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Thread: Skippy has passed; 12 y/o Yorkie with likely pituitary tumor (Trilostane)

  1. #41
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    Apr 2009
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    Unfortunately a small number of our members have had their dog`s system be resistant to the effects of Vetoryl, but I really don't think you're at that point right now.

    Increasing the dose to 20 in the morning/20 in the evening sounds reasonable to me. Having Skippy's cortisol checked in 2 weeks is a great idea and that falls within Dechra`s guidelines.

    I know this journey has been so frustrating for you so I'm sending some huge comforting hugs.....keep your chin up!

    Hugs, Lori
    Last edited by Harley PoMMom; 02-11-2017 at 10:07 AM. Reason: correct my mistake regarding Judy's Abbie being resistant to Vetoryl

  2. #42
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    Thanks Lori,
    I will stop whining - now. I know Skippy and I are very fortunate and the situation could be much worse. I appreciate your kind words.
    Skippy's Mom

  3. #43
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    I made a mistake regarding Judy's Abbie being resistant to Vetoryl when actually Abbie started out with Lysodren and when that became ineffective in controlling her cortisol Abbie was switched to Vetoryl, (Thank you Judy for correcting me). I am so sorry for that inaccurate statement.

    Please do not ever feel that you are whining, our hope is that this forum is a place where our members are comfortable enough to share whatever is troubling them, ok?

    Hugs, Lori

  4. #44
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    Jun 2012
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    Canada
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    Hmm, so it's still elevated enough that if you wanted to increase the dosage you could. You could even do a 20/15.

    Pffft whine away. (I just call it good old fashion worry and concern) still if not here then where else could you get it all out and know those reading understand, exactly, what you mean.

    HUGS
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  5. #45
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    Nov 2016
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    Maryland but currently staying in Indiana
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    Lori and Sharlene,
    Thank you for your support. My comment about stopping whining was simply to say, perhaps to myself, buck-up and remember how fortunate both you and Skippy are at this point in time. Many dogs and their owners on this forum have lost the battle or are suffering grievously. Skippy does not appear to be in pain, he is tolerating the dose increase to 20/20 that we began on Saturday and while there is no observable improvement in clinical/behavioral signs, he is no worse. My fear is that I am missing something and that Skippy is dying by inches. But ultimately we all die by inches; I understand that and just want to make sure I am doing all that I can to ensure that he lives his remaining inches with the best quality of life possible. Never one to simply accept and endure, I'm going to secure a new blood panel when he has the next stim test in tenish days (he hasn't had one since he was diagnosed in November), an orthopedic evaluation and hydrotherapy (since he won't or can't walk), if it is available at Purdue. Maybe I'm simply reinforcing my own denial but to do nothing and watch him slip gently into the night is completely unacceptable until I have exhausted the possible remedies. If there are other things that I should pursue, I would be grateful for your thoughts or ideas. Thank you again.
    Skippy's Mom

  6. #46
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    I think you are doing an exceptional job advocating for Skippy and you are looking into and doing every possible course of action in order to help your sweet boy.

    Regarding his dose of Trilostane, Dr Peterson replied to one person on his blog that
    smaller dogs tend to require larger amounts of the drug.
    So it is entirely possible that Skippy's dose just needs more tweaking in order to get his cortisol controlled and see improvements in his remaining symptoms.

    We certainly understand how worried you are about your precious boy, so just to reinforce...You are doing an excellent job!!!

    Hugs, Lori

    Link to Dr. Peterson's quote: http://www.endocrinevet.info/2012/12...rilostane.html You'll need to scroll down to May 7, 2015 at 11:29 PM for his response.

