Attila-Calcinosis cutis, starting treatment w/ Lysodren..(Attila has passed on)

My 8 yr. old French Bulldog, Attila, was diagnosed with Cushings over a month ago. (I do not have his blood levels, but we've done the ACTH stim test twice) I tried holistic meds for a month to no avail. In fact, his cortisol levels were higher in the ACTH stim test at the end of the month. My holistic vet insists Trilostane is safer, while my regular vet has been treating Cushings for 20 years with Lysodren (and warned me that there have been sudden death cases w/ Trilostane). After much research and a few sleepless nights, I realized they both have dangers and decided on Lysodren since my regular vet will be treating him. Attila's only health issue through his life has been severe skin allergies which have been periodically treated with steroids (which could be what caused the Cushings). Last month (before any holistic treatment) Attila had two bouts of a few days of bloody diarrhea :eek:for which he eventually had to be hospitalized for 2 nights. They couldn't find the cause, but he got back to normal with antibiotics and bland food.
I have some questions: 1) Has anyone's dog had irregular bowel movements since getting Cushings? 2) Is there food that will help Attila tolerate the Lysodren better? 3) I'm scare of destroying the boy's adrenals, so any support as I start the induction phase tomorrow is much appreciated. Grateful to have found such a knowledgeable and gracious group.

Hi and welcome to you and Attila,

I have never worked with Lyso, but we have plenty here that have. Please let us know how much Attila weighs and the amount of lyso you are going to give for the induction phase.

Please also tell us what led the vet to test for cushings. Normally if a pup gets cushings from steroids, it is called iatrogenic cushings, and the cushings symptoms should go away after the pup is slowly weaned off the steroids.

Looking forward to hearing more about Attila.

Thank you for responding. Attila is normally 26 pounds, but ballooned up to 34 lbs. with his swollen belly (he now looks like a pot bellied pig). I got him tested not only because of his weight gain, but he started to make little groans when any pressure was put around the belly when picked up. He started wanting water all the time and peeing much more which was clear color. He even had 2 accidents at work (he came to work with me to act as an unofficial therapy dog in the office). He had a bigger appetite and was panting more. He would only get steroids at most twice a year when his itching and red bumps got too severe.
I will be giving him 1/2 of a 500mg. tablet of Lysodren with his breakfast and dinner.

At present he wants to drink constantly and can't make it too many hours without peeing.

While we wait for some of the Lyso moms to check in, here is a link for Lysodren loading Instructions and related tips in our helpful resources section.

http://www.k9cushings.com/forum/showthread.php?t=181

Welcome to the board. I can't help with the Lysodren as I'm using Vetoryl (Trilostane), but there are really knowledgeable people here who have experience with Lysodren and will help you through.
My dog started treatment last April and we're just now getting some good control. It is quite a relief when all that drinking starts to wane..it's taken awhile for us but finally the water dish is not constantly empty! My dog (age 9) is still active and getting better everyday.
She had a very bad gastro bout, including bloody diarrhea the summer of 2012. It turned out to be a clostridium overgrowth but they didn't find it for about 4 months. So it was off and on all that time. We didn't see Cushings symptoms until maybe Feb or March of this year. It could have been brewing before that but who knows?
Since Cushings she has had only a few bad poops, nothing like when she had the bacterial thing, but gastro upsets are common talk on this forum. Don't know if that's a Cushings thing or just a dog thing.

I'm sure others who know more will be posting soon to give you some good advice on the Lyso.
We all started here feeling terribly worried and upset but things really do get better! :)


Barbara

Hi I am a lysodren mom. My girl Haley used it for over 4 yrs with no problems. Key is to have an experienced vet and to follow dosing protocols and instructions carefully... keep an eye out for any changes whatsoever in eating/drinking.

Measure water intake BEFORE starting so you can tell if it is reduced.

I do want to question one thing about the dose - do you mean 1/2 of a pill in the am and 1/2 in the pm? Or do you mean 500 mg in am and 500 mg at night? (that's a pill each meal)

Trying to figure out if it's 500 or 1000 mgs a day. 500 mgs is within recommended dosing range but 1000 mgs would be too high. Max for your dog (starting dosage) is 772 mgs.

I think the dosage is ok but just want to double check.

Here is info that helped me. Read it over and over. Never give a pill if your dog is sick regardless - just wait. The drug continues to work for TWO days after the last pill so when in doubt withhold the dose ok? Always give the pill AFTER the dog has eaten so you can see if there was food left over or if the dog's eating pattern is slower. Any hesitation - just don't give it. You can always ask us and we'll give you our thoughts.

Give the drug wrapped in cream cheese - it's easy to hide the pill, dogs love it and the fat in the cheese helps coat the tummy and absorb the drug.

Don't change the diet during the load because signs of overdose are vomit and diarrhea and you won't know if it 's the new food/treat or the drug.

ARe you off of the steroids or not? This concerns me a bit if not. Tell us more about that. Also how long ago was the bloody diarrhea?

Start a diary as you watch for all signs of load and water intake so you can track changes. AGain watch your dog eat and drink PRIOR to loading so you can more easily spot changes while loading ok?

You will be fine. Oh and make sure your vet gives you prednisone to have on hand in case of emergency. Kim

http://www.k9cushings.com/forum/showthread.php?t=180
http://www.k9cushings.com/forum/showthread.php?t=181

I can't help with the Lysodren either as my Isabel is on Vetoryl (Trilostane). But I wanted to say hello and tell you the support on this forum is wonderful. I think everyone started scared but with the info here and moral support (at all hours!!) will really help you. I am still at the beginning (only 13 days in) and I already feel better than I did on day one. My heart goes out to you..I know how you are feeling. You aren't alone!

Karen and Izzy

Thank You for support. To Frijoles mom - I will be giving 250 mg (1/2 a pill)in the morning and 250 mg at night. His diarrhea ended a week and a half ago. He has not been on steroids for several months since his Cushings cleared up his skin. Thank you for the feeding and watering suggestions. My husband will be the one who will have the most time to monitor him so I will relay all this info. I must sound like a broken record to him, but he knows I've been worried and woken up very early every morning by Attila wanting more water..again, Thank you.

Just wanted to welcome you. I am not versed in Lysodren so I cannot help you with that. Please keep a doggie diary, you will use it many times to reference things. I write in mine first thing in the morning so I don't forget anything. Hope all goes well with the treatment. If you are vigilant about watching you dog will do fine. Blessings
Patti

Hi and welcome to the forum. You mentioned a bloated belly, which causes discomfort when pressure is exerted. Have you had an ultrasound done, to ensure there is nothing else going on with any organs? It is expensive, but definitely a good idea.
There are many knowledgable pet parents on here who will help you get through this.
Tracey

I understand what you're feeling. I'm about to start my Boston on Lysodren in two weeks, and I'm terrified. I keep thinking, what if I don't see the signs that she's had too much? What if I hurt her? I would never forgive myself. :(

But I know that many people here have gone through loading and done just fine, and my vet advocates a very conservative loading dose--about 125 mg per day for a 13 lb Boston.

Praying things go very, very smoothly for you.

I have not done an ultrasound, but if it's necessary, I will, especially if its still sensitive after losing some bloat - funny, how after spending so much money on Attila up to now, spending more doesn't seem to matter as much. For Boston "grapey", I will keep a diary as suggested and keep you posted on Attila's progress w/Lysodren. He took his 1st dose and is still alive and well....oh, and I bought cream cheese for the pill.

Good girl. Its scary at first but trust me it will become a no brainer and you'll know it's saving her life. I'll be out of town tomorrow but will check in on Sunday morning. You will be fine. Kim

Day 1 success! :)

It'll get easier as time goes forward and you know how Atilia reacts to the drug, how fast the load goes and then we hope, smooth sailing on maintenance. :)

hugs,
Sharlene and Molly Muffin

MISSION ABORTED: Attila woke me up twice in the middle of the night. He had peed and pooed (solid) indoors (on his paper) and needed to be let outside to go some more. About an hour later he scratched on my door and I found diarrhea (light in color) and he had vomited his undigested dinner. He drank lots after vomiting and vomited a little more. No energy change, but now he's sound asleep. I called the vet on duty and she said not to give him a prednisone tablet since this was probably not an Addison's reaction, but he is just not tolerating the Lysodren in his system. She did say to continue with Lysodren tomorrow as planned, but I am going to wait to speak with my prescribing vet before doing anything. FEEDBACK?

Has anything changed other than starting the Lyso? New food, treats, bedding, cleaning products, yard sprays, etc?

No, Nothing has changed. However, Im thinking I didn't give his gastro intestinal tract time enough to heal from his previous system upset 2 weeks ago.

He stopped his holistic meds 2 days ago, but I've been told that should not adversely affect himAlso, he is still on a bland diet of sweet potato, oatmeal and whitefish (and fish oil). Maybe not enough fats to help with absorption of medication? Ill be at work today, but checking this thread periodically. Thanks

Stopping the holistic meds may not have bothered him but the combination of stopping something the body is accustomed to and starting something new at the same time may have caused a problem. I'm just not sure. The fats in the feed are probably pretty low. It helps if you give the Lyso does in something like cream cheese or peanut butter. His system may not be quite up to par from his recent bout, like you say. AND your vet is right - there are pups who simply cannot handle one drug or the other and have to switch but I think it's too early and there are too many other possibilities to make that determination just yet.

