My girl pug (confirmed Cushings & confirmed calcinosis cutis) / Tobey has passed

I think there were some studies that looked at three times a day, and if I remember correctly a member here who tried it. Usually it is too hard for the owners to keep up that kind of schedule dosing and meals, etc.

This is a link to Dr. Petersons blog where Dr. Feldman did a study on the various dosing options and Dr. Peterson's discussion of that option:

http://endocrinevet.blogspot.ca/2012...rilostane.html

hugs,
Sharlene and Molly Muffin

Back on page 3 again, lol!!

So, today is Tobey's third ACTH test. This is the first one where they are using the gel, instead of the injectible cortrosyn, which was used for the last 2 tests.

We discussed increasing the dose to 30 (from 10/10). I don't want to go with one 30mg in the morning, so I'll probably do 20/10, even though its not as cost effective.

Right now, her symptoms seem to peak in the afternoon. The heavy water drinking is between 3-7. She is not peeing at night nearly as much, which has been nice for us, and her I am sure. The CC is another whole matter, and the vet did comment that she can see how it's spreading more.

Her weight is up another pound. :( She hasn't been up to 20 pounds in years. I know it's because 1. I am home-cooking, and 2. I can't keep the family from giving her treats all the time because they feel sorry for her. I cut her food back from 7.5 ounces to 7 ounces, but I'll need to cut it back a bit more to try and bring her weight down. This will be a challenge for sure!

Well, her cortisol levels are up. :(

Pre 2.9
Post 8.6

We are upping her dosage to 20mg am and 10mg pm. I'll be flying through these vetoryl capsules!

I figured her cortisol was up because her symptoms have been coming back more.

Quote:

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Originally Posted by Renee

Well, her cortisol levels are up. :(

Pre 2.9
Post 8.6

We are upping her dosage to 20mg am and 10mg pm. I'll be flying through these vetoryl capsules!

I figured her cortisol was up because her symptoms have been coming back more.

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Well phewy :( sorry that Tobey's numbers are up, and hoping the increase in her Vetoryl dosage will do the trick. Has Tobey's next ACTH stimulation test been scheduled to see if the increase dose adjustment is adequate?

Hugs, Lori

Renee, I'm a little worried that you may be comparing apples to oranges since the testing agent was switched this time around. There must have been good reason why your vets opted for the gel this time around, but it looks as though there are reasons why at least one specialist is not keen on it (Dr. Mark Peterson). Plus, according to Dr. Peterson, apparently the testing time frame should be different when using the gel.

http://endocrinevet.blogspot.com/201...n-testing.html

Since you have been seeing symptom rebound, these results may indeed be accurate. But I just wanted to point out some additional thoughts to factor into the big picture.

Marianne

Hi Renee,

Did the vet say if this is something they would be using going forward or a one off on the gel?

Drat that the numbers are going up, but maybe it doesn't signify as much in light of what Marianne mentioned and the link provided.

The symptoms though can often tell the story too, so raising is probably what you'd want to do anyway, but you know the drill, keep an eye on Tobey, just in case. :)
You do have a bunch of worry warts around here :)

hugs,
Sharlene and Molly muffin

The last test was using the injectible, and it was 3 hours after dosing, with the post check an hour after the injection (four hours after dosing).

This time, with the gel, the test was 3 hours after dosing, and the post check 2 hours after the gel. So I guess that would be 5 hours after dosing.

I guess we do have a discrepancy in the amount of time between the dosing and the post draw. The reason the gel was used is because 1. the gel was initially what she had planned to use, but could not get before we needed it when all this first started, and 2. it is less expensive than the injectible (which was her initial plan).

When we first planned the ACTH tests, she couldn't get the gel in time, and so she ordered the injectible which arrives next day. Then the gel arrived a week or two later, and now she has to use up the gel since it expires much quicker. I probably won't get the gel again... but, she ordered it for me, and I can't see wasting it.

That said, I do believe the results are accurate enough to warrant the increase. Tobey's symptoms have been coming back, especially mid-day. I have been tracking them, as was suggested, and can definitely see them peak around 3. Since the increase was from 8 to 8.6 between the two tests, I feel that it is more likely correct. If there was a huge swing one way or the other, I would want to redo the test just to be sure.

Recheck in two weeks. I'll have to work on how to adjust the testing time frame to match up with her initial ACTH test. I need to use up the gel before going back to the injectible.

Renee:
Sounds like you are keeping track of things and have a good plan. Hope this dosage is the right one for a while as I know it is a lot to keep putting them thru this all the time. Tipper has had so many, I cringe every time she has to get another one. Blessings
Patti

Thank god you are the organized one Renee! :)

Tracking is one of the only ways I can keep things straight when so much is going on and needs to be figured out. It just makes sense to me and I agree that because you Do know when she seems to be slipping during the day, then it is more likely that the test results are going to match what you are seeing, so in this case the increase does make sense.

yes, I see what you mean about the gel and not wasting what was ordered for you.

hugs,
Sharlene and Molly Muffin

Just a quick update:

So far, no real difference one way or the other with the 20/10 dosing. I am still seeing a big peak in water intake and hunger in the afternoon, but it hasn't been a week yet on the new dose, so I am being patient. Boy, do I wish they made an extended release!

I am taking her in today for her rabies vaccination, so I really hope she does not have a reaction to that.

And, little funny from my vet: I am also taking in my rescue pug Skeeter for his vaccination. We always joke he is the last healthy pug I have, and they asked if I was sure I wanted to risk bringing him in! Hahahaha.