Page 8 of 13 FirstFirst ... 678910 ... LastLast
Results 71 to 80 of 125

Thread: Emma - New Member Post

  1. #71
    Join Date
    Jan 2016
    Location
    Glen Cove, NY
    Posts
    1,941

    Default Re: Emma - New Member Post

    So, if you fast the dog before testing, do you still give them the Trilostane?
    Joan, mom to my Angel Lena, Angel Gable, Angel Phoenix, Angel Doree, Cooper, Sibble, and now Raina.

  2. #72
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Emma - New Member Post

    Quote Originally Posted by lulusmom View Post
    Marianne, I didn't think to ask about the acth stimulation. Ever since the "meal induced hyperadrenocorticism" revelation, I'm of the firm belief that fasting is always best as any dog with this condition will see a rise in cortisol after a meal. It's a rare phenomenon but I would err on the side of caution. Like the LDDS, there is the same differences of opinions for the acth stim test. Some labs say fast, some references say fasting is not necessary unless the dog has high blood lipids and then there is Dr. Peterson who says fat in the blood should not skew the results, which makes sense considering you have to give trilostane with a meal for proper absorption. If I had a dog today that I suspected had cushing's, I would definitely fast my dogs for both of these tests. The woman I spoke to was a local antech facility and to tell you the truth, she wasn't that well versed. I can try calling what looks like the corporate customer service number and ask about both tests. The woman I spoke to yesterday was hesitant to give me any information because I was not a vet. She decided to share the information after I told her that the vets where I live in rural TN can't spell cushing's, much less be well versed in diagnostic protocol.
    I agree that if I was taking a dog in for Cushing’s disgnostic rather than monitoring purposes, fasting might be preferable even if the lab doesn’t require it for tests involving cortisol levels. If for no other reason, blood might be drawn at the same time for other tests that *do* require fasting to be accurate.

    Mainly, though, I guess I am just mean-spirited enough that I don’t want to provide Sharon’s vet any “cover” by suggesting that IDEXX may require fasting for a diagnostic ACTH. They don’t, and that darn bossy vet ought to get her facts straight before inflicting her misinformation on conscientious pet parents! There, glad I got that out of my system ;-).

  3. #73
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Emma - New Member Post

    Quote Originally Posted by Joan2517 View Post
    So, if you fast the dog before testing, do you still give them the Trilostane?
    Joan, I think what Glynda was talking about in terms of fasting is when the ACTH or LDDS test is being used to initially diagnose Cushing’s. When the ACTH is instead used to monitor trilostane treatment, the trilostane should always be given with food before the test so that it will be metabolized properly.

    If the ACTH is instead being used as a diagnostic test, there is no need to give food. And the LDDS is always a diagnostic. So when used diagnostically, fasting is fine and perhaps even preferred by some laboratories. However, IDEXX is one lab that apparently doesn’t require fasting prior to any ACTH or LDDS testing, regardless of the purpose of the test.

  4. #74
    Join Date
    Jan 2016
    Location
    Glen Cove, NY
    Posts
    1,941

    Default Re: Emma - New Member Post

    Thanks for clarifying, Marianne.
    Joan, mom to my Angel Lena, Angel Gable, Angel Phoenix, Angel Doree, Cooper, Sibble, and now Raina.

  5. #75
    Join Date
    Apr 2008
    Location
    Tennessee
    Posts
    6,593

    Default Re: Emma - New Member Post

    Antech is based out of California so I called their West Coast contact number. The rep told me that it is not mandatory to fast for the LDDS or the acth stimulation but they recommend that you do because a meal can cause excess fat in the blood. Emmagirl, thank you for letting us share information on your thread.

    Hugs,
    Glynda

  6. #76
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Emma - New Member Post

    Thanks for this info, Glynda! I’d say we’ve now really covered our bases (and yes, many thanks also to Sharon for letting us hijack Emma’s thread ;-)))))).

  7. #77
    Join Date
    Feb 2018
    Location
    Eastern NC
    Posts
    64

    Default Re: Emma - New Member Post

    Hello all, I’ve been trying to cut out some time to make a comment on your last posts, but I’m due back to the vet in 30 minutes for Emma’s post ACTH test and have a quick question, or comment.

