Acth stim results

[tamims05]

My minpin has numerious issues(arthritus, sards so he is blind, cushings, liver spot, mottled pancrease, gallbladder sludege, increase hormones, etc. He is between 14-15 as I got him 14 yrs ago from the pound and they estimated him at 1 yr at the time. about 4 years ago he had spine surgery at the base o fthe neck to remove the bottom part of vertrbre that was prssing into his nerve. he was paralized in al 4 limbs at the time of his surgery. He was able to walk but recently deterioating. He is pressing his head and trying to put pressure on his bottom jaw. he is up all night whining(he hadnt made a sound for nearly 2 yrs before). He crys loud sharp cries. I have taking him to vet hospital and they upped his trilostate. He is now crying louder than ever. I do not know if this is in relation. His thyroid medicine was cut in half last oct. I dont know if that has to do with this also, but he has slowly deterioated since then although he has gained muscle mass back. anyway I was wondering if anyone knoew what the normal ACTH level would be for a dog on trilostane. His first reading was ACTH Stim: cortisol pre 121 nmol/L (58-144), Cortisol post 203 nmol/L low (225-425) and then 2 weeks after upping his dose it was ACTH Stim: Cortisol pre - 111 (58.0 - 144.0nmol/L); Cortisol post - 123 (225.0 - 425.0nmol/L) SInce the increase in trilostane his cries are so loud that it is very upsetting. They have him on gabapentin and tramadol which do nothing. He cries and cries and I think the hospital have totally missed it but i dont know. Does this second readin look normal or does it look like they could be throwing him into addisons???

[Squirt's Mom]

Hi and welcome to you and your baby boy!

One thing jumped out at me - the head pressing and pressure on the jaw. Has anyone looked into the possibility of a brain tumor? Head pressing is one of the signs for a turmor. Trilostane (Vetoryl) has been shown to help these tumors grow if they are prone to do so. The cortisol will act as a sort of treatment helping to keep them smaller then when it is lowered, the tumor starts to grow.

As for the ACTH results we are used to seeing them in ug/dl units. That post of 123 nmol converts to 4.46 ug/dl which is within range. For a dog on Trilo you want the post to be between 1.45 and 5.1 ug/dl. So his ACTH is not too low, so you can't stop worrying about Addison's concerns.

It would help us a great deal if you could post the abnormal results from a general health screen that shows things like BUN, CHOL, ALT, and so on. Just those that are too high or too low along with all the little letters and normal ranges that follow each value. The more you can tell us about your sweet boy's health history, medications, and so on the better feedback we can offer.

I am glad you found and am sure others will be along to add their thoughts soon.

Hugs,
Leslie and the gang

[judymaggie]

Hi -- I wanted to add my "welcome" to you and your pup! Leslie has gotten you off to a good start and has eased your concerns about the possibility of Addison's. Your dog has certainly had a complicated history and kudos to you for taking such good care of him. We will be looking forward to seeing any test results you can post.

[molly muffin]

Hello from me too.
the range you are posting is for doing the diagnostic phase. Once on medication the range is different. As is his post is good, but I am wondering if perhaps pain from other areas is not now showing up since the cortisol has been lowered, arthritis, disc, etc

Also has his teeth been checked? I'd mention the head pressing jaw area and ask them to check it out. It might be they could do an MRI if that is feasible and not too expensive to check on any possible tumors pituitary or otherwise that could be causing problems too.