Alivia was recently diagnosed with Cushing's - Alivia has passed

Hi Mary Beth,

Thank you for all the information you've provided on Alivia. I'd still like to know if the other adrenal gland is normal in size. Maybe you can just call the vet and ask?

Glynda

Hi, Glynda.

Your post reminded me that I needed to call them and request the ultrasound report again. Thank you! I just got off the phone with them and they are to fax it to me, so hopefully I will have it in a little while and will post the info. The receptionist wouldn't be able to tell me anything and I am still waiting for a return call from the IMS from two weeks ago, so that would have been useless! :mad:

Thanks again for your time!

Stay tuned....
Mary Beth and Alivia

Hi, Glynda.

I finally received Alivia's ultrasound report that was done by her IM. It is not really long so I will type it in its entirety. I am not at all happy that it contains things she never even mentioned! Here goes:

Ultrasound Abd - liver- course echotexture throughout with small hypoechoic lesions scattered throughout
GB - single stone noted along with other echogenic debris in lumen
spleen and kidneys unremarkable
urinary bladder WNL
left adrenal: 2.29 x 0.35 x 0.42 cm
right adrenal: 2.43 x 1.21 cm x 0.5 cm
suspect adrenal mass, right side, cranial pole

Looking forward to your thoughts and anyone else who would like to comment as well!

Thanks,

Mary Beth and Alivia

Quote:

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Originally Posted by Rene

Hi Mary Beth,

When I mentioned it earlier it, was Dr. O that told me that the Maintenance lyso could be used along with the lignans and melatonin without loading. My IMS confirmed this. However, Snoops cortisol was too high (104.8/426.4 ng/ml) and she had to be loaded. I believe Ali's is much lower and according to this theory, you could try this. I believe the course was to administer for three months and retest the cortisol and intermediates.

I was really hoping after I posted that, that someone who has actually tried this succefully would come along and post their experience. It did not work for Addy but I am curious what Zoe's Cortisol was when they started? Supposedly, it is only an option for cortisol that is not really high.

I am also skeptical and would love to know if this actually worked for anyone and what the cortisol was before and after the 3 months if it did...anyone?

Your doing a great job with your research...hang in there. Any decision is a good decision!

Rene and Snoopie

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Hello,
I just wanted to relay my experience with Max - a maltese who was initially diagnosed with Atypical Cushings. I was resistant to doing a full loading so tried the Maintenance dose of Lysodren only route (with Melatonin and Flax hulls).

3/27/09 adrenal panel from Univ of Tenn cortisol levels:
pre 22.1 ng/ml
post 192.7 ng/ml

Max at the time I started was 11.5 lbs, and, 4/10/09 I started him at the low end of the Maintenance dose range at approx 25 mg/kg - so Max got 62.5 mg of Lysodren twice a week (mondays and thursdays)

5/16/09 ACTH stim results:
pre 4.4 ug/dl
post 21.4 ug/dl

5/20/09 - did a "mini load" of 62.5 mg per day for three days (wed, thursday and friday)

5/25/09 (monday) - changed his dose to 62.5 mg three times a week (mon, wed, friday)

8/7/09 ACTH stim results:
pre 3.2 ug/dl
post 11.9 ug/dl

Aug 2009 Max was diagnosed with a heart murmur

Sept 2009 Max tested positive for Lyme Disease (treated successfully with antibiotics)

in Feb 2010 Max had his spleen removed and biopsied and liver biopsied (both biopsy results were benign)

still maintaining Max on the 62.5 mg three times a week

6/11/10 ACTH stim results:
pre 3 ug/dl
post 16.5 ug/dl

by this time, Max had lost some weight and was down to 8 lbs, 12 oz

still maintaining Max on the 62.5 mg three times a week

3/18/11 ACTH stim results:
pre 3.8 ug/dl
post 28.1 ug/dl

You can see the Maintenance Dose only did not work for Max.

However I DO think I wasn't as focused on the Lysodren treatment as I could have been. What I mean is that after the May 09 "mini-load", Max's cortisol levels did drop somewhat. But then they went up again by the time of the next ACTH stim. In August of 2009 I should probably have done another "mini-load" and seen where that took us. But at that time Max was diagnosed with the heart murmur and that led to visits to the cardiac vet, and then he tested positive for Lyme, and then came the spleen removal - and I let all those things distract me from trying to control the Cushings.... :(

After the 3/18/11 ACTH Stim being so high, I decided to go the full loading route. This was mostly because of Max's heart murmur - the cardiac vet suggested I get the cortisol levels under control.

If you are interested, you can read the rest of Max's story under his thread - but for a quick summary: I loaded Max at the 50 mg/kg rate (he got 93.75 mg twice a day) and stopped after 4 1/2 days. The ACTH stim results were pre 0.8 and post 1.1 ug/dL. A little too low since Max was very lethargic. He was eating, but was very lethargic and not the normal Max. I gave him prednisone for 4 days. Retested with another ACTH stim this past Monday and he was pre 1.6 and post 2.4 ug/dl. Am now starting Maintenance at the low end of the range - giving him 31.25 mg three times a week. Just started the first dose today.

I hope our experience is helpful to you. I know I was/am eager to hear actual experiences of other people, and I think this site helps one do that.

Janette

Hi, Janette,

Thanks for your post, but I am really confused.

I am looking at Alivia's results from University of Tennessee and the normal cortisol baseline range is: 2.1-58.8 ng/ml and the normal range post ACTH is: 65.0-174.6 ng/ml

According to what Alivia's results say, your Max's are almost always way too low. Or, are the normals that much different for a male dog?

I will read your thread later on to see if I can figure out why your numbers are so low.

Thanks,

Mary Beth and Alivia

Mary Beth, the results that Janette posted are in ug/dl. Ali's results are in ng/ml. That's why Max's results appear low, & I think that might be what is confusing you. To convert Ali's results to ug/dl, simply move the decimal one place to the left. For example, the normal ACTH range you posted would be 6.5-17.5 ug/dl. The other thing to keep in mind that the normal range on an ACTH for a healthy pup is much, much different than a cushpup under treatment. A pup under treatment needs to have their ACTH from 1-5 ug/dl.

Hope this helps.
Debbie

Thanks, Debbie -

I see now where her first results from U of Tenn were in ng/ml and the others were in ug/ml. I guess the testing must have been done elsewhere. Can they make this any more confusing?? :confused:

Alivia's first ACTH test was $410. That was for the test only, no examination. The breakdown was actually $322 for the test and $88 for a .2 ml injection of Cortrosyn. So expensive for one test! Is that about standard? I know things vary geographically, but if she has to keep having this test done, I may have to drive her to a different location!

Thanks for all the information everyone!

Mary Beth and Alivia

$410.00 for an ACTH stim test sounds high to me. My vet was charging me $160.00 for Harley's stims.

That is outrageously high for a stim. My GP vet was charging about $250.

Wow! That is a HUGE difference. I have been suspecting that Ali's IMS is extremely expensive. It is bad enough that she charges a fortune for testing, I just found out when I requested a copy of Alivia's ultrasound report that she fails to tell me things that the tests show - she NEVER mentioned a gall stone. Not happy about that.