Cushings Diagnosis

[Gizmo'smom]

Hi my name is Teresa and this is my first post.
Gizmo is my 7 yr old Maltese who gas been diagnosed with cushing based on an ACTH Stim test pre ACTH cortis 14.8 and post 26.5. He is on 10 mg Vetoryl daily and appears better. He recently has an excessive thirst which of course causes frequent urination. The vet has suggested increasing dosage to 15 mg which will need to be compounded watch him and retest in 4 wks. He has had 2 ACTH Stim tests the results above are from the first one but I don't have the results from the 2nd one. I do know the results showed an improvement. He has been on Vetoryl for almost 2 months. Would increasing his dosage take care of excessive drinking and urination?

[Roxee's Dad]

Welcome to you and Gizmo,

Please tell us more about the symptoms that led to the Cushings diagnosis. How much does Gizmo weigh? I'm guessing around 15 pounds?

It would be hard to guess if an increase is the right thing without knowing his weight and latest ACTH stim results. If Gizmo is around 15 pounds and he is only getting 10 mg per day of Vetoryl (Trilostane) then it probably is a bit on the light side. Recommended starting dosage should be around 1 mg per pound on the low side.

The best I can answer your question is that when his post ACTH stim result is below 9 ish (Ideally between 1.45 to about 5) his symptoms should start to subside.

Looking forward to hearing more about Gizmo :)

[goldengirl88]

Welcome to the forum. Sorry your baby is having problems. If you could get copies of all testing done and post the abnormal results along with the labs scale of normal results we can better see what is going on and help you. Has your dog ahs the following: LDDS, ACTH, Urine, Blood Panel, Ultra Sound? We will want the results fro any done. What were the symptoms your dog started with, and since you started treatment have they changed? What is the weight of your dog. What is the dosage you are giving and how many times a day? This is important as you do not want to over medicate the dog especially the smaller ones. These are powerful drugs that need monitored carefully in order for your dog to do well. The best news is you found this forum. We will help you along this journey, and please feel free to ask for help, that is what this forum is about, help and education. Is you vet experienced with Cushings? Read and educate yourself as you are the only advocate for your dog. It will all be ok and you will get the hang of it. Blessings
Patti

[Gizmo'smom]

Thank you both for responding. The message I posted had been written a while ago and I couldn't figure out how to post. At this time Gizmo has been on 15mg for 10 days. The vet first suggested Cushing during his annual check up because of protein in his urine, heavy panting and weight gain from 15lbs to 17.5lbs in a year. My husband said it was because of all the treats I give him but our other dog receives the same food and treats and hasn't gained weight. The lab test April 2013 annual check up CHEM: ALP=568 (10-150) 209 Jul 12, CK=221 (10-200), Chol=638 (112-328) 459 Jul 12, TCO2=16 (17-24), AG=25 (12-24), 3+ hemolysis and 1+ lipemia UA: USG=1.033 (1.042 in Jul 12) 1+ Brb, ph=8.0, 4+ Protein (1+ in Jul 12).

At this time the Vet suggested that we needed to watch for Cushing and retest the urine within the next 3 months. ACTH stim test done 9-7-13 PRE-ACTH cortis 14.8 (2-6) POST ACTH cortis 26.5 (6-18) which the vet said based on the results a low-dose dex suppression test was not needed and prescribed 10mg vetoryl daily with retest in 3wks. At 3wks there was no change continued dosage up thru 6wks - pot belly was gone and panting had stopped. Second ACH stim test done 10-19-13 I don't have the test results at this time but will call on Monday. He weighed 15.6 lbs at this time. Per call from Vet his results had gone down but not as much as she would like to see. Continued on 10mg vetroyl recheck in 3 months. 3 weeks ago he started drinking excessively and peeing in the house. He actually looked like he had no idea he was peeing. Called the Vet and she suggested trying 15mg vetroyl to see if it stopped. Been on them for 10 days and nothing has changed. He isn't lethargic he seems happy and healthy other than the drinking and peeing. His current weight is 13lbs. Prior to me obtaining the 2nd set of results do you have any suggestions? Are the results above what you need or do you need additional information? Thank you very much

[frijole]

OK so the vet only did an acth test to diagnose right?

What we really need is the result from the last acth test. Please get that. Get both numbers please (there are 2)

Thanks Kim

[molly muffin]

Hello and welcome from me too. :)

That urinalysis actually has given me some concerns. Did the vet say anything about 4+ protein and other results on the urinalysis? Has a follow up been done since July?

