Re: Atypical Cushings treatment
Atypical Cushing's is a form in which the cortisol is NORMAL but two or more of the intermediate, or sex, hormones are elevated. Since Paddy was taking Vetoryl for Cushing's a normal reading on the UTK test is expected if the drug is prescribed at the right dose and properly given (with food). Studies have shown that Vetoryl CAUSES elevations in some of the intermediates so running the UTK panel at this stage of the game was really a waste of money. Now if the Vetoryl has consistently been causing his cortisol to be TOO low and the original diagnosis of Cushing's was in question, then stopping the drug and then checking the intermediates might have made sense to me. Regardless, you don't stop giving the Vetoryl, or Lysodren, just because there are elevations in those other hormones if the diagnosis of conventional Cushing's, with elevated cortisol, was accurate - you give the melatonin and lignans with the Vetoryl or Lysodren. And it is the combination of melatonin and lignans that work on the intermediates - giving one or the other alone will not work. So I highly question the IMS' understanding of Atypical Cushing's. UTK does not recommend using Vetoryl in Atypical pups but prefers Lysodren because of the studies that show Vetoryl causes those elevations. It is feasible that Lyso also could cause elevations in the intermediates but I don't know of any studies supporting that. So all in all I am confused about what the IMS was hoping to achieve with the UTK panel as well as telling you to stop the Vetoryl and use melatonin only.
"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.