New to this Forum-with Ollie a Cushings Dog, False Positive Cushings

[Harley PoMMom]

I would recommend having a full ACTH stimulation test performed before restarting the Trilostane, this is the only true way to know if his adrenal glands are properly producing enough cortisol.

[Eve]

My vet never raised the possibility of a false positive Cushing's diagnosis. My dog was on trilostane for a few months and suffered GI problems. And now he has been diagnosed with hyperparathyroidism, a condition that can look like Cushing's. So, he's off the medicine now and I'm told it's difficult to determine whether he has Cushing's until the hyperparathyroidism is treated.

All to say, you're ahead in being cautious about false positives. I've already spent mega-money on Cushing's tests and meds, plus a hospitalization for my dog's bad reaction to trilostane. It's still possible he may have Cushing's but I regret his premature treatment for it. Vet should have done the parathyroid test first since he had high calcium, a strong clue. I've been educated after the fact upon finding this forum.

[labblab]

Hi again from me. Yes, it does make sense to me that Ollie’s glucose level will start to rise again if his cortisol level is also increasing due to the withdrawal of the trilostane. As Lori has said, the ACTH is definitely the preferred way to assess his adrenal rebound. But if you see steadily increasing glucose as well as the return of other Cushing’s symptoms, then I’m guessing you’re correct that Ollie is bouncing back again. In that scenario, the ACTH remains the best monitoring test, but I do believe a resting cortisol would be better than no test of cortisol at all. And also yes, when/if you do resume the trilostane, I’d do so at a reduced dose.

Marianne

[alleng8304]

Thank you and I agree-glucose running in 200's again-was in 60-120-do I increase insulin?

[labblab]

I’m afraid I have no expertise re: the diabetic side of things. I’d have to rely on the advice you’re getting from your vet and the folks at K9diabetes. My uninformed guess would be that a lot depends on the trajectory of starting back on the trilostane. If that’s not going to happen for awhile, then Ollie’s insulin needs may need to be increased. If it’s safe to resume the trilo soon, then temporarily leaving the insulin as is may be the best route. That way, you’ll only be adjusting the dose of one med at a time. But once again, this is just a guess on my part.

Marianne

[alleng8304]

sounds logical