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View Full Version : Yanni - 10.5 yo Maltese X Shi Tzu - Trilostane



Scot F
05-06-2009, 11:06 PM
Mod note: Originally posted on John's thread (http://www.k9diabetes.com/forum/showthread.php?t=753) but moved here to create a new thread for Yanni and Scot - Alison

Hi John,

I'm a new subscriber and fellow Cushings parent from your home town. Must say it's a huge comfort to read everyone's stories and know I'm not alone.

Little Yanni (Maltese X Shi Tzu 10.5 years old, 7.5kg), started showing symptoms at just over 9 years of age, was diagnosed about 9 months ago, and began the arduous and hugely expensive exercise of Trilostane treatment and monitoring about six months ago. In that time, we've done 6 stim tests at $300 plus, a specialist's visit at just over $600, plus about $400 in Trilostane. Finding that $2800 in after-tax money has been a real stretch for our family, but we'll be happy if we see him stabilize.

Yanni started with 1 x 30mg once a day, which did nothing. Still ravenous, constantly sniffing for food, drinking uncontrollably and very badly incontinent (a real blow given he's a house dog and my better half had a hard time embracing the idea of pets inside in the first place).

A couple of stim tests later we went to 1 x 30mg twice a day - still nothing! I came home one day to find my wife had inadvertently given him an additional dose during the day, with no ill effect. Desperate and broke, I continued with 1 x 30 three times a day, for a week or so till we could afford to go back for another stim test. The next test showed his cortisol levels still just outside the range. My vet quietly chastized me for verying the dosage, but then added that it really had been a waste because of the way the drug works.

Our specialist decided we'd take the gross of the 3 doses I'd been giving Yanni (90mg total) and split into a morning and evening dose of 45mg. This worked a treat on slowing up his appetite and thirst, pretty much straight away. However, we had a terrible episode after a week, when we got Yanni up in the morning to go outside for toilet, only to have him collapse in agony, on his side with all four legs locked out in spasm.

It was terrible. I'll never forget the crying. He was so distressed he lost control of both ends, so a whole night's full bladder and bowel ended up on the new carpet. Thankfully it calmed down after about 2 minutes, and he got to his feet. For the rest of that day he was shaky, and shaken. I stopped the Trilo for a whole day. By the next morning he was ok. I gave him his morning dose, and took him for a stroll in the park, where he seemed to have no difficulty getting around, albeit at a very gentle pace, with stops to sniff and ponder about every minute or so.

Reading your story, I'm assuming his cortisol got way too low, and his joints got too inflamed. Looks like another stim and another $300 coming up.

What do you think?

Scot from Sydney

BestBuddy
05-07-2009, 03:20 AM
Hi Scott and Yanni,
What was the stim number on the last ACTH and how long ago? I am just wondering if the 90 is too much. The Dechra brochure says an average of 2-10mg per kg so even at the highest Yanni should probably only be getting 75mg (maybe 45 and 30 would work). If Yanni has any more problems I would definitley stop the trilo until you could get an ACTH.
Jenny

John II
05-07-2009, 04:33 AM
Hi Scott and Yanni,

Glad to see that you've found your way here and happy that Alison has started you on your own thread - it certainly sounds like you have a story to tell! :)

It's great to find a group of people so informed, helpful and kind isn't it?

It looks like you and Yanni are about five months further along the treatment path than Angelina and me - I may be thinking up questions for you rather than answers. :D

Reading about Yanni's collapse has me worried - I was happy to think that Angelina's episode last Sunday had been the result of her lying on one leg and it falling asleep... but now I'm wondering if she'd had a 25% collapse? :confused: Angelina'd had the same response (without the mess thankfully):

Scot from Sydney:
"Thankfully it calmed down after about 2 minutes, and he got to his feet."

As for us - I took Angelina for a Stim test today (another $500 including electrolyte check) and we are awaiting the results tomorrow - when our story will continue. In the meantime the Resident (Specialist returns from leave tomorrow) advised to continue Angelina on 30mg a day until the results come in.

But seriously, dosing changes, stim tests, electrolyes, liver enzymes, PDH versus ADH versus Atypical, Vets who like Lysodren versus Specialists who like Trilostane, high cortisol versus arthritis... why can't this be simple? (sigh)

It's good to see another Sydneysider here - I'm sure we'll be comparing notes!

John the Grey

Roxee's Dad
05-07-2009, 09:48 AM
Hi Scot,
I would also like to chime in and welcome you and Yanni. If your fellow Sidneysider John the Grey hasn't informed you yet, We like numbers:D,

Please post the results for any blood test (abnormal results) including the normal ranges and the ACTH results. I am assuming he was dx'd with pdh cushings???

Also wondering if Yanni's Thyroid (T4) was checked and was he checked or tested for diabetes in the process of his diagnosis?

The others as I affectionately call them have so much experience, the test results and history, will help them better understand how Yanni was dx'd and better able to help you sort thru this.

Looking forward to hearing more from you. Wishing all the best to your little buddy Yanni.

John (Roxee's Dad)

Squirt's Mom
05-07-2009, 02:34 PM
Hi Scot and welcome to you and Yanni! :)

I am glad you found your way to us here and decided to share yours and Yanni's story with us.

As John said, we like numbers and details so if you have them, it would really be great if you could post the actual test results along with the units of measurement (ug/dl, mnol/L, etc.) and the normal ranges, especially the ones used to diagnose the Cushing's and the latest ones. Is Yanni on any other meds, supplements, herbs, etc at the moment and if so, what for?

Our Trilo moms and dads will be along with their own set of questions, I'm sure. :p We ask so we can give you the best feedback we can; we don't get nosy til later on. :D

I'm glad Yanni is doing better now and hope he doesn't have a repeat performance of the collapse. :eek:

Hugs,
Leslie and the girls