I am so glad to find this very helpful forum. This is my first post and I hope someone can help me. My dachshund, Freckle's will be 14 in three months. Until recently she has never had any health problems and was energetic and playful. I started to notice changes earlier this year. She was drinking more water, urinating a lot, and developed a voracious appetite. She does not have other signs of Cushing's such as hair loss, panting, infections. Just recently I noticed her hind legs are weak, her belly is bigger, she has less energy and her water consumption is even higher; 28 oz/day an increase from 17 oz in April. She had her annual physical on April 16 and I told the vet I suspected she might have Cushing's. A blood chemistry and hematology profile, fecal test and urinalysis followed. The chemistry part was all within the normal range. The hematology had some highs and lows and my vet said some of these (I don't remember which) were due to clotting in the blood caused by the blood that was drawn for the heartworm/lyme test first; it was difficult getting enough blood for the hematology profile and apparently caused blood to clot which affected the test results. Does that make sense? The out of range results were:
HCT 60.30% range 37-55, HGB 19.2 g/dl range 12-18, PLT 28 range 165-500, RBC 8.89 range 5.50-8.50, LYMPHS 0.66 range 1.00-4.80.
On April 29 a urine/creatinine ratio test and urinalysis was done from a sample I collected. The results:
Urine Cortisol 41.2 ug/dL
Urine Creatinine 71.5 mg/dL
Urine Cortisol Creatinine Ratio 180
> 34 Cushing's possible
Urinalysis Results:
Specific Gravity: 1.020, PH: 6, Protein: Trace
A low-dose Dexamethasone Suppression test followed on May 28 :
Cortisol - Pre Dex 2.7 Ref Value 1-6 ug/dL
Cortisol - 4 hr Post Dex 5.1
Cortisol - 8hr Post Dex 5.7
Lab's Interpretation:
> 1.5 and > 50% of baseline consistant with hyperadrenocorticism. Further testing required to differentiate adrenal tumor from pituitary-dependent
After the LDDS test results came back my vet sent in an email that it does appear that Freckle's has Cushing's and she is trying to determine if an ACTH Stimulation or a High Dose Dexamethasone Suppression test would be the best choice to determine if pituitary or adrenal based. I am still waiting to hear! I would like to know if it really is important to know which one Freckle's has? I have read that the FDA has approved Trilostane for BOTH pituitary and adrenal based Cushing's in dog's. If she has an adrenal tumor I would not consider surgery anyway because she is elderly and I think it would be too risky. So why are further tests needed before medication can begin? Also I was under the impression that the ACTH test can not determine the type of Cushing's.
Thank you in advance for any information.
Laurel