Gracie 14 yr. old Bearded Collie with Cushing's

[Lindanovick1]

I am new to this forum- thank you for admission. below you will find detailed information on Gracie. As of 8-12-13, I noticed her hair had thinned and she became dissingerested in her food. She started to refuse her food and was seen by the vet. They did an abdominal sonogram revealing a 2.5cm mass on her adrenal gland. She's been off Vetoryl, LignansHMR, and Melatonin for 1week. Now receiving Mirtazapine to stimulate her appetite and her Thyro-tab.
The appetite stimulant IS working. She is to be seen for a total cortisol level and T4 tomorrow. Thoughts?????
Linda Novick Huntington, NY- Gracie- Female/spayed-Bearded Collie, 14yrs. old, 52lbs. Gracie was Dx'd with Atypical Cushing's January 2013. Overt symptom was hair thinning and loss on body and tail, increased water intake, appetite and increased sleeping. Dx.d Hypothyroid- 2011.
Benign hamartone cyst surgically removed from hind leg, 2008. Presently cyst on her tail; not bothering her.
Slight heart murmur detected 2010, presently Gracie's hearing is not as sharp as it used to be. Gracie also has had bouts of dry/flaky skin; this has cleared up with antibiotics and Cushing's meds., along with a medicated shampoo. She's had a few UTI's in the last few years, successfully treated with antibiotics.
My Vet , Harborside Vet. Hospital, Huntington, NY, consulted Dr. Rhett Nichols, Endocrinologist prior on her case.
There are some meals she will not finish completely at first but then, comes back and finishes. She does get lots of treats and extras. She drinks more water during the day, less at night.
Her activity is okay, she does sleep more and sometimes has trouble getting up from laying position.
ACTH and LDDS test done. Sample sent to Univ. Tennessee. Results: CORTISOL (baseline) 19.6; POST ACTH=198.0. ANDROSTENEDIONE (baseline)=0.34;POST ACTH=6.15,ESTRADIOL (baseline)= 129.1, POST ACTH=142.4, PROGESTERONE(baseline)=0.13;POST ACTH=3.86, 17OH PROGESTERONE(baseline)=0.16; POST ACTH=5.08, ALDOSTERONE(baseline)=145.5; POST ACTH= 344.7
Meds.: Vetoryl 30mg. BID, Melatonin 6 mg BID, Lignans HMR OD. Gracie was also Dx'd Hypothyroid in 2011 and takes Thyroid-tab 0.5mg BID
After initial of Cushing's treatment- repeat ACTH/T4 levels were done (don't have copy of results on hand but Vet said "Cortisol and T4 were where they wanted them to be)
Nutrition: Eukanuba natural lamb/rice- Adult 3/4 cupX2/day
Supplements: Young at Heart 1 scoop AM and Missing Link Plus 1Tbs. AM/PM

[Harley PoMMom]

Hi Linda,

Welcome to you and Gracie, and I am so glad you found your way here.



ACTH and LDDS test done. Sample sent to Univ. Tennessee. Results: CORTISOL (baseline) 19.6; POST ACTH=198.0. ANDROSTENEDIONE (baseline)=0.34;POST ACTH=6.15,ESTRADIOL (baseline)= 129.1, POST ACTH=142.4, PROGESTERONE(baseline)=0.13;POST ACTH=3.86, 17OH PROGESTERONE(baseline)=0.16; POST ACTH=5.08, ALDOSTERONE(baseline)=145.5; POST ACTH= 344.7

Could you edit your post and add the reference ranges and units of measurement to these values...Thanks!



Meds.: Vetoryl 30mg. BID, Melatonin 6 mg BID, Lignans HMR OD. Gracie was also Dx'd Hypothyroid in 2011 and takes Thyroid-tab 0.5mg BID


Just wondering, are her thyroid tests done 4-6 hours post pill? Also, I didn't see her weight listed, could you tell us how much Gracie weighs?

