New member: Schnoodle & Cushings or not?

[makajo]

Hi Everyone, I am new here and new to all the Cushings fun! Over the last month I've learned more about it than in nursing school! I have an 8 yr old schnauzer/poodle mix since she was 3 months old. Over the years she has always had issues with things being wrong but never a definitive diagnosis. Looks like pancreatitis, possibly a UTI, possible allergy, maybe to chicken, maybe grain, slight heart murmur, could be CHF....So over the years its been new foods, antibiotics and times of just shaking my head and letting her be "as is". I even switched vets for a new perspective. A month ago, I noticed Shelby was breathing differently. She has always been a LOUD, snorer but I was told its fine. Well, her breathing was fast and she was pulling hard in her sleep. Respirations were twice the norm and I had noticed during the days prior to this she was panting at rest, awakening from sleep and panting. So I took her in, concerned about the CHF. Xray on heart didn't show anything indicating CHF, or lung issues. Heart was slightly larger but not concerning. The vet was more concerned about her peeing in the house. I have just assumed it was behavioral. She has 24 hr access via doggie door but will go in spurts of just peeing on the rug. Then weeks she is fine. So the testing began. Blood tests showed elevated ALT, and ALK and her urine was dilute but not as dilute as they see in Cushings but ACTH recommended. ACTH came back "high norm". Referral to specialist in endocrine. Ultrasound showed nothing impressive...Right adrenal ever so slightly larger than left. No tumors/masses. More blood work, and urine, which again nothing indicative of a definitive Cushings. Low Dose Dex last weekend. Results normal. Vet is calling me tomorrow to discuss atypical cushings. My mind is in overdrive. Do I just give up on the cushings dx and let the dog be. She seems happy, eats, sleeps plays. She battles dry flaky patchy skin, weird black rash/spots on belly, repeated yeast in ears/skin, panting, urinating, some increase in drinking...OR do I treat like cushings and deal with side effects and adverse possibilities of treating a non cushings dog with those meds? Do I ask for the UT testing for atypical? How much more is that test? We are in this for thousands now and still have no answer. When is enough testing enough to say enough??? I'm need to find the line...especially since hubs is not on board with the expense of all this. Thank you!:confused:

[labblab]

Hello and welcome to you and your baby girl! I apologize that I only have a few minutes to type right now, but I surely do understand your questions and your frustration. In advance of your conversation with your vet tomorrow, here's an article that provides a bunch of helpful info re: current debate about the meaning, diagnostics, and treatment for "Atypical Cushing's."

http://www.2ndchance.info/cushingsbehrend2010.pdf

As you will see, there are still a lot of questions about the significance of elevated adrenal hormones other than cortisol. Having said that, we do have members here who have seen improvement in their "Atypical" dogs after initiating various treatment protocols. But with others, not so much.

As far as the UTK testing, the cost is a bit more than a standard ACTH. Your vet would draw the blood and inject the stimulating agent just as was done before. But this time, the blood samples would be shipped to Tennessee for analysis. I think their charge is really quite reasonable -- less than $100 I believe. So the biggest expense is the cost of the stimulating agent, as is always the case with an ACTH.

Given your dog's symptoms and previous testing history, however, the IMS may just recommend going forward with a trial course of treatment with melatonin and lignans, just to see whether you see any improvement.

At any rate, I do think this article will be helpful to you. And we will be really anxious to hear what your vet recommends tomorrow.

Marianne