5 year old Frenchie, elevated ALT, skin lesions— I suspect Cushing's, what to do next

[addy]

Sorry to hear that Frenchie is feeling under the weather. If you are about one month in to treatment, have you had his cortisol rechecked? There should be another ACTH test at 30 days.

(

pre) Cortisol Sample 1: 5.3 ref range 1.0-5.0
(post) Cortisol Sample 2: 3.7 ref range 8.0-17.0

The cortisol can continue to drop. It looks like the mid Novemeber test results are above. He might be a bit too low now for him to feel great. My Zoe dropped down to post 1.9 and was not feeling well from that low of cortisol. Dechra states post can drop to 1.45 but some specialists think no lower than a post of 2ug/dl.

[molly muffin]

Yes, I agree with Addy, my first thought is that the cortisol might have dropped too low and I would get a another ACTH test to check as this is most likely to the be the culprit and should be eliminated first.

They say, and when I say they, I mean others on the forum have experienced that the cc can get worse and then start to get better. It is Usually one of the last things to clear up, symptom wise.

Hang in there. We know it is a tough road to travel.

hugs,
sharlene and molly muffin

[turtlesmom]

So I was concerned that Turtle had a macroadenoma and got him a MRI. He does here are the results, copy pasted from PDF:

MRI of the brain has been performed. T2W, T1W pre and post Gd, T2*W, FLAIR and PDW
transverse images, T1W post Gd and T2W sagittal images and T1W post Gd dorsal images.
Findings:
1. There is a slightly lobulated mass in the region of the pituitary gland that measures 1.5cm x
1.9cm x 1.5cm in size. The mass is post Gd hyperintense and pre Gd has some ventral
hyperintensity that corresponds with a region of FLAIR and T2W hyperintensity without loss of
T2*W signal. The mass is causing compression of the interthalamic adhesion and thalamus
bilaterally.
2. The ventricles are normal in appearance with bilateral symmetry, and CSF contained within
nulls appropriately on FLAIR.
3. The cerebellum is contained within the caudal fossa.
4. The cranial cervical spinal cord included is within normal limits.
5. There is a small volume of fluid (based on the presence of a meniscus) within the left tympanic
bulla without obvious alteration to the bulla wall. The external ears are within normal limits.
6. Ocular, retrobulbar and nasal structures included are normal for the breed.
Diagnostic interpretation:
1. Pituitary mass most suggestive of macro adenoma Ddx: meningioma.
2. Early left-sided otitis media vs. fluid retention.

[goldengirl88]

I am so sorry to hear this. No one ever wants to hear this diagnosis though it is in the back of our minds every second of every day. I will pray for you and your baby. Blessings
Patti

[turtlesmom]

Thanks Patti.

I am feeling okay mainly thanks to Dawn's thread. I am near Davis and will try to go there too.

Just found this very good review article on meningioma:

http://www.integratedveterinarypatho...meningioma.pdf

[Trish]

Sorry to read this news about Turtle, I am pleased you already have a plan to work on though and hopefully you get an appointment to discuss this treatment further asap. xx

[molly muffin]

Good idea going to Davis to see what they think. Maybe Turtle would a good candidate for the radiation therapy too. Butter seems to be doing better after having had it.

hugs,
Sharlene and Molly Muffin

[Dawn Anderson]

Just wanted to pop in and see how little turtle is doing. Were you able to get to Davis ? Butters is doing so much better this last week , tumor is still shrinking.
When I was there in Dec , Dr Kent mentioned that he was working with a 5 year old french that also has a server case of CC like Butters. Really hoping that he was referring to Turtle. Please keep in touch have been thinking of you both often.

Take care
Dawn and Butters