Vetoryl for impossible to pill dog?/New CCD diagnosis [Archive] - Canine Cushing's Information and Support Forums

CookieJones

05-30-2010, 02:34 PM

Hi. We're new here and very glad to have found this group. Our 13 yr old Bichon was diagnosed with Cushings (vet sent to Univ of Tennessee), and he's fairly sure it's adrenal.

We're dying to treat the Cushings because it's making her miserable (heat intolerance, panting, overweight, lethargy, weak legs, etc), but we have two complications.

First, she's prone to bladder stones, so the vet has her on daily Clindamycin to prevent bladder infections. Second, she's impossible to pill. Not just difficult, but impossible. She chokes if we try to force it down. So meds must be given either mixed with food, or - in the case of Clindamycin (nasty bitter taste) - mixed with water and squirted in her mouth with an oral syringe (followed by a strong-tasting treat).

The 'impossible to pill' part is the big challenge. Two months ago we tried Vetoryl 30mg - opening the caps and mixing with food (yes even though the insert says not to). We had to stop it after a few weeks because of vomiting/dry heaves and increased lethargy. But the strength in her legs had started to improve, and the vet said her 2-week follow up test was perfect, so the dosage, at least, was not the problem. More importantly, about a day after we stopped the Vetoryl, she started getting much better, bouncing around like a puppy, climbing stairs with no problem, and overall a very happy dog. We hadn't seen that in years. It lasted about two weeks, then she slowly reverted to her old, lethargic, weak-legged self. The vet thinks the Vetoryl had probably just started to work when we had to stop it.

That raises my first question - is the vomiting likely due to taking the Vetoryl out of the capsules? I've searched all over but can't find the reasoning behind this restriction. Does anyone know - Is it merely unknown/untested? Or is it actually known to harm the dog? Or just due to the handling risk to humans (eg a pregnant woman)?

Now we've found a reputable pharmacy that compounds a liquid suspension form using real Vetoryl as the base. We started her on that 10 days ago (at a lower dose - 20mg) via oral syringe. But yesterday she got a bit of the dry heaves, so I'm worried we may have to stop it again. Which would be a shame, because it looks like it's starting to work again.

Anyone have experience or thoughts re this? She still has a huge appetite and has not lost any weight. Could the liquid suspension form be the problem? Or could the Vetoryl be reacting with the Clindamycin maybe? They're given roughly 8 hours apart (Vetoryl 9am empty stomach, Clindamycin 5pm before dinner).

She gets her 2-week follow-up in 4 days, unless I stop the Vetoryl before then.

Any thoughts/advice greatly appreciated.

Harley PoMMom

05-30-2010, 03:13 PM

Hi and welcome to you and your precious girl from me and my boy Harley! I am sorry for the circumstances that brought you here but so glad that you found this forum!

One reason your girl might be getting yucky from the Vetoryl is because she is being given it on an empty stomach. Vetoryl should be given with food to be absorbed properly and the food acts like buffer for the tummy. Some of us whose pup's tummies are sensitive to the cush meds do give our pups Pepcid AC 20-30 minutes before their cush meds...please ask your vet first before doing this.

I was wondering if you could tell us more about your girl, you see, the more we know about your beautiful girl the better our feedback will be when answering your questions, ok?

1) How much does she weigh?
2) What tests were performed to confirm her cushing's?
3) Was a CBC/Chemistry blood panel done and if so, could you post anything on there that is marked abnormal with the reference ranges and the units of measurements.
4) Was an ultrasound done?
5) At any time during her cushing testing was she having bladder/ stone issues?

We are here for you, so ask all the questions you want and we will try to answer them the best we can, ok. ;):)

Love and hugs,
Lori

CookieJones

05-30-2010, 05:38 PM

Hi Lori and Harley, thank you so much for your response.
That's very encouraging - I'll start giving a bit of food with the Vetoryl. Later I'll ask the vet about the Pepsid AC. We'll be so happy if that's all the problem is!

