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Thread: Rudy: New diagnosis, on Trilostane/Vetoryl, lethargic

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  1. #1
    Join Date
    Aug 2010
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    Default Rudy: New diagnosis, on Trilostane/Vetoryl, lethargic

    Hi, I am new here, been reading all day and just wanted you to know I feel so much better after reading this. Apollo has almost identical symptoms to what my dog has.

    Rudy was diagnosed with Cushings July 22 and started on Vetoryl that day. I saw vast improvement in the water drinking, panting and peeing within a few days. But about a week later, my poor puppy looked half dead. He was lethargic, not eating and his hind legs suddenly seemed to give out on him. He no longer wanted to go for walks more than a few feet.

    I called my vet and he was surprised because he said Rudy's cortisol was 'super high' according to the ACTH test we had done. He gave me a script for prednisone in case Rudy got 'shocky'. Rudy weighed about 45 lbs at the time he was diagnosed, so he was prescribed the 60 mg capsules once a day.

    I quit giving Vetoryl to him since Monday. He has improved every day since, finally eating a little bit and today he actually made it to the park for a shorter walk, but did not appear to have as much trouble as he had even yesterday.

    My vet said to give him the Vetoryl every other day, since it is in capsule form and I can't just half the pill. He also said I could open up the capsules and sprinkle half on his food every day if I wanted to, but I have read not to do that.

    My question is: since he is almost back to normal and has been off Vetoryl for 3 days now, when should I start him back on every other day? It is obvious to me that the dosage was too high even though it is correct for his size. We are supposed to have a follow-up ACTH on Aug 21st and I believe I read in here that he needs to be taking his meds for 2 weeks prior to that time in order to get an accurate reading?

    I hope there is more good news on Apollo from the Vet today!
    Last edited by MyRudy; 08-05-2010 at 07:16 PM.

  2. #2
    Join Date
    Apr 2009
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    Chandler, AZ.
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    Default Re: Rudy: New diagnosis, on Trilostane/Vetoryl, lethargic

    I want to welcome both you & Rudy! I must warn you that we tend to ask a lot of questions of new members, but that just helps us to give you the most appropriate feedback possible from the group's collective experience. Can you tell us a little more about Rudy's history? What symptoms led you to take Rudy to the vet? What tests were done to diagnose Cushing's? Some of these tests may include an ACTH, low dose dex test, or even an abdominal ultrasound. If you could post the actual results for us, that would be great. We are not trying to second guess your vet, but we have seen too many pups mis-diagnosed due to lack of sufficient diagnostic testing, a vet who is inexperience in treating Cushing's, or both. Did your vet rule out diabetes & thyroid problems? I ask about these 2 problems as their symptoms can overlap with Cushing's.

    I'm very concerned about your vet's experience in using trilostane & treating Cushing's. Trilostane only has a half life in the body of about 12 hours, so every other day dosing is a complete waste of time. Most members who use trilo, dose once daily, some members have to dose twice daily. We do have many members using trilo, so I'm sure some of them will be along to offer their input.

    Looking forward to hearing more.

    Debbie
    Mom to 2 Cushing's angels

  3. #3
    Join Date
    Aug 2010
    Location
    Houston, TX
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    Default Re: Rudy: New diagnosis, on Trilostane/Vetoryl, lethargic

    Quote Originally Posted by StarDeb55 View Post
    I'm very concerned about your vet's experience in using trilostane & treating Cushing's. Trilostane only has a half life in the body of about 12 hours, so every other day dosing is a complete waste of time. Most members who use trilo, dose once daily, some members have to dose twice daily. We do have many members using trilo, so I'm sure some of them will be along to offer their input.

    Looking forward to hearing more.

    Debbie
    Yes, this is exactly what I was concerned about! Thank you so much. I fear my vet is not very experienced as well.

    Rudy went to the vet first in June for his 6 month check-up since he is a senior dog (12 1/2). I had recently noticed excess drinking and peeing and some coughing as well as one of his hind legs giving out at the end of our walks. I described these symptoms to the vet and he did a urine test and blood test that day, but I have no idea what kind and I never got the numbers on any of the tests I've had done on him.

    He said his urine was very watery and that his blood levels were in normal ranges, he had been worried about kidney disease. So next we had a urine bile acids test as he was afraid of liver disease. That came back with numbers a little high but he said still not too far from normal.

    An ultrasound was performed a few days later and it showed all organs normal except the adrenal glands were both enlarged. So then they performed the ACTH and all I was told is that the cortisol levels were super high. I will need to call the vet's office tomorrow to get the actual numbers.
    Last edited by MyRudy; 08-06-2010 at 09:05 AM.

  4. #4
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    Nebraska
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    Default Re: Rudy: New diagnosis, on Trilostane/Vetoryl, lethargic

    Welcome from me as well! I question the dx as well as the experience level... hard to know without those reports. If I were you and it isn't too big of a deal I would go in person and get copies of the reports.

    I just went thru an ordeal with my vet and there were several times when I'd get a verbal report that didn't quite have all the info in it that was in the reports. So if you can - go get copies of all blood tests, etc that have been done. Then post the results here and it will help us understand the situation a bit better and help guide you thru the process.

    Cushings is a serious disease but it isn't imperative you start treating right away so I'd cease with the trilostane until I had a greater comfort level that the dx is right. Frankly the regime you are on is a waste of time - as Deb said - the drug doesn't last long enough in the system to be effective with every other day dosing.

    Hang in there and keep us posted. Glad you found us. Kim

  5. #5
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    Apr 2009
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    Scottsdale, AZ
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    Default Re: Rudy: New diagnosis, on Trilostane/Vetoryl, lethargic

    Corky and I also want to welcome you and Rudy.

    I know you have gotten some very good information, but I just want to mention that you can get Trilostane compounded in other doses than Vetoryl. Corky is taking Trilostane, and is doing very well on it. His IMS started him on the lower dose, and then increased it as it was necessary. Corky started with his dosage once a day, and is now dosing twice daily.

    I hope everything goes well with Rudy's treatment.

    Terri
    Last edited by littleone1; 08-05-2010 at 08:22 PM.

  6. #6
    Join Date
    Aug 2010
    Location
    Houston, TX
    Posts
    94

    Default Re: Rudy: New diagnosis, on Trilostane/Vetoryl, lethargic

    Thanks for everyone's advice, I feel better already.

    I had another vet at this same clinic for many years and then I guess he quit working on Saturdays (which is the only day I can take Rudy in since I work and am single) so I got switched over to this new vet. My other vet was much older and more experienced and he explained things much better than the new guy. I may ask for him back and just take time off work if necessary.

    I am going to call them tomorrow and ask them to fax the test results, is that okay? What reason do I give for wanting them?

    There were a few days this week when I thought I was going to lose Rudy. I don't understand why he is worse now than he was before I gave him any pills at all. His hind leg weakness is the most difficult to deal with - I felt just like Apollo's mom did, it was like Rudy aged 30 yrs in a matter of days!

    I gave him a total of 11 pills and the last few I wish I had not given him. I have paid close to $1,000 already with all the tests and $100 for a month's supply of vetoryl which the vet told me I would have to keep Rudy on for life.

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