New to site - questions on holistic vs traditional treatments

[BetsyFoxhoundMix]

Looking for people to have intelligent discussion with about the pros and cons of treating Cushing’s disease in dogs with traditional medical management versus holistic management. If you had or have a dog who had Cushing’s disease or has Cushing’s disease I would love to know many details like what the testing is like and how often it occurs and what it is like to be on trilostane including side effects and how often dogs have to be monitored etc. etc. I have joined a couple Cushing’s groups on fb but there is not much discussion going on. From what I read testing results might not even be accurate. If ultrasound of the abdomen shows two enlarged adrenal glands and liver changes consistent with Cushing’s, and alkaline phosphatase is over 1500, what is the point of testing when you could get false positives and false negatives? ($500) Why not just try treating and why not try starting with Holistic? And if you treated holistically, I’d love to hear the details. Thanks so much. Her only symptom is excessive drinking and so I monitor her water or she would be peeing all over the inside of the house. As it is I let her out every 30 to 45 minutes in the daytime when I’m home. She also just had her first urinary tract infection a couple weeks ago (c/w Cushings) tested NEG for everything else. Also, she never took steroids. She is happy and energetic at age 10 with no other medical problems that we know of and on no medicines. I treated her holistically for the drinking problem last fall with HMR lignans and melatonin as per the University of Tennessee protocol. It didn’t do any good. I did that just in case she had Cushing’s.  had her tested in December 2020 and she was negative for everything including diabetes etc. Then she had a urinary tract infection a couple weeks ago and that’s where we found out about the sky high alkaline phosphatase and did an ultrasound of the abdomen. Uti resolved on CIPRO. I am a human nurse practitioner but not a vet. But I have done a lot of reading and have the above questions. It’s hard to ask all these questions of your vet because they just don’t have time. I only work 2 to 4 days a month now so I am home a lot with her and my other two pit bulls. Betsy the one with likely Cushings is a 22 pound primarily American foxhound with Pomeranian, Chihuahua, and Russell type terrier on embark DNA.

[BetsyFoxhoundMix]

It says I cannot attach attachments but I have for labs and ultrasound report. Can someone move this to a new thread, I think I posted under the wrong thread thanks

[mytil]

Hi,
I have moved your thread to the main discussion section.
How are you uploading the numbers? (pdf or jpg)?
Welcome to our wonderful group!
Terry

[BetsyFoxhoundMix]

Thank you I took screenshots on my iPad and then crossed out patient identifiers, and then tried to upload as pictures and I assume they are JPG but it says they are too big and I have no idea how to make them smaller. I am finding it confusing to figure out how to post or find things, I thought this group not been active in a year and suddenly I came upon a bunch of posts from today. ��*♀️

[BetsyFoxhoundMix]

I cannot figure out what I am supposed to click on in order to see responses to my post, I only find them after I click over and over on a bunch of different tabs. Which tab do you recommend that I stick to? Sorry to seem so stupid, I am used to computers and different programs etc. but I’m not able to figure this one out. Also lacking a little sleep as one pitbull had ACL surgery on Tuesday!

[BetsyFoxhoundMix]

I tried to post labs and ultrasound under my profile. Is there somewhere else I’m supposed to post them?

[labblab]

Hello and welcome from me, too! I’m going to keep this note brief so that we can first get you straightened out re: posting your replies and viewing the replies of others. I’ve now consolidated all of your postings in this one single thread, here on our main “Questions and Discussion” forum. From now on, you’ll always be returning here to post any additional replies. So here’s where we’ll start — more to follow.

Marianne

[labblab]

OK, I’m back once again. I’m hoping you’ve now found your way back to your thread here, and as you’ll see, you can just keep scrolling up and down in this thread to read any replies that have been posted, including your own. They’ll all be posted here in chronological order. To begin with, let’s not worry about trying to get your photos uploaded — let’s first make sure you’re able to navigate around here in your thread, OK? So when you have a chance, go ahead and post a new reply here so that we know you’re all settled in with knowing how your thread works. And then we’ll go from there.

