Hello again from, too! I do think it’s a good idea that you’ve advanced Macie’s monitoring testing, because it may be the case that her cortisol level is not being controlled sufficiently right now, and a Vetoryl dosage increase may be in order. In looking back at her April ACTH results, they were in a range that would be considered OK as long as symptoms are being adequately controlled. However, her cortisol may have drifted upward during these past three months, or even the previous post-ACTH level of 6-7 may just not have been low enough to keep symptoms from rebounding. Some dogs need to keep their post-ACTH level consistently within a lower range of 2-5 ug/dL in order to keep all symptoms under control.
Another thought relates to Macie’s thyroid level. It is not uncommon for Cushpups to suffer from low thyroid, as well, and hypothyroidism can cause significant problems with coat and skin issues. For some dogs, low thyroid readings are actually secondary to the Cushing’s, and resolve once effective Cushing’s treatment is underway. However, other dogs may develop genuine hypothyroidism in its own right. This is easy to treat with simple, inexpensive medication. Since it seems to me as though it may be a possibility, I’d want to make sure that a blood chemistry panel including thyroid analysis is performed alongside the ACTH.
Please do let us know what you find out with her testing, and continue to update us re: her progress, OK?
Marianne