 weeks later another ACTH to check

this is how it was with Jenny and Lysodren. More ACTH tests initially to make sure she was ok, fewer later. I was just trying to give you a heads up. sorry to confuse you. Judi

[goldengirl88]

Mary:
i just wanted to welcome you and Cooper to the forum. I sincerely hope you can find out if Cooper has Cushings. The people on here can't be beat, they know this disease inside and out, and they will give you lots of support. Hang in there and good luck to you and God Bless you both.

[NoonelovesmelikeNorman]

Hi Mary, I along with Norman (cushings Doxie) and Millie (yorkie-pooh)Welcome you and Cooper to the group. Great site! Take a breath and know your in good hands..so much knowledge.

Peace and Blessings,

Sharon

[molly muffin]

Well hello Mary and welcome to you and Cooper.

I'm so sorry to hear that Cooper is having yet another issue to have and try to deal with. The good thing is that if it is cushings that is making the diabetes hard to control, then perhaps getting the cortisol to normal will help with the diabetes.
Do be aware that Dr. Petersen, a highly rated specialist, recommends that if you go with Vetroyl for dogs with diabetes, twice a day dosing is recommended over once a day dosing.

I think the others have given you good suggestions to start with, so I'll leave with a big hug and a welcome.

hugs,
Sharlene and Molly Muffin

[scoora]

Welcome Mary and Cooper. You have found your way to a group of wonderful, knowledgeable and loving people.
Big hugs.

[Cooper]

Thank you for the warm welcome! I spent some time reading through the threads to gain some knowledge. We are going to move forward with the next test and go from there. She has been feeling really well the past week it's hard to believe there is anything wrong with her!

I did have one question- I read several times that prednisone should be on hand just in case of emergency? How do you determine the emergency? She does not allow us to test her blood glucose at home (our vet is wonderful and her office is about 2 minutes away so we go there for random tests and curves). I'm just wondering what type of home testing would be involved, if any, with Cushings?

Thank you for all your help! I'll post her test results when we have them

[Simba's Mom]

Welcome to the family Mary and Cooper, this is an awesome site, plenty of encouragement and knowledge. You are in good hands.

[Harley PoMMom]

There is no home testing for Cushing's, just keen owner observation. ;)

When a dog's cortisol drops too low is when prednisone is needed, symptoms include but not limited to: lethargy, vomiting, diarrhea, not eating, and/or the dog just not acting themself.

[Cooper]

Hello again, it's been awhile since I have visited the site. We had decided to hold off on testing Cooper until the end of March since my husband was going to be visiting family for the first two weeks of the month. Since then life seemed to be a little crazy and I had to have some surgery. All is well now but now I worry that we put Coopers testing off for too long and hopefully haven't harmed her by not doing it sooner. Her diabetes has been well regulated and with the exception of a UTI she has been doing great.

However the last few days her stomach seems bloated. I'm obsessing. She has been thru so much with the diabetes and pancreatitis I am scared to death she has Cushings. I'm also concerned about the cost... Although we will do whatever we have to do for her. I'm going to call the vet on Monday and schedule the test... Sorry to be venting. My family thinks I am over reacting :(

[frijole]

Welcome back. FYI it is a great sign if the diabetes is under control because typically if a dog has both the diabetes is hard to control due to the cushings.

Also the tummy bloating could be from the pancreatitis. Not sure if it is controlled right now or not but don't waste money on cushings tests if it isn't because you could get a false positive. Tell us more about how Cooper is doing. Thanks! Kim

[Cooper]

Hello again after such a long time. Cooper has been fairly good with her diabetes since last spring but for the past 4-6 weeks I cannot seem to regulate her at all. so.. after another trip to the vet this morning I decided to go ahead with the Cushings test and have scheduled it for Thursday. I'm so praying that she does not have it since she already has pancreatitis and diabetes but at least I will know and we can decide how to proceed from there. I have to say diabetes is very nerve wracking but Cushings is scaring me to death. Anything I should watch out for? I looked at the posts here today and saw something about a puppy passing two days after the test. I couldn't even read the thread. Is this test dangerous to her? My vet has been outstanding in treating the diabetes and dealing with my anxiety so I feel confident with her doing the test. I just feel so bad my baby has to go through one more thing :(

[Harley PoMMom]

Generally the two tests performed to diagnose Cushing's are the low-dose dexamethasone suppression (LDDS) and the ACTH stimulation. Both are relatively safe, some dogs do have mild reactions to the stimulating agent in the ACTH test, such as anxiety and an increase in drinking.

Since the LDDS test is known for creating false positive results when a non-adrenal illness is present (like uncontrolled diabetes), if this were me I would prefer the ACTH stimulation test as the diagnostic test for Cooper.

Hugs, Lori

[Cooper]

Good evening,

Cooper's test results came back and she does not have Cushings! After all the testing we have done, our vet feels it is just her chronic pancreatitis that is causing her diabetes to go crazy. Thank you all for your help and support! Your fur babies are lucky to have you!

[Harley PoMMom]

Was a spec cPL test done for the pancreatitis? Chronic pancreatitis can make it difficult to control diabetes. What treatment plan does Cooper's vet have in mind?

Hugs, Lori

[Cooper]

Hi Lori, Cooper had her first pancreatitis attack when she was a year old. She has had them off and on since then. According to the vet, it is what caused her diabetes. She's on a low fat diet, takes Pepcid AC twice a day, Cerenia when she throws up or won't eat, and a painkiller when it gets bad. It has actually gotten better with flare ups less frequent since she's been on insulin. My poor baby is such a trooper!