[BetsyFoxhoundMix]

Thank you yes I found the link to this thread in my email. I got so confused when I first came on the site and saw that moderators wanted updates for July from everyone but I was the only one who answered, LOL. So I thought the site was in active and then all of a sudden I clicked on some thing and found a bunch of posts from today. Then I got really confused LOL. Anyway here I am!! And I’ve taken screenshots of all the labs from a couple weeks ago and the ultrasound of the abdomen. Basically she was peeing frequently so I took her to the ER vet because my vet was too busy, they did lab work and urine and alkaline phosphatase was too high which bought her an ultrasound of the abdomen. She spent the night on IV fluid and IV baytril for the UTI. I told him I felt she might have Cushing’s and to please zero in on the adrenal glands and liver during the ultrasound which they said they would do anyway. Long story short after the ultrasound an internal medicine specialist at the same Emergency And Referral hospital saw her and called me and wants to test her with the dexamethasone challenge test which I put off till the middle of August because my pitbull Little Mouse needed to have TPLO for ACL rupture on Tuesday. So she is five days postop now and I’m trying to keep my other pitbull and her calm and let Betsey out to P every 30 to 45 minutes etc. and also trying to figure out what to do about Betsey. She is 10 years old and happy and no skin issues but had her first urinary tract infection which may or may not be due to the Cushing’s. I noticed the hair on the back of her shoulders and neck has turned curly from straight over the last year. The drinking problem started last summer at the end of the summer. At that time I treated her myself with HMR lignins and melatonin as I knew it wouldn’t hurt her to see if it would help. It didn’t so I took her to the vet in December where she had a normal alkaline phosphatase of 85 and pretty normal other lab work but urine was spilling 1+ protein. Anyway she was still having her drinking problem but I was limiting water a little bit otherwise she would be peeing all over the floor every second which was a huge management problem with two other dogs. So now I’m wondering since she is happy and 10 years old and this excessive drinking and peeing which is more the more she drinks, and a little hind and wasting, and the abnormal ultrasound and lab work, should I test her or should I just try more holistic treatments? From what I read treating with traditional medicine does and does not lengthen their lifespan depending on what you read! So far she does not have diabetes. Thyroid was borderline in December but he felt not worth treating if she could lose a few pounds by dieting. So she did and then at the ER vets they told me she was too thin and I should have her gain weight which made no sense at all because I felt she needed to lose another pound or two to get back to what she was in 2019.

[labblab]

Yay!! You made it back to your thread, so now we’ll be able to keep everybody’s replies consolidated right here. That’s excellent. First of all, thanks so much for all of the great information that you’ve already given us about Betsy. In fact, you’ve been so thorough that I want to take some time to digest everything before writing a lengthier reply, myself. I apologize that it will likely be tomorrow before I can get back here, but I will indeed be back.

In the meantime, I see you’ve opened a photo album, and that is likely the best place to try to upload your screenshots. If you’re having trouble, try uploading them one photo at a time. I think the photo software is easily challenged by multiple large files. If that doesn’t work, perhaps you can just type the text of the ultrasound report into a reply here if it’s not too lengthy. And in terms of labs, all we need are any abnormal readings along with the reference range for that value.

So once again, I’m sorry I’m not able to add a lengthier reply right now, myself. But we’re truly very glad you’ve found us and I will be back.

Marianne

[BetsyFoxhoundMix]

Thanks so much no hurry, not a worry. We don’t have the scheduled dexamethasone challenge test until August 11. And quite frankly I really wish I could delay it longer because of my pitbull here with the ACL surgery. If that is reasonable. Depending on her symptoms and lab values etc. Because quite frankly I am feeling overloaded right now. Trying to keep the pitbull from breaking her leg 🤪


Yay!! You made it back to your thread, so now we’ll be able to keep everybody’s replies consolidated right here. That’s excellent. First of all, thanks so much for all of the great information that you’ve already given us about Betsy. In fact, you’ve been so thorough that I want to take some time to digest everything before writing a lengthier reply, myself. I apologize that it will likely be tomorrow before I can get back here, but I will indeed be back.

In the meantime, I see you’ve opened a photo album, and that is likely the best place to try to upload your screenshots. If you’re having trouble, try uploading them one photo at a time. I think the photo software is easily challenged by multiple large files. If that doesn’t work, perhaps you can just type the text of the ultrasound report into a reply here if it’s not too lengthy. And in terms of labs, all we need are any abnormal readings along with the reference range for that value.

So once again, I’m sorry I’m not able to add a lengthier reply right now, myself. But we’re truly very glad you’ve found us and I will be back.