  7. #47
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    Just a brief update on Skippy:

    Skippy had his fourth Stim Test in three months on Thursday. We have now increased the dosage five times, mostly by increments of five since beginning this saga in December. On his current dose of 20/20 (29lbs) his cortisol increased to pre 5.6 and post 13.1. (His last post was 10.) Clearly, Skippy is going in the wrong direction. While his clinical signs continue to improve slightly, many of the behavioral issues remain, e.g., trembling a lot, often trots home after poops instead of going for a walk, is fearful, ravenous and sometimes anxious, sleeps a lot on the wood floor, no interest in play and little interest in being petted or cuddled. Local vet added Xanax and an NSAID to his pill repertoire a week ago. Purdue wants to wait a week on current dose and see if there is improvement in clinical symptoms. If not, they will then retest and run a blood chemistry panel. They kept emphasizing that it's not the numbers but the clinical signs. In Skippy's world, neither are great. The adenoma on his butt is not growing but now the new Purdue vet thinks I should have a biopsy. (The prior vet said leave it alone until cortisol is under control.) My question is whether others have had experience with cortisol levels going up with treatment? Does this suggest that Skippy has a macro tumor? (This vet mentioned the possibility but thought that Skip did't "look like" he had one.) Thanks in advance for any input as I am at a loss.
    Skippy's Mom

  8. #48
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    I just reread some threads and read a few others related to dosing with Vetoryl and I am still uncertain. Two days ago, I sent the local vet a lengthy email summarizing Skippy's history of dosing and Stim tests and ask to see her. She responded that she didn't need to see him but wants me to increase the Vetoryl dose to 30/30 and Stim again in two weeks. I picked up the 30mg. box last night and gave him the first dose this morning. But, I am very worried that this is too big of an increase. Here's the history:
    12/6 79.2 (Began dosing 2 BID with Vetoryl 10ml)

    12/20 Pre - 2.2 (Marked Lipemia) Post – 10.8 (Moderate Lipemia, Slight Hemolysis)

    1/23 Pre – 6.3 Post – 16
    Purdue increased dosage to 15/10 BID

    1/30 Consultation with local vet and that day we increased the dose to 15/15 BID

    2/10 Pre – 6.8 Post – 12.0
    Purdue increased dosage to 20/20 BID

    2/23 Pre – 5.6 Post – 13.1
    Purdue kept dose the same 20/20 and wants to Stim again in a week.

    3/1 Local vet increased dose to 30/30 and I gave one dose this morning.

    Is this too big of an increase? I would feel more comfortable going 30/20 but I know the local vet believes that Skippy (29 lbs.) is being seriously underdosed in light of his continuing clinical signs and symptoms. Finally, I emailed Dr. Feldman and he suggested that I discuss switching to Lysodren with the vets.
    Skippy's Mom

  9. #49
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    Good morning and I hope someone can please help. I increased 29lb Skippy's vetoryl two days ago to 30/30 as directed by his local vet; the IMS said leave to old dose, 20/20 alone and Stim again in a week or ten days. He has been very restless in general at night but was far worse last night. He is trembling, even while sleeping and last night for an hour or so, he was trembling so hard that I thought he was having a seizure. I have watched him all night and he is now sleeping but trembling slightly. Also, he is reluctant to eat and his perianal adenoma has started bleeding but perhaps the bleeding is coincidental. Should I withhold the Vetoryl; the local vet is off today. I could call Purdue and see if they could Stim him again today. Am I overreacting; I am so afraid of overdosing him on this drug. Thanks so much for any help.
    Skippy's Mom

  10. #50
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    Default Re: Skippy, 12 y/o Yorkie with likely pituitary tumor (Trilostane)

    Hi Carole,

    It seems curious to me that you are getting recommendations from both Purdue and your local vet.. and possibly another vet via email. I would personally choose one vet's recommendations to follow, or at the very least, have them consult with each other and all agree on what to do. As it is now, you've got one telling you to increase, one to stay the same and another to possibly switch meds entirely. I'd be completely confused and uncertain what to do!

    If it were me, at this point I think I'd call Purdue and schedule the test they asked for... tell them about the increase and then follow their recommendations.
    Last edited by DoxieMama; 03-03-2017 at 07:25 AM.
    Mama to Jackson and Kira, and my darling Cushing's angel, Visuddha

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