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Thread: "combo test" - ccr + hddst

  1. #1

    Default "combo test" - ccr + hddst

    hello, i m new here, so i m sorry if i didnt put my question into right forum. my maffy/small poodle female, cca11-12 yo, adopted/ is suspected to have cushing. we were told we are going to test her by Cortisol/Creatinine Ratio (CCR) with Dexamethasone Suppression Test (can be found here: http://thehormonelab.com/handbook/ad...shings-disease), but when i next time called to the vet she said she is going to do acth test.. i was confused as she changed her mind in 3 days, so i decided to change vet. i would like to do this combo test as it seems to be good for dog who is easily stressed by takeing to vet, has very high apetite - so it is stresfull to not feed for morning, or whole day /depend on test acth/ldds/ and is heat sensitive so it is dangerous to bring her /in car/ to vet in this hot weather... so as i know about this test i would lik to do it rather than ldds/acth (which i dont know if are even good for easily stressed dog- ?). what do you think? is this test good one ? we have laboratory where they do ccr /no mather ofdexamethasone supression/ and they also do samples for this combo test for the vet who told us about it - so they shoul know how to do ccr... but they do not interprete the test, so the vet should do it. i found vet who agreed to help me with it, but do not have any experience with this test, so he only can interprete by protocol he can find on internet. do you think it is possible to diagnose like this? can anyone help me with any advice? another problem we have is how to get dexamethasone pills - "dexamethasone 0,5mg" is not registred in slovakia or czech republic...i tried in uk, but we need prescription and i dont know any vet or doctor in uk
    i ll be very happy if anyone can help. thanks. diana and maffy

  2. #2
    Join Date
    Apr 2009
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    Georgia
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    Default Re: "combo test" - ccr + hddst

    Hello and welcome to you and Maffy! The combo test that you are describing is not performed here in the U.S., so those of us who live here do not have experience with it. However, I do understand that it is used as a diagnostic tool in Europe, and one of our members who lives in the Netherlands is very familiar with it, and I believe it was used to diagnose her own Cushing's dog. I will ask Saskia to stop by to take a look at your questions, OK? But yes, I do think this method is less stressful for a dog, and I have never exactly understood why it is not used more regularly here. American vets often use the UCCR alone as an initial screening test to see whether Cushing's may be a possibility, but without the added feature of the dexamethasone tablets.

    In the meantime, can you tell us more about Maffy's overall health history, and also the symptoms that are making you think she may have Cushing's?

    Thanks so much, and once again, welcome!
    Marianne

  3. #3
    Join Date
    Apr 2009
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    1,118

    Default Re: "combo test" - ccr + hddst

    Hi Diana and Maffy :-)

    I am Saskia from The Netherlands and yes, my Cukie was diagnosed with Cushing's through the CCR/Dexamathasone Suppression test. In The Netherlands, and most of Europe, this is the way to diagnose Cushing's. And it's a perfectly good test. I too wonder why it is not used more often, outside Europe since it is much easier on the dog... And therefore, no elevation of the Cortisol level because of stress So I would say yes, you can give Maffy the UCCR/Dexamethasone supression test...it will be a lot easier on her...and you In the link you provided (the hormonelab) they do mention the UCCR/Dexamethasone supression test and nowhere do they mention it is less accurate or less dependable...they just say it would be a good test for nervous dogs. Well, in my opinion, it would be a good test for all dogs

    Wishing you and Maffy all our best,

    Saskia and Quincy

  4. #4
    Join Date
    Feb 2016
    Location
    Washington
    Posts
    1,063

    Default Re: "combo test" - ccr + hddst

    Hi Diana, welcome to you and Maffy. As Marianne asked, I am also curious the symptoms that Maffy has so you suspect Cushing's. Have you had recent bloodwork done and if so, could you share any abnormal results from that?

    I look forward to learning more about your girl.

    Shana

  5. #5

    Default Re: "combo test" - ccr + hddst

    thank you all for your support and interest! i have a really big problem with this test... first i heard about was few weaks ago when i called to vet /thought to be an expert for endocrino/ and i remind her ur story /i m not sure if she remembered but this doesnt matter/...i told her i would like to do lddst..she said why? i said how why? i would like to get diagnose... than she said but you did uccr i said yes. she: and it was positive so why d you want another test... i said i know it it hight sensitive but low specific.. she said : as i know all positive tested dogs had cushing... i was quiet.. than she asked me if i did it with dexamethasone supression... i said NO. and she said - BUT YOU HAVE TO D IT! i started to be angry and said: it is why i call you now to do it! /ok now she at least understood what do i want... / and se said we ar going to do "combo " test... i didnt hear about it before so i asked a little and decided to study first..we arranged meeting after 2 days.. ok, i studied and after 2 days i called her and asked when i can come to take pills ...and she said: we are not going to do the combo but acth! i started to be angry and confused....why did she change her mind?? i didnt undesrtood...and there were many strange things in this call..so i decided to find another vet. and since this time i m looking for someone to do the combo...but they seems tey dont know it. they allways think i want simply uccr and try to explain me it is not enought... i found info about the combo in 3 sources but not more... the interpretation is diferent in all 3 articles /i ll add/... yeastrday i called to laboratory where they mentioned the combo on their website. i mentioned i hav a big problem to get tablets /they ar not registred in slovakia and czech too..i dont know where "the expert" has it from../ ...she, the lab. vet didnt want to beliveve but promiss to check it. i asked if this test is used and if it is good for diagnose...she said yes... so i told her i ll call later. so i did. and she told me : yes now i see it is problem with the tablets, maybe you can try ii austria... but this test is not good for diagnose, it is low specific /what???/ and if it is positive it dosnt mean cushing /what?? it cant be positive or negative as i understand... it can give results - numebers what can mean for example 0-15 /has cushing/, 16-20/doubtful/, 21-100 /normal, so no cushing/...it is just and example to explain that itcant be positive or negative.../but maybe my understanding is wrong... / but the lab vet said diferent thinks in first call and second call.. an said lddst and acth are the test of choice... so i m confused..i started to think about acth because i dont have energy for this( and dont know where to get the tablets from...( i was "decided" to do acth and now i read here the combo is good... what shell i do now?

  6. #6

    Default Re: "combo test" - ccr + hddst

    so now i ll wait to your answers...again i m sorry for my english and hope you will understand my posts..
    more about maffy i write in document i would like to add here and also the blood works, but dont know how to do it.

  7. #7
    Join Date
    Apr 2016
    Posts
    354

    Default Re: "combo test" - ccr + hddst

    Hi & welcome from us too! I want to say that my grandparents( Baba & Zedo) came to America from Czechoslovakia many years ago, from near Bratislava. We still carry on some of the old traditions and the food also. I think your English is very good. I'm not qualified to give advice, but you came to the correct place for help. My dog Whiskey was diagnosed with UCCR then ACTH. He likes the vet so there is no stress for him to get the tests. It seems that your vets advice is very confusing, so I hope from the advice here and a good vet you can help your Maffy feel better soon!
    Can you type or copy & paste the abnormal results directly into the post? Or take a photo and upload it to an album?
    Again welcome, Annie and Whiskey

  8. #8

    Default Re: "combo test" - ccr + hddst

    nice to hear from you as a "czechoslovakian" tanks for hopefull words...i hop so too...ok i ll try to add it somehow. wait a moment..

  9. #9

    Default Re: "combo test" - ccr + hddst


  10. #10

    Default Re: "combo test" - ccr + hddst


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