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OK, it ? time. Can someone please explain to me in laymans terms the
ACHT stim test, I'm unsure of the meaning. Just what are they stimulating??? We are keeping her at 10mg am & 10mg pm and will have her tested again in 14 days.
pre-3.7
post 8.2
Thanks Dawn & Buttercup
Those are pretty good numbers for her first stim, and I completely agree on staying her current dose for now!
Hopefully one of the experts will stop by and explain the ACTH better than I could.
Posting actual results
Endocrinology
2/23/2014 (Order Received)
2/23/2014 @ 9:22 am (Last Updated)
Cortisol - Pre
ACTH
3.7 ug/dL
Cortisol - Post
ACTH
a 8.2 ug/dL
a
ACTH Reference Range:
Canine: Feline
2 - 6 0.5 - 5 Pre-ACTH (resting) cortisol
6 - 18 5 - 15 Post-ACTH cortisol
18 - 22 15 - 19 Equivocal post-ACTH cortisol
>22 >19 Post-ACTH cortisol consistent with
hyperadrenocorticism
<2 <0.5 Post-ACTH cortisol consistent with
hypoadrenocorticism
1 - 5 n/a Desired pre- and post-ACTH cortisol on
lysodren therapy
ACTH response test is only clearly positive (>22) in 30% of
dogs with hyperadrenocorticism (HAC); equivocally positive in
another 30% of dogs with HAC, and normal in 40 % of dogs with HAC.*
If the ACTH response test is normal and HAC is still suspected,
proceed with a low-dose dexamethasone suppression test.
Dogs with iatrogenic Cushing's disease will have flatline response
test results in the low end or below the normal reference range.
Both HAC and hypoadrenocorticism are rare diseases in cats.
*Reference: Feldman and Nelson; Canine and Feline Endocrinology and
Reproduction. 3rd ed. W.B.Saunders Co., 2004.
An ACTH stimulation test measures how well the adrenal glands respond to the hormone ACTH. Here in the U.S. the stimulating agent usually used in the ACTH stimulation test is Cortrosyn (cosyntropin).Quote:
Originally Posted by Dawn Anderson
The test is performed by taking two blood draws; the 1st blood draw tells us what the dog's resting/baseline cortisol is, this 1st blood draw is also known as the "pre" number. After the "pre" blood draw is done the stimulating agent is injected and after 1 hour the 2nd blood draw is taken which is known as the "post" number.
Someone once described the ACTH like this - imagine a sponge full of water being squeezed to see how much water was in there. This is what the ACTH is doing with the adrenals - not squeezing them literally but causing them to empty as much cortisol as they can.
Dog's with Cushing's generally have an exaggerated response to the ACTH.
Buttercup's ACTH stimulation numbers look great!
Hope this helps.
Hugs, Lori
Lori explained it really well.
I call it the dump. The pre is what is circulating in the body and the post (the dump) is what the adrenal glands have in reserve.
sponge, dump, it's what is being produced and held in the glands.
Sharlene and molly muffin
Oh thank you all so much, this is bringing tears of joy, it has been such a emotional & painfull journey for both of us. I prayed so hard that I was doing right by her and would be able to save her and give her a blessed life. Looks as if I made all the right decisions at the right time, THANK YOU GOD & MOTHER NATURE, you both have blessed us, me with her & her with me, hard to express the feeling I have of being able to rescue/save her my friend my compainion my teacher my life coach oh heck my soul partner. Just knowing that we wont have to say our finale good-byes for quite some time is oh so comforting. Now we can both really start healing, her, her body & me my body & soul.
SO come on my girl, summer is not far & the beach is calling out to US.:D
Dawn & Buttercup:p
Dawn, You are doing a fantastic job with Buttercup, and I am so happy that she is responding so well! YAA!!! And here's to warmer weather!!!
What good news! I'm so happy she is feeling better and her numbers tell the whole story.
Shelly
Dawn I am so happy to hear Buttercup is doing well!! I've counted my blessings too, but you said it so eloquently! :-) Here's to Buttercup and her Mommy!!
Dawn:
I am so glad you and Butter's made on the way up. It has been a long hard battle
for you both. I hope it continues to go well for you both. Blessings
Patti
I'm so happy for both of you that Butters is showing such improvement!
Dawn:
It is nice to know your Butters is still going uphill with her progress. I am happy every day that I hear she is improving. Blessings
Patti
Butters goes back on sat. for her 2nd ACTH stim test. Everything is still going well for her. Of course the majority of the CC is still hard as a rock, my poo girl. Only has 1 small spot that keeps popping open, its a very small spot though. More fur trying to grow, but very sparce and slow. Her attitude and disposition continues to improve . Will post her results when I that them.
