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Old 05-14-2009, 02:27 PM
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Squirt's Mom Squirt's Mom is offline
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Join Date: Mar 2009
Location: Bauxite, AR
Posts: 175
Default Re: Barney - 8yo Jack Russell Terrier

Hi Kelley,

The ACTH is a stimulation test while the LDDS is a suppression test. The ACTH test shows what cortisol the adrenals have in reserve. Alison, I think it is, describes the ACTH as squeezing the adrenals like a sponge to get all the cortisol out. That is the post number we see with an ACTH. With the LDDS the adrenals are suppressed to see how they handle being told to stop releasing cortisol. In a normal dog, one which doesn't have Cushing's, the adrenals will respond by slowing down. In a cush pup, the adrenal glands won't stop releasing cortisol even tho they have been suppressed by the dexamethasone. So the ACTH simply shows the amount of cortisol in the adrenals while the LDDS shows how well the adrenals are functioning. Since some of the docs involved in Tee Jay's case question the initial diagnosis, perhaps this is why they want another LDDS...to see how the adrenals are functioning now. I'm not saying they are right or wrong to want this, but thought I might offer an idea as to why.

From my own experiences with the ACTH and Squirt, her levels got high until that tumor was removed, then it went down dramatically. We hear about non-adrenal illnesses sometimes causing elevated cortisol and I didn't fully understand that until last year when all that was going on with Squirt. Now I do understand that sometimes an illness or problem other than Cushing's can cause cortisol levels to be in the range for a Cushing's diagnosis based on the ACTH only. If we had proceeded to treat with Lyso based on the UTK panel cortisol reading of 32.8 ug/dl instead of having the ultrasound (further testing), no telling what may have happened or if she would still be here.

It is extremely frustrating and can get expensive, but making absolutely sure of what you are dealing with first will make the journey much easier down the road...that's my thinking anyway.

Hang in there!
Hugs,
Leslie and the girls