Marianne

[BetsyFoxhoundMix]

OK I finally got the screenshots into the photo album but it says if they are not used in an hour they will be deleted. I don’t know what they mean by using them. I hope they will stay there for you. The key is to select a smaller file size for each picture. Thanks again!

[labblab]

Yep, I see them -- good work! And it's been more than an hour since you posted them (although I have no idea what that warning means, either). Some typical Cushing's abnormalities there, for sure. More tomorrow...

[labblab]

OK, I’m back again. After reading through Betsy’s medical history and viewing her labwork, yes, she definitely looks like a Cushpup to me. The ultrasound report, elevated liver enzymes, abnormal white blood cell counts (“stress leukogram” pattern), elevated platelets and cholesterol, proteinuria and vulnerability to UTIs — I’m probably leaving out other stuff, as well. The only surprising thing to me is that, aside from excessive thirst/urination, she doesn’t seem to exhibit significant outward symptoms that are the hallmark of the disease. As far as further diagnostic testing, under these circumstances I do believe that the LDDS would be the test of choice for Betsy since it is the most likely to return a “positive” result for a dog who truly has Cushing’s.

If you do get a positive result, then of course the question shifts to whether, or how, you choose to treat. I can give you my personal 3-word answer to your question about effective longterm holistic treatments. There are none. At least none of which I’m aware that have been clinically proven to lower cortisol levels into a therapeutically effective range. Another member this week has asked us about Adrenal Harmony Gold. Anecdotally, some people have told us that either Adrenal Harmony or Cushex drops seemed to help control symptoms for a time. But to our knowledge, neither product has been subjected to actual clinical testing to validate the maker’s claims. And the reason why we know about these products is because the owners have ended up coming here for help when those holistic products failed. Also, in terms of your own experience, if Betsy does indeed suffer from elevated cortisol it is not surprising that the melatonin and lignans did not help, either. Those supplements are recommended by UTK for treatment of “Atypical Cushing’s” which arises when various adrenal hormones *other* than cortisol are elevated. Those supplements may help lower some of the other hormones, but they do not have an effect on cortisol that’s sufficient to treat the symptoms of conventional Cushing’s.

So if you do decide to treat, the two commonly used medications that have been proven to lower cortisol are trilostane (Vetoryl) and mitotane (Lysodren). In recent years, Trilostane has become the more common treatment of the two worldwide. We have info about both of these medications, however, on our “Helpful Resouces” subforum:

https://www.k9cushings.com/forum/forumdisplay.php?10-Helpful-Resources-for-Owners-of-Cushing-s-Dogs

Before grappling with medication specifics, however, I think one of your key questions is whether or not to treat at all right now even if Betsy does have Cushing’s. In younger dogs, in my opinion a prime goal of treatment is to stave off chronic systemic damage that Cushing’s can cause over time. In older dogs, my concern is more about immediate quality of life — are the symptoms causing obvious discomfort.

In Betsy’s case, her only obvious symptom right now seems to be the excessive thirst/urination which we might tend to discount as being a big deal. Except that symptom alone *does* seem to be understandably problematic for you due to the frequency and the volume of her urination. One warning that I’ll give you is that you are risking kidney damage if you limit water intake for a Cushpup. Due to a physiological process that I’m not sure I even understand, Cushpups are drinking so much water to keep up with excessive urine that they’re producing, rather than vice versa. So it is not safe to limit their fluid intake. If excessive thirst/urination is a genuine problem for you girls (it was definitely a problem for me and my big Lab boy), then you’d likely want to look into effective treatment.

Digging a bit further in Betsy’s case, her proteinuria and possible gallbladder sludge could be other treatment prompts. Cushing’s can indeed cause kidney changes that cause protein loss in the urine and if left unchecked, this can also cause kidney damage. Cushpups are also vulnerable to developing gallbladder mucoceles which can require surgical intervention. And yes, if Cushing’s is left untreated, you can expect UTIs to become frequent and irritating visitors.

So these are a few of the immediate issues that might push me towards treatment if Betsy were my own. We can certainly talk further about other Cushing’s risks, as well as the logistics of treatment. But I’ll go ahead and close for now. Please do bear in mind that I am not vet, so my thoughts and opinions come from my personal experiences as well as reading about the journeys of other Cushpups here throughout the years. But I’m always happy to share info and offer support in any way that I’m able.

