"I had it done years ago - and now I am headed for another one - the ultrasound showed another nodule... " Hi Carrie. Thyroid issues can have many causes. Please check out the link below to see what others have done to get themselves back on track. Best of health to you now and after the holidays! A link that might be useful: http://www.naturalnews.com/043264_thyroid_nodules_nutrition_pharmaceutical_medicine.html

Kellyeng, How did you make out with your thyroid results? Sueb, Sounds like you had a good start to your 50th bday goal by not gaining while on vacation. Build from there. Keep thinking positive and about lifestyle changes, not just weight loss. Trim 100-200 calories everyday, not so much your body misses them, enough to make difference over the course of a year. A little less cereal, a smaller amount of yogurt, one less piece of bread - you get the idea. Don't worry on the actual calorie amount, just tweak each meal by taking a smaller portion or skipping a calorie laden beverage. Whether we like it or not, movement is crucial to weight loss and maintenance. You need to find a way to move more. You know the usual things - park farther from the door, take the stairs, stand up more. Can you add an activity that doesn't seem like exercise? Horseback riding? Ice skating? Bike riding? Swimming or treading water? For fitness the expression is: don't sit when you can stand, don't stand when you can walk, don't walk when you can run (although I only run if I'm being chaaed). For long days touring when we travel, I tell my husband the rule changes to don't stand when you can sit, don't walk when you can ride, and don't ever pass a clean bathroom without using it. But I digress...

No, the ACTH stimulation test checks only for increases in steroid hormones and does not measure the sex hormones, so it cannot be used to diagnose atypical Cushings. I don't know what a 7200 profile is either, but any vet can send a blood sample to the Tennessee Endocrine lab. Screening tests for Cushings only test for typical Cushings; they cannot be used to diagnose atypical Cushings. They are: Urine cortisol:creatinine ratio- determines if there is enough extra cortisol being produced to spill into the urine. A negative test here pretty much rules out typical Cushings, but a positive test is not conclusive. ACTH stimulation test- pretty good diagnosis for Cushings, but 5% of tests are falsely negative Low dose dexamethasone suppression test- False positives occur frequently with stress or other diseases, but a negative result pretty much rules out typical Cushings None of these are helpful if steroid hormones are not being overproduced as with atypical Cushings though. All of those tests can be normal, but the adrenal gland would still be producing too much sex hormones. There is no way to diagnose a specific liver disease just on lab work. All those results mean is that there is some sort of liver disease present, but it does not tell you exactly what is going on. In fact, those kinds of numbers are pretty commonly seen in Cushings, typical or atypical! Has a CBC been done? Usually dogs with typical Cushings have characteristic changes in the CBC, commonly referred to as a "stress leukogram." A non-invasive way to maybe help determine what is going on in the liver is an ultrasound. While you can't make a specific diagnosis with it, livers that have steroid hepatopathy (as from Cushings, typical or atypical) have a characteristic vacuolar change on ultrasound. Ultrasound may be suggestive of other liver diseases that could explain those lab results as well. You can also look at the adrenal glands for changes in size and/or shape and see if there is evidence of Cushings that way. I can't remember any specific changes in atypical Cushings but we didn't see that many cases, even in school. But with typical Cushings you can almost always see changes in the size of the adrenals, with pituitary-dependent Cushings (most common in dogs) showing both adrenal glands enlarged, and adrenal-dependent showing one enlarged and one small adrenal gland. I am a *huge* fan of ultrasound-guided liver aspirates. While it would require heavy sedation, unless your dog has any medical reason that he can't be sedated, I personally would do it. I would do a coagulation profile first, because the liver makes most of the coagulation factors and since your dog definitely has evidence of some sort of liver disease I would need to know if he can clot properly before sticking a big needle into his liver. But if the coagulation profile was normal and he doesn't have other problems that make him unable to be sedated, I would go for it. Using ultrasound guidance on the aspirate is very helpful especially if there are any lumps or bumps that specifically need to be sampled. Aspiration with a large needle for cytology has been shown to be a very sensitive and specific means of diagnosing liver disease; there is no need to get a larger sample such as with exploratory surgery. But even if you couldn't do a aspirate I think and ultrasound would be incredibly helpful. None of the medications you are currently giving your dog are harmful, and it is possible that they may be helpful even if he doesn't have chronic active hepatitis, since he definitely has some sort of liver disease. Those medications are good for generally helping the liver no matter what the cause. I think that feeding him the human grade food is great for every dog, but especially for dogs with liver disease. You are doing a great job managing his joint disease without aggravating his liver with NSAIDs. We got cases like Jet all the time in school. The vets know there is a problem, and Cushings was strongly suspected, but could not be proven conclusively. Even with all the wizz-bang toys and incredibly smart, board certified specialists, we couldn't always get a definite answer either. Since the Tennessee endocrinology lab started offering their sex hormone profile we have been able to get more cases figured out, but some are just mysteries and we don't know how to treat them. Anyway, I would strongly suggest an abdominal ultrasound first, plus aspirates if possible, to help diagnose the liver problem. To specifically diagnose atypical Cushings, you need to measure the sex hormones which is most commonly done through the University of Tennessee lab. Any vet can submit a sample to them, and the results come back with a potential diagnosis and suggested treatments; it's a no-brainer for the most part. I know how frustrating it is when you know there is a problem with your pet that isn't being addressed. Keep on bugging your vet until all of your concerns are addressed. It's their job. It sounds like you are doing everything in keeping Jet happy and healthy, and besides the panting he seems comfortable, so that is good. Good luck with a diagnosis. Here is a link that might be useful: Diagnosing Liver Disease

Thank you, thank you, thank you to Silversword and lamom. You get what I am saying. I was not trying to "goat" anyone into anything or stir up the pot. I really was posting my deep thoughts, kind of like a journal to myself while at the same time trying to explain the situation. The reason I wrote the stuff about the BM being proud of being 'white trash' was because I was trying to explain about what I am dealing with here. That is all. I am the furtherest thing from someone who is all high and mighty and I don't think I am better than anyone else. In fact I am more of the black sheep in my family partly because I am not so judgmental and I am the rebel. I have tattoos, moved out at 17 on my own, don't like people to tell me what to do, etc. And yes I freely admit I am a control freak. That is something I am working very hard on. After the first post I was just adding details and my mind and thinking were changing. I am glad that my tune has changed since last Sunday. I am feeling much more optimistic now. Honestly I didn't think I was even going to come back to this site and I told myself today ok just go see what was said but don't post anymore. I am glad I did come back because both silversword and lamom made feel better and realize that not everyone here is so judgemental. I can take criticism and I was really thankful for the first few posts that told me to grow up because that is exactly what I needed to hear. And I do not get off on or enjoy writing inflammatory posts. I am sorry I was just writing my story and the quotes that sylviatexas posted that I wrote on the first day I registerd were written because that is what was said. I was not making anything up, that is my story and I am sticking to it, lol. My DH did not graduate but I don't hold that against him. I still love him very much. He also had a drug addiction in his past but you know what he is stronger for it and has proven how he can overcome almost anything. People do change and I do not hold their past on them forever. When I say he went through a bad period that is what I was referring. There is, of course, way more to the story and lamom is right you can not describe it all in one post, or even probably in 100. But what matters most is that this site did help me. I got a change to write my thoughts down and try to figure out what in the world I was really feeling. The more I wrote about SS and what HE has to deal with the more I found that I do care about him. I really do. It is still going to take time to build a relationship but I think it is all going to be ok.