New to forum-8 y/o chihuahua Tara/Vetoryl

[Christine]

My name is Chris. My chihuahua Tara was diagnosed with cushings in June. (She probably had several of the symptoms for several months before being diagnosed)

At the moment she is in Vetoryl-15 mg. Her first blood work after taking the med showed the med was working- last week she had it again and the levels were high. The vet thinks the first test was false - this upsets me since she went a month and a half with a dosage that was too low. Instead of 10mg she is now on 15 mg. Vet will recheck in 3 weeks, Tara is 8 years old.


She has gained a lot of weight, drinks a lot of water, urinates a lot. She also has enlarged liver and gallbladder, her breathing is bad due to the disease and allergies. She also has a heart murmur-on meds

Has anyone used holistic meds? I went online and found naturally products that seem to be successful for some dogs. If you have tried it - can it be taken with the med or half and? Any success?

[Harley PoMMom]

Hi Chris,

Welcome to you and Tara! Sorry for the reasons that brought you here but glad you found us.

I was wondering if you could get your hands on copies of all the tests that were done on Tara and post any abnormal values that are listed along with the reference ranges and units of measurement...i.e...ALT 150 U/L (5-50). We are especially interested in any results from all Cushing's tests...Thanks!

Cushing's is when a dog's system produces excessive amounts of cortisol and unfortunately I don't know of any holistic medications that bring that increased cortisol down within the therapeutic range.

I see that Tara has a heart murmur and is on medication, could you tell us exactly what medications she is currently taking? Also how much does Tara weigh?

Has the Vetoryl lessened any of her symptoms?

Please know we are here for you and Tara and will help in any way we can so do not hesitate to ask all the questions you want. ;)

Love and hugs, Lori

[goldengirl88]

Chris:
Welcome to the forum. I just wanted to ask you what testing you had done to confirm Cushings? Could you please get copies and post the abnormals on the results? This will let everyone help you. How much does your dog weigh and what are the names of the other medications being taken? Do not worry about your dog using a lower dose. That is the very best way to go. Start lower and let your dogs body adjust to the drug. Many vets start high and there are problems. Were you given prednisone in case you dogs cortisol drops too low? Is your vet knowledgeable about treating Cushings? If not you should find one, it will save time, money and heartache. Call Dechra the drug manufacturer and start a file on you dog. There are vets there to answer your questions. 866-933-2472. Start a daily doggie diary, you will need it to refer to. The right dosage and you vigilance will keep your dog safe. Any time you go to the vets keep your own copies at home. If you choose to leave that vet you have your own file with no hastle. Blood pressure readings and diet are important with Cushings. Wishing you and your baby good luck. Blessings
Patti

[Christine]

Thanks Lori,

All I can tell you is that the vet stated that her level on the ACTH
was high- I think he stated 411. She is on Benazepril-5mg-1/2 tab a day. She is also taking Ursodiol 1/4 a tab a day due to her large gallbladder. When I took her in in June I was concerned with her lack of activity and breathing. They first x- rayed her- thought she had a tumor- ultra sound showed an enlarged gallbladder and liver. She also is supposed to take a liver supplement- one given by vet is too large and cannot be take with food or crushed. I found one online that is an a liquid form- I am considering buying it.

Her weight is around 20lbs- she was around 12 before the disease.

I am glad I found this forum- after reading what others are observing with their pets has helped me understand what is going on with Tara.

I just wished that we were at the right dosage in mid June after Tara started Vetorly at 10 mg. After 12 days starting with Vetoryl I took Tara back for another ACTH slime test to check if
we were at the right dosage. They stated it was back at normal range- I did not need to increase her dosage. Apparently this was not the case since the vet was surprised by the results of her ACTH test last week.

I did notice a little improvement- but she still was drinking and eating a lot.

The Vet I started off in June is now on leave. I talked to one of the vets at the clinic to see if he would now take her case. I plan to take Tara to see him this week so he can evaluate her and not wait until 3 weeks from now for a retest of her ACTH. Her med has changed - 10 mg in the morning and 5 mg in the evening.

