Re: Newly diagnosed Cushings (8 y/o Min Schnauzer) Jasper
Hi Tina,
A belated welcome to you and Jasper!
We are a Lyso household as well but my Squirt was never loaded due to the type of Cushing's she has - Atypical. We went directly to a maintenance dose schedule when she showed signs that her cortisol was rising. Squirt weighs about 15 lbs and is taking 250 mg twice a week - this has controlled her cortisol for a year now. So, yes, it is possible for a maintenance dose to lower and control the cortisol in some cases. Since Jasper did load, his adrenal glands are prepared for the maintenance dose.
What that means is this - the job of loading is to erode a miniscule layer of the outer cortex of the adrenal glands to stop the continual communication between the adrenal, the pituitary and the hypothalamus glands - the glands that dictate when and how much cortisol to release as needed. In Cushing's, this communication goes into overdrive and tells the adrenals to release cortisol all the time, flooding the body. Once the pup is loaded, this communication becomes more normal - the erosion has done its job. Then we wait for a few days for the adrenals to adjust then maintenance is started to maintain the level of erosion the load achieved. The adrenal glands can and do regenerate that eroded layer so that is the job of maintenance - to maintain what the load achieved, not further erode the cortex.
The conversion for the ACTH is - (if my math is correct! To convert nmol/L to ug/dl you divide the mmol/L by 27.59 )
6.96 ug/dl
6.74 ug/dl
So the post number, the number that counts, is a tad bit higher than we usually like to see after a load which would be between 1 and 5 ug/dl. Since Jasper did load so quickly and seems to be sensitive to the Lyso, I think you vet is being appropriately cautious. She seems to have a good handle on Cushing's from what I have read so far. And you are doing a superb job of being a diligent mom - the most critical factor in Cushing's.
I am so glad you found us and many of us here understand how you feel. When I arrived here over four years ago, I was a total basketcase. A dear friend here later told me she envisioned a woman with her hair standing on end as if her finger were in a light socket! She kindly left out the part about bulging eyeballs and flying slobber! These wonderfully kind and knowledgeable folks took my hand and gently led me along until I could breath again...then they began to teach me - not an easy job, either! The more I learned the further the fear moved away from me...and I know that will be the same for you. Never hesitate to ask questions; we will do our best to help you understand, or we will try to learn together if we don't already know. You and Jasper are now family here and this family sticks together through thick and thin!
Keep up the good work and know you and Jasper will never be alone. We will walk this path with you every step of the way.
Hugs,
Leslie and the gang
"May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"
Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.