If I were you, I would stop the Lyso for now and let his system settle really good. I would wait until he has solid stools for a day or so and his appetite is strong. If he is still nauseated or has diarrhea when you get home today, I think I would have him checked just to be sure the diarrhea isn't rearing it's head again or he doesn't have another infection of some sort. I would also talk to the Holistic vet and ask about this just to get their take on it.

Hi and welcome. I guess I'm a Lysodren mom. My boy wasn't treated too long on it but I can tell you that the guidelines provided to you earlier were very helpful. It does seem really scary but after being on this forum for several months now I feel like I would choose Lysodren for my pup again if I had to. As for when you start treating him again, trust me you will know when he is loaded. You know your dog best and you will notice that slight change in water or eating that will signal you that the induction phase is over and it's time for an ACTH test. I had trouble keeping my dog in maintenance phase but when he was in control the change in him was amazing. It was so great to see all of the Cushing's symptoms subside. I'm not on here much anymore especially since I'm back to work after a nice summer break. If you ever have any questions feel free to intact me via private message. I can help with what I can. That being said, the support and knowledge on here is amazing. I couldn't have one though all I have without the support found here. Good luck.

Thanks Kaibos Mom- I am stopped for now and giving him Flagyl to help with the diarrhea. The vet on duty said to give him 5mg. of Prednisolone too, but I dont see how 1 pill of Lysodren could lower his Cortisol that much, and my husband is hesitant to give him more drugs. Waiting for our Cushings vet to call back and direct me. Ohhh these sensitive Frenchies!

Poor guy! Hope he feels better soon.

It doesn't matter if the cortisol got too low after one pill or not - rule #1 is to never ever give lysodren to a sick dog. Vomit and diarrhea are signs of overloading so you have to get over both of those before you even think of restarting it. Otherwise you will not know for sure if it is the lysodren or not - not worth having an acth test (expensive) done after a single dose.

I don't know what supplements you were giving but it could also be that 2 days wasn't enough to cleanse them out of the system. Are there any other drugs you are giving? Just checking to be safe.

Tremendous job of keeping a close eye out. The other thing you have to make sure doesn't happen is pancreatitis. Cush dogs are prone to it. So you want the tummy to be able to digest food and for eating patterns to be normal.

Great job. Not impressed by whoever it was that told you to give the next dose - they obviously have never had to live thru the stress of loading. Glad you stopped and checked in. Keep up the good work. Kim

Thank you Kim for the info. to look out for pancreatitis. Attila's not on any other meds, but I dont think his system got stabilized enough before we started Lyso. We have stopped it - I didnt listen to the doctor who told us to stay with it, I also only gave 1/2 5 mg. pill of prednisolone - I did not feel comfortable with it. Our treating vet has not called me back yet, so unless she's on vacation, it makes me lose faith since I think I should be able to contact her during the loading phase since she's the expert. We are giving Attila Flagyl right now for his diarrhea. Feeding bland food of oatmeal, sweet potato and a little white fish. He is eating and drinking up a storm with no vomiting and has good energy. My husband has reintroduced the holistics in the meantime. I will wait until his system is sound until we do anything.

You are right to be upset that your vet has not contacted you yet. When a dog is loading access to a vet 24 x 7 is important. Especially when the back up or office tells you to give lysodren anyway... not good.

Glad things seem better today. I'd be cautious about adding a bunch of new things to the mix (holistic treatment) because any change in meds, food, treats etc will make you wonder what is causing the diarrhea, vomiting etc. I'd try to stick to as little change as possible so when you do start the lysodren again you have a very clean slate.

Keep us posted and you are doing the right thing by holding off. Kim

I agree with Kim. Too many changes right now to add the Lyso to the mix until you see how the changes are going to work. Let him adjust to his regular feed and the Holistic meds before restarting the Lyso - then do not change one single thing during the load. ;)

Hi - The vets office FINALLY called to check in - turns out the prescribing vet was never called by the office. They called her right away today and she wants Attila to get another ACTC stim test just for precaution and meet with us at the end of the week when she's back in the office. 1 pill of Lysodren doesn't seem to be enough to give an Addison's reaction and he's been showing no signs since early Saturday morning. His diarrhea is clearing up with Flagyl, and everything else is normal. I feel like this is a waste of money, and I am starting to look for other vets that have experience and can also be available more during the loading and maintenance phase of Lysodren. Anyway, the vet said they's be negligent if they didn't recommend an ACTH stim test.