Is her Vetoryl being given with food? Is her vet performing the ACTH stimulation test 4-6 hours post pill? When you get the copies of all the tests could you post any thing that is marked abnormal, we would especially be interested in all ACTH stimulation test results.

With Gracie refusing food it does sound like her cortisol may have dropped too low. When this happens sometimes prednisone is given, is she taking any prednisone? Have her electrolytes been checked?

I want you to know that we will help in any way we can, and please, do ask all the questions you want, ok. ;)

Love and hugs, Lori

[Lindanovick1]

All of her tests have been done 4 hours after food. Her Vetoryl is given with food as well. I tried placing a lot of information in a "signature line but it was too much. What I placed in my post is my signature line for the Yahoo Cushing's group.
There is so much to type if I include the reference ranges--YIKES.

[LtlBtyRam]

I'm pretty new around here. Welcome to a forum of PAWSOME folks.
Angela

[frijole]

All of her tests have been done 4 hours after food. Her Vetoryl is given with food as well. I tried placing a lot of information in a "signature line but it was too much. What I placed in my post is my signature line for the Yahoo Cushing's group.
There is so much to type if I include the reference ranges--YIKES.

We only need the items that are out of range (high or low). It would also be helpful to see the LDDS test results and any and all acth tests.

I'm a bit confused - you started off with a diagnosis of atypical cushings and then later it became full blown cushings and you started on the trilostane? Trying to understand the sequence.

Agree that lack of appetite is not what we see with cush dogs unless the cortisol has dropped. Glad you found us - this is a really helpful site. Kim

[Lindanovick1]

Good morning. Gracie is Atypical Cushing's. Instead of typing consistently atypical, I refer to her diagnosis as Cushing's. in my post of her original ACTH STIM, I have posted the base line and then her results. Her past results are not important with our present situation, in my opinion.
Today she is having a Total Cortisol, T4, and Chem panel drawn. As soon as I get these results, we may know further what is going on.
I will post these results to the forum as soon as I get them. Meanwhile; she is off Vetoryl, Lignan's HMR, and Melatonin and only getting the appetite stimulant and thyroid med.
Thanks for your support.
Linda and of course, Gracie

[addy]

Her past results are not important with our present situation, in my opinion.

I understand why you may feel this way but really, we need as much history as we can possibly obtain or our feedback is pretty irreverent


ACTH and LDDS test done. Sample sent to Univ. Tennessee. Results: CORTISOL (baseline) 19.6; POST 98.0. **normal range 65-174.6
ANDROSTENEDIONE (baseline)0.34;POST 6.15,**normal range .7-3.97
ESTRADIOL (baseline) 129.1, POST 142.4, **normal range 27.9-69.2
PROGESTERONE(baseline)0.13 POST 3.86, **normal range .10-1.50
17OH PROGESTERONE(baseline)0.16 POST 5.08 **normal range .40-1.62
ALDOSTERONE(baseline)=145.5; POST ACTH= 344.7 **normal range 72.9-398.5


Brief summation:

I have added the normal ranges based on those listed on Zoe's UTK panel in 2010 which I dont believe have changed. So on this test it looks like normal cortisol so atypical was diagnosed.

Then it appears a mass was found on her adrenal gland so I would surmise Vetoryl was started. Somewhere along the line she quite eating so what we dont know, the missing piece to the puzzle is what she weighs and her ACTH monitoring results once starting 30 mgs of Vetoryl.

So---- what we need to know and you can call your vet to get copies of the tests which you should always ask for for your records is when were the monitoring tests done, what were the results and how much does Gracie weigh?:):):):):):)

Glad to see you found your way here.

[frijole]

Thanks Addy for explaining why I asked for more info. :)

FYI I had a dog that had an adrenal tumor and she quit eating. She was misdiagnosed with cushings. Not all adrenal tumors result in cushings. Since my dog's tumor is rare I just wanted to make sure that isn't what you are dealing with.

Kim