Cushing’s Diagnosis & Options/Questions

[EspressoOrElse]

Hi friends, need some advice. Considering end of life options.

We are a week today on Vetoryl (5mg twice daily). While the good news is no side effects, we have had absolutely no improvement. Recent development this week are neurological issues. She has lost fine motor skills, has fallen a few times, ran into obvious things a few times, etc… We have our ACTH test scheduled a week from today (which will be two weeks on Vetoryl at that point). Beyond all this are all the other classic symptoms. We’ve added a diaper at night.

Given no symptom relief I asked my vet if we could go from 5mg to 10mg and push the ACTH test by two weeks. Vet disagreed. She wants to check numbers two weeks into 5mg and go from there. She agreed we will probably need to increase the dose, but unwilling to do that until we test. She let me know the ACTH test will just let us know that we “aren’t pushing numbers too low. We never raise a dose at two-week check because it works better over time and we don’t want a roller coaster of up and down doses.” She also said “Usually if the first test is normal or still high, we wait two more weeks to see what happens and then we may increase dosage.” Any thoughts on this? Am I being too impatient?

I’m frustrated because Petrie is still suffering, if not more at this point. Vet wants to basically wait another ~2-3 weeks before considering to increase dosage and then test again. This was my fear as now we are talking two tests in less than 30 days. To be completely transparent, I’m beginning to have thoughts that, given the advancement of now even more issues, I don’t want to wait until Petrie is at her worst (or has to experience her worst before we realize she can’t for the long haul). And with that, not sure if we should even move forward with the ACTH test considering her anxiety, but consider a different comfort option here in the near future. Am I being unreasonable about this?

I struggle as I realize there is no cure to this and find myself wondering how long I’m going to drag her though this with just the hope Vetoryl will turn her back to the way she was.

[Harley PoMMom]

The vet is correct in that is not recommended to increase the dose at the 2 week treatment window because cortisol may continue to drift downward during the first 30 days of treatment; however in saying that, if Petrie's ACTH stim test shows that her cortisol level is high you could tell the vet you want to increase the dosage another 5 mg for a total of 10 mg daily or split to 5 mg twice a day.

In some dogs with the pituitary type of Cushing's the tumor on the pituitary gland can grow, and if large this is when neurological symptoms start to appear. The only way to see if this is happening is with a MRI.

I am so sorry that you and Petrie are going through this and my heart goes out to you. The one fact I can tell you is that only you know Petrie the best and know what is best for her.

Hugs, Lori

[EspressoOrElse]

Hi Friends,

Petrie crossed the rainbow bridge peacefully in my lap, getting kisses and being told how much she is loved on November 20, 2023. Everything went as planned. I want to say thank you to the mods and everyone else that offered thoughts and help during this time. It bought us a few more weeks together, for which, I am incredibly thankful for. Unfortunately, Petrie began having too many complications and her comfort/quality of life began to be compromised. Her ashes are already back home and she rests next to the side of the bed. Now begins the time to heal.

Thank you for having this forum. It helped us make important decisions these past weeks

[labblab]

I am so sorry for your loss of your little girl.. But thank you so much for returning to let us know what has happened. We are very grateful that you are allowing us to join you in honoring Petrie’s life and celebrating her sweet spirit. She has now been added to our special memorial thread, where she joins all our other beloved Rainbow Bridge babies.

https://www.k9cushings.com/forum/sho...288#post211288

If you’d like for us to add a photo link to her memorial line, it will be our privilege to do so. At any time, you can send a photo to our gmail account, and we’ll take care of the rest: k9cushings@gmail.com.

Thank you, also, for all of your very kind words. Petrie was such a lucky girl to have you for her parent. She was released from this world cradled in love, just as she lived her life. Please know that we’ll welcome you back at any time should you wish to share more stories about your sweet girl, or if you just want to talk. You and Petrie will always remain part of our family.

Take good care of yourself, and sending my best wishes to you always.
Marianne

[Harley PoMMom]

I am so sorry for the loss of your beloved Petrie and my heart goes out to you at this most painful time. Please know that we are here for you and always will be.

With Heartfelt Sympathy,
Lori

[Joan2517]

I'm so sorry for your loss of Petrie.

[judymaggie]

I am newly back on the forum but have read your posts about Petrie. She was obviously much loved by you and you have offered her the loving act of letting her go. Let your heart heal by focusing on all the wonderful times spent together.

[gyrochris]

I didn't finish reading the whole thread I'm so sorry about your dog You know Penny's 14 and that's a good life for her She's ready to go Now my Min Pin at 13 Here's Dad made it to 16 but let's not split hair share Pennies had a great life You know I'm not going to let her suffer But I understand your pain She's my best friend in the whole world world