tag:blogger.com,1999:blog-1020386515354656609.post1722556217996386166..comments2024-03-19T15:11:11.769-04:00Comments on Insights into Veterinary Endocrinology: What's the Best Protocol for ACTH Stimulation Testing in Dogs and Cats?Dr. Mark E. Petersonhttp://www.blogger.com/profile/10804290441832222507noreply@blogger.comBlogger67125tag:blogger.com,1999:blog-1020386515354656609.post-14712256224586855372017-09-26T14:56:18.526-04:002017-09-26T14:56:18.526-04:00Thank you Dr. Peterson! I have been moderating ca...Thank you Dr. Peterson! I have been moderating canine cushing's support groups for 12 years and there is absolutely no doubt that if this approach becomes established protocol, it can make a huge difference for many pet owners who are financially unable to treat their dogs and afford the acth stimulation tests. I think this could be the best thing since sliced bread. :) You are a trusted expert by many of us who often use this amazing site to educate our members and help them become better advocates for their dogs. You've been my personal go to with questions over the years and you have no idea how many dogs have benefited from your Q & A pages and your personal answers to me and others. It is not uncommon for members to educate their general practice vets, using pages out of your site, so you've also helped provide free continuing education for many, many vets over the years as well. I think I speak for scores of us who are dedicated to helping pet owners and their dogs when I say thank you from the bottom of my heart for being so gracious with your time and knowledge. You rock the canine cushing's world!<br /> Lulus momhttps://www.blogger.com/profile/10765302059863474228noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-78557679592800089272017-09-18T19:13:30.550-04:002017-09-18T19:13:30.550-04:00Yes, I know the work well and I do think this appr...Yes, I know the work well and I do think this approach has great promise. Certainly makes more sense thank the ACTH stimulation test!Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-82770536785749959012017-09-18T17:52:41.646-04:002017-09-18T17:52:41.646-04:00Dr. Peterson, are you familiar with the study; Pr...Dr. Peterson, are you familiar with the study; Pre-trilostane and three-hour post-trilostane cortisol to monitor trilostane therapy in dogs conducted by L. Macfarlane, BVMS DipECVIM-CA MRCVS1, T. Parkin, BSc, BVSc, PhD, DipECVPH, FHEA, MRCVS2 and I. Ramsey, BVSc, Phd, DSAM, FHEA, FRCVS, DipECVIM-CA3? The results of this study indicate that this monitoring method shows that the pre-trilostane and three-hour post-trilostane cortisol concentrations were better than the post-ACTH cortisol concentrations at discriminating between dogs with excellent control and those that were undercontrolled. Do you see this as a possible futyure choice to monitor Vetoryl treatment using a simple pre-pill cortisol rather than having to go through the hassle and expense of an ACTH stim test?Lulus momhttps://www.blogger.com/profile/10765302059863474228noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-60485477385283099342017-06-19T07:25:58.455-04:002017-06-19T07:25:58.455-04:00If you only touched the powder a couple of times, ...If you only touched the powder a couple of times, you should be okay. But please talk to you own doctor and show him the package insert for the drug.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-69627498439574193782017-06-16T02:40:24.456-04:002017-06-16T02:40:24.456-04:00Dear Doctor, my vet never warned me that I should ...Dear Doctor, my vet never warned me that I should not touch vetoryl if I want to get pregnant. Several times he said that i should split capsule of 5 mg becouse there is no such kaopsule. For a long time I can not get pregnant, and I was wondering if I can do some blod test becouse touched a vetoryl and i touched powder inside couple of times I read that is dangerous to humans. Is there a blood test or something that I can do. Thanks in advance and sorry for bad English, I write from Serbia SofiaAnonymoushttps://www.blogger.com/profile/14675071383363371552noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-89218809528174903912017-02-28T04:21:52.715-05:002017-02-28T04:21:52.715-05:00Make sure you are giving the drug with food. If yo...Make sure you are giving the drug with food. If you are, then I'd switch to Lysodren (also needs to be given with food). Talk to your vet.