Bye for now,
Marianne

[BetsyFoxhoundMix]

I wrote out a thing checking her weights and sort of a timeline about that because in the ER I was told to have her gain weight and I was told to have her lose weight in December. Anyway I will upload those files from photos in a minute. I had written it all out in here and then it disappeared so I wrote it by hand and took pictures.

[labblab]

I had written it all out in here and then it disappeared so I wrote it by hand and took pictures.
Here’s a tip to keep you from “timing out” when you’re in the middle of composing a reply. When you first log in, be sure to check the little “Remember Me” box right below your username and password. That will keep you constantly logged in unless you manually log yourself out.

Also, when you’re composing a long post, first click on “Go Advanced” and then periodically hit the “Preview Post” button. That does double duty by letting you review what you’ve already written plus it also acts as a “Save” function.

Last but not least, sometimes when I’m adding a complicated reply, I’ll type it out beforehand somewhere else on my computer and then just paste it into a reply here.

Hopefully one of these suggestions will keep you from losing any postings in the future — I know how frustrating that is cuz it’s happened to me, too!!

[BetsyFoxhoundMix]

OK, wow, this is very very helpful. The guy who wants to test her is an internal medicine specialist and said if she has Cushing’s he would follow her if I wanted him to which is better than our regular vet who is always busy. Plus if we have an emergency this guy is at the emergency hospital because it’s a big referral place, and all her records would be online there. He said we would treat with Trilostane. I agree that we are probably in for a bunch of urinary tract infections and so now it seems even more important to try to treat her. I will read the file on medicines that you sent me the link to. I have done a lot of reading about this and was scared when I read things about dogs on medicine for Cushing’s going into shock etc. from Medication doses that were too high etc. So I will get her tested and the dexamethasone suppression test is what the doctor scheduled for August 11. You’re right, Betsey is a happy dog who is always walking around doing stuff and wagging her tail and social with the other dogs, affectionate to me, no skin problems, no potbelly, etc. etc. But she does not race around chasing my pitbull‘s like she did two years ago but then again she’s older. Thanks again so very much!

[Kevin]

Betsy's Mom,

I can't offer the expert advice that Marianne can provide but we are in the middle of treating a Cush Dog and have been thru alot. Still searching for something that helps our guy... searching and hoping. Currently on a low dose Vetoryl as Cooper didn't initially tolerate Vetoryl very well.

Holistics. Man where to begin. We've tried a few. Probably the one you'll see the most come up as an option are Lignans and Melatonin. Man, we religiously stuck with that protocol for 3 months. Nothing. Not even a HINT of improvement for Cooper. No adverse reactions either but no positive clinical signs. The other one you'll see alot is Adrenal Harmony type liquid drops. Usually they have Ashwaganda and/or Astragalus along with some other herbs. Cushex, Prana... there are a bunch of brands out there.
Many have those two ingredients I mentioned. We tried the Adrenal Harmony. Nothing as far as any improvement. Boy, we'd pour over the success stories out on Amazon. About 90% of the reviews out there are super success stories. Are they fake reviews?... I don't think so. The people seem genuine and most are verified purchasers. I can't really speak to how almost everyone has a positive result w/ many of the holistic stuff. We did not see any indications of any improvement.

Would I try holistics again? I don't know. Its a sore subject now because I feel like we wasted time when we could have been trying harder to get Cooper acclimated to Vetoryl. I guess I'd say if you try holistics and your guy isn't improving or regressing, move on. But there is no guarantee w/ Vetoryl either. He didn't tolerate it well in the beginning. Does seem to be tolerating it ok at a lower dose but none of the clinical signs are going away(only a week in on the lower dose). This is tough disease. I've been thru Cancer and now Cushings. I'd say its a tie. Cushings is really hard emotionally, watching it take your Dog down. Even though they are here, they aren't REALLY here for alot of us, at least while the disease isn't being controlled.

Sorry I can't offer any great advice. More just my recent experience. Thoughts and prayers.

[labblab]

Kevin, I just want to thank you for giving your thoughts to Betsy’s Mom. The things you have to say are just as valuable as anything I am writing. You’re speaking from your real-life experiences, and that’s super helpful. So don’t ever hold back from adding things on anybody’s thread — it’s our collective thoughts that helps chart the path forward for us all!