Was Gizmo's thyroid checked? High CK can be a symptoms of hypothyrodism. Just one option, but it does have some of the same symptoms with drinking and peeing as cushings.

Is Gizmo eating okay, not ravenous as with cushings, but not picking or not eating either?

I agree with Kim and John, we really do need to see the follow up ACTH results and if a chem and urinalysis hasn't been done since July, then I would probably want a follow up done as well.

Welcome to the forum. So glad you figured out how to post. Let us know if you run into any problems with that.

Sharlene and Molly Muffin

[goldengirl88]

High CK can also mean that while taking the blood sample the muscle was punctured. So you need to do further testing about the thyroid to determine which it is .Blessings
Patti

[Gizmo'smom]

Gizmo's regular vet was out today so I need to call back on Tuesday in regards to results. When you say say u need results from last ACTH test and you need both results are you referring to pre and post cortis? The vet suggested cushings based on the urine results April 2013 and confirmed based on ACTH test September 2013. Looking thru results I have I don't see a thyroid test. He has always been an aggressive eater but he is getting worse. While he was waiting for his dinner tonight he was shaking. He always waits for Sparky, multiple mix, to finish eating then Gizmo goes behind him and eats anything that is left. He sometimes can't wait to get outside to pee and starts before he gets outside. There us no color in his urine. It appears clear and he goes for at least 2 mins. The excessive drinking and peeling was nit a problem until he began the vetoryl.

If CK is the code for thyroid results April 2013 CK was 221 (10-200) range July 2012 CK was 174. I will contact vet or someone in the office to get latest results schedule urine and thyroid tests and another ACTH test.

Urinalysis other results color-dark yellow, clarity-cloudy, gravity-1.033, glucose-negative, bilirubin-1+, ketones-negative, blood-negative, protein 4+. Protein test is preformed and confirmed by the sulfosalicyclic acid WBC 0-2, RBC 0-2, bacteria-none, epi cell-1+, mucus, casts, crystals - non seen other-amorphous debris pres, hallucinogen-normal.

I don't know what most of this means bout I don't want my little guy to leave me anytime soon. I just recently lost my 13 year old kitty very unexpectedly at the around the same time as Gizmo's diagnosis.

[Dawn Anderson]

Hope all is going well, I have a ?, do you know if its PDH or Adrenal based that is causing the cushings.

Dawn &Buttercup

[Gizmo'smom]

I believe the vet is leaning towards pituitary however it is only based on the two ACTH tests done so far. Spoke to a different vet today. Second ACTH test results pre 4.3 -- post 9 and they like to see both numbers between 2-4. Appt on Wednesday blood work, urinalysis, check kidneys and thyroid. Will post results as soon as possible. Thank you all.

[goldengirl88]

Seems like you are doing well and have a good plan for your Gizmo. Hope all goes well. Blessings
Patti

[Gizmo'smom]

I'm doing ok just worried about Gizmo. I will continue to work with the vet and post results when recd. I am just concerned that it might be something other than or in addition too the Cushings but I should have a better understanding of that tonight.

Thanks,

Teresa - Gizmo, Sparky and Bosch.

[molly muffin]

Hope so too. Crossing fingers, toes and paws here. :)

Sharlene and Molly Muffin

[Gizmo'smom]

Gizmo has been diagnosed with diabetes in addition to cushings. His blood sugar is 596 they would like to see it at 150. He has sugar in his urine and ketones in his urine. Vet has prescribed insulin twice a day with a prescription food diet. Kidneys and thyriod are fine. Sodium and potassium are a little low so she is concerned about the opposites of cushings. Going tonight to see how to give him insulin and what to watch for. Leaving him at vet Friday so they can keep an eye on him and also have an ACTH test done. How can a puppy that appears so happy and healthy be so sick? I'll have to pimp out the other puppies and kitties to pay for his treatment. Just kidding. So we are off to the vet tonight and again on Friday. If any of this does no sound right please advise. I'm keeping my fingers crossed that nothing else happens and his treatments go as expected.

Bye for now
Teresa, Gizmo, Sparky and Bosch

[molly muffin]

Well that explains some of the things that we saw in the urinalysis that were off.

Hi Theresa,

Glad you got it figured out at least.

Now we also have a sister site, k9diabetes.com/forum Wonderful people and we have members that are on both sites as they are dealing with both the diabetes and cushings. So, head over, sign up and say hi from all of us over here. :) Just kidding, the administrator there is just wonderful and so are the members.

They'll help you with any insulin/diabetes questions and we'll help with the cushings or opposite questions. Is the vet saying she is suspicious of Addisons?

hugs,
Sharlene and molly muffin