Awww so glad that Butter continues to improve over all. Hoping for a good test on Saturday. :) :) That cc will continue to get better as the cortisol goes down, so hopefully you'll see even more improvement there in no time.
She has sure come a long way since this started. I remember when Davis was saying it was the worse case of cc they had ever seen and I'm sure they were right. Look where she is now. Just amazing. I'm so proud of both of you. I feel like a proud forum mommy. ROFL
hugs,
Sharlene and Molly Muffin
Your to sweet Sharlene, yes you are a forum momma and that's a wonderful thing to be. So much info. on the forum but most importantly real compassion, sympathy,empathy and support. You and everyone involved in the creation , hosting and administration of the forum are a blessing and have saved sooo many lives from being snuffed out before their time. I am inspired by all that everyone doses here and will strive to give back all that I have received from you all..
Momma Dawn and baby girl Butters
I second that Sharlene,
I truly believe that Daisy would have died if I hadn't found this forum.
Pre-forum, I'd never heard of Cushings and I paniced when Daisy was diagnosed because everything seemed doom and gloom.
Daisy has many aunties and uncles here :)
One big family :) all across the globe
Sharlene and molly muffin
Dawn:
You bring hope and inspiration every day to this forum with all you and Butter's have been thru. Blessings
Patti
Number 2 ACTH stim test down.
PRE# is down & POST# is up
Vet want to increase dose to 30 mg a day. Would like some feed back on this upping, concerned that the pre is so low.
Thanks Dawn
3/9/2014 (Order Received) 3/9/2014 @ 11:07 am (Last Updated)
Cortisol - Pre
ACTH
1.8 ug/dL
Cortisol - Post
ACTH
a 9.7 ug/dL
2/23/14
Cortisol - Pre
ACTH
3.7 ug/dL
Cortisol - Post
ACTH
a 8.2 ug/dL
Hi Dawn.
I think you've got some wiggle room. What dose was Butters on?
Butters was on 20mg per day, 10am and 10pm
Dawn
My personal opinion is that you could increase just a bit, to see if you can bring that number down a bit more... but, if you think symptoms are controlled, you may just ride this out another few weeks and then retest. I made that choice myself when we had similar results for Tobey.
So the new dose will be 15mg am and 15mg pm?
Just wanted to update, since I suggested riding it out for a bit.
We got the results for Tobey's last stim test just today, and the progress has not been quite enough. I am glad I waited though on the increase, so I could see how her numbers progressed over a longer time period, before increasing dose.
Vet wants to do 20mg am & 10mg pm
Dawn
Butters also weighed in at 96lbs.
How are Buttercup's symptoms? Do they seem better controlled during the day and appear at night or vise versa?
I wanted to add that I think you are doing such a wonderful job with sweet Buttercup. ;)
Hugs, Lori
This is Tobey's current dose too.Quote:
Originally Posted by Dawn Anderson
Actually the only symptom she is displaying is the CC, which is slowly very slowly improving, ie starting to grow fur but much of it is still hard as a rock, pot belly is virtually gone now and as for her demeanor she is pretty much back to her old self, drinking and eating normal and strength in hind qrts also increasing.
Dawn and Butters
Dawn:
What a blessing you and Butter's have been given. There is nothing better than improvement after all you have dealt with. Blessings
Patti
Round 3 stim test, will post results when we get them:D
:) Crossing fingers. I'm sure they'll be fine, since she has been doing so well. :)
hugs
Sharlene and molly muffin
i hope the results will be ok too.
Dawn:
Hoping for some good numbers for Butters. How has she been doing? Hope everything is good. Blessings
Patti
the numbers are in and we hit the Jack Pot. Her dose is perfect at this time.
pre 2.6
post 6.8
Yeah, will have her tested again in 1 month, if numbers still look great, then we can stretch the testing to 2 months.
Dr & I are impressed that in just 6 weeks we were able to get her dosed properly. Low & slow is the only way to go..
Proud mom
Dawn :D
Wonderful news Dawn! I hope that the trend continues.
Awesome Dawn. :-).
Wat to go Buttercup!!!
Hugs
Sharlene and Molly muffin
Hooray for the Buttercup household! So glad to hear things are going well.
Those are great numbers! But, as I was reminded by someone else on here - if the CC is still active, you may shoot for just a touch lower. That all depends on how the CC is. I would be thrilled with those numbers too. :)
So happy to hear Butters is doing well--this is great news!