I did ask about the baseline from his blood test last summer and she said 4. and I believe the results were 4.6 ug/dl at the 4 hour mark and 4.4 ug/dl at the 8 hour mark. would that make sense or help at all? I have no clue.
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I did ask about the baseline from his blood test last summer and she said 4. and I believe the results were 4.6 ug/dl at the 4 hour mark and 4.4 ug/dl at the 8 hour mark. would that make sense or help at all? I have no clue.
I truly don’t understand why your vet ran the UC:CR. All it can tell you is whether excess cortisol is being produced, and any illness or stress can cause elevated cortisol. In that vein, I must ask how the urine sample for the UC:CR was obtained. In order to accurately reflect a dog’s typical cortisol production, the urine sample should be obtained at home when the dog is not stressed, preferably the first pee of the morning. And actually, some specialists prefer that a pooled urine sample from three successive mornings be used for the test in order to average out the results. If your vet performed the test on a sample that was obtained there at the office, any stress that Blue was under could have skewed the results upwards. We all naturally manufacture more cortisol when we are scared or excited.
If your vet is still searching for confirmation of the Cushing’s, I don’t understand why she didn’t go ahead with the ACTH right now instead of doing the UC:CR. The ACTH is a diagnostic test that is specific to Cushing’s; the UC:CR is not. Why wait now for another month before proceeding with the ACTH?
I regret sounding so confused by your vet’s gameplan. I know it must feel very worrisome to you for me to be constantly second-guessing her. But in good conscience, I feel as though I need to continue to raise these questions. For whatever reason, she seems really hesitant to try to confirm the Cushing’s, either via the ACTH or skin biopsy or more complete diagnostic thyroid testing. As long as Blue remains stable through this month, then I guess all you are losing is time. But at the risk of sounding like a broken record, if his skin worsens, I would not wait to press for some quicker action on the Cushing’s front. By any chance, would you want to try to upload some photos of his skin bumps to your photo album here? If so, we could at least take a look at them and compare them to other known cases of CC among our members here.
Marianne
Edited to add: I just saw your note about Blue’s resting (baseline) cortisol level being around 4. If so, then he truly did not show any suppression during the LDDS test. As discussed earlier, that type of result is most often consistent with an adrenal tumor. That’s why the ultrasound was performed. In the absence of any adrenal tumor or mass showing up on his ultrasound, though, it seems as though it is a pituitary tumor that is causing his Cushing’s should he truly suffer from the disease.
thanks my sentiments too! no... the urine sample was taken by us at home first thing Friday morning and dropped off to vet first thing. she called Saturday morning saying he had elevated levels, and she wanted to do additional urine test for cortisol based on the initial findings from Friday, but she was going to use that sample i had given her Friday. so today...she said that additional test showed elevated cortisol/creatinine but she will do additional blood testings in a month. so im not sure now what to think. should I be worried that a month is going by or should I be hoping the thyroid meds we started on Friday will be enough. how would I know? would he take a sudden turn? what should I be expecting? I half worried when I heard liver, kidney, creatinine, words, I got nervous. as for his bumps, sure I could try to get a photo tonight. see how they are looking. I honestly don't know what it should look like, and was hoping for a biopsy to determine but she felt at office visit that that's what it was (CC).
Here is a google link showing images of calcinosis cutis in dogs. WARNING - some of the pics are graphic.
https://www.google.com/search?q=calc...w=1366&bih=603
Do you remember what elevated levels in the urine your vet was worried about on Friday?Quote:
Originally Posted by Larinda
If your vet believes the bumps are truly CC, then the thyroid meds will be of no help no matter how long Blue takes them. Low thyroid does not cause CC. The thyroid meds will not lower elevated cortisol levels, either. So I honestly don’t know why your vet is waiting for a month to perform the ACTH and/or to confirm the CC diagnosis.Quote:
...should I be worried that a month is going by or should I be hoping the thyroid meds we started on Friday will be enough. how would I know? would he take a sudden turn? what should I be expecting? I half worried when I heard liver, kidney, creatinine, words, I got nervous. as for his bumps, sure I could try to get a photo tonight. see how they are looking. I honestly don't know what it should look like, and was hoping for a biopsy to determine but she felt at office visit that that's what it was (CC).
If Blue does have Cushing’s, you’d expect any symptoms caused by elevated cortisol to continue to worsen over time in the absence of treatment. Most symptoms might only worsen gradually. The one I’d be most concerned about is CC, because it can worsen and spread very rapidly.
Marianne
i tried to get some photos...I think I created an album. blue's bare belly from last july ultrasound (hair never grew back) and his elbow, which bleeds at times, and the top of his back, when you pull away the hair, you see flakes and bumps, sores like, and clumps of hair fall out with the flakes. sounds gross I know. we are doing a once a week medicated bath and two times a week medicated mousse but im not seeing any improvement in a weeks time. we have to be vigilant in checking him as his hair is so black and thick, you have to feel to find these spots. as far as I remember...liver and cholesterol levels were high. then after the additional urine test, cortisol and creatinine levels high. I wish I understood more about these tests. so now she wants to do the acth in a month. and a t4 check.
Thanks so much for setting up your album. Blue looks like SUCH A SWEETHEART!!!!! No wonder you love him so!
The fourth picture of him comes out clearly for me, but unfortunately, the photos of the bumps are blurry when I click on them to enlarge them. I’m looking at them from my iPad, though, and maybe other folks can see them more clearly. But I can’t see them well enough to really evaluate his skin.
Have you clicked on the link that Leslie gave you of the Google photos of CC? Do any of them look similar to what you’re seeing on Blue?
Marianne
I got a closer photo but im having trouble uploading it into my album. not sure why. not sure how to add it to this post . sorry I cant be more helpful. any suggestions?
Larinda, you can try emailing the photo to us at our administrative mailbox: k9cushings@gmail.com. If it comes through clearly, maybe we can problem-solve the uploading issue. We recently upgraded our forum software, and are still working out some glitches. Unfortunately, uploading photos doesn't always seem to work as smoothly as before. But we can see what we can do.
In the meantime, though, I'm still wondering whether you've had the chance to look at the CC photos in the link that Leslie gave you. Do they look anything like Blue?
Marianne
ok i'll try that thanks. its the strangest thing.(kinda gross really-sorry.) but the yellow you see in the photos that i emailed is flakes of skin, with hair clumps attached, that fall off, and red spots like bumps. we have to pet him to feel for them, and pull his hair away on his back to find these bumps, as his hair is so black. I did look at the photos Leslie shared with me and some look like him and others not so much. gosh, maybe we should force the issue of a biopsy. but then again, would that be a mute point? I certainly don't want him flaring up any worse! but he's no better just yet with the medicated shampoo. the vet did think it was CC's, but did not biopsy it. I guess I was hoping you all would know and be able to tell me yes or no. maybe we are in early stages? because some of those photos looked really bad and I don't want poor blue getting to that place? I guess that's why im worrying about it so much. but what else could it be right? We are only on thyroid meds now, and Our next vet apt is in a month (march 28th) and they will do those blood tests, T4 and ACTH, but I bet we are going to be looking at that vetroyl aren't we. unless you think I should call the vet now and force the issue? awe thanks guys for putting up with me being such a pain. you're the best for taking the time to talk to me. thanks! im in unchartered waters here. I just want whats best for blue.