I'll do my best to answer the questions.
1) She weighs 22 lbs now, but her healthy weight is closer to 17 lbs.

2) Cushings tests - I'm a bit foggy on the details (it was 1 1/2 yrs ago) but can ask the vet. I do remember: We had to leave her all day, and he sent it to Univ of Tennessee for analysis. A few crude notes I scribbled (pls forgive spelling) say it was low dose dexamethasone suppression test, results suggest atypical cushings, probably adrenal. Other scribbled notes say
- Cortisol elevated, 248 (vs normal 55-174), Estradiol and Progesterone elevated, Aldosterone too low to measure,
- Liver function normal, Urine Cortisol:Creatinine elevated, ALK PHOS not elevated
Also that we did subsequent Endogenous ACTH test (?try to rule out type of cushings?) but it was normal (30 vs normal 20-120) and urinalysis was normal.

3) Our vet is very thorough so I'm sure CBC would have been done if it's standard procedure. I don't know what to look for in my notes, but can ask vet.

4) No we did not do ultrasound. The vet did tell us about it (to test malignancy?) but also said it's expensive, and not essential in light of other evidence, so we opted not to.

5) I don't think she had any bladder issues during the test, or since. The vet was pretty insisitent that her bladder be resolved before doing anything else. Would it have affected the tests?

(Interesting, those same old notes from talking to vet also say "Univ TN people prefer Lysodren over trilostane for atypical cushings because trilostane may increase the OTHER hormones" ... and something re "17hydroxyprogesterone issue". Of course I have no idea what it means.)

Again, thanks so much for your help it is greatly appreciated!

Franklin'sMum

05-31-2010, 01:15 AM

Hi and welcome to you and your pup :)

You're right, Atypical cushing's is usually not treated with trilo (vetoryl) as it often increases the intermediate hormones, but interferes with aldosterone (that's the thing which regulates the electrolytes.) Have you been getting electrolytes checked at the stim tests? It's very important that they be checked.

When my little boy Franklin was on trilo (he's a bit of a mystery. Long story) he went off his food if I gave it to him on an empty stomach, too. What a number of people do (aside from the pepcid) is to wait until the pup is almost finished their food, then give the meds. Some use peanut butter, cream cheese, pill pockets and things like that to disguise the pilling. I used to use a little minced/ ground beef, or wrap it in a little bit of ham. He loved getting his tablets.
Hope that helps a bit, and looking forward to hearing more about you both,
Jane, Franklin and Bailey xxx
________
Ipad Cases (http://accesoriesipad.com/)

CookieJones

06-04-2010, 02:24 PM

Hi Franklin'sMum,

Thanks so much for you reply. I wish I had checked earlier and seen your post re electrolyte testing, before I took her yesterday for her ACTH stim test. So, I just called the vet's office, and relieved that they said yes electrolytes were included.

I'd like to know more about what you said re Vetoryl interfering with aldosterone, esp since her aldosterone was already low to start with. Is it dangerous? Are there any symptoms we would notice? We were afraid to try Lysodren mainly because of the handling/exposure concerns - young grandchildren playing around in the yard or inside where she might have an accident.

Re the pilling - incredibly, we've tried all of those tricks to get a pill down her, to no avail. She literelly chokes. I suspect it's not just stubbornness, but something physical, like maybe her throat is too narrow, or misshapen, etc.

Luckily, the Vetoryl doesn't taste too bad and she doesn't mind the liquid suspension which is flavored. I forgot to ask the vet about Pepsid AC, but am happy to report that giving food with it DOES seem to be keeping the dry heaves away, so far (hooray!! and thanks Harley PoMMom and you for the tip). So the Vetoryl-administering problem just might be solved (fingers crossed).
Clindamycin is still the big challenge because it's nasty bitter taste is nearly impossible to mask with food. (a whole other chapter by itself!)

Just curious - why did you take Franklin off trilostane?

Again, thanks so much for your help and excellent tips.

sunimist

06-04-2010, 05:13 PM

Hi and welcome!

Just time for a quick note, but you can also get Lysodren in suspension form. My girl took the chicken flavored Lysodren for a while. Your vet can have it compounded for you, or at least, mine did. :)

Shelba and Suni

Harley PoMMom

06-04-2010, 05:44 PM

I posted my reply in blue. :)

2) Cushings tests - I'm a bit foggy on the details (it was 1 1/2 yrs ago) but can ask the vet. I do remember: We had to leave her all day, and he sent it to Univ of Tennessee for analysis. A few crude notes I scribbled (pls forgive spelling) say it was low dose dexamethasone suppression test, results suggest atypical cushings, probably adrenal. Other scribbled notes say
- Cortisol elevated, 248 (vs normal 55-174), Estradiol and Progesterone elevated, Aldosterone too low to measure,
- Liver function normal, Urine Cortisol:Creatinine elevated, ALK PHOS not elevated
Also that we did subsequent Endogenous ACTH test (?try to rule out type of cushings?) but it was normal (30 vs normal 20-120) and urinalysis was normal.

Usually our cush-pups have elevated ALK PHOS levels, so the fact that your pup doesn't is a little alarming to me.

3) Our vet is very thorough so I'm sure CBC would have been done if it's standard procedure. I don't know what to look for in my notes, but can ask vet.

4) No we did not do ultrasound. The vet did tell us about it (to test malignancy?) but also said it's expensive, and not essential in light of other evidence, so we opted not to.

The ultrasound is a great diagnostic tool if done on an optimal machine and read by a qualified person. It shows alot of the major organs that the cushing disease can harm; liver, gall bladder, spleen, pancreas, kidneys, and the adrenal glands. The view of the adrenal glands can show if your pup has pituitary or adrenal cushings by the size of the adrenals.

5) I don't think she had any bladder issues during the test, or since. The vet was pretty insisitent that her bladder be resolved before doing anything else. Would it have affected the tests?

(Interesting, those same old notes from talking to vet also say "Univ TN people prefer Lysodren over trilostane for atypical cushings because trilostane may increase the OTHER hormones" ... and something re "17hydroxyprogesterone issue". Of course I have no idea what it means.)

Again, thanks so much for your help it is greatly appreciated!

I'd like to know more about what you said re Vetoryl interfering with aldosterone, esp since her aldosterone was already low to start with. Is it dangerous? Are there any symptoms we would notice?

Low aldosterone can be dangerous to our pups but lets look at her Chemistry panel when you get it back, what we want to see is her sodium and potassium levels and her Na/K ratio. If she would start to act lethargic, start vomiting or have diarrhea, this could be an indication of low electrolyes or low cortisol and she should be seen by a vet ASAP.

Hope this helps.

Love and hugs,
Lori

AlisonandMia

06-04-2010, 09:22 PM

Hi,

I am wondering if the aldosterone being too low to measure was because the aldosterone level was too low to measure or whether there was simply not enough of the blood sample left after the other tests with which to run that test. We have seen that happen with UTK panels - it will say something like "insufficient to measure" - and I'm pretty sure it refers to the blood sample rather than the amount of aldosterone in the sample being low.

You might want to clarify that with Dr. Oliver.

Alison

lulusmom

06-04-2010, 10:01 PM

Alison, the endogenous acth is normal which isn't uncommon for a dog with an adrenal tumor, which is probably why the vet is pretty sure an AT is involved. Both high and low aldosterone is indicative of an AT so I think it's very possible that the aldosterone really was too low to measure. I also seem to recall that UTK is pretty clear in their comments and state that the info is unavailable due to insufficient sample. I believe Lulu's aldosterone couldn't be measured on her first UTK panel because of an insufficient sample. I'll try to dig that out and verify.

Cookiejones, did your vet mention that surgery could be an option and a total cure for your girl, if she does have an adrenal tumor?

