Thank you so much Marianne. I will be calling my vet first thing in the morning (in 5 hours) Amanda
Printable View
Thank you so much Marianne. I will be calling my vet first thing in the morning (in 5 hours) Amanda
Update: Took Yohnny to vet yesterday morning. They admitted him. He could barley stand or walk. They gave him painkiller and intravenous drip. Did ultrasound and xray and bloodtests. Results came back with anemia, elevated kidney levels (could be dehydration), elevated liver values, and elevated "sedimention rate" (not sure this is correct translation). He is staying, he is stable, and they are going to do more tests today to see how they compare to yesterday. They did a needle test on his liver and will have the result of that today too. I am so worried adn want him home. Will give you numbers and more info when I have it. he has had an enlarged liver since he was diagnosed with Cushings. Now they see that part of the liver looks ”different” vet is hoping to find out what the ”difference” is due to.
I’m so sorry he’s feeling poorly! Absolutely you did the right thing by taking him in. I know how much you want him back home again, and hopefully this is a problem that’s only temporary. We’ll anxiously await additional news whenever you’re able to tell us more.
Sending healing hugs to Yohnny, and comforting hugs to you. We know how hard this must be for you, and we’ll stay right here by your side.
Marianne
Marianne! POSITIVE UPDATE. Yohnny is home :)! Vets are not totally sure what the issues were, but he has his energy and appetite back and is standing and walking again.He had a strong systemic inflammation. He may have eaten something. His arthritis coupled with systemic inflammation could be the reason he did not want to stand or walk. Vets do not think it had to do with his Cushings. But they will meet with his cushings vets next week so we will see if there is any connection. Once again thank you for your wonderful support Marianne. I hope you have a wonderful weeked.
That’s great news!!!! I’m so happy for you two!!!
I am curious whether they did check Yohnny’s cortisol level there at the hospital. Of course, something totally different may have been going on. But we have witnessed this same chain of events with other dogs who have been overdosed with Vetoryl: near total collapse and then a swift miraculous recovery once they receive IV fluids to restore their blood chemistries, as well as supplemental steroids if needed. So I’m still left wondering whether or not oversuppressed adrenal function may have played some part in this.
It’s very good that they’ll be consulting with his Cushing’s vet next week. In the meantime, I’m hoping they’ve told you to keep him off the Vetoryl until they do have the chance to consult. If Yohnny was my dog, I would want to let him bounce back from this ordeal and hear from the specialist before restarting the medication.
But for sure, this is very good news to take us into the weekend!
Marianne
Thank you Marianne. We are both enjoying very much being together at home today. Vet told me they check his "salts" due to his Cushings. Not sure what that means though. He has been off Vetoryl since Wednesday.
This is summary from vet:
Due to Yohnny not currently on vetoryl, no cortisol levels were taken to see check his medication dose.
A general blood sample was taken which showed mild anemia, elevated liver values, high blood platelets and a strong systemic inflammation.
The platelets and liver values correlate to Yohnny's cushings and there is nothing that worries me. The proteins that show liver function, as well as Yohhny's bile acids - which also show the function, were completely normal. So Yohhny's liver works well.
The anemia is difficult to say what it is caused by, Yohnny has had some low red blood cells before. Inflammations in the body can cause some low red blood cells. I think these should be followed up.
The red blood cells are not so low that they affect how Yohnny feels. He has fine mucous membranes and a normal pulse so the heart does not need to pump faster.
What stood out in the blood test was thus the strong systemic inflammation picture.
Ultrasound of the abdomen showed an altered area in the liver. The liver was also large, which it can become in Cushing's disease. A sample was taken from the changing part of the liver, the sample was unfortunately not diagnostic but to know for sure what the change in the liver is requires that you open the stomach and take a biopsy. I consider it unlikely that it is the change in the liver that is behind the deteriorating health as Yohnny got better so quickly on drip and pain relief. Had something malignant (cancer) in the liver caused his bad health, one does not expect such a treatment response.
Ultrasound examination of the heart showed that the heart is working fine, he has a leaking valve but there is nothing that currently affects him in any way and he therefore does NOT need to take any medicine for his heart disease. He therefore also has no increased risk of anesthesia.
In conclusion, it is difficult to say what made Yohhny so bad. How he was feeling probably correlated with the strong systemic inflammation. He responded nicely and quickly to drip and pain relief. It could be that he simply ate something inappropriate (food poisoning / gastritis), he also has severe osteoarthritis of the elbow joints and hip which, together with the general feeling of illness you get from such severe inflammation, may have contributed to his unwillingness to move . Of course, it is not possible to say for sure, but I am very happy to see how quickly he recovered - something that speaks against a disease of a more serious nature that you always have in the back of your head with older dogs (cancer)!
Give no more Vetoryl until I have consulted your other vets. We will talk next week!
I’m so relieved to hear that Yohnny remains at home and is still doing well. And thanks so much for your detailed summary of the vet’s report. The one piece that really surprises and disappoints me, though, is the fact that they did not check Yohnny’s cortisol level. Truly, I think that low cortisol remains a possible explanation for his collapse and I don’t understand why they wouldn’t have checked that. I’ve gone back to review what you had written about his recent pre-Vetoryl tests:
For our U.S. readers, those first three results all translate to between 5 - 5.4 ug/dL. The September reading had dropped clear to around 1.8 ug/dL. Something had happened to cause Yohnny to metabolize the medication differently even though his dose was unchanged, and his cortisol may have dropped even further at the time of his collapse. It would have been really helpful to know what his level was at the time he was hospitalized. And I’d definitely want to know where his level is at before considering starting back. Whether or not there’s something else going on that is responsible for the change in his response to Vetoryl, we do not know. But as I said earlier, we’ve seen cases where dogs simply end up processing the medication differently over time, requiring dosage changes as a result. If appropriate changes are not made, dogs can end up overdosing with results that look very similar to what happened to Yohnny.Quote:
His most recent Pre Vetoryl Tests have been 148/138/149 (30-200) but this latest one was different: 51 (Sep 14, 2021)
So, for sure I’ll be very interested to hear what your Cushing’s specialist has to say about all this in the coming week. In the meantime, I surely hope he continues to do well!
Marianne
Hi Marianne and thank you for being so involved and adament about Yohnny’s health. Vet that had been taking care of Yohnnys cuahings called today. We are going in for an ACTH test tomorrow morning. So in you opinion they should have done this earlier? Is there anything else I should ask/keep in mind when I see vet tomorrow? Thank you ad always.
I’m so glad to hear about the ACTH test. The current status of Yohnny’s cortisol production will be the most important factor in making a decision about restarting his Vetoryl, and if so, at what dose. When you took Yohnny in to the hospital at the time of his collapse, they may not have been able to do a full ACTH due to his condition and also the IV meds he was receiving. But in my opinion, they definitely should have at least checked his baseline cortisol level as part of his initial blood draw.
But I think an ACTH now will be very important. Also, I would think your vet would want to draw enough blood to check Yohnny’s basic blood chemistries as well. The balance of sodium and potassium is especially important to monitor, both when a dog is actively taking Vetoryl or also when an overdose has been suspected.
That’s the main thing I can think of in advance of your visit tomorrow. Good luck!
Marianne
Thank you Marianne. This is very helpful. Still waiting for results of ACTH test. In the mean time vet called and his red bloodcell count has gone down. 32 lats Thursday, now 23. Vet asked for a stool sample so that is my mission right now. The knot in my stomach is back. :(