Cushing’s Decision App
With all cases of canine Cushing's disease, it is about making a judgement call on whether to commence endocrine diagnostic testing. Some presenting features may enhance your suspicion of the disease’s presence; others may reduce that index of suspicion.
We have created a Decision App that helps you weigh up these features. The app is not designed to offer a definitive diagnosis; it is here to highlight the features that most strongly support or oppose the presence of suspected Cushing's. You can then use the results to inform your thinking when you assess the full clinical picture.
Note: Check the resources section for a glossary of terms used in the app, and for further help and support on Cushing’s disease and Vetoryl.
To get started, complete the app using example data from this case study. Follow the Decision App instructions, referring to the information below throughout.
- Owner reports a little more lethargic and panting more than usual
- Stress leukogram
- ALKP 6 x upper reference limit
- ALT 2 x upper reference limit
- Total T4 decreased
- Urine specific gravity 1.016
- Pre-prandial bile acids normal. Post-prandial bile acids mildly increased (22 umol/l)
- Positive low dose dexamethasone suppression test