We are back from having the ultrasound today and meeting with the Internal Medicine Specialist.

Good news is that she doesn't have any tumors anywhere. Her adrenal glands are slightly on the large size, and liver a tad large. No sign of liver disease, gall bladder, anything that I asked would cause her ALP's and ALT's to be raised. The IMS, told me that looking at the results and all her other tests (that I have posted here) that Molly does indeed have cushings.

Her recommendation is that another LDDS test (we had the last one two years ago, negative) and see what those results are. If they clearly show cushings, on top of the ACTH showing cushings, then we would start her on low dose, 5 or 10 mg of trilostane. She said that was the low end, and that she is of the mindset that you start low and go up, rather than high and go down and that is what she would advise my vet. (I'll be returning the 30mg box of vetoryl)

If the LDDS is low, borderline, not clearly showing cushings, we'd wait and then retest in about 3 months. She also recommended another full blood panel workup and urine workup, prior to starting molly on any medication. So, if the LDDS is high, we'll move to doing the full blood and urine panels.

I am so much more comfortable with this IMS. I did say I was fine with the vet doing the LDDS, as long as she (the IMS) is consulted. If I feel at any time that my vet isn't on board with the treatment, then I'd rather see her directly. She was fine with whatever I decide.

Interesting, my vet told her in her faxed notes, that I had "read on the internet, much information, that made me wary of treatment" pffffft and hmmmmph

This doctor was fine with my reading up and had just recently attended a conference by the vet association. She said, they compile information from all studies done in the US and I want to say UK too, and then issue statements regarding treatment based upon these findings. She said there would be either a statement or a paper issued soon, a new one I mean, she doesn't think it's been released yet, regarding Cushings treatment. One thing will be not waiting for clinical signs to start low dose treatment if all testing indicates cushings and all other diseases or possible issues ruled out.

She has heard Feldman speak several times she said, after I mentioned papers written by Feldman and Peterson. (she said on you are familiar with the big names in this area and laughed) She said they both are doing excellent work, along with U of Tenn regarding this disease that is so hard to diagnose and hard to treat.

So, in essence, I feel comfortable with her prognosis and her plan at this point and hope my vet can get on board with what we want to do.