Blood testing is important to identify Cushings disease

In a continuation about Cushings disease; Dr. Becker explains the importance of blood testing to determine what is going on in your dog.  It is a difficult disease to identify.  

The Importance of Blood Testing

I think it’s important for you to ask for a copy when you have annual blood work done on your dog. I would show the blood work to the pet owners and say, “Look, your dog has had ALP elevation for two or three years,” and their answer would be, “Why didn’t my veterinarian tell me?”

Unfortunately, many reactive veterinarians simply won’t address Cushing’s disease until all of the symptoms are there, or until you begin telling him or her about the symptoms: “My dog’s peeing in the house,” “My dog’s hair is falling out,” or “My dog’s incontinent at night in bed.”

Oftentimes once you start complaining, your veterinarian starts digging. But if you want to be proactive in preventing this disease from occurring, you need to be asking for copies of blood work and why every single blood work value is not balanced or correct.

Your veterinarian needs to partner with you to be able to identify if your dog is at risk of having pre-Cushing’s symptoms, or indeed already cushingoid. So if the ALP value is already elevated in your dog’s blood work, you need to ask your veterinarian if this could be the start of Cushing’s disease.

The diagnosis of Cushing’s disease is difficult. Typically it’s with the blood test. There are two blood tests that many veterinarians will do.

An ACTH stem test is a two-part blood draw that veterinarians will do to diagnose Cushing’s disease, along with a low-dose dexamethasone suppression test. Both of those are two-part – sometimes three-part – blood draws that compare the cortisol levels in your pets’ bodies to be able to make a consistent diagnosis of Cushing’s disease.

After Cushing’s disease has been diagnosed, your veterinarian will want to determine if it’s indeed adrenal or pituitary dependent. In my opinion, the best way to rule out an adrenal tumor is non-invasive ultrasound. Some veterinarians prefer to do a secondary blood test called a high-dose dexamethasone suppression test.

It is important to have a definitive diagnosis of Cushing’s and what type, either adrenal or pituitary dependent. This way, your vet will be able to offer you treatment options to the best of his or her ability.