#92: Cushing’s: Diagnose like a pro, and treat it like you mean it. With Dr Sue Foster
Who feels like Cushing’s is a nice disease to diagnose and manage? Like, how often do you feel like your hyperadrenocorticism patients are really doing REALLY well? My guess is: not that often. This episode will change that.
Dr Sue Foster is a registered specialist in Feline Medicine and Senior Lecturer in Small Animal Medicine at Murdoch University in Western Australia. She’s also a medical consultant for Vetnostics and ASAP Laboratory, where a large part of her role is interpreting cortisol test results and supporting veterinarians in their clinical decision-making. In this conversation, Dr Sue challenges the belief that Cushing’s is to some degree a ‘lifestyle’ disease that doesn’t always need to be treated, we discuss the subtle ways that it can present, and of course we take a deep dive into those slippery cortisol tests, which should feel a lot less slippery after this episode. Dr Sue also presents a paradigm shift in how we think about treating these cases.
0:00 Understanding the cortisol lab tests.
4:40 ACTH stim vs LDDT – which is better?
10:28 The TRUE significance of ALP in diagnosing Cushing’s.
13:30 Fasting triglycerides – your friend in Cushing’s screening?
16:26 Deciding when to test for Cushings .
18:27 More on triglycerides and lipaemia
23:52 Why Cushing’s cases don’t all have to have pu/pd.
26:04 The many different faces of Cushing’s – spotting the sneaky hyperA case .
29:42 Why we should consider treating Cushing’s even if they aren’t textbook cases.
31:41 Cushing’s and anxiety.
35:40 The dog with the high ALP but no clinical signs of Cushing’s.
39:44 Treatment trials for the ‘undiagnosable’ Cushing’s case.
45:13 Monitoring Cushing’s therapy with ACTH stim testing.
52:30 The quick and easy ACTH stim test.
56:20 Treating Cushing’s like a pro.
This episode is supported by the SVS Pathology Network.
QML/TML Vetnostics (QLD & Tas): 1300 838 765 firstname.lastname@example.org
Vetnostics (NSW & ACT): 02 9006 7468 email@example.com
ASAP Laboratory (VIC): 1300 838 522 firstname.lastname@example.org
Vetpath (WA): 08 9317 0777 email@example.com
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