Date - Sat, 2 Sep 2000 17:55:00 -0400 
From  - "Dot & Chris" falapink@IWAYNET.NET
To - CYBERSCOTS

I, too, have noticed that many Scotties have elevated liver enzymes from people posting to the list.  I am beginning to think it is a somewhat normal thing.  I just hope it doesn't mean future problems for the scots that are 'normal' now.

That is what my vet says & I did read this in a paper from tufts.  As a dog ages the liver enyzmes to increase which is normal, but when the just skyrocket is when further investigation is called for.  I know that when Fala was 8 his AST was elevated & then when he turned 10 his AlkPhos turned up extrememly elevated from his previous year so it was fractionated & that is when the Cushing's syndrome was found.  I think it important in an aging dog to have yearly blood test done to look for things like this & to use as a base line to monitor them yearly for disease progression.  With Fala, we were so concerned about the Cushing's becoming full blown which it did the last 2 months that other symptoms he exhibited were ignored & when his blood was retested it told us of the cancer's progression into his liver & lymphs.  Gee I still am blabbering aren't I...guess I just want to stress that to have blood work done around 6 years as a base line & if possible at the annual exam at least have a chemistry profile done that includes liver enzymes & a glucose (older dogs are prone to diabetes too).

dot 

Dot & Chris & Fala Pink
Be Obsessed - Visit the Scottie Obsession Page
http://www.iwaynet.net/~falapink

PS The oldest Scottie of my friend, 10 years old, has Cushings.

Cindy:

As much as I agree with 90% of what you have written, I think it is most misleading to state Lysodren as the *only or even preferred drug therapy for Cushings. Although it has a long standing pharmacological reputation as being efficacious, there are medical/veterinary critics who argue in favor of Anipryl over the older drug modality,  Lysodren. Each present with their own list of precautions.

It's just my personal opinion, but speaking as a retired pharma rep, today more than ever, there are *choices, what may be appropriate for one patient may or may not be for another. My Kugel being a perfect case study of tolerating Anipryl for nearly 6 years, for which I am eternally grateful.

I agree most, with your statement to get a clear and definitive diagnosis with a qualified specialist before beginning any drug therapy. Second opinions are worth their weight in gold in our experiences with Kugel.

Advanced, scientific technology coupled with extensive research has allowed us the privilege to exceed yesterday with improved tomorrow's.

Debbie of  ~ TRADITIONS ~ Handcrafted Dog Tiles ~

Hi CyberScots, 

Each of these drugs works via a different mechanism.  Anapryl works on the pituatary gland to suppress the hormone that causes the adrenal gland to produce excessive steriods.  Lysodren actually destroys the adrenal cortex that is producing the steroids.  If the cause of Cushings is a pituatary tumor (causing the excess production of hormone), both drugs can work.
But if a scottie already has a liver problem, lysodren can be very harmful because it is very harsh (like chemotherapy) and it metabolized by the liver.

However, if the cause of the Cushings is an adrenal tumor, the *only* real cure is surgery.  :Lysodren may help in the short term, but it will not destroy a tumor.

This is why it is so important to get a differential diagnosis from your vet to determine the underlying cause of the Cushings.  What are the tests available to differentiate between pituitary and adrenal dependent Cushings in a dog?  The high dose or ultra high dose dexamethasone suppression test or an endogenous ACTH level.  About 75% of dogs can be differentiated using the high dose dexamethasone suppression.  If the dog suppresses, the diagnosis is pituitary-dependent.  If there is no suppression, then the dog could still have either form of Cushings and an endogenous ACTH level should be submitted.  In other words, the results of the high dose dexamethasone suppression test can only identify dogs with pituitary-dependent Cushings.

If cortisol levels are not suppressed by a high dose of dexamethasone in a dog with confirmed Cushings, the odds of pituitary-dependent versus adrenal-dependent Cushings are 50:50.

Jane Morley