Molly, 13 yr, shih tzu - lhasa aspo - Molly has passed

Hi again, Sharlene.

John is so right, nonadrenal issues can certainly increase cortisol readings. But the LDDS is more vulnerable to "false positives" than is the ACTH. So if it was something other than Cushing's that was causing the elevation, you'd expect Molly's results to be reversed. It would be the LDDS that would be elevated, but the ACTH less likely. :confused:

You mentioned that the specialist who reviewed the ultrasound and labwork does think that the results all point to Cushing's. Did he/she have any explanation for the discrepancy between these two tests?

Marianne

I can see where a UTI would cause cortisol levels to rise, but the ACTH/LDDS situation is strange. I don't have my papers handy at the moment, but in the consult follow up to my vet, the IMS said that if LDDS test does not support ACTH, to wait and retest in 3 - 4 months. If it Does support ACTH, then to begin with 5 - 10 mg Trilostane.
That makes me wonder if perhaps it isn't quite as unusual as I thought. I have not yet had a call from my vet who did the testing and when I called last night, I was told that they were waiting on the culture/sensitivity test results. I did ask if they did a cortisol/creatine ratio or not, but the girl I spoke to didn't know and the vet had already left for the day. (that was around 6pm)
I think it is strange that the vet hasn't called since normally she would have. I wonder if she is still miffed about my questioning her and going to the IMS. I don't know if they forwarded the results to the IMS or not. The IMS is at an emergency vet hospital.
I think it is strange about the results, but no one else seems to be acting very concerned.

Thanks for the support!
Hugs,
Sharlene

Quote:

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Originally Posted by molly muffin

I can see where a UTI would cause cortisol levels to rise, but the ACTH/LDDS situation is strange. I don't have my papers handy at the moment, but in the consult follow up to my vet, the IMS said that if LDDS test does not support ACTH, to wait and retest in 3 - 4 months. If it Does support ACTH, then to begin with 5 - 10 mg Trilostane.

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Given all the circumstances surrounding Molly's symptoms (or lack therof) and testing, I think the recommendation of the IMS to wait a little while and then repeat the LDDS is a very reasonable one. :)

It does not seem to me as though there is any need to rush into treatment until the puzzle pieces show greater clarity. And in the meantime, it sounds as though Molly remains a happy, beautiful little girl. ;)

Marianne

Congrats on becoming a forum host, Sharlene!

I just sent you a message too, but I wanted to publicly thank you for accepting. I was hoping they were going to ask you because you have done such a wonderful job welcoming people, supporting them, and offering encouraging words. You are perfect for this role!

Julie

Hi Julie,
I got your message and responded. Thanks for the welcome. I'll try to live up the great job that you and Addy are doing. You know the bar is high right. :) :) :)
I guess being talkative can be a good thing!

I'm going to try calling the vet again tomorrow. So far I've had no luck catching her. I find it strange that she hasn't called me yet, normally she does call as soon as test results come in yet nothing about the LDDS. I think she might still be miffed that I opted for the specialist consult.

I agree we are holding off for now on the Trilostane. I wonder if the tumor is very small if it can still put out the signals to suppress. Her labs only went wonky in March, so perhaps they are thinking that in 3 - 4 months, there will have been cortisol in her system long enough that it will no longer suppress. Man I hate second guessing. Either way Molly is still happy for now, so I'm okay with that.

Thanks all!
Sharlene

Hi Sharlene,

A belated congrats from me. You have been terrific and with so many new members we need all the help we can get:D:D

You are doing an awesome job and we are so very thankful.

hugs

thanks for being a host! I read Molly's thread but your questions for her are out of my realm but wanted to say hi!

Thats okay, they are out of my realm too! :)

Sharlene

Whoooo Hoooooo! I just spoke with the lab tech at my vets and the prognosis for now, based upon the LDDS is that it is not Cushings at this time. Not to say it won't go that way. We'll retest her in 3 - 4 months for cushings and we'll keep an eye on her liver with some regular blood tests too. I'll always want to keep an eye on the protein.
I've asked the vet to get back to me by early next week on liver supplement ideas or what we can do for that.
She also does not have a UTI. They think that the small trace amount of blood was from the 2 small crystals, that might be aggravating but are not large enough to be life threatening.
So for us this is a good day. I hope that everyone else is getting good news today too. We're calling this Good News Friday!

Hugs,
Sharlene

Hi Sharlene,

That is certainly good news! I'm all for Good News Friday!

I'm glad you didn't decide to treat even before this, because it just didn't sound like Molly had enough symptoms. Sort of like Hannah. Watching and waiting and retesting sounds like a good plan.

Have you heard of or talked about Denamarin as a liver supplement? Hannah has been on it for about 6 months. When she was diagnosed with Cushing's, her ALKP was 1770. She tried Anipryl for a few months and it did drop the ALKP, but her behavior was the same. We then stopped the Anipryl and did nothing. Her ALKP creeped back to 800 in a few months. That's when we started the Denamarin. Three months later it was 186 (normal!) and a couple of days ago it was 250, so a little high, but not terrible. I am a big fan of the Denamarin. :D

I hope they'll find something that will work for Molly. But at least you can have a happy and relaxing weekend!