ohiogal said:
Hi everybody,
I just got off the phone with the vet, and based on everything we've done on Casey so far she thinks the strongest possibility is Cushing's. I'm taking Casey in on Monday so they can do the tests, and I'll get the results by Tuesday. If the Cushing's tests are negative, then I'll have her tested for acro (unless we can do both at the same time, which the vet is going to look into.)
I'll keep y'all posted, keep the happy kitty thoughts coming.
(PS Gayle I saw your post, and AFAIK Casey's heart is fine - the vet did an ultrasound on it and it looks perfect, no wall thickening or anything. All the other organs checked out too, except for the gall bladder.)
I am curious why the vet thinks it's Cushings... are you having issues with thin skin and ripping? No enlarged liver? Any balding?
Any chance you can find out info on exactly WHAT tests are being done? Some are a waste, and I don't think there is any firm yes/no result for cushings.
Most people wait until after testing for acro and IAA because there are just too many signs/symptoms that are the same for acro and cushings, but cushings differs with the skin & hair issues that do not affect acros.
Many vets think acromegaly is rare but it's not near as rare as cushings.
Unless Casey has the specific cushings signs, I think your money would be better spend on the other 2 tests.
Cushings Info
Many different signs of Cushing's syndrome can occur, including excessive drinking and urination (polyuria/polydipsia), increased appetite, enlargement of the abdomen, lethargy, muscle wasting, poor coat condition/hair loss, curling of the ear tips and the development of very thin and fragile skin. The skin can be so fragile that it very easily bruises and also can very easily tear.
Cushings
Symptoms and signs include the following...
concurrent diabetes in 81% of cases
polydipsia (excessive thirst) and polyuria (excessive urination)
pendulous abdomen
polyphagia (excessive hunger)
alopecia (hair loss) and poor coat
muscle wasting and weight gain in over 50% of cases
hepatomegaly (enlarged liver)
fragile skin syndrome in almost 50% of cases (skin may tear off easily)
infections
depression
weight loss in almost 20% of cases
easy bruising
In addition to thin skin and bruising, cushings disease can create skin conditions that include:
comedones (blackheads)
baldness on the trunk and abdomen
poor coat condition
abscesses
hyperpigmentation
Additional secondary infections produced by Cushings disease in cats may include facial abscesses, bacterial and fungal cystitis, pyothorax, bronchitis, rhinitis, pancreatitis, and demodicosis.
Cushings further info
Cushings Test Info from Dr.Lisa
You may want to ask your vet to peruse VIN if she/he is a member. I am not faulting your vet for the test that was run because it seems like this has never been very clear-cut but here are some excerpts from the VIN consultants with the date of their comments noted:
5/18/10 VIN consultant #1:
The ACTH stim has much lower sensitivity than the LDDS in cats. 60% of cats with hyperadrenocorticism return normal ACTH stim results.
That is, most cats with Cushings will not be picked up by a stim.
(LDDS = low dose dexamethasone suppression test)
6/25/10 VIN consultant #1:
The ACTH stim test is not recommended; it has very low sensitivity for Cushings in cats. The test of choice is a dexamethasone suppression test using the canine high dose.
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Other VIN consultants have recommended a UCCR...Urine Cortisol:Creatinine Ratio and while cushings can't be diagnosed simply by an elevation in the UCCR, it can be a useful tool.
The UCCR is a SENSITIVE test for Cushing's (e.g. very few animals with Cushing's would have a negative UCCR), but it is not a SPECIFIC test (e.g. many other diseases will make the UCCR elevate e.g. uncontrolled diabetes could).
So among the screening tests, we usually pick a LDDS to screen cats (using the 'high' dose for a dog DSP).
Adrenal ultrasound is also used since false positives and false negatives can be seen with the LDDS.
So, as you can see, the Dx of cushings is not straight-forward so you should probably keep going with your 'hunt' for answers....IF you and your vet are still concerned about cushings.
For the tests for acromegaly and IAA, have both the IGF-1 and the IAA tests done.... both are done only at MSU so they will have to be FEDEX'd and you won't have the results for a week or more.
Glad the heart looks OK; usually an echocardiogram is to be done to be sure.
Gayle