If you only gave one pill and you haven't since and its been several days then the cortisol would have risen and the test wouldn't be valid anyway.... seriously don't do an acth test - too expensive to waste your money like that.

Get the tummy healed up and you can try again and if it repeats then you might have to try trilostane or start questioning the diagnosis.

Since you gave the pill has the water intake been the same? Is appetite back to normal? Kim

That's what Im thinking about the ACTH test -but the vet has me a bit worried. I dont intend to start any meds until his tummy is regular. His water intake is the same (we are keeping track) and he's been eating voraciously like the piglet he is. Thanks Kim

Nah, I wouldn't have the ACTH done either. If your boy was still showing signs his cortisol might be too low, then by all means have one but he isn't so don't waste the money nor put him through unnecessary stress. Tell your vet she hasn't been "negligent" and you have chosen to pass. :D

Thank You oh Wise Ones! I will take your advice on not doing the ACTH test right now if you don't think any indication of a serious cortisol drop will show at this point (reaction happened early Saturday morning). I think the negligence was in my vet office not contacting my prescribing vet on time. Amazing that these decisions about Attila keep me up at night - but apparently you have all been through it...again, thank you for your guidance and support. Laura & Attila (the Hun)

:D:D:D No problem. Yes we have been there and seen that so many times it is pathetic. Keep us posted. Kim

I'm a bit late to the party, but welcome to the forums. As you have already found out these folks are PAWSOME.
Angela

We are back on here and under the care of a new doctor who specializes in Cushings Disease and is currently doing research on alternative treatments. Attila had a suppression test to determine whether pituitary or adrenal tumor that came up inconclusive, so he is having an ultrasound on Monday. I will report all info once I get it. In the meantime, I have not had a thorough sleep in several weeks since Attila scratches at my door to get water at least 3 times a night. He uses the pee pads well, but I also let him outside anyway and he goes again. I just bought an H2O self feeder so that he can drink whenever he wants, but I dont know if this is a good idea since I have heard dogs are not good at self monitoring. He seems to be able to take breaks from drinking today (I am testing it today). I know many of you are no longer dealing with the symptoms of extreme thirst & peeing, but if you have any suggestions so that I can sleep, please let me know. Also, if any of you like a mineral supplement during this time, I'd appreciate those suggestions. Thank You

When a dog has or is suspected of having Cushing's retricting water can be detrimental. With Cushing's the increased amounts of cortisol make the kidneys work harder thus the dog pees more often and the dog HAS to drink more water to keep up with kidneys. :eek:

Giving Attila free access to water and then providing him with pee pads will hopefully curb him from keeping you awake.

Hugs, Lori

Hi Laura,
I think this is the first time I posted to your thread, so welcome from me too.:)

I totally understand the drinking and peeing thing. My Cush boy never used Pee pads before and was not about to start, no matter how hard I tried. He would hold it until he burst something before he would actually have an accident in the house. He could no longer get out his doggie door due his rear leg weakness. That made the potty issue a huge problem when I worked. Yes, it is a challenge, but please resist the urge to take Attila's water away. Cush pups need access to water 24/7. That could means getting up and pottying at all hours of the night. Do you have anyone who could take a shift or two, so you could get a better night's sleep? It normally get significantly better once the cortisol levels are controlled.

Dear Lori & Kathy- Thank you so much for clarifying that!!! My husband was pushing the advice of one doctor to cut off water at 8PM, and I believed the other doctor who said he needed consistent H2O access. I will keep the self - drinker and maybe I'll get some sleep. (of course Attila loved the fact that I have been at his beck and call). As long as there are pee pads out, Attila will use them, although we'll see how flooded our bathroom is. I seem to be the only one who hears him at night, so unfortunately, my husband is of no help for shifts.

Wow - good thing you asked. The doc that said to withhold water after 8 pm is not who I would go to for cushing's help. The other one is the one I'd put my faith in. Seriously. Kim

UPDATE: Hello Everyone who has been so helpful in checking in on this thread! Attila was tested and had an ultrasound which showed that Attila does not have an adrenal tumor. I found a vet who studies Cushings, Dr, Bruyette at VCA.(unfortunately, Attila did not qualify for his present study) Attila started Trilostane on Sunday October 12th. and got his ACTH Stim test this Monday the 20th. The levels indicate that his Cushings is under control so far. Yay! I requested all the results as everyone suggested so that I can track everything. He is drinking less, still very hungry, and still using the pee pads at night, but he has his old skip in his step, and he is trusting his hind legs more. I am very optimistic and will have him tested again in a month. I will keep reading this forum so that I'm as educated as possible, and maybe I'll eventually be able to help someone else. I especially want to find other ways to support aspects of his health that this disease may have compromised. I want to thank you all for being there when I needed the clear information and support.