    Emma gets so nervous now going to the vet because she knows what’s coming and today she was shaking so much I didn’t know if I was going to be able to hold onto her. She was clearly very stressed and certainly afraid. So I had a thought, how much does that stress affects her cortisol levels and the test results? I know that stress causes more cortisol production and I just wonder if you’ve ever had this question before. Thanks - Sharon

  8. #78
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Emma - New Member Post

    Hi again, Sharon. Gosh, I feel so bad for you and little Emma — I can imagine how tough it is for you to drag her in when she’s so scared and miserable :-(((. Hopefully you’ll be able to space out these vet visits more and more as time goes on.

    In answer to your question, yes, stress can elevate cortisol levels. That’s why your own daily observations about her symptom relief or symptom progression are also a very important part of her overall clinical assessment. On an ACTH, I suspect any stress component would have a bigger effect on the initial baseline reading as opposed to the second stimulated value. But I don’t know whether or not that’s actually true. At this point, though, the stress may be a constant whenever you take her in, so you’d still be able to compare her test results in an apples-to-apples fashion.

    I hope things went as well as possible for you girls yesterday, and we’ll be anxious to hear the results.
    Marianne

  9. #79
    Join Date
    Feb 2018
    Location
    Eastern NC
    Posts
    64

    Default Re: Emma - New Member Post

    Hi Marianne,
    Emma had her ACTH stim test on May 31, 2018 and IDEXX returned these results:

    Pre 1.3
    Post 3.4

    She had her Vetoryl at 8am with food, and the test was run at noon, 4 hours later. I am a little surprised and slightly concerned with her results. Her prior test was run on 5/3/18 - 14 days after this vet took Emma off Trilostane compound and put her on Vetoryl.
    Those results were

    Pre 4.6
    Post 7.5

    What is your opinion on the last results? Do you think either number is too low? The pre is 1 point away from being out of range (IDEXX ref. range)
    Her symptoms are under control. She does not drink water all the time, and she is patient about her feeding times. Its harder to keep the weight off, I don't know why. She likes her daily walks and is happy. She isn't lethargic...she stays awake most of the day with naps here and there.

    Her biggest problem now is constant itching from flea bite dermatitis which has me flea hunting all day with a flea comb, and just yesterday I tried applying food grade diatomaceous earth on her. Its a daily battle we fight every year when spring rolls around. I will not put her on flea preventative, so I don't know any quick fixes. She also has a bath every week. Sometimes 2 baths. I hate to see her suffer from those darn bites. One flea can cause her a lot of discomfort.

    Thanks for your input and anyone else that can provide an opinion on whether the last results seem too low.

    Sharon

  10. #80
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Emma - New Member Post

    Hi again, Sharon!

    I’m so glad to hear that Emma seems to be feeling so well right now. That’s excellent news :-).

    On the face of it, these most recent ACTH results are very good given the fact that she seems to be doing so well with her cortisol at this level. I do understand your hesitation, though, given the fact that the results are indeed lower than the last time around. I’m going to try to put together the timeframe, though, and you’ll please correct me if I’m wrong. I’m thinking your vet vet didn’t change Emma’s dose back in April — it was just the switch from the compounded trilostane to the Vetoryl? Then her level was tested after two weeks, and now it’s been about five more weeks since then.

    It’s clear that Emma’s level has come down more since being switched to the Vetoryl. But after about seven weeks since the switch, I would hope that her cortisol level has pretty much stabilized now on this current dose. You take such good care of Emma and watch her so closely, I think you’ll notice any behavioral changes that would signal her cortisol dropping too low. I do understand that you don’t really want it dropping any lower than it is now. But since she’s outwardly doing really well, I’d be inclined to leave things as they are right now. Is that what your vet is suggesting as well? And what timeframe is the vet suggesting for retesting again? Also, remind us as to what dose she’s taking — I’m afraid I’m too lazy to go back and look ;-).

    Marianne

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •