cushing and diabetes

[Iraklis]

Hi Tasia ,

I am from Athens ,Greece ,too!
My name is Iraklis!
Welcome and sorry this happened to your baby!
***

Who is your vet?

Have you performed an ultrasound or an MRI?

What is her food?

The ACTH IS done but ,imo, an ultrasound and an MRI (even though expensive) will save you tons of money in the long run...

[goldengirl88]

Welcome to you and your baby. Sorry your baby is having troubles, but it sounds like you are doing am good job keeping things in line. I see both you and Iraklis are from the same place! Small world! Blessings
Patti

[molly muffin]

An LDDS test is a suppression test, can they suppress at 4 hour, can they suppress at 8 hour for the baseline. This is a diagnostic test ONLY. Once you start treatment, vetroyl, then the follow up is Always an ACTH or at the very least a baseline cortisol with electrolytes. I don't know what on earth that vet is thinking and it doesn't follow any protocol as set by the manfacturer or the leading professionals in the field.

So, once you are on treatment do not bother with an LDDS. DEMAND at the very least a baseline cortisol, even better, find a vet who knows what they are doing. Lordy, this one is going to give us all a heart attack with answers like that.

What you want to know is if the cortisol starts to go too low (life threatening) or if it is too high (won't help to control the diabetes) only an ACTH or at the very least a baseline can do this.

I hope that helps you out a bit.

Sharlene and molly muffin

[tasia]

Hi, Iraklis! My vet is in Helliniko,Athens. This is my second one. I think he is ok but not experienced enough with cushing. Can anybody explain what baseline cortisol is so as to talk with him about it?THANKS!!

[Iraklis]

His name?

Baseline cortisol is the reading obtained prior to being ACTH stimulated.

Try to get an ultrasound and if possible an MRI.

[labblab]

Hello from me, too. Here's a direct link to the diabetes forum. I hope you will join them, too, so that they can help you with your insulin questions.

http://www.k9diabetes.com/forum/

Also, here's a quote from one of our other staffers, Lori, that may help give you a better understanding of the use of baseline cortisol readings to monitor treatment:

Regarding the cortisol testing, Dr. Audrey K. Cook and another colleague performed a study to see whether a baseline test could be used to monitor dogs being treated with Trilostane. Here are a few excerpts from her article:

During trilostane treatment, baseline cortisol concentrations between 1.3 and either 2.9 μg/dL or ≤ 50% of the pretreatment baseline cortisol concentration correctly predicted acceptable control of adrenal gland function in 147 of 168 (88%) dogs...

...In addition, a baseline cortisol concentration ≥ 1.3 μg/dL could reliably exclude the possibility of an overdose of trilostane in an ill patient or when a patient is reevaluated following a reduction in the dose of trilostane...

...Therefore, measurement of a timed baseline cortisol concentration may be regarded as a screening test for acceptable control of adrenal gland function; a result within the target range would preclude the need for an ACTH stimulation test in a substantial proportion of patients. For those dogs with baseline cortisol concentrations outside the defined target range, an ACTH stimulation test may still be necessary before appropriate adjustments in the dose of trilostane are made...

...However, it is important to regard measurement of baseline cortisol concentrations as a screening test for adequate control of adrenal gland function in clinically stable patients; this technique is not designed to replace the criterion-referenced standard of an ACTH stimulation test when a more detailed evaluation of adrenal gland function is needed. Limitations of the use of baseline cortisol concentrations to monitor treatment should be carefully weighed by both pet owners and clinicians, and this option should possibly be reserved for patients in which the cost of an ACTH stimulation test is an issue for the owners.

Full article can be found here: Evaluation of the use of baseline cortisol concentrationas a monitoring tool for dogs receiving trilostane as a treatment for hyperadrenocorticism

Hugs, Lori

Marianne

[lulusmom]

This was a question you posted on another thread which I've provided feedback below:

Ι am sorry to thread-jack a bit but Husko never got tested for diabetes and was constantly losing weight since summer.
(anyone/everyone is welcome to answer this in my thread...is there anything pointing to diabetes in his health-tests I should look for?)

A good number of symptoms associated with diabetes overlap with those associated with cushing's; however, weight loss is rarely associated with cushing's so diabetes would be the first suspect. Your vet should have tested the blood glucose. You should also note that many of the blood chemistry abnormalities are also common with both diseases. Diabetic dogs can have elevated ALKP, cholesterol, triglycerides as well as low T-4 (thyroid hormone).

[Iraklis]

Would it also mess up LDDS and ACTH results?

[Squirt's Mom]

Yes, Iraklis, diabetes can skew the Cushing's test and result in false-positives just as can hypothyroidism, kidney or liver disease, and other conditions.