Marianne

[BetsyFoxhoundMix]

Hi Kevin thanks for your reply, I wrote a very long reply and it disappeared even though I thought it was auto saving. Long story short I tried lignans and melatonin in the fall with no improvement in the excessive drinking. So we will get tested August 11 and then start Vetoryl. She is definitely not what I would call suffering now she seems happy and interested in everything including affectionate and wanting to be with the other dogs and me. If we get to a point where medicine is not working and she appears to be suffering then I will have to put her to sleep, I would not want to keep her alive just for my benefit if she is really suffering. Sounds like from everything I am reading here including from you and Maryanne that it would be wasting time to try any more holistic treatments. Thank you so much and I hope your dog will improve soon!

[BetsyFoxhoundMix]

Hi, so my 10-year-old 20 pound fox hound Chihuahua mix, Betsy, is in the process of being diagnosed. She has her Dexamethasone test August 11. She has lab work and ultrasound of the abdomen and clinical picture consistent with Cushing’s disease. My question is in the last week she has developed sores on her skin that are sort of scabby and flaky. I got an oatmeal/aloe bath for her which I gave her, not soaking but with a shower sprayer And I got some stuff that’s a salve from the natural dog company called skin soother healing balm made of essential oil‘s etc. She’s also losing fur around the sores.

Is there any sort of generally recommended special shampoo and or salve that is recommended? I realize Cushings puts dogs at risk for skin issues and I don’t know exactly what skin issue this is I’m just wondering if there is a general recommendation I could try other than what I have tried. I emailed the Internal Medicine veterinarian who I have already spoken to on the phone when she had her UTI at the emergency hospital and he said he would take a quick glance at the sores on the skin when she comes in for her test but that I need to take her to her regular veterinarian to deal with it. Because of Covid the regular vet is backed up usually two weeks, there is curbside pick up which is stressful for the dog, I guess I had hoped that someone knows of some special shampoo that is really good for Cushings dogs. I’d rather try a few things before I take her to one more vet appointment. These areas are not itching her at all. Thanks!!

[LauraA]

It does sound like it could possibly be Calcinosis Cutis. Some dogs with Cushings do get this condition and it is when the high cortisol causes mineral deposits to form under the skin. These then push their way out and cause lesions and scabs and the hair will fall out. Usually it starts around the back/neck area and even the underarms (or should that be under legs :P ). A punch biopsy will diagnose for sure. Activated charcoal baths do help, as does DMSO. Neosporin ointment is another thing that is commonly used. Shampoos that seem to help are douxo or Trizchlor (any shampoo with clorhexidine). But if it is CC then you need to get the cortisol levels down for it to resolve.

[labblab]

Hi Cathy, and welcome back! As you can see, I’ve gone ahead and merged your new set of questions into your original thread about Betsy. We’ve found that it works best to keep all the information about any given dog consolidated in one single thread. This way, our readers will know exactly where Betsy is in terms of her Cushing’s journey, and we can easily review her entire history.

Having said that, Laura is right on the mark in terms of what she’s written above. As you already know, Cushpups can be vulnerable to developing skin irritations or infections, in general. But probably the most serious potential skin complication is Calcinosis Cutis. The eruption of these particular lesions can really adversely affect a dog’s quality of life, and can progress pretty rapidly. As a result, I hope your internist will seriously examine these spots when you take her in. If I were you, I’d specifically ask him whether he thinks this is Calcinosis Cutis. To better prepare yourself for the conversation, here’s a link to a related informational thread here on our forum:

https://www.k9cushings.com/forum/showthread.php?8909-Calcinosis-Cutis-treatment-thread

And if you’re a Facebooker, here’s a group that’s devoted to discussion of the condition:

https://www.facebook.com/groups/988564191285009/

You can also just Google “Calcinosis Cutis in dogs” in order to find more pictures and articles. Of course, this may not be Betsy’s problem at all. But even if not, the medicated shampoos that Laura has listed above should also be helpful with a range of other superficial skin infections, as well.

