What other tests can confirm Cushing's when my dog's results are inconclusive?

Unfortunately, that's just the nature of some diagnostic tests - they don't always give a clear answer, just like in humans. So repeated testing over the course of a few months, or retesting with a different type of test, may be needed to get a diagnosis. Cushing's disease is notoriously hard to diagonse in many dogs, because the testing is often borderline or inconclusive.

Cushing's or Hyperadrenocorticism is a fairly common endocrine disease in dogs. It can be caused by a bit of overactive tissue in the brain (in the pituitary gland, which is the master ruler of hormone secretion in the body) or a mass in an adrenal gland (sits by the kidneys, secretes hormones as directed by the pituitary gland). Basically what happens is an excess of a hormone in the body, usually a steroid called cortisol, if it is traditional Cushing's. This then causes some symptoms in the pet, blood work changes, and sometimes other changes like high blood pressure. I suspect based on the value that you report that this was a liver enzyme elevation call ALP. This very commonly occurs in pets that have Cushings, but is not specific for Cushing's and elevation can be caused by other disease processes. This value does not correlate with severity of disease as many dogs have a high value. It sounds like your vet is on the right track by recommending an ultrasound to look at the adrenal glands and also the rest of the abdominal organs to rule out other disease processes. Ultimately Cushing's Disease has to be diagnosed by some sort of endocrine testing which your vet may recommend as well. Treatment if then based on what type of Cushing's disease is present. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

I am sorry about the high vet bill. A CT scan would give more accurate results and a better image than ultrasound. Most veterinarians do not have access to CT scan for dogs and therefore use ultrasound instead. I think it is very cool that your veterinarian has a CT scan unit available. You should call your insurance company and see if they will cover it for you. Explain the situation. Maybe get your veterinarian to talk to them as well. They probably don't have CT scan listed because most vet clinics do not have a CT scan machine available.

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Your Vet needs the LDDS first to make the diagnosis that Roxy does actually have Cushings.....and sometimes we can tell from the LDDS if the Cushings is more likely PDH in origin vs tumor (since 70% of patients with PDH suppress plasma cortisol to less than 50% of the pre-treatment value ). If Roxy does not suppress to less than 1/2 of the pre treatment value at 4 hours, then we need the HDDS test which helps us to differentiate Cushings due to adrenal tumor vs PDS. So LDDS first. Then HDDS if the LDDS did not suggest PDH. Other simple things to look at with Roxy: urinary incontinence, trying her on a Proin or DES trial and looking at her vulvar conformation and make sure she doesn't need a vulvoplasty. Good luck!

He does not look like a Cushing's dog to me, but I would have to test him to be sure. A UCC test would be nice, but a low-dose dexamethasone suppression test would give more information and can easily be done. The human pathology labs should have the capability to measure cortisol (I've done this in India). This black/bald skin tells me that the skin has been inflamed for a long time. I wouldn't be surprised if it is mange (he looks like a classic mange dog) that is causing him to look like this. Mange can take a long time to treat; sometimes over a year with heavy burdens. If the mange was not treated for long enough, then it could have come back. He should be tested again for mange. Other conditions that would cause a lowered immunity should be ruled out (especially if he has demodectic mange). I would want to check a CBC and possibly check the thyroid levels if he was showing other signs of hypothyroidism. If you are having problems finding a vet doctor to do these tests, then my friend's organization in Pune may be able to help. The link to the website is below: http://www.bodhisattva.in/ I hope that helps and Rudy gets better soon.

Hi there and thank you for posting your question. The medication used to treat Cushing's disease can cause some pretty serious problems if not monitored appropriately. Unfortunately, the blood testing to monitor Cushing's is expensive. For the first two to three months I will perform this particular test called the ACTH test to monitor the response to treatment and to make sure that the medication is not causing the reverse problem called Addison's disease. If the dog is well regulated I might spread out the blood test to once every 6 months to ensure that the values are regulated. Of course, this is something that you will have to discuss with your veterinarian who is ordering this blood test up every few weeks. Every doctor is different with how they monitor their patients, so not all of us will recommend the exact same plan for every patient. I hope this helps guide you in the right direction. Please let me know if you have any further questions or concerns and I would be more than happy to help you further.

I'm sorry that Miller is not feeling well. We certainly see an increase in ALKP as an early sign of Cushing's disease, but ALT is not as commonly elevated. I am attaching a handout with more information about Cushing's disease below. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1551 The most common test that we will use to diagnose Cushing's disease is called a Low Dose Dexamethasone Suppression Test. I am attaching a handout below that discusses the specific tests we use for Cushing's disease. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=636 However, an abdominal ultrasound is also an excellent test to evaluate the adrenal glands to look for evidence of Cushing's disease. So, I would discuss with your veterinarian if they would recommend doing further blood testing first or an abdominal ultrasound. That answer will likely depend on what Miler's lab work looks like when it is rechecked in 2 weeks. Good luck! I hope that was helpful and you can figure out what is going on with Miller. Thanks for using PetCoach.