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-36469054627764563622017-02-27T12:12:41.732-05:002017-02-27T12:12:41.732-05:00My 29lb neutered dog was diagnosed with Cushing...My 29lb neutered dog was diagnosed with Cushing's in early December and began a course of Vetoryl 10ml BID. We have steadily increased the dosage to where it is now, 20/20 daily based on Stim testing (five total). Each post test was in the range of 9 to 16; the last one, 13 was higher than the previous one, 12 even though the dose was increased by 5 ml daily. He has had two US's and a blood panel in 12/16. He also has a perianal adenoma; I'm waiting on surgery to try to get his cortisol under control. Should I pursue an MRI of his pituitary? Should we keep bumping the dose? His clinical symptoms are somewhat improved but still lots of trembling, lethargy, drinks somewhat more than he should and needs to go out in the middle of the night. Thank you for your thoughts or ideas.Carolehttps://www.blogger.com/profile/02109502377816823604noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-70021355368072399732017-02-22T21:53:53.648-05:002017-02-22T21:53:53.648-05:00If you think your dog is not symptomatic for anyth...If you think your dog is not symptomatic for anything, I would NOT recommend any further testing or treatments at this time.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-69254494248604565812017-02-22T13:35:26.955-05:002017-02-22T13:35:26.955-05:00Dr, can you help me. My dog has just been diagnose...Dr, can you help me. My dog has just been diagnosed with a-typical Cushing which the vet says is good news. Does he need a stim test? He is an older rescue litter doxies approximately 10 years. I only brought him to the vet to get his nails trimmed and I got concerned when he lost half a pound. I asked the vet to run a blood test. He has no Cushing symptoms. Anonymoushttps://www.blogger.com/profile/00380269650934773102noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-25595866046188738392017-01-09T20:42:48.284-05:002017-01-09T20:42:48.284-05:00Many dogs will need (or at least do better) on twi...Many dogs will need (or at least do better) on twice daily treatment, and that is no way predicts that your dog has an expanding pituitary tumor.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-69854883173373324082017-01-09T13:08:24.283-05:002017-01-09T13:08:24.283-05:00Hi there,
Following on from three weeks of seemin...Hi there,<br /><br />Following on from three weeks of seeming good health on 30mg Vetoryl and all seemed well. Now, for the past week, he has returned to PUPD symptoms (making him unitary incontinent again) and the deep "panting" he suffered from before. My vet wants to do another ACTH stim and assay test, which is totally fine. She also said that he might need a BID dose of Vetoryl. Do you have any experience of a twice a day dose - and does this very short period of improvement give more of an indication of a growing pituitary tumour? I'm just very worried that my four year old dog will continue to feel very unwell during this period of testing, which I'm sure you understand. Jackiehhhttps://www.blogger.com/profile/00971326063319685924noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-29268388753601340622016-12-22T09:41:58.434-05:002016-12-22T09:41:58.434-05:00Pituitary surgery might be the best, but you need ...Pituitary surgery might be the best, but you need a facility with experience (not many available). I'd talk to your vet about this, but if there aren't any experienced pituitary surgeons nearby, then I'd start the Vetoryl.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-14687606277476813642016-12-22T04:58:37.757-05:002016-12-22T04:58:37.757-05:00I have had my dog scanned now, and he doesn't ...I have had my dog scanned now, and he doesn't have an adrenal tumour. Is the next step wait and see if the symptoms fully resolve on Vetoryl, or do you think there is any merit in an MRI to see if he has an operable pituitary tumour. I'm not keen on surgery, but as a mentioned before, he is only four and if he could be "fixed" permanently it could be worth it. Do you have knowledge of this type of surgery and is it something you would advise/consider? Also, my dog is loosing pigment from around his eyes and nose - - could this be a side affect of Cushings??Jackiehhhttps://www.blogger.com/profile/00971326063319685924noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-32868808606398060852016-12-21T15:25:35.457-05:002016-12-21T15:25:35.457-05:00Thank you.Thank you.Anonymoushttps://www.blogger.com/profile/08549016052964347968noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-55544962098899836002016-12-21T13:36:30.220-05:002016-12-21T13:36:30.220-05:00The Vetoryl needs to be started based on these res...The Vetoryl needs to be started based on these results. Talk to your vet about the correct dosage. I cannot do that online.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-88233166554395291342016-12-20T18:21:36.494-05:002016-12-20T18:21:36.494-05:00Good evening Dr.Peterson,