So look this info over, and feel free to get back to us with additional questions.
Marianne

[BetsyFoxhoundMix]

Thanks so much this is so helpful. If it turns out to be calcinosis cutis is it reasonable to ask the internist dealing with her Cushings to also deal with this skin problem? Or do the vet internists only usually want to deal with the drugs and tests specifically for Cushing’s? I’m getting the feeling from other things he says that he doesn’t want to deal with anything except the drug and the testing, levels etc. Thanks




Hi Cathy, and welcome back! As you can see, I’ve gone ahead and merged your new set of questions into your original thread about Betsy. We’ve found that it works best to keep all the information about any given dog consolidated in one single thread. This way, our readers will know exactly where Betsy is in terms of her Cushing’s journey, and we can easily review her entire history.

Having said that, Laura is right on the mark in terms of what she’s written above. As you already know, Cushpups can be vulnerable to developing skin irritations or infections, in general. But probably the most serious potential skin complication is Calcinosis Cutis. The eruption of these particular lesions can really adversely affect a dog’s quality of life, and can progress pretty rapidly. As a result, I hope your internist will seriously examine these spots when you take her in. If I were you, I’d specifically ask him whether he thinks this is Calcinosis Cutis. To better prepare yourself for the conversation, here’s a link to a related informational thread here on our forum:

https://www.k9cushings.com/forum/showthread.php?8909-Calcinosis-Cutis-treatment-thread

And if you’re a Facebooker, here’s a group that’s devoted to discussion of the condition:

https://www.facebook.com/groups/988564191285009/

You can also just Google “Calcinosis Cutis in dogs” in order to find more pictures and articles. Of course, this may not be Betsy’s problem at all. But even if not, the medicated shampoos that Laura has listed above should also be helpful with a range of other superficial skin infections, as well.

So look this info over, and feel free to get back to us with additional questions.
Marianne

[labblab]

I think it’s certainly reasonable to ask him, but unfortunately it doesn’t sound as though he’s anxious to assume much responsibility for primary care. The degree to which we’ve seen the involvement of specialists in Cushing’s care is variable, depending on complexity of cases, the Cushing’s experience of the referring general practice vets, and I guess just the interest level of the internist. However, in terms of Calcinosis Cutis, I think you’ll find that the single most important factor is lowering the cortisol level which apparently he does intend to take charge of. Other than that, you may actually pick up as many tips about shampoos, etc. from the Facebook group, for instance.

However, as Laura has already mentioned, CC can only be definitively diagnosed via a biopsy of the skin. If the internist thinks CC is a possibility after visually inspecting the sores, then the question is whether or not he would recommend going ahead with a biopsy. I would think he’d be the one to perform that, as opposed to your regular vet. Or if you have a veterinary dermatologist available to you, you might choose to seek that even more specialized consultation.

I will say that if CC is confirmed, it’s pretty much a guarantee that the Cushing’s diagnosis is accurate. There are a few other underlying conditions that can occasionally cause CC, but it’s pretty much definitive for Cushing’s in a dog who exhibits other typical Cushing’s symptoms/abnormalities, as well.

Marianne

[BetsyFoxhoundMix]

Thank you so much! I’ve been reading on the Facebook page and there are a few suggestions. One woman is using Botanica cleansing wash and natural herbal cream from this parkmore Irish horse imports based in Kentucky. She had used multiple things for cc with her dog prescribed by her vet which never worked for the last four months and she says in two days this is working. Her dog does not have Cushing’s but got cc from steroids. A couple veterinarians had prescribed this non-prescription wash and cream for their patients who then found it online and started ordering it. Her friend has a dog with Cushings who this is working beautifully on, who has cc from Cushings. I think I’ll spare poor Betsy the biopsy, I ordered the stuff and I’m just going to start using it. Our dexamethasone test is on the 11th. I noticed that when people say what dose of Trilostane they are on they will just say the milligrams but they won’t say whether it’s once or twice a day. Is it assumed if someone just says 10 mg that it means once a day?


https://www.parkmoreirishhorseimports.com/botanica-natures-healing-energy?fbclid=IwAR0VpRgvwxLJO7-L0nS1n39fhwf8ykWk296Lokf7msIxgOavgWaXWPTIsx0

[labblab]

I noticed that when people say what dose of Trilostane they are on they will just say the milligrams but they won’t say whether it’s once or twice a day. Is it assumed if someone just says 10 mg that it means once a day?
I think that’s probably true. Usually, people will explicitly say if they’re dosing twice daily.

And thanks for the info about the cleansing wash/cream. I’m not registered on Facebook myself, so I welcome any info supplied by others ;-)))).

