Hi all, foster girl with Cushing's

[labblab]

Happy New Year to you and Lucy, too!! I’m so glad to hear that she’s getting some relief from the drinking and urination. But so sorry to hear about those fluid filled lumps. I can’t say that I’m familiar with fluid filled cysts like that, and I’m surely sorry that you and Lucy are having to deal with them. But thank goodness she’s still a happy girl — by far, that’s the most important thing of all.

Once again, best wishes to you both!
Marianne

[Squirt's Mom]

I'm glad things are going good for Lucy other than the sores coming up. At first I thought it was calcinosis cutis, a rare complication with Cushing's but the more I read I realized your description doesn't fit CC so I am stumped too. Hopefully her vet can figure it out and have a solution. Bless her heart...and yours too!

Hope you and yours have a blessed 2024!
Leslie

[medusa]

Ηι . just an update about my sweet Lucy.

The last month she is much better, there are days that she will not need toilet for 5-6 hours, that never happened before. I also noticed that new healthy hair grew back in some parts of her chest!
She had also blood work last week and all seem to be normal, even ALP was down to almost normal levels.
We did not test her cortisol levels yet, next month probably.

She seems healthier in general so we decided its time to start her treatment for leishmaniosis also before it progress (if left untreated can soon affect her kidneys, spleen and other organs)

Hope you are all ok, Matina

[Harley PoMMom]

Thanks so much for your update, so happy to hear Lucy is doing better.

Hugs, Lori

[medusa]

Hi, hope you are all well.

Sweet Lucy is still with us, zero interest for adoption. I know there are very few chances for her to be adopted at this age and with 2 serious illnesses. Anyway she will always have our home.

She is still on 15 mg once a day, she is relatively good, even has some new healthy hair in her chest belly area. She is now on meds for both Cushing and leismaniosis, the meds for leismaniosis make also the dogs to pee more, so not mush improvement with urination.

Today, we had arrange for her a monitoring test , this time i manage to have it for free in the shelter clinic.
They called me and told me that instead of ACTH test they did the LDDS test. I am wondering if that is normal for monitoring Cushings!

We also arranged for an ultrasound to see the organs, i am feeling a mass or more probably an enlarged organ in her belly. Can be both cushing's or leismaniosis they both affect internal organs as i understand.

She is always funny, happy, energetic and has a huge appetite

Hope the best for all fur babies of the forum.
Thank you, Matina

[labblab]

Hello again, Matina, and thanks so much for this update. I’m sorry to hear that Lucy has gotten leishmaniosis. I didn’t know much about this disease, but now I have read more about it and I surely hope the medication will keep her comfortable. I see that the disease can cause enlarged lymph nodes and also an enlarged spleen, so perhaps that is what you’re feeling in her belly.

As far as the LDDS, I’m afraid it is *not* used for monitoring trilostane treatment. In many cases, it is considered to be the best diagnostic test for Cushing’s, so perhaps the shelter vet was thinking it would be a good choice for continuing to test Lucy. Or perhaps they couldn’t obtain the ACTH stimulating gel, and thought the LDDS would be a worthy substitute. But unfortunately it is not.

So I do not think it would be safe to increase Lucy’s dose, regardless of the LDDS results. However, I’m thinking that even if an ACTH had been done, now would not be a good time to increase her dose since the effects of the leismaniosis might be stressing her body and temporarily raising her cortisol level due to that illness and not the Cushing’s. It might be best to wait on the ACTH, anyway.

Under these circumstances, I do think there is one way in which the LDDS may be helpful, though, and that’s to ensure that Lucy’s baseline cortisol is not dropping too low. That will be the first reading on the test, and from safety’s standpoint, the biggest issue is to make sure the adrenal function is not being oversuppressed by the medication. So if I’m not being too confusing, I would not increase Lucy’s trilostane based on the LDDS. But if Lucy’s baseline cortisol is dropping too low, it might be important to lower her dose.

I hope I’m making sense in what I’ve written. If not, please don’t hesitate to ask me to explain more clearly. And please do keep updating us on all the testing.

Big hugs to Lucy!
Marianne

[medusa]

Ηι Μarianne, thanks for the quick response.

I think i understand what you say. I will not get exact facts about her progress but i will at least be able to have an idea if the current dose is working and if she even may needs lower.

She had the leismaniasis from the first day we found her, but its at an early stage, so we decided that cushings was a priority. We started the treatment last 2 months. It's a conservative treatment, just some pills to keep it from progressing. Leismaniasis its very often in mediterenean area, and can be as bad as cushings and cause death if left untreated. Poor Lucy she probably had no proper care at her previous home.

I think she ll defineteley need an ultrasound as next step and a proper test in near future .

I ll come back with the test results when available.

Thank you again.

[labblab]

Yes, from my reading I saw the disease is common in the Mediterranean. I see it is found in some parts of the U.S., too, but just not commonly in areas where I have lived. If Lucy has had it all along, then an ACTH would likely give you helpful monitoring information when you’re able to have it done in the future. But also yes, it sounds like an ultrasound may be a top priority right now.

As always, you’re doing a wonderful job of taking care of Lucy. She’s sooooooooooo lucky to have found her way into your home and heart!

[medusa]

Hi,all. Marianne thanks for your encouraging words.

Just an update for the test.
They definitely did an LDDS instead of ACTH test, i had the results today. They also did full blood work although we did one month ago. Normal sugar levels, ALP is lower than 9 months ago, was 650 then 250 now (6-180 normal)

These were the results ( she had the pill 3-4 hours before the test)
1.3 μg/dl [ref. 0.7-8.0]
3.0 μg/dl
9.7 μg/dl

They told me to just stay on the same dose and that seems to work... I am not sure how they came to that conclusion.
Thinking of continuing the meds as she seems ok and has no bad reaction and retest her in my vet in one month. ( i don't want to stress her more now, her small legs are full of wounds from the needles)


here are the results of her first ldds exam 9 months ago.
26.2 μg/dl [ref. 0.7-8.0]
11.8 μg/dl
8.2 μg/dl

As i understand the meds at least work. Maybe someone can get something more from these results?
Thank you!

[labblab]

Thanks so much for giving us these results. Unfortunately though, as I wrote before, I do not know of any way in which the LDDS test results generally can be used to make monitoring decisions after Vetoryl treatment has been started. Lucy’s baseline cortisol does fall within normal range, so that’s good. However, we probably don’t want it dropping any lower. Even though the normal baseline range for a dog without Cushing’s is listed on your labsheet as low as 0.7 ug/dL, we frequently see the desired results for a Cushpup taking Vetoryl to be at least 1.45 on both the pre and post-ACTH testing. As long as Lucy is generally looking well, you’re probably OK to still maintain this same dose for another month until you can have a genuine ACTH performed. But if she starts acting unwell before then, I’d halt the Vetoryl until you can recheck her cortisol to make sure it has not dropped even lower.

And as far as those original diagnostic LDDS results, I can’t remember whether we already talked about them, but they are indeed consistent with Cushing’s, and also with the form of the disease caused by a pituitary tumor.

Once again, you’re doing a great job taking care of her. She’s a very lucky little girl to have you!