I also wanted to mention that most cushing's experts do feel that Lysodren is a more appropriate treatment for an adrenal tumor but not so much because Trilostane always elevates the intermediate hormones but because Lysodren can shrink the tumor. Trilostane on the other hand, enlarges the adrenals and while there's been no studies that show that the growth of an adrenal tumor is facilitated by this enlargement, some in the medical community believe it's possible. To be fair, Lysodren has been around since the 60's so there's probably lots of retrospective studies to fall back on that show how well Lysodren works on adrenal tumors but we don't have that with Trilostane because it is a relatively new drug. I suppose time will tell.

Glynda

CookieJones

06-11-2010, 05:10 PM

I'm so impressed with the all knowledge here and so grateful for all your advice.

Sorry for my slow response but have been swamped all week. And still waiting for copies of some older tests, but at least have the new ones from last week's tests.

Hi AlisonandMia, that 's a scary thought - ambiguous wording - the problem could be my own messy notes. I'll look for that exact wording when I get copies of those results.

Hi sunimist and lulusmom, and thank you. The vet did mention surgery as an option, but said it's tough surgery with strenuous recovery. I think her age and her other complexities concern him.

Regarding Lysodren - that was the first thing the vet prescribed, and as sunimist pointed out was possible, we also got the compounded liquid. But we were scared off by the warnings in the insert, re danger to people if exposed, etc etc, because children/toddlers are often around, and she was having accidents in the house. Maybe we over-reacted. (?)

Thanks Harley PoMMom for pointing out her unusual alk phos. Still waiting on copies of that (older) test, but last week's test shows elevated alk phos of 198 (ref 5-131). Vet said blood work was 'all over the place', electrolytes a little high, but ACTH results say we need to increase her Vetoryl, which was 20mg, so now she's on 30mg, and we retest again in 2 weeks.

Not sure which of the results to show, you probably don't want the whole long list. Here are just the out-of-range ones, let me know if you want others:

superchem out of range
-----------------------------
Na/K ratio 26
Potassium 5.7 (ref 3.6-5.5) *Hemolysis 2+ can cause 20-25% increase
Calcium 12.0 (ref 8.9-11.4)
Alkaline Phosphotase 198 (ref 5-131)
GGTP 26 (ref 1-12)
Cholesterol 415 (ref 92-324)
Triglycerides 485 (ref 29-291) *Hemolysis 2+ can cause up to 10% decrease
Urea Nitrogen 40 (ref 6-31)
BUN/Creatinine Ratio 40 (ref 4-27)

CBC out of range
--------------------
Platelet count 613 (ref 170-400)
Absolute Monocytes 1040 (ref 0-840)

Cortisol etc
--------------------
June 2010 ACTH (2 wks after 20 mg Vetoryl started - not fasting)
Cortisol Pre = 2.4; Cortisol Post = 13.9

Mar 2010 ACTH (2 wks after 30 mg Vetoryl started)
Cortisol Pre = less than 1; Cortisol Post = 2.9

Aug 2009, initial (apparently LDDS?), no meds
Cortisol Pre = 6.2; Cortisol after 4 hr = 4.2; Cortisol after 8 hr = 3.9

Harley PoMMom, re the ultrasound, it sounds great, and if the vetoryl doesn't work, that's probably our next step. But given the cost, we're hoping it won't be necessary. (this is all adding up!)

many thanks, again

CookieJones

06-16-2010, 03:57 PM

Hi, I'm still working on deciphering the vet records (50+ pages of printouts) and manually transcribing them (very slowly). At least I have the chem/cbc and adrenal stuff done.

Her "normal" Alk Phos reading was 92 (ref 5-131) from a superchem in May 2009. But her Alk Phos last week was elevated (198). Others out of range both times were Platelet Count (591 then, 613 now, ref 170-400), Absolute Monocytes (930 then, 1040 now, ref 0-840) and GGTP (13 then, 26 now, ref 1-12). And the others from last week that were elevated, as previously posted (Urea Nitrogen, BUN/Creatinine ratio, Potassium, Calcium, Cholesterol, Triglycerides).

Another note - both superchem results noted some Hemolysis (1+ in May 2009, 2+ in June 2010) and flagged certain tests as possibly being affected. I don't know if any of those might land out of range once adjusted (or how to adjust them).

These are her results from Univ of Tennessee adrenal panel (Aug 2009). I don't understand the *** note on the Aldosterone (N=72 N=23 etc)... or what to make of it all.

Test .................... Result ..... Normal ....... Result ..... Normal
......................... (baseline) . Range ** .... (post ACTH) . Range **
Cortisol ng/ml .......... 24.8 ...... (2.1-58.8) .... 248.2 * ... (65.0-174.6)
Androstenedione ng/ml ... 0.72 * .... (0.05-0.57) ... 7.48 * .... (0.27-3.97)
Estradiol pg/ml ......... 105.7 * ... (30.8-69.9) ... 96.0 * .... (27.9-69.2)
Progesterone ng/ml ...... 0.07 ...... (0.03-0.49) ... 1.79 * .... (0.10-1.50)
17OHProgesterone ng/ml .. 0.25 ...... (0.08-0.77) ... 3.91 * .... (0.40-1.62)
Aldosterone pg/ml *** ... < 11.0 .... (11-139.9) .... 32.4 ...... (72.9-398.5)

* Above or below reference range
** Mean normal range values for spayed female dogs (N=36), QNS = insufficient sample
*** Normal Range values for male and female dogs (N=72 baseline, N=23 post-ACTH)

These results: indicate [X] the presence of increased adrenal activity.

Comments: Values are increased as indicated. The low aldosterone levels often indicate the presence of a primary adrenal tumor. Consider items 1 through 5 on the treatment option sheet attached. Item 6 would also be a consideration.

I also was reminded in going over the records, that they did a liver biopsy a year ago and did find some issues, (details tbd). Still trying to get a handle on the big picture here, but after reading the other stories in this forum - okay, I'm seriously rethinking two things - Lysodren instead of Vetoryl, and getting that ultrasound.

Again, thanks for any insight/suggestions/etc.

StarDeb55

06-19-2010, 08:29 PM

This is the first time that I have posted to you. I am the medical lab technologist that may have been previously mentioned. The general lab results look pretty good. You have the typical elevation in liver function test including alk phos. Lori has already mentioned that the alk phos result is really a pretty slight elevation compared to most of our cushpups. For example, my Harley, just had his ACTH, along with monitoring bloodwork for long term medication use. His alk phos is holding steady at around 620. We have seen pups in this group have alk phos numbers in the thousands. My 1st cushpup, Barkley, could run a alk phos of 1200-1500. If we could get him down to 800, that was a major improvement.

When it comes to the hemolysis comment, what that means is that there was some trauma during the blood draw, usually a difficult stick. This causes some of the RBC's in the sample to be destroyed (hemolyzed), & this destruction will release the contents of the RBCs into the serum which is the part of the blood that the testing is usually done on. RBCs are rich in potassium, so this is one of the first results that would be affected. Some of the liver enzymes results may be affected, also. Usually the lab results will indicate that a hemolyzed sample will increase specific results a certain percentage, you can use that percentage to try to correct the result. If no percentage was posted, there is no way to correct.

When it comes to the comments on the UTK panel about trilostane increasing the 17-OH progesterone, it may, it may not. What you need to look for is a return of symptoms, even with ACTH results that are within range. If this should happen, I wouldn't immediately assume you have a secondary hormone issue, there is a better chance that the trilo simply needs to be given 2x per day. Trilo's have life in the body is approximately 12 hours, & if you are noticing "bounce back" symptoms later in the day, after the morning dose, this may be the issue. I really can't make any other comments on trilo as I do not use it. I have used lysodren with both of my boys.