[BetsyFoxhoundMix]

To stay on my thread but discuss something else I don’t know how to change the title? Anyway I thought it was on this site that I read that Carefirst Pharmacy compounding pharmacy is where people are having Trilostane compounded. . I’m in North Carolina and they are in Oklahoma and they will not ship. I just spoke to the pharmacist. Does anyone have the exact name and phone number of a pharmacy that is recommended that will ship to North Carolina who can make liquid Trilostane? Thanks so much I’m trying to get this organized before we are prescribed. Obviously I’m looking for a good price.

[labblab]

Cathy, I think you must be confusing two different “Carefirst” pharmacies. The pharmacy that has been referenced here in conjunction with veterinary compounding is located in New Jersey, and according to their website they do ship to N.C. Here’s a link to their web home page:

https://www.cfspharmacy.pharmacy

And here’s a related reference page that one of our staffers posted a while back:

https://drive.google.com/file/d/1XwqXk1oUoGLEsJuXyCKgIQ6J7JoB7jiw/view?fbclid=IwAR29bvIBa1N3MmENXQd4GRe7xX4Lj2Y89dLa mde-7c5xcjqj1KDcp_Xbt9U

I just checked and they still list chewable trilostane tablets on their website. You would need to inquire as to whether they will still compound a liquid suspension. Is there a particular reason why you’d prefer the liquid? I have absolutely no research evidence to back me up on this, but just from anecdotal accounts here over the years, I’ve wondered whether there may be more issues that arise over efficacy/stability when liquid preparations are used as opposed to tablets or capsules.

As far as changing the title of any individual post, I think you can type in the title of your choice for that reply if you opt for “Go Advanced” when you’re typing out your replies. Members cannot change the overall title of their threads — only staffers can do that. But I think you do have the power to retitle any individual reply when you’re creating it. I just now did that with my own reply, and I don’t think I had to be a staffer to have that option. Just let me know, and remember you have to first select “Go Advanced” for your reply.

[Jonathan]

For what its worth, I had success with Cider Vinegar (I was skeptical, too, but it worked) on those little spots.
My little girl began as Cushing, and not thyroid, which eventually turned into both, and I can assure, her life was extended from the meds... and a happy life for the most part.

Cushings/vetoryl is like a roller coaster, so dont buy in large supply of of individual dosage, (or do) and hold onto what you dont use.
= thats humor, because the levels will often change, you may actually be happy you have previous leftover

I'm 3 years removed from the CushPup life, so I dont quite remember the specific science (I leave that to the WONDERFUL members who do) but I try to pass along my experiences, and can relate to the uncertainty of it all.

Im just here to say that you are not alone, and to be a small part of the forum that helped ME get thru it.

[BetsyFoxhoundMix]

Thankfully I found the correct pharmacy and spoke with them on the phone. I did ask about the liquid being stable especially in the hot weather and they said there was no problem but I’m not sure if that’s true or not because I didn’t talk to a pharmacist. Anyway I did choose to get the splittable tablets that are chicken flavored and I’ll ask my vet to order the 20 mg splittable tabs. That way I can get as low a dose as 5 mg,
I will ask if she could be put on a dose no higher than 10 mg once daily to start with. She is 20 pounds and 10 years old. Thanks for the info about go advanced! ❤️🐾🐶

[BetsyFoxhoundMix]

Thank you so much Jonathan! I’m so sorry for the loss of GIgi. But so glad that she had a good life as a Cushings dog. I spoke to the pharmacy and they make chicken flavored tablets in 20 mg that are quartered so I can get the lowest dose of 5 mg or the highest of 20. Which is perfect. At least to begin with. 30 of the 20 mg splittable tablets is $39. 60 of them is $64.
I ordered Bert’s bees charcoal bath for Betsy for her calcinosis Cutis, if that is what it is but I think it is.

It’s going down the back of her spine. It’s not terrible yet anyway. I’ve been putting on it anointment made for people and pets with lavender and some other essential oils that are OK for dogs. It seems stable at the moment but I really only found it very recently. Interesting about the Apple cider vinegar! I also ordered some stuff I listed above called Botanica cleansing wash that contains Teatree and lavender oil‘s, and a natural herbal cream, that some other people have had Great luck with. I’m waiting for it to come. The website is parkmoreirishhorseimports.com It is based in Kentucky as well as overseas. Spread the word if you know anyone else struggling with calcinosis cutis. Apparently this one woman I was messaging with tried everything her vet prescribed for four months and nothing worked till she got this stuff.