My heart is breaking since I lost another dog recently with hemolytic
Anemia which came on suddenly. I an still depressed with her death and see Tara advancing with this disease rapidly.

Thanks for any advise you can give me.
.

[Christine]

Thanks Golden Girl- For your information. I am not sure if the first Vet was knowledgable about this disease. I am starting with a new Vet this week at the same Clinic since the first Vet that was seeing her is on leave. I feel he needs to see her- and understand what i am observing. We just talked on phone about her most recent results. Should I ask for a copy of her blood work?

Do they ever lose some of their pot belly? In the last several months it seemed to increases.. She now looks pregnant.


Should I consider a specialist who deals with internal medicine?

[goldengirl88]

Yes you need to get a copy of everything you have done from now on. The pot belly goes away on some, on others it does not. Make sure you write down a list of questions to ask this new vet. Don't be afraid to ask how many cases of Cushings they have handled. It is your dog and you are the advocate for him. Be armed with your information and get the most out of this visit for your dogs sake. Blessings
Patti

[Junior's Mom]

Hi Chris, welcome to the forum. When Tara has had her acth tests done, was her dose of vetoryl given 4hrs before, and with a meal each time? If not, this can cause incorrect test results. Was the vet following recommended cortisol levels for a cushings dog, or a normal dog? Some lab reports don't differentiate.
Getting copies of all lab work done so far is a good idea. It will help you, if you had to go to a different vet, and it will help everyone on here to see what has be going on with Tara.
Did she ever have an ultrasound?

[Christine]

Yes she had an ulrasound- enlarged liver and gallbladder. When I took Tara for her Slime test I just gave her the med with a small treat.

Another problem I am having is the liver supplement. I was given SAM- e. it is so large she refuses to take it. I do not want to force it down her- I was lucky she took Vetoryl with a pill pocket. The liver supplement can not be crushed or given with food.

[Squirt's Mom]

I use this liquid SAMe with my babies -

http://www.iherb.com/product-reviews/Lumina-Health-Cell-Food-SAM-e-Liquid-Formula-1-fl-oz-30-ml/13301/

[Christine]

Thanks for the web site for the liquid form of Sam-e. I will order it today. What is the dosage you give your babies?

I am so happy I found this forum for support and information

[Christine]

I got copies of the lab work that has been done since diagnosed with Cushing's in June.

June- this is after the first 14 days on Vetoryl- 10mg 6/14/13

Cortisol- Pre and 1 Post (ACTH)

Test Result Reference Range UOM
Cortisol, base line 2.77 0.1-6 ug/di
Cortisol, 1 hr
Post ACTH 38.6 <20 ug/di



August- 8/27

Cortisol- Pre and 2hr Post ACTH(ChL)

Test Result Reference Range UOM

Cortisol, base line 4.65 0.1-6 ug/di
Cortisol, 2hr.post ACTH 38.8 <20 ug/di

Utrasound: Bilateral adrenal enlargement
Hepatomegaly
Enlarged gall bladder.

Vet changed Vetoryl to 10 1/2mg. I was told to split the capsule.
I read your information on Vetoryl- should not split capsule. Does any one else split the capsule?

I do not understand the lab-

She has an appointment Tues. I am concerned with her breathing and gain of weight since June. I know that this disease is progressive-but I feel she is advancing quickly.

[addy]

I dont quite understand the tests either it seems her cortisol did not move at all.

Regarding the capsuls-DO NOT SPLIT THE CAPSULS and Dechra's technical bulletin specifically states that. I would send a copy to your vet and ask him why he would suggest that when the drug manufacturer says dont do it.

http://www.dechra-us.com/Cushings-Syndrome/Veterinarians/Prescribing-VETORYL-1.aspx

Have you asked your vet how many dogs he has treated with Vetoryl and how long he has been using the drug?


Are you telling me that the ACTH test was done in June, your dog had a post of38.6 after 14 days on Vetoryl and no other test was done until August?

