Page 3 of 15 FirstFirst 1234513 ... LastLast
Results 21 to 30 of 143

Thread: Cooper - diabetes and cushings - sweet Cooper has passed

  1. #21

    Default Re: Cooper - diabetes and cushings

    I just wanted to post a quick update on my Cooper. We did the 60mg dose of vetoryl once a day and 30units of insulin twice a day for about 2 weeks because we were going on vacation and didn't want to push things with Cooper while we were gone. When we got back from vacation we did a glucose check and 6 hours after his morning insulin his blood sugar was in the upper 200s (which was the absolute lowest we'd seen but still not in the desired range). The vet said to start giving 60mg of vetoryl twice a day.

    He wanted us to stay at that dose for 3 weeks then do an ACTH test. We're 2 weeks into it and I just rushed him to the vet. His teeth were chattering for a bit so I left a message with the vet to see if this was some indication that the insulin was too high. Cooper went and took a nap then woke up and his back legs were twitching and he walked into a wall.

    I took him straight to the vet. His blood glucose reading was 169. But she said she's more worried about him getting an overdose of vetoryl and that it sounds like he's getting addisonoid (is that a word?). His electrolytes were very low so he's spending the afternoon at the vet getting fluids and when we pick him up we'll find out how we're going to adjust his dose.

    I had never heard about the teeth chattering or muscle twitching, so I thought I'd post his update so more threads would show up if people were searching!

  2. #22
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Cooper - diabetes and cushings

    Oh dear. It looks as though our worst fears have been realized as far as the possibility of overdosing Cooper with the addition of that second 60 mg. capsule.

    I will keep my fingers crossed that he rebounds quickly. But depending upon how low Cooper's cortisol actually went, do be aware that Vetoryl's manufacturer advises against resuming dosing entirely until clinical symptoms reoccur and the cortisol is back to a normal level:
    If the ACTH stimulation test is <1.45 μg/dL (<40 nmol/L) and/or if electrolyte imbalances characteristic of hypoadrenocorticism (hyperkalemia and hyponatremia) are found, VETORYL Capsules should be temporarily discontinued until recurrence of clinical signs consistent with hyperadrenocorticism and test results return to normal (1.45-9.1 μg/dL or 40-250 nmol/L). VETORYL Capsules may then be re-introduced at a lower dose.
    Thank you so much for letting us know what has happened. We will continue to warn against starting dogs off at too high a dose, and so Cooper's experience may end up helping another doggie further down the road.

    In the meantime, sending many healing hugs your way. Please keep up updated!

    Marianne

  3. #23

    Default Re: Cooper - diabetes and cushings

    My Jenny, also diabetic and Cushings went Addisonian from too much Lysodren. Thank goodness you caught it

    The only hope I have for Cooper is that his BG stayed at 169. Jenny dropped as low as 40 so maybe you caught it in time.

    Jenny's ACTH was at .2 after her overdose last April and she was on prednisone for about 4 months and hasn't been on anything but insulin since August 2012

    It isn't the end of the world if it happens. Her hair looks better and she is frisky. And her cortisol is very very slowly coming back up

    Please keep us posted. good catch. hugs, Judi

  4. #24

    Default Re: Cooper - diabetes and cushings

    Wait, so when they go Addisonian it's a long term, new condition sort of thing? I had assumed it was just a short term effect and that once the vetoryl was out of his system he'd go back to normal.

  5. #25
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Cooper - diabetes and cushings

    Due to the mechanism by which trilostane works, more often than not, cortisol levels do rebound relatively quickly in dogs who have "crashed" while taking the drug. However, there are exceptions and there is no way to predict in advance. For some dogs, it may take months before cortisol levels normalize. And a few dogs remain permanently "Addisonian" (meaning that they will require lifelong steroid supplementation from that point onward). But at this point, it is far too early to suspect longterm issues for Cooper. In the short term, the important thing is to stabilize him with IV support as is being done.

    But since trilostane does have the potential to cause longterm adrenal suppression, you want to make sure your vet doesn't leap right back into resuming the trilo -- even at a lower dose -- until you are certain that his adrenal function has normalized once again based on his behavior and ACTH monitoring results.

    Marianne

  6. #26

    Default Re: Cooper - diabetes and cushings

    I'm getting so antsy to talk to the vet now, there's nothing worse than looking things up on the Internet! She had mentioned doing his ACTH test early (he was scheduled for it next friday.) I'm hoping she wants to do it tomorrow, although I think I still would have to wait until Monday for the results.

  7. #27
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Cooper - diabetes and cushings

    Yes, I agree with you. If Cooper's electrolytes have dropped low enough to need IV support, he also needs to have his cortisol level checked ASAP. If it has dropped too low, he may need some oral prednisone for at least a few days in order to make up for the loss. The last thing you want is for him to go into a crisis over the weekend when your vet is unavailable. So even if the ACTH results are not known until Monday, I encourage you to ask your vet for prednisone to have on hand should Cooper appear to need it over the weekend.

    I realize this is even a bigger issue for him since he's diabetic, and big changes in his steroid levels have an impact on his insulin needs. So I'd definitely want a gameplan in place before the weekend.

  8. #28

    Default Re: Cooper - diabetes and cushings

    Thanks! I will be sure to ask for some emergency meds in case we need them.

  9. #29
    Join Date
    Dec 2012
    Location
    London, UK
    Posts
    1,431

    Default Re: Cooper - diabetes and cushings

    Just wondering how you and Cooper are? Hope everything is ok

    Mel
    Xxxxx

  10. #30

    Default Re: Cooper - diabetes and cushings

    Thanks for asking! He's doing well today. He got fluids all afternoon yesterday and sent home with prednisone (sp?). The vet had me give him half a 20mg tablet last night. She said to skip the vetoryl last night but to start again this morning since he really seems to need it to get his insulin to work. We're cutting back his dose from a 60mg pill twice a day to a 60mg in the morning and a 30mg at night. She said at the first sign of twitching or anything else unusual to stop the vetoryl, give him a prednisone and bring him right in.

    He'll have an ACTH test in a week and a half. I think the vet is trying to hold back a bit on testing since he's got so much going on. I guess the vet wants to let his body adjust to everything. But if Cooper does have another Addisonion episode, I'll be stopping his vetoryl and making sure I don't start it again until his ACTH test comes back above 1.45 or whatever it's supposed to be.

    Luckily I'm a stay at home mom and I have a 2 year old who naps around noon. Cooper had his little episode at 11am and I hate to think what would have happened if I wasn't here giving my son lunch. With the way the insulin and vetoryl work together he's most at risk 6 hours after his morning meds, which is right at noon. We're almost always home at that time for my son's nap.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •