Hello. My boy, Paddy, was diagnosed with Cushings right before Christmas. He had the ACTH test and results were sample 1 - 11.0 . And sample 2 was 21.2. Is it normal for the first one to be so high?

His ALP has been above normal for a few years now (since 1-2014) but that has been the only thing that was out of range. In the fall of 2013, he had a neck injury and took rimadyl for maybe a week or two, followed by prednisone for 10 days or so (not simultaneously). His vet attributed the elevation to that & prescibed adenosyl/Denamarin. His ALP was 140 previously and 1-2014 it was 449 & ALT was normal at 35. When it was rechecked the following July it had gone down to 301 and down to 278 after that. It would then fluctuate over next few visits. His doc said he was/ is overweight & could be fat deposits elevating ALP. His ALT went up a little but was still in normal range. Last July, ALP was up to 468, ALT 100. I took him to vet in October for not acting "right". ALP was 576 & ALT was up to 166. Referred to internist for an ultrasound. IMS said his liver is small and one side rounded. Didn't mention anything about his adrenal glands but took an aspirate from rounded side. He said it could either be cushings or age related degeneration. I didn't get the ACTH done til December. Vet said it was clearly Cushings. We (vet & I) decided to wait til after holidays to start vetoryl.

Scheduling/family issues (I don't drive & have hard time getting to vet) occurred & just getting ready to start vetoryl tomorrow. He is 23-24 lbs & will be taking 30mg once daily. I read here,though, to start at just 1mg/lb. I e-mailed Dechra & the response I got was 1-3 mg/lb & follow advice of our vet. I'm nervous about it. Paddy's doc works Weds- Fri and alternate weekends. I'm wondering if I should wait til next week when she'll be working more days. Just haven't met the other doctor yet.

The only symptoms I notice are weight gain and panting. He doesn't seem to drink that much & he's still a picky eater. His energy level isn't what it used to be.

Is there any other testing that should be done? Should I wait til next week to start the vetoryl, in case he has any side effects?

Thanks for any advice! I don't really have anyone to talk to about this and am always second-guessing things.