Harley's visit to the Univ. of Penn.

[Squirt's Mom]

Re: Harley's visit to the Univ. of Penn.

Thank you, Lori,

Happy Mother's Day to you as well.

Hugs,
Leslie and the girls

[LuvMyMunchie]

Re: Harley's visit to the Univ. of Penn.

Hello to all,

Just wanted to wish everyone a "HAPPY MOTHER'S DAY."

.....and a very "Happy Mother's Day" to you and all the other Moms from me also!!

Louise

[gpgscott]

Re: Harley's visit to the Univ. of Penn.

Hi Lori,

So you have a complicated diagnosis going on and you may or may not have an adrenal tumor.

Concerning the melatonin implant, Stephanie (corgipalliesmom) still does it, I do not.

As has been mentioned there is no concensus concerning the effective life of the implant, and the needle is large and can cause bleeding and scabbing.

I like the oral. It is cheap, you see it go down, and in our case combined with the lignans and other support (purified lignans, lecithen, milk thistle) it is effective.

I have not studied your entire thread and so some of these comments might not apply to your case.

I can't see a downside to trying the oral melatonin first.

As has been mentioned the most commonly prescribed dose we see is 3mg twice daily and you do not use the timed release product.

Best to you and Harley.

Scott

[Harley PoMMom]

Re: Harley's visit to the Univ. of Penn.

Hi Scott,

Thanks so much for posting to me, your opinion on the implant was very much appreciated and helpful.

the needle is large and can cause bleeding and scabbing.

Harley does not like needles, so this was valuable information, and I don't want to put him thru undue stress if I don't have to.

So, the oral Melatonin and the pressed flax hulls will be what he is on.

Thank you again Scott,

[Harley PoMMom]

Re: Harley's visit to the Univ. of Penn.

Hi To All,

I sent DR. Oliver a e-mail concerning Harley and his diagnosis and treatment, I would like to share it with you all and get your opinions/advice/whatever

The cortisol levels are fairly normal, although baseline is slightly
high. So, this would be called Atypical Cushing's syndrome (cortisol
essentially normal, but sex hormones are increased).
>>>The Estradiol levels are very elevated and probably causing rhe most
problems. Other intermediate hormone levels are also increased at
baseline. by DR. Oliver of Harley's Full Adrenal Panel.

But does Harley have pituitary cushings as well as Atypical? So will I
be treating Harley with something more powerful later? (Pituitary
cushings noted below by his endogenous test)

The hormone levels above support what is called Atypical Cushing's, and
it is due to a pituitary-dependent condition based on the endogenous ACTH
test result. Atypical Cushing's can be caused by eithe pituitary-dependent
disease or adrenal-dependent disease; in this case, pituitary-dependent. answer by Dr. Oliver

I'm sorry for all the questions, and I hope you can answer them for
me. Should I be running more test? Another ultra-sound? His Ultra-
sound did show a 7.3 mm nodule on his right adrenal gland, (U/S done
4/14/2009 @ University of Pennsylvania Vet. Hospital).

The nodule is probably not an issue at this point. The endogenous ACTH
level indicates the problem is with the pituitary (probably a small tumor
in the anterior lobe of the pituitary) that is releasing excess ACTH, and
this is stimulating the adrenals to produce excessive adrenal steroids.

>>>Treatment in this case can be melatonin and the flax hull product, and a
maintenance dose of Lysodren can also be added to give greater coverage
(treatment effect). I can discuss this with your veterinarian if it would
be helpful.

>>>Hope that helps. Regards, Jack.

[stardeb55]

Re: Harley's visit to the Univ. of Penn.

Lori, Dr. O isn't saying that Harley has Pit Cushing's, too. What he is saying is that the source of the Atypical is coming from a lesion in the Pit gland which is causing the adrenals to pump out the excess intermediate hormones. To have Pit Cushing's, the cortisol must elevated. Harley's cortisol is basically normal. (You always look at the post value which is the most important). Atypical can be either adrenal or pit-based, just like regular Cushing's.

What do the vets say about monitoring the nodule on the adrenal gland? Have they said to do a US after a certain period of time to see if there are any changes in that nodule? If they haven't said anything, I would ask.

Debbie

[Harley PoMMom]

Re: Harley's visit to the Univ. of Penn.

Debbie,
Thanks for your post.

Harley's vet want to do another U/S in 6 months to see if the nodule has grown.