I feel like I am missing puzzle pieces. Something is not sounding correct. :confused::confused::confused:

[Harley PoMMom]

I got copies of the lab work that has been done since diagnosed with Cushing's in June.

June- this is after the first 14 days on Vetoryl- 10mg 6/14/13

Cortisol- Pre and 1 Post (ACTH)

Test Result Reference Range UOM
Cortisol, base line 2.77 0.1-6 ug/di
Cortisol, 1 hr
Post ACTH 38.6 <20 ug/di



August- 8/27

Cortisol- Pre and 2hr Post ACTH(ChL)

Test Result Reference Range UOM

Cortisol, base line 4.65 0.1-6 ug/di
Cortisol, 2hr.post ACTH 38.8 <20 ug/di



I have a question regarding the timing of the ACTH post tests. The first one done on 6/14/13 has the post draw performed 1 hour later after the agent was injected. The second post draw, done on 8/27, was done 2 hours after the agent was injected.

Now, it would seem to me that either the vet used two different kinds of stimulating agent or the 2nd post draw was done incorrectly.

Could you verify what stimulating agents were used, the 1 hour post will probably be Cortrosyn or Synacthen, the 2nd draw could be the Acthar Gel.

Hugs, Lori

[Trixie]

Hi Christine,
My dog started on the medication in April. She was then about 14 pounds and we started with 12mg. (6mg twice a day). I did not see any changes in symptoms for a number of weeks. We did acth tests and steadily raised the dose and we're now at 28mg (14mg 2x a day). She also has gained weight and now weighs about 17pounds.
Her numbers on the acth went down at first, then up, then down again.
It's taken 3, almost 4 months of dose tweaking to finally see some results. Drinking is down but still not back to normal. We had bloated belly, not too bad and that is somewhat better. Still get some panting now and then. There is finally improvement, but yes, it's taken awhile and it's not like all symptoms are totally gone, but it is a lot better!
Do not split the capsules and make sure you always give it with food.
There's constantly tweaking going on with the amount of Vetoryl.That's why there is an ongoing need to do the acth tests so you can see where the level is, as it can change for many reasons.

My dog also has a high liver number and is on Denamarin (sam-e). They do make a chewable pill-though I don't know if your dog would want to chew it, and I see Leslie gave you a link for liquid Sam-e.
Once you can get your dog on the optimum dose of Vetoryl you will eventually see a change for the better in the symptoms...it just takes time and patience.

Barbara

[goldengirl88]

Hi:
Welcome to the forum. I just wanted to let you know that it is a really bad idea to split the capsule. Dechra told me never to do it. Also I saw where your baby has an enlarged gallbladder. You need to get that looked into if possible. These Cush pups seem to have a lot of gallbladder issues. Mine has sludge, which turns into gallstones which are painful as my dog has one. If your dog has sludge it will eventually turn into a stone, and there is medicine for the sludge to thin it more. I am thinking you would need an ultra sound of the gallbladder or a scan to see why the enlargement. I am proactive on everything and I try to stop the small things from getting into bigger issues. I wish you and you baby good luck on this journey. Blessings
Patti

[Christine]

Her 1st ACTH states:
Cortisol- Pre and 1hr Post ACTH (ChL) (R)

2nd test
Cortisol-Pre and 2 hr. Post (ChL) (R)

This is the only blood work I received last week. Her gallbladder did show sludging. They tapped it and pulled 16ml of bile. She is know on Ursodiol.

Somehow I feel there is something missing with this blood work. Maybe there was another- I just can not remember. I will ask.

She is seeing a vet Tues. The Vet who first saw her never worked with her before. She went on leave in August. Tara was a healthy dog. The reason for this appointment is to have stability. The vet she normally sees is semi-retired. She needs a doctor who is full time. I have been with this Clinic for over 20 years and have been happy with it. I do plan to ask the doctor if he has worked with many cases concerning Cushings. I am also asking if Tara should see a specialists. The doctor in June stated that if she did not improve after several months of taking Vetoryl she would consider this. Tara has showed slight improvement in her activity.

Thanks for your support