Cushing's Diagnosed - is ultrasound necessary for treatment

[lhopper]

After high cortisol levels, my dog had an MRI that showed enlarged liver and some other enlargements.   He had the ACTH? stimulation test which came back positive for Cushing's disease, which was expected.   My vet wants to do an ultrasound now.  I'm sure it's expensive (as was the stim test) and I'd asked about just skipping the stim. and doing an ultrasound since most of my reading indicates that's the next step,  but he said no that wasn't a good idea.   My question is- is the ultrasound necessary to determine the treatment.   Should the MRI results be sufficient to show whether the Cushing's is pituitary dependent or adrenal based?   I'll do what I need to, but also don't want costly unnecessary tests. Thanks very much.

[lindapalm]

Our dog had Cushings and I felt her vet wasn't doing enough testing, we had to request a ACTH test after she was on meds for two months to see how her levels were  She didn't have and MRI or ultrasound, just a low dose dex test to verify she had Cushings, even though she had every symptom.  I would ask your vet what the ultrasound would show that the MRI didn't, and if he still thinks its necessary for treatment, I'd go with it.  This way you'll be sure you've checked everything necessary. Its a very difficult disease, and I feel the vet really has to stay on top of things, which it sounds like yours is.

[Sandra_G]

You won't be wasting your money on an ultrasound. It tells so much more than most tests.
The ACTH stim test tells what the dogs numbers are with cushings... & how high are his numbers to begin with, &/or is the disease getting better & going lower in numbers with treatment.  My dog has to have the ACTH done every month for now,  but I waited two months. I don't feel that her cushings is getting better right now. My vet charges 300.00 for the test & it gets crazy after awhile.
Unfortunately, Cushings reeks havoc on a dogs body. My mini poodle has it for 1 1/2 yrs. & has been on Trilostane. It needs to be upped in her dose again.
Read the post from me today. Go to my site & READ WHATS BEEN GOING ON.  This disease is a mind blower. My best to you & your dog.