Hello, and welcome to you and Blue — we’re so glad you’ve joined us! First of all, it’s unusual for severe Cushing’s symptoms to come on overnight; usually it’s a process of symptoms steadily worsening over time. However, having said that, Blue certainly does exhibit a number of the most common outward symptoms. So, combined with a “positive” blood test, Cushing’s has to be suspected. I am guessing the diagnostic blood test was the 8-hour LDDS test? If so, however, this is one clarification. Depending upon the results of that test, Cushing’s in general can be diagnosed. Also, if the results turn out in a certain pattern, they point to a pituitary tumor as the cause. However, they can also turn out in such a way that either a pituitary or adrenal tumor could be the cause. I suspect that’s what happened for Blue, and the goal of the ultrasound was to see if an adrenal tumor was indeed present. Based on the ultrasound report, it sounds as though no tumor was seen. Therefore, if Blue has Cushing’s, it must instead be caused by a pituitary tumor. In that event, you’d expect to see both adrenal glands to be enlarged to some extent (because they’re being “overworked” by churning out excess cortisol, as it were). However, a minority of cases do not show adrenal enlargement, especially early on in the disease process.

So here are some questions for you. Can you find out the exact results of Blue’s diagnostic blood test, as well as any other blood panel abnormalities? Cushpups typically display elevated liver numbers, especially the ALKP (or sometimes listed ALP). Often they also have high cholesterol and also some abnormalities in white blood cell counts. Finally, did the ultrasound note anything abnormal at all about any internal organs? In addition to adrenal enlargement, Cushpups often exhibit liver abnormalities as well.

Once we see this additional info, that will help us chart the path forward. As I say, Blue certainly does sound as though he is suffering from Cushing’s symptoms that are affecting the quality of his life. And if cutaneous calcinosis is emerging, you really do want to nip that in the bud because it can make a dog’s life miserable. In fact, if a biopsy confirmed CC, that would pretty much confirm the overall Cushing’s diagnosis in and of itself. And if Blue were mine that would definitely prompt treatment. But we can talk more about that in another reply.

Once again, welcome to you both!
Marianne