[BetsyFoxhoundMix]

So she had her dexamethasone test August 10, 2021. Cortisol baseline was 12.8 which is very high. Four hour cortisol post dexamethasone was 11.08 hour cortisol post dexamethasone was 13.8.. The internist said this is unequivocal she definitely has CushingÂ’s. Which we already knew because of her other lab work, symptoms, and abdominal ultrasound results. She will be starting on 5 mg of vetoryl twice daily. She is 20 pounds and 10 years old. We are getting it from chewy, he does not want it compounded unless we do it later on because if we have trouble stabilizing her or finding the right goals he doesnÂ’t want to worry that itÂ’s a compounding issue versus just an issue being able to control her appropriately. That is fine, a months worth at 5 mg twice a day will cost me nine dollars , on her pet insurance.
He prefers to do the “pre-pill cortisol test” instead of ACTH to monitor thru time. If you Google that there are lots of articles about it, apparently it is equally as accurate may be more so than the ACTH test, it is cheaper, and it takes less time.
Anyone else use this test? I havenÂ’t read anything about it on this page. Apparently itÂ’s a better predictor of the dogs clinical status.

https://laboklin.com/no/news/details/article/hyperadrenocorticism-in-dogs-treatment-options-monitoring-and-control/

https://www.dechra.co.uk/news/dechra-launches-improved-monitoring-method-for-cushingoid-dogs-1?PID=5356&M=NewsV2&Action=1

[labblab]

Hi again, Cathy, and yep those results are indeed consistent with Cushing’s. That particular pattern of results can be seen in dogs having either pituitary or adrenal tumors. But since Betsy’s ultrasound showed that both of her adrenal glands were enlarged (as opposed to seeing a mass in a single enlarged gland), the assumption would be that the origin of her Cushing’s is a pituitary tumor.

I don’t have any argument at all with your vet’s dosing recommendations. Like him, I also recommend that people start off treatment with brandname Vetoryl if they can afford it. It seems better to me to shift to a compounded version only after a dog has been stabilized, just as he suggests. And yes, we’re familiar with the pre-pill monitoring protocol and do have dogs who are being followed in that manner. We have related info on our “Helpful Resources” subforum, including this link to a monitoring flowchart published by Dechra:

https://drive.google.com/file/d/1aQO-aek8tZHFyehNYAoW81hCSIpmiXNe/view?fbclid=IwAR194mX2KFv2SsptINmTmkzyRhb97IG87EeV Ak1ubAxplZWjCrdlG4CE7p0

Here’s some other treatment information that you may find helpful, as well:

https://www.k9cushings.com/forum/showthread.php?8925-GENERAL-GUIDELINES-for-Vetoryl-(trilostane)-Dosing-amp-Monitoring-with-ACTH-Stimulation

So good luck to both you and Betsy as you launch into treatment, and definitely keep us updated!
Marianne

[BetsyFoxhoundMix]

I forgot to thank you for these so thank you! I have another question, if a dog is stabilized on vetoryl with appropriate cortisol levels, and the dog is not a diabetic, does that decrease the amount of urinary tract infections if the urinary tract infections were because of Cushing’s? Betsey had her first time urinary tract infection a few weeks ago when she was admitted to the ER hospital and it was decided to test her for Cushings. She has not had a UTI since, but I have been home and letting her out to P every 30 to 45 minutes and also giving her cranberry powder on her food. I was just curious if normalizing the cortisol levels decrease the risk of UTI in a non-diabetic dog. Thanks !!
We started 5 mg of vetoryl Sunday morning, twice a day. With food. Meaning a total of 10 mg in 24 hours. So far so good.

[labblab]

Hi Cathy! That’s great that Betsy is doing well so far with the Vetoryl. And yes, our hope would be that she will become less vulnerable to UTIs once her cortisol has been stabilized in a lower range. A consistently high level of circulating cortisol can make a dog more vulnerable to infections, in general, because it has a suppressive effect on the immune system. Once Betsy’s cortisol is down within the therapeutic treatment range, we’ll hope that a UTI will be far less common for her.

Marianne