Is my dog's Cushing's disease blood test timing normal for diagnosis?

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.

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!

Thank you for posting the results! I'm not sure what you are reading regarding diagnosing early and late, it is not so much of an issue with Cushing's. In really really advanced cases there can be a lot of damage done to other body systems but it is usually caught on way before that stage. And your dog is not there. From your results I can see that the post result is a two fold increase from the high end of normal. This makes me think the disease has likely been rumbling away for some time. Like I say the most important determination of progression of the disease are the clinical signs. If your dog is getting coat change and a pot belly then it's been going on for a few months. The acth stimulation test is not perfect but it is highly suggestive of Cushing's in this case. If your dog has clinical signs I would get your vet to start therapy with vetoryl which should make a huge difference. It's not too late to start treatment.

Hello and thanks for using Petco Pet Education Center, formerly Petcoach! Cushing's disease doesn't typically cause bloody diarrhea, vomiting and collapse. I would be worried something else is going on either with the Cushings or it's not Cushings and could be something like Addisons- which is more emergent. There is a test for these diseases but Dexter may need just a basic panel at this time to find out more information. If it is Cushings, it is not too late to intervene but the vomiting and diarrhea will complicate things. I recommend getting him to a vet right away and start with an exam and basic blood work. A lot can change in 3 months. Good luck and kisses to Dexter!

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.

Hello, Sable can eat her normal meal. Fasting before the test can actually invalidate the test results. So she may eat and take her medications normally the morning of the test. Hope this helps and best of luck.