Since you appear to be considering a switch to lysodren, I need to alert you to the fact that there is a minimum of a 30 day washout when switching from trilo->lysodren, or the other way around. Not only is there a washout period, but you also need to look for a return of symptoms.

Hope this helps. Please feel free to ask if you have any more questions.

Debbie

CookieJones

06-20-2010, 07:26 PM

Thanks so much, StarDeb55, all of your info is extremely helpful, it solves several mysteries for me. Regarding the possible switch to Lysodren - apparently I jumped the gun because the vet says for now he wants to stick with the Vetoryl. I guess that's assuming we can find a dose that works without making her sick (which it did last week), otherwise maybe Lysodren will be back on the table.

I'm still digesting things, but later on might may have a question or two for you, if you don't mind. ... Thanks again.

CookieJones

11-30-2011, 10:05 PM

Hi, we haven't posted for a while, but our Bichon, Riley, has been doing great on Vetoryl for about 18 months now - even though it's presumably adrenal. Her Cushings symptoms are much improved, especially her energy level and weight. She also takes Clindamycin for bladder stones.

But she'd getting old, and now poor thing also has Canine Cognitive Dysfunction, with the incontinence, confusion and all the rest. So we're going to try adding Selegiline (generic Anipryl). Since it's also a Cushings med, I'm hoping someone here can help.

My first question is about food restrictions. The human version of Selegiline says to avoid tyramine-containing foods (fermented foods, marinated meats, fish, pork, cheese, peanuts + much, much more).
Does this apply to dogs, too? I know those are mainly 'human' foods, and maybe why I can't find much info. But she's so hard to feed with this cognitive problem (doesn't recognize her food) that we've had to cheat and use more human food, especially to get her meds in. She needs food before the Vetoryl, and a strong-tasting chaser after the bitter Clindamycin, and usually she just won't eat dog food. Some of the human foods we 'cheat' with:
• Baby food (favorite = Gerber "Ham + Ham Gravy")
• People food that "falls" onto the floor - bacon, pork, hot dog, knockwurst, fish (canned salmon, fresh shrimp, cooked scallops), spaghetti and meatballs, bones from pork chops or pork ribs.
• Rotisserie chicken or hamburger or pork with rice or pasta
• Dried chicken strips (Happy Hips) - favorite snack.
• Peanuts as a snack

Do these all have to be stopped while on Selegiline? (p.s. Yes, we avoid known toxins like chocolate, onions, garlic, mushrooms, avocado, raisins, grapes, macadamia nuts, etc)

Moderator's Note: I have merged your update into your pup's original thread. Normally, we like to keep all posts on a pup in a single thread, so other members can refer back to the pup's history, if needed. I have also modified the thread title to include the new CCD diagnosis.

jmac

11-30-2011, 10:34 PM

Hi-
I wish I knew the answer because my dog, Hannah, was on Anipryl from March through Oct. We just weaned her off to see how she does without it. I found concerns about using Anipryl with Tramadol, but was told that was only in humans and that it should be okay in dogs. I never had her try it at the time because we ended up on something else. I did not see any information about food restrictions. She doesn't get much people food, but she does get an occasional piece of cheese or a tiny bit of bacon from breakfast every couple of weeks. We never noticed anything. I think it is hard because so many studies are based on humans. If you get this question answered, please let me know!

Good luck to you!
Julie & Hannah

lulusmom

12-01-2011, 12:38 PM

Hi and welcome back.

I've done quite a bit of research on Anipryl (Selegiline) and as far as I know, there are no dietary restrictions for dogs. People usually don't have dietary restrictions either unless they are getting a hefty dose of the drug.

