My Boxer has Cushing's. Why does the vet recommend LDDST before HDDST?

Question

Hi, my 10 Y.O. boxer seems to have Cushings. Need to decide next test. Vet sugg. LDDST, why not do HDDST right away if it's more likely to tell us if PDH or adrenal based? We have eliminated diabetes, hypothyroid and kidney failure w CBC. Main symptoms have been chronic UTI (past 2.5 years, 5-6 infrections), increased thirst and urination accidents.Thanks. Pet's info: Dog | Boxer | 10 years and 3 months old

Laura Johnson VMD · Accepted Answer

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Your Vet needs the LDDS first to make the diagnosis that Roxy does actually have Cushings.....and sometimes we can tell from the LDDS if the Cushings is more likely PDH in origin vs tumor (since 70% of patients with PDH suppress plasma cortisol to less than 50% of the pre-treatment value ). If Roxy does not suppress to less than 1/2 of the pre treatment value at 4 hours, then we need the HDDS test which helps us to differentiate Cushings due to adrenal tumor vs PDS. So LDDS first. Then HDDS if the LDDS did not suggest PDH. Other simple things to look at with Roxy: urinary incontinence, trying her on a Proin or DES trial and looking at her vulvar conformation and make sure she doesn't need a vulvoplasty. Good luck!

My Boxer has Cushing's. Why does the vet recommend LDDST before HDDST?

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