Cushing's without symptoms?

[Summereyre]

My 14 year old Cairn terrier needed his teeth cleaning. Preoperative blood work was done and showed 'some problems' with his liver.
A cortisol:creatinine ratio test was done and this week the vet called saying my dog needs another (expensive) urine test to see if he might have Cushing's disease. I was under the impression that that was what this test was for, but apparently not. I'm still not sure what they looked at this time other than that the test was inconclusive.
My dog is showing none of the symptoms of Cushing's whatsoever. Can he still have Cushing's ?

[pbpatti]

Sorry I cannot help you with your question, welcome to pets.ca, there are a lot of knowledgeable people here who may be able to help you.

I hope your furbaby will be ok.

[hazelrunpack]

He could be in the early stages of Cushing's, but he could also have had an elevated cortisol reading due to stress. It's not too uncommon for a dog to be stressed enough at the vet to screw up the cortisol levels. If you want to know for sure, a more definitive test for Cushing's will have to be done. But if he's showing no symptoms, you might want to have a discussion with your vet about the pros and cons of waiting vs. doing the test right away. He many have a compelling reason for doing the test sooner rather than later.

Meanwhile, welcome to the board. And if you get a moment, we'd love to see pics of your Cairn!

[rainbow]

Welcome to pets.ca and I second the request for pics.

Although the canine cushings forum is no longer open you may find some useful information here ....

http://www.caninecushings.net/forums...isplay.php?f=8

[Frenchy]

I would go ahead and have your dog tested. If he does have cushings , it will be easier to start the treatment right away and have it under control.

[Summereyre]

Hi everyone and thanks very much for the welcome and the replies.

This was only my second visit to this particular vet who is a very young woman. I am not saying that therefore she is not knowledgeable, or that I know more about dogs then she does, but she asked if he was drinking more than usual and he is definitely not. His coat is in fine form and only yesterday he trotted round the park for nearly an hour - which is not bad for a 14 year old dog.

@ Hazelrunpack, my Cairn (pic included hopefully has had to have both eyes removed due to Ocular Melanosis and he is definitely very stressed at the vet due to not being able to see what is going on.
Also he's not coping terribly well with his blindness at home even though he's had a year to get used to 'living in darkness' now.

I am thinking of asking for his test results to be emailed to me and maybe going for a second opinion. Not sure if they're willing to email me the test results or print them out for me if I go to there in person.

@Rainbow, thanks for the link, there is tons of useful information there !

[hazelrunpack]

Oh, he's a handsome fella, Summereyre! It's a pity about the loss of his eyes, but if he's trotting around for an hour at the park, he must be getting around pretty well. He certainly looks happy in his picture!

What's his name?

If they can't email the test results, they might be willing to mail you a copy of the results. Our vet often follows up with a mailed copy of the lab reports.

[ScottieDog]

Your Cairn is a handsome fellow--he doesn't look his age at all!

I have had some experience with the Cushing's tests. I had a Scottie that was tested at age 4 (a rescue with limited history). She was drinking excessively, had very dilute urine, was overweight/potbellied and had brittle hair texture. A blood panel revealed elevated Alkaline Phosphatase levels. She definitely had symptoms. She had the low dose dexamethasone suppression test and it was negative. At age 10, she had emergency surgery to remove her spleen. A liver biopsy revealed liver tissue indicative of Cushing's. Again we did the low dose dexa test and results were negative. I did some research on Cushing's and wanted to give you some links that I found helpful:

http://www.kateconnick.com/library/cushingsdisease.html
http://www.peteducation.com/article....2+1597&aid=416

From the first link:
"Urine Cortisol/Creatinine Ratio Test: Considered a screening test, this cannot diagnose Cushing's, but it can rule it out. A urine sample is examined for the relative amounts of cortisol versus a normally excreted protein metabolite, creatinine (the latter is used to control for the degree of dilution of the urine). The greater the ratio, the higher the cortisol level. High cortisol in urine is suggestive of high cortisol in the bloodstream. Many conditions other than Cushing's disease can cause false positives, so this test is not considered diagnostic. Nonetheless, if the cortisol/creatinine ratio is okay, the dog is not likely to be Cushingoid, so this is a good screening test."

You mention an expensive urine test. It sounds like the Urine Cortisol/Creatinine test was done. This is a screening test. Other tests involve bloodwork: the ACTH Stimulation Test, Low Dose Dexamethasone Suppression and the High Dose Dexamethasone Suppression Test (only given if the Low Dose is positive). Information about each of these tests is in the first link. I could see doing the low dose dexa suppression test, however, if your dog gets very stressed at the vet please discuss this: cortisol is a stress hormone. Cushing's can be treated--not cured sadly--and dogs can have a good quality of life with this disease. However, getting the medications adjusted to the correct levels can be tricky. You would need to consider any other health problems and make a judgment call whether treatment is warranted at his age and lack of symptoms. This is where you need to have a great relationship with your vet.

I wish your cutie pie all the best. I know it is hard to watch them get old and slow down. I recently had to tell my 14 1/2 year-old goodbye, so I understand.

[rainbow]

Your little boy is very cute and looks so happy.

Good luck with getting a correct diagnosis and please keep us updated.

[Summereyre]

Thanks for all your help and kind words

hazelrunpack my dog is called Eddie.

ScottieDog : the urinetest which was done last week was the Cortisol/Creatinine one, that is what it said on the urine sample kit they gave me anyway, which they sent off to the lab two days later (I was actually worrying about his urine going off
They needed two samples from two consecutive mornings.
The vet told me that a second urine test needs to be done for which they need three tubes with urine, and on the second day I'd need to give him three tablets....I'm sure I'm not explaining this very well but then it wasn't explained to me in much detail either. This second test is the expensive one (same cost as having his teeth cleaned which is what I came in for in the first place)
Thanks for the links. The relationship with the vet is a problem, we've moved a lot during my dog's lifetime so he's been treated by various vets.
Sorry to hear about your 14 1/2 year-old passing away recently.

I have emailed the vet asking for the results of the first urine test to be emailed to me, and also if she could explain her reasons for him needing the second test..so far I've not had a reply so I'm waiting (im)patiently

[ScottieDog]

I'm not familiar with the urine test you are describing. I know my vet chose to do the low-dose dexa suppression test. I believe it was around $160 (U.S.). I know the test was under $200. This told my vet everything he needed to know. You may want to find out the cost of the low-dose test and ask if it could give good results and then decide which test would work the best for Eddie and your finances. It is very odd that you aren't seeing any signs of Cushing's. I'm sorry I can't give a more specific cost of the test, but my dog was ill for so long, I had so many records and I filed them away when she passed.

Make sure you ask lots of questions and understand everything being done. This isn't an emergency situation where you have to make choices within minutes. It is hard to watch our babies get older and have health issues, but you are being a great doggie momma to advocate for his care. Good luck and hugs to Eddie.

And thank you so much for your condolences for my sweet Mac. He was my first dog and his loss has been very difficult--I lost him and my girl Tipper (the one with suspected Cushing's) in less than a year.

[Frenchy]

Originally Posted by ScottieDog

I'm not familiar with the urine test you are describing.

Me neither and I had a dog with cushings. My vet didn't know too much about that condition and wasn't a big help , it was very frustrating , even after going to a second vet ..... once you get the results , fax or e-mail them to a vet school in your area and ask them if they can help you.

[rainbow]

Summereyre, do you have an update on Eddie?