The ACTH results are th...Good evening Dr.Peterson,<br /><br />The ACTH results are the following:<br />Cortisol M0 3.12 ug/dLL<br />Cortisol M1 24.16 ug/dLL<br /><br />She is an English Bulldog weighing 22k and will be 12 in January.<br />Do you believe I should start her tomorrow on 30mg and have another test in 15 days?<br />Any other recommendation is appreciated.<br /><br />Anonymoushttps://www.blogger.com/profile/08549016052964347968noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-34406310055535087462016-12-19T13:11:20.121-05:002016-12-19T13:11:20.121-05:00Thank you!Thank you!Anonymoushttps://www.blogger.com/profile/08549016052964347968noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-36815221895433795662016-12-19T08:15:42.073-05:002016-12-19T08:15:42.073-05:00If the cortisol levels are high, then the drug sho...If the cortisol levels are high, then the drug should be started at a lower dose.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-77740504876938017922016-12-18T15:00:16.898-05:002016-12-18T15:00:16.898-05:00After her ACTH results tomorrow, will her cortisol...After her ACTH results tomorrow, will her cortisol be high even though she has been off Vetoryl for 2 weeks? If so should we start again or wait for symptoms to return?<br />ThanksAnonymoushttps://www.blogger.com/profile/08549016052964347968noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-682833446182819802016-12-13T03:39:57.525-05:002016-12-13T03:39:57.525-05:00You want to monitor both labs and clinical signs.You want to monitor both labs and clinical signs.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-44312170099957773162016-12-12T18:19:18.840-05:002016-12-12T18:19:18.840-05:00Thank you.
So it is not recommended to wait for sy...Thank you.<br />So it is not recommended to wait for symptoms to return such as excessive thirst etc?Anonymoushttps://www.blogger.com/profile/08549016052964347968noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-41941432632073010312016-12-12T17:14:49.054-05:002016-12-12T17:14:49.054-05:00I'd do another ACTH stimulation test in 2-4 we...I'd do another ACTH stimulation test in 2-4 weeks to see if you need to reinstate the Vetoryl.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-42357556764632250832016-12-12T13:23:29.605-05:002016-12-12T13:23:29.605-05:00Hello.
We had to suspend my dog's Vetoryl las...Hello. <br />We had to suspend my dog's Vetoryl last week because her ACTH came back very low. <br />Do we need to test her again using ACTH or how do we know her cortisol level? <br /><br />Anonymoushttps://www.blogger.com/profile/08549016052964347968noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-55022739621671010922016-11-28T17:44:43.028-05:002016-11-28T17:44:43.028-05:00These days, most vets do an abdominal ultrasound t...These days, most vets do an abdominal ultrasound to diagnose or exclude an adrenal tumor. I agree with you... I like to know if the dog has adrenal hyperplasia or adrenal tumor. It's not difficult to do the ultrasound if the operator has experience.Dr. Mark E. Petersonhttps://www.blogger.com/profile/10804290441832222507noreply@blogger.comtag:blogger.com,1999:blog-1020386515354656609.post-73617314183418133172016-11-28T10:30:09.022-05:002016-11-28T10:30:09.022-05:00I've just had my four year old dog diagnosed w...I've just had my four year old dog diagnosed with Cushings using an ACTH stir test and a urine sptest for cortisol production. He has started on Vetoryl at a 2mg/kg SID. Can you please tell me what further tests he will need - most importantly does he need US to look at adrenal glands and/or scan of pituitary glad? I am very concerned he may have a tumour - I would wish to do everything necessary/recommended to ensure his care is the best it can be. Your advice would be very much appreciated. Jackiehhhttps://www.blogger.com/profile/00971326063319685924noreply@blogger.com