Pet Lovers

[HappyDaze]

@CamilleP just got a call from the vet. His creatine levels came back fine so it still appears he is not cushings. This is the second time in 2 or 3 years we tested and he always comes back negative for cushings. So now we need to find out why his ALP (you were right, it is not ALT) skyrocketed. None of his other enzymes or bloodwork is abnormal so it is frustrating. Here we go again- more specialists, more tests and tons more money. Sometimes it seems to be neverending.... Thanks for all your info. I will keep you updated.

[CamilleP]

HappyDaze, the test your vet used sounds like the urinary creatinine to cortisol ratio test, and while it is often a good screening test, it is NOT the gold standard test for Cushing's Disease.  You do not actually have blood levels of cortisol measured pre and post ACTH stimulation to tell you if your dog has elevated blood cortisol or not.  I would suggest you speak to your vet to find out exactly what tests have and have not been done.  Even if the ACTH stimulation test comes back "normal", the condition called Atypical Cushing's Disease can still exist, leading to the same symptoms.  The symptoms are just caused by different hormones being abnormally elevated.  If your vet is unwilling to answer your questions, you can investigate whether there is a specialty clinic in your region that has an endocrinologist on staff.  The study of the hormone systems of the body is their specialty, and treating those systemic disorders is what they have studied in detail.  A consultation with an endocrinologist, with you providing the test results your dog has had so far, might help you find out what is really going wrong, and give you a way to go forward to hopefully fix it. 

[HappyDaze]

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@CamilleP wrote:

HappyDaze, the test your vet used sounds like the urinary creatinine to cortisol ratio test, and while it is often a good screening test, it is NOT the gold standard test for Cushing's Disease.  You do not actually have blood levels of cortisol measured pre and post ACTH stimulation to tell you if your dog has elevated blood cortisol or not.  I would suggest you speak to your vet to find out exactly what tests have and have not been done.  Even if the ACTH stimulation test comes back "normal", the condition called Atypical Cushing's Disease can still exist, leading to the same symptoms.  The symptoms are just caused by different hormones being abnormally elevated.  If your vet is unwilling to answer your questions, you can investigate whether there is a specialty clinic in your region that has an endocrinologist on staff.  The study of the hormone systems of the body is their specialty, and treating those systemic disorders is what they have studied in detail.  A consultation with an endocrinologist, with you providing the test results your dog has had so far, might help you find out what is really going wrong, and give you a way to go forward to hopefully fix it. 

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@CamilleP yeah the specialists I have seen all specialize in endocrine diseases and immune diseases. I am having one of the specialist come to my vet's office Wed to do further testing and an ultrasound. I've been to a multitude of specialists test him and study him but they can't seem to find the exact cause of his issues and the stim test perfomed in the past when his ALP levels were elevated initially also came back negative. I will see if the specialist wants to do another one but I doubt they will. All his other bloodwork and thyroid and hormone levels are pefectly normal. He is also very energetic-not lethargic. It is frustrating and I've spent thousands upon thousands of dollars. I am just happy he is still a very happy, energetic, payful dog but getting to the bottom of this would be nice. It has been a close to 3 year frustrating experience.

[CamilleP]

HappyDaze, if your dog has all the symptoms of Cushing's Disease and had an ACTH stim test that came back negative for elevated cortisol, that is a classic result for Atypical Cushing's!  Please ask your endocrinologist to run your dog's next ACTH stim test through the University of Tennessee's Veterinary Diagnostic Lab's adrenal steroid panel.  The good news is that the medicines for treating Atypical Cushing's don't even require a prescription, the HMR lignans are available online and melatonin is available in even grocery store pharmacies.  I'll be crossing my fingers that the Tennessee panel shows your dog has Atypical Cushing's, so you can set him on the road to health very soon!

[NC Bandwagon]

If your dog has that disease, HappyDaze, then I'm sorry if they do. I have no advice for this one, but I hope it gets better for them and you. If it's not something that can be cured, then I hope they live a long, happy life and I'm sure you're being wonderful to your pets.

[HappyDaze]

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@CamilleP wrote:

HappyDaze, if your dog has all the symptoms of Cushing's Disease and had an ACTH stim test that came back negative for elevated cortisol, that is a classic result for Atypical Cushing's!  Please ask your endocrinologist to run your dog's next ACTH stim test through the University of Tennessee's Veterinary Diagnostic Lab's adrenal steroid panel.  The good news is that the medicines for treating Atypical Cushing's don't even require a prescription, the HMR lignans are available online and melatonin is available in even grocery store pharmacies.  I'll be crossing my fingers that the Tennessee panel shows your dog has Atypical Cushing's, so you can set him on the road to health very soon!

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Excellent, I will print out the information on their website and tell them I'd like it sent there. Looking at the symptoms of Cushings, he really only has the thirst and the incontinence symptoms they show. Actually they don't show incontinence but I know that can be sign. He also has gotten a few urinary tract infections over the past 3 years. Other than that, he doesn't have an of the other symptoms they show but I know not all dogs have all the symptoms.

ETA: had my boy's ultrasound today and no issues -no masses, no odd things, nothing but good healthy innards except a slightly enlarged (high end of normal still) adrenal gland (only one) but he has had this for a few years now. It has not grown any bigger. After consulting with two specialists today, I decided to wait on sending anything to UoT to do the panel for various reasons. I am just thankful there were no tumors. yay!

[HappyDaze]

@CamilleP you want to know what is ood? My dog who they think may be pre-cushings (the one I've been posting about), stopped having incontinence for a week now, not a single drop. We are baffled as dogs with cushings or pre-cushings do not have symptoms that come and go, they usually stay the same or get worst. The specialists are stumped too. The only thing I added to his routine was CoQ10. After I saw this change, I started looking online and I've found a bit of evidence that this can help dogs prone to bladder and kidney infections, and, of course, dogs with heart issues and a little bit of evidence that it can help with neurological issues, which some conentend incontinence can be a sign of in some dogs. Just thought it is odd!

[CamilleP]

I'm glad that the ultrasound showed no tumors, HappyDaze, and also that the supplement has helped his incontinence.  I hope that, if your dog's condition does backslide that your specialist consultants are good with the UofT testing, so you can get a full and complete picture of what his adrenal glands are doing, and that, if he is indeed affected by some kind of Cushing's eventually, that you can find a safe and effective treatment for him, to keep him happy and healthy for as long as possible!  Best Wishes!