Suni

[sunimist]

Thank you Marianne for responding.

Symptoms: She has them all full blown! Pot belly, panting, heat sensitivity, excessive drinking, overweight, enlarged liver, high liver enzymes, anxiety and enormous appetite and excessive peeing.
There is no doubt she has cushings.

If we could slow the panting, anxiety, heat sensitivity, the enlarged liver and get the appetite under control, it would be wonderful, because they all play a part in her being able to breathe without such labored gasping.

As far as her trauma on going for testing. She gasps, coughs and cries all the way to vet and then back, and while there. That's 120+ miles taking a huge toll on her breathing. Not up for that at all. So yes, as I promised her, no more testing, ultrasounds, or intubations. If being able to breath, if only a little, is not addressed and preserved, she won't be with me long. So this is a chance I am willing to take for her sake. My feelings are being buried for now I think.

Am I being too unrealistic? I can't think of anything else to do.

[labblab]

Thanks so much for this additional info, Shelba, because now I better understand what you’re struggling with. Of course, normally we always stress the importance of testing here, both for diagnostic and monitoring purposes. But in sweet Suni’s case, it seems to me that you’ve entered into sort of a hospice phase where all the usual bets are off. Her immediate comfort is the sole issue, and if I were in your shoes, I’d probably be considering the same option. I’m kind of in the same place with my Luna. I’m no longer worried about long-term ramifications of doing this or that. If I can try to make make the present day better for her, then that’s the choice I pick because I’m aware every morning that this may be the last day that we’re gifted to be together. So if your vet is willing, then I understand the experiment that you want to try.

I’ll be very anxious to hear how things go and surely hoping for a good result, my friend. Lots of love to you and sweet little Suni, always.

Marianne

[sunimist]

Thank you, Marianne for understanding more of where I am coming from. Like I said, this is not a spur of the moment decision, and it has caused me a lot of anguish to arrive at where I am now. I understand that it would not be a right decision for most, but for me it is the only hope I have for my sunshiny girl. I have shed many tears trying to arrive at a decision and I am sure I will shed a lot more. However, in the end, I truly feel a little relieved and am at peace with this. If it fails, it's all on me and I will have to live with it.

I love you girl, and so appreciate your loving and caring input. I hope and pray you find an answer that will help your precious Luna. It sucks, don't it??!!

FYI, Dr. just called and will call back. She wants to make sure there is nothing else out there that we have missed to try. Bless her, she is so darn special!

[sunimist]

Quick update on Suni. The vet wants to do a UC:CR test and a thorough ultrasound to take a good look at the adrenals, hoping to get the answer one way or the other. We are still contemplating what route to take. What would you do? I just want to do what's best for my baby, that's all.

[labblab]

I don’t think there’s any downside at all to doing a UC:CR since you would be collecting the urine samples yourself, at home. As a reminder, in order for that test to be accurate, the process should be as stress-free as possible for Suni. That’s why the urine should be collected at home and not at the vet’s. We’ve been told that, ideally, the test would be performed on a pooled sample — collecting the first urine of the day on three successive mornings, pooling it and refrigerating it until the pooled sample is taken to the vet for analysis. An elevated UC:CR cannot confirm Cushing’s (there can be other causes including simply feeling stressed), but a normal result definitively rules out Cushing’s.

Urinary Cortisol:Creatinine Ratio
Creatinine is excreted in the urine at a constant rate; cortisol is not. The UCCR is a sensitive test to detect cortisol hypersecretion. It is imperative the dog is not stressed for the urine sample collection. To minimize stress, the owner should collect free-catch samples for 1-3 days at home and bring to the practice; first morning samples are ideal. Samples can be pooled to increase chances of observing an elevated cortisol due to daily variation. Stress and non-adrenal illness can cause increases in urine cortisol levels. False positives are common (specificity is as low as 20-25%), but a normal ratio is considered truly negative, and HAC can be ruled out.

So if it was me, I’d go ahead and perform a UC:CR first, since it shouldn’t be stressful for Suni. If that result is elevated, then you can shift to making a decision about the ultrasound or any other testing.

Marianne

[Squirt's Mom]

I would definitely do the ultrasound. It was the ultrasound that saved Squirt's life the first time she was diagnosed with cushing's because it was a tumor on her spleen that caused ALLLLLL her cush tests (LDDS, HDDS, ACTH, and UTK panel) to come back positive even tho she didn't have the disease at that point. Had I started treatment based on those tests it could have easily killed her 1) when the tumor ruptured or 2) from an overdose because she didn't need the drug to start with. So please do get the US for sure.

[sunimist]

Thanks, y'all! Yes, she is going to do both the uc:cr and ultrasound, at least. I will give Suni some valium for the trip as it won't affect either of those tests and maybe she can travel better. Will be making the appointment Monday.

Oh my! Thank you Leslie for that information! I did not know, or either forgot, about angel Squirt's ordeal. Sure did love that baby!
,
And thank you Marianne for reminding me about the pooling samples. Ideally, I guess it should be done 3 days before the test? I can do that after I get an appointment date.

I am so embarrassed! It's sinful how much I have forgotten about all this. I am trying to catch up though, and my gratitude to you girls for helping me do that! XXOO

[labblab]

Thanks, y'all! Yes, she is going to do both the uc:cr and ultrasound, at least. I will give Suni some valium for the trip as it won't affect either of those tests and maybe she can travel better. Will be making the appointment Monday.

Yep, I’m so glad Leslie had the chance to reply to you, too! And just to reconfirm, Valium *would* skew the results of a UC:CR, but since you’ll be collecting the urine at home it will be a non-issue for Suni during her vet trip.

And there’s absolutely no cause for embarrassment, girl! It’s been a very long time since you had to deal with Cushing’s, and it’s no surprise at all that it wouldn’t be in the top drawer of your memory bank ;-).

[Squirt's Mom]

Goodness....I deal with this stuff every day and still can't remember what's what a great deal of the time! I'm sure my age has NO part to play in that tho.

[sunimist]

So the valium would not affect her test results if taken after I collect the samples. And hoping the samples would be stable enough for testing? I am wondering about other meds she takes. Will have to remember to ask about that. Thanks for pointing that out Marianne.

No, of course age would not play a part in what we forget, Leslie!!
!