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. Topics: 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 [email protected] Vetnostics (NSW & ACT): 02 9006 7468 [email protected] ASAP Laboratory (VIC): 1300 838 522 [email protected] Vetpath (WA): 08 9317 0777 [email protected] Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up to date easy-to-consume clinical episodes at vvn.supercast.com, visit thevetvault.com for the show notes and resources for this episode, and connect with us through our online Vet Vault Network. for episode highlights, discussions, questions and support. Join us at Vets on Tour in Wanaka, New Zealand on 13 - 18 August 2023 for great CE, live podcasting and snow... lots of snow!

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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