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Dr. Scarlett
Dr. Scarlett, Veterinarian
Category: Veterinary
Satisfied Customers: 4053
Experience:  I am a practicing small animal veterinarian with 16 years experience.
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My dog (a 10 year old female Shih Tzu) was not eating and very

Resolved Question:

My dog (a 10 year old female Shih Tzu) was not eating and very tired. She started drinking a lot and urinating more than usual. This went on for 3 or 4 days so I took her in to be checked. They weighed her and she had lost 1 lb. since January - down to 9.2 lbs. The did blood tests as they thought it could be diabetes. The result was no to diabetes but then then did more blood tests and said she had Cushings disease. Even before I got her back on her medication, she returned to normal, playing, no excessive urination, and playful again. Could the tests be wrong? Here are the results of her first test - GLU, BUN, CREA, PHOS, CA, TP, ALB, GLOB, ALT are all in the normal range. ALKP, TBIL, CHOL are ranked high and AMYL was ranked low. Then they took another sample and had it shipped off for testing and it came back as Cortisol at 7.7 flagged high. Could all this be a fluke? She has always been very healthy. We walk 2 miles a day (one in the morning and one in the evening) and she eats Science Diet dog food.
Submitted: 10 months ago.
Category: Veterinary
Expert:  Dr. Scarlett replied 10 months ago.

Dr. Scarlett :

Hi,

Dr. Scarlett :

Unless your vet did either a LDDS test or an ACTH stim test, you can't diagnose Cushing's disease.

Customer:

w

Customer:

what kind of tests are those? are they blood

Customer:

what is involved in these tests?

Dr. Scarlett :

Hang on just a sec!

Dr. Scarlett :

They are blood tests, but require a little "extra"--the LDDS (low-dose dexamethasone suppression) is an 8 hour stay at the clinic--they draw blood, give a small amount of steroid, then draw 2 more blood samples at 4 and 8 hours after the injection.

Dr. Scarlett :

Here is a good website about Cushing's testing: http://www.VeterinaryPartner.com/Content.plx?P=A&A=636

Dr. Scarlett :

Certainly a high alkaline phosphatase, increased appetite, and increased drinking go along with Cushing

Dr. Scarlett :

disease, but I would never treat a dog for Cushing's without further diagnostic testing.

Dr. Scarlett :

Partly because of the expense & partly because of the side effects.

Dr. Scarlett :

This website has a lot of info on Cushing's disease--look at the right hand side for different topics: http://www.VeterinaryPartner.com/Content.plx?P=A&A=1193

Dr. Scarlett :

So do you know if the other sample that had a cortisol of 7.7 was a LDDS test?

Customer:

No, it could have been as he had to send the blood sample to Minnesota for testing.

Dr. Scarlett :

There should have been 2 cortisol values--a pre and a post IF they did an ACTH stim test or 3 values if they did a LDDS test. But if it was just a single cortisol level, I'd want further verification of Cushing's.

Customer:

Thank you very much. I just have not felt that comfortable with this quick diagnosis. I went ahead and got the medicine - Vetoryl - but maybe I should take her somewhere else and check this out.

Dr. Scarlett :

I think I would. Then if it is Cushing's, you already have the Vetoryl! :)

Dr. Scarlett :

Where are you located?

Customer:

Norman, OK Do you have someone you would recommend.

Dr. Scarlett :

Sorry, I don't know anyone in Norman. When you mentioned MN, I thought you might be in WI!

Dr. Scarlett, Veterinarian
Category: Veterinary
Satisfied Customers: 4053
Experience: I am a practicing small animal veterinarian with 16 years experience.
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