We've had a number of members who have treated their dogs with Anipryl and at no time do I recall anybody mentioning dietary restrictions on tyramine foods. I even went back and checked the FDA's Freedom of Information Summary for Anipryl and there is nothing. I am including a link below to that information in case you want to know more about the drug and the efficacy studies that were done.

www.fda.gov/downloads/AnimalVeterinary/.../ucm117013.pdf

If you still have serious concerns about this issues, I would recommend that either you or your vet contact Dr. David Bruyette at VCA West Los Angeles. Dr. Bruyette is not only one of the developers of Anipryl, he is a reknown endocrine expert and the medical director at VCA West Los Angeles. There is nobody more qualified to give you the answers you are looking for. You can find his contact information below:

http://www.vcahospitals.com/west-los-angeles/about-vca.html

I hope this helps.

Glynda

CookieJones

12-01-2011, 03:09 PM

Hi and welcome back.

I've done quite a bit of research on Anipryl (Selegiline) and as far as I know, there are no dietary restrictions for dogs. People usually don't have dietary restrictions either unless they are getting a hefty dose of the drug.

We've had a number of members who have treated their dogs with Anipryl and at no time do I recall anybody mentioning dietary restrictions on tyramine foods. I even went back and checked the FDA's Freedom of Information Summary for Anipryl and there is nothing. I am including a link below to that information in case you want to know more about the drug and the efficacy studies that were done.

www.fda.gov/downloads/AnimalVeterinary/.../ucm117013.pdf (http://www.fda.gov/downloads/AnimalVeterinary/.../ucm117013.pdf)

If you still have serious concerns about this issues, I would recommend that either you or your vet contact Dr. David Bruyette at VCA West Los Angeles. Dr. Bruyette is not only one of the developers of Anipryl, he is a reknown endocrine expert and the medical director at VCA West Los Angeles. There is nobody more qualified to give you the answers you are looking for. You can find his contact information below:

http://www.vcahospitals.com/west-los-angeles/about-vca.html

I hope this helps.

Glynda

Thank you so much, Glynda! This is tremendously helpful. I just looked at the FDA document and also didn't see any mention. So sent my question to Dr. Bruyette as you suggested. I'll post back w/ any info. Thanks again, you guys are wonderful.

Squirt's Mom

12-01-2011, 03:23 PM

Just in case you were wondering...here is a reply from Dr. Allen to another member about using Trilo and Anipryl at the same time -

I'm glad your Boston's cortisol concentration is under control. Because Vetoryl and Anipryl work by completely different mechanisms it's unlikely that the two drugs together will cause over suppression of adrenal gland function (Addisonian crisis). Furthermore, the Anipryl dose used to treat Cushing's is two to three times higher than the dose used to treat cognitive dysfunction. My advice in this situation is be certain to follow the recommended Vetoryl protocol of re-checks every 3 months and if your Boston shows signs of appetite loss, vomiting or diarrhea stop Vetoryl immediately and contact Dr. Verluys.

Regards,

Tim

Timothy A. Allen, DVM (SAIM)
Technical Services Veterinarian
Dechra Veterinary Products
Toll free: 866.933.2472
Fax: 913.327.0016

http://www.k9cushings.com/forum/showthread.php?t=3438

Squirt was on Anipryl for around 9 months and I don't recall any dietary restrictions at all.

Hugs
Leslie and the gang

CookieJones

12-02-2011, 12:47 PM

Just in case you were wondering...here is a reply from Dr. Allen to another member about using Trilo and Anipryl at the same time -

http://www.k9cushings.com/forum/showthread.php?t=3438

Squirt was on Anipryl for around 9 months and I don't recall any dietary restrictions at all.

Hugs
Leslie and the gang

Good to know, thank you! Just gave first dose this morning, right along w/ the Vetoryl (both liquid compounded), so far so good. Except that Selegiline must taste nasty because she tried to spit it out as she does w/ Clindamycin which is horribly bitter. Vetoryl she doesn't mind.

That reminds me - has anyone ever used the transdermal gel form of this (or any) med on a dog? Apparently it goes on their inner ear flap.
Her vet says transdermal usually doesn't work well on dogs - anyone tried it?

p.s. Still no reply from the Anipryl expert, but did get her vet finally who said pretty much what people here have, that dietary restrictions are likely not necessary for the low dose she's on (5mg).