New Cushings Diagnosis, Bloodwork Extremely Off

[SamanthaS]

I'm dealing with Brand new Cushing's diagnosis as well. Except his blood work is off the charts erratic. And his cortisol testing came back positive for Cushing's. I'm going to try and include a copy of his blood work from December and February. If I can figure out how. He's 10 1/2 and acts like a teenager still. We are having difficultly getting it under control. His symptoms are greatly improving but blood work is not. He is taking trilostane.

[Wylie's Mom]

Originally Posted by SamanthaS

I'm dealing with Brand new Cushing's diagnosis as well. Except his blood work is off the charts erratic. And his cortisol testing came back positive for Cushing's. I'm going to try and include a copy of his blood work from December and February. If I can figure out how. He's 10 1/2 and acts like a teenager still. We are having difficultly getting it under control. His symptoms are greatly improving but blood work is not. He is taking trilostane.

Hi and welcome, Samantha . You're right, those numbers are really out of range! But some of them are heading in the right direction. What are his last two ACTH tests showing for cortisol numbers, pre- and post- ...? Bc when cortisol comes into control via the trilostane, other things should start falling in line. If cortisol is not coming down, then the med must be titrated up -or- a different/new Cushings med needs to be tried (ie, lysodren etc....).

I know how frustrating and confusing this stage can be - been there! And what's worse is that it can be a stage that lasts a relatively long time bc all of it is happening while you're trying to correctly titrate the Cushings med, which always takes time / trial & error.

But try not to worry too much, you will get him there - no doubt !

What are the main symptoms you're dealing with? Is it the polydipsia and polyuria...or...? When is the next ACTH scheduled? Lastly, his thyroid has been checked, yes?

[Wylie's Mom]

Also - I went ahead and grabbed your post from that other thread and created your own thread for you - hope that's okay with you .

[Buddylove86]

It takes to regulate this disease, but if clinical signs are improving the medications are working. I hope you had an abdominal ultrasound as part of the work up as well not just the ACTH stim test or Low dose dex test for diagnosis. If not I would have one done by a radiologist/internist.

[DeeDee63]

Hi, I am new here and do not have a Yorkie yet, 2 Aussie's though. I'm looking in to becoming a vet tech and am studying common pet diseases before my interview. This article is really informative on Cushing's Disease - and you can ask a vet a question too
https://www.vetary.com/dog/condition/cushings-disease I'm sure once you get familiar with the condition, you'll do okay, the outlook is generally positive!

[Wylie's Mom]

Originally Posted by Buddylove86

It takes to regulate this disease, but if clinical signs are improving the medications are working. I hope you had an abdominal ultrasound as part of the work up as well not just the ACTH stim test or Low dose dex test for diagnosis. If not I would have one done by a radiologist/internist.

For the most part,theoretically, I do agree with you. However, from a purely clinical (and anecdotal) perspective - it is super common for a newly-diagnosed Cushings dog who has numbers off the charts to have totally normal looking adrenals via u/s. That's been more my experience than not, the last 10 years. Kinda interesting, really, bc clinicians (of course) always strongly recommend the u/s in newly diagnosed dogs - when in fact it's most common that nothing comes of it. That said, I do understand why they want to do it.

[Buddylove86]

They want to do because it helps differentiate if it adrenal or pituitary disease. You ideally need to know which one it is. Different forms require different treatment Trilostane or lysodren, radiation, or surgical removal. Cushing's is not always treated with oral medication that is why abdominal ultrasound is part of the work up to rule out functional adrenal tumor.

[Wylie's Mom]

Originally Posted by Buddylove86

They want to do because it helps differentiate if it adrenal or pituitary disease. You ideally need to know which one it is. Different forms require different treatment Trilostane or lysodren, radiation, or surgical removal. Cushing's is not always treated with oral medication that is why abdominal ultrasound is part of the work up to rule out functional adrenal tumor.

What I'm saying is that the reality is that many/most pet owners get no clear result from the u/s. They're often told it's "inconclusive" - that they couldn't confirm or exclude, for sure, the presence of absence of an adrenal tumor. Can't tell you how many times I've heard that from Cushings dog owners - probably 95% of the time. For my Wylie (who saw a Cushings specialist), the u/s did nothing for us clinically whatsoever - it just cost more money and that was it.

Like I said, I understand why they want to do it - it may provide them add'l diagnostic clues. However the reality is that it often does not, at all.

[Gew]

I lost my Cushing baby in July at 16., and it wasn't from Cushings, so relax. It can be managed, not cured. I found the k-9 Cushing forum the best. There are so many knowledgeable people willing to help.

I wish you all the best. My girl was happy and lively till her last days.

Gew