My dog has Cushing's. Is a CT scan or ultrasound better for diagnosis?

Hi there. It would help to know what specific tests have been done so far. The most common test used to diagnose Cushing's disease is called a low-dose dexamethasone suppression test (LDDST), but an ACTH stim test or urine cortisol/creatinine ratio can also be used in some cases, especially if initial LDDST results are inconclusive. I'm not sure what was found on her ultrasound exams, so I can't comment on that without more information. But if she hasn't had an ultrasound done by a board-certified radiologist, this would be a reasonable next step to consider. Since getting a diagnosis has been such a challenge for your pup, I would consider requesting referral to an internal medicine specialist at this point. He/she can evaluate Hanz, go over all of his previous testing and lab results in detail, and help you determine the best way forward from here.

Cushing's can be pituitary in origin or adrenal in origin. A sonogram can not be performed on the pituitary as it is in the brain. This would require a CT or MRI. A sonogram can be performed on the adrenal glands but this does not definitely diagnose Cushing's (is just one of the tests to help aide in diagnosis), that would require blood testing. It is not a disease that goes away on its own unless surgery is performed to remove a mass that is oversecreting hormones. It sounds like the diagnosis was never truly confirmed, especially if medications are being stopped. I would recommend getting a little more clarification from your vet as to this. If additional help is needed referral to a veterinary internist would be the next step. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

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!

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.

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.

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.

I am so sorry to hear this and I know how hard it can be to tell if your pet is having a good quality of life. The three big things I look for are: 1) Good appetite 2) Comfort level- are they moving around on their own, able to posture to urinate/defecate well, using the stairs, able to rise and lay down easily. If not- would medications or other therapies help? Also, with neck pain- can they eat/drink from their bowls well? 3) Are they still doing the things that make them 'them'- whether it be greeting you at the door, wanting to take walks, whatever it is that makes their personality unique. To answer your specific questions- the term 'tumor' can be scarab, but Cushings can be a disease managed without a loss of comfort, although it may take management- Eg checkups to make sure they don't have urinary infections or skin infections. I would certainly be concerned about any neck pain and want to ask your vet if any therapies would help improve their comfort. I hope this helps!