Tipper - adrenal tumor/breathing issues

Hi Everyone:
All I can say is it's not even 5oclock and Tipper is hungry. She was never like this on the 30mg. I am thinking she is still uncontrolled. She is going around the floor where it meets the wall looking for crumbs! How she thinks these things up I will never know. When she has gastro symptoms and cannot get outside to eat grass she goes along the edge of the carpet and eats fuzz. I think she is trying to throw up and figures the fuzz will do it. She is being one naughty girl bulldozing things while I am typing this. I don't think I need an ACTH test to tell me what is going on here. Blessings
Patti

Hi Patti,

Was it on 30mg that Tipper's pre number went to .07 and she was having panic attacks during the storms?
I can't remember for use but it's a fine balance sometimes.

hugs,
sharlene and molly muffin

Hi Everyone:
Last nite Tipper was really hungry again, and would not let me alone before her bed time snack. I have to get her weight down she is like a barrel. Sharlene her pre number did go low on the 30 you are right. I am nor sure what to do now. Should I give her 20 in the morning and 5 around 3-4pm or do I go up to 7mg or 8mg on the trilostane part of the dosage instead? I know she is not controlled and I am seriously concerned about damage control here. It seems the last time she was uncontrolled a few weeks ago and now I hear her start with this congestive noises, and sticking her tongue out over and over again. There is some connection between her boing uncontrolled and these things she exhibits. She gets her ACTH on the 16th, but that is a good 2 weeks away, and I am concerned about the damage this cortisol is doing on top of what she already has. I need some opinions here on the best route to take. I am wondering if 20mg Vetoryl in the morning and 10 mg trilostane in the evening would still make her pre number go low since they are not all taken at once?? I am stumped and need some help please. She did sleep ok last nite, but was very noisy and congestive sounding. Also I am wondering what to so about Tipper's ultra sound in October. It will tell if the tumor has grown on her adrenal gland, but if she is not able to have it removed what good does it do to get one? It will just get me even more upset and depressed. She has too many issues to survive this operation so should I put her thru this, and also spend money on an ultra sound I could use the money for her treatment?? I am not sure where to go with this???? Some opinions would help. It is dark here, and supposed to rain, so I hope Tipper does not get upset. Blessings
Patti

I think I would try to get a more even distribution of the Trilo over a 24 hour period. Instead of a big dose in the morning and small dose in the evenings, try to give the same amount both times.

As for the US - that is up to you. I fully understand the quandary over the expense when there is no action you plan to take based on the info it could provide. However, it would let you know how rapidly the tumor is growing and could explain why the Trilo dose is needing to be tweaked so often now. As the tumor grows, she will probably need more and more of the Trilo to control the signs. One of our members, Corky, went to a three times a day dosing (he also had an adrenal tumor that was not operable).

Keep your chin up, Mom. You are doing a fine job!
Hugs,
Leslie and the gang

I was wondering the same as Leslie...why not an even dosing for Tipper? Splitting the dose evenly morning and evening I think would help. When is Tipper's last big meal? Maybe you can shift her meals slightly later.
I think the even dose is going to help with control...doesn't sound like she's getting enough in the evening to get her through the night.

Barbara

Since her current dose is 30 mg a day, right?, ideally you would split that 15mg am and 15 mg pm - but that would also mean using a compounded Trilo to get the 15mg. You might ask the vet about 10mg 3X a day to avoid the compounding, or go up to 20 2X a day, but that may be too much, I just don't know.

Hi Everyone:
No Tipper was on 30 mg Vetoryl and that is when it made her pre number drop to low at .7 and they said she needs to be on a lower dose, that after a while on the same dose a smaller dose will work. So we tried the 20mg Vetoryl and it was not enough so we got 5 mg trilostane compounded. So her current dose is 25mg 20 of which is Vetoryl and 5 of Trilostane compounded. So it is hard to split 25. Maybe I should do 15 day and 10 at nite?? I would have to give her the second dose earlier than 12 hours though as that is when she gets hungry is between 6-8. She does get a snack at 6pm. She will start looking for her snack at 5-5:30. So I need to have the second dose in her and working before that. She gets her am dose at 7am, and I will have to give her the pm dose at like 4-430 instead of 7 pm. It should be ok as she is already taking 25 at a time, and overlapping it really will do nothing to her except work before she gets hungry. She has already had 30 mg before also. That is the only way of splitting it , unless I would give her 20 and 5 as I don't know if 15 will hold her all day??? I need to get this worked out so maybe I will call Dechra. Blessings
Patti

Hi Everyone:
I called Dechra and went over the scenarios with them. They want me to try 20mg Vetoryl morning and at 4-430 the 5mg Trilo. They want just enough to take the edge off her hunger. If that does not work I have to go to 15/10 split which they think is not as good. She will have to be on either one or the other for three consecutive days before her next ACTH test. It will be easier on me only giving her 2 pills in the morning. It is so expensive to do all these different combinations, but I am not a quitter and I will go on until this is right. I have been trying to live in my bubble and tell myself everything is going ok. That seems to be the only way I can get thru this, as I am worried about this tumor growing. I would give anything or everything in the world I have, if my girl could be healed. Blessings
Patti

Hi Patti,
I have definitely lived in my bubble many times during my life. It is equipped with all the latest technical toys.;):D what I have figured out over the years, is that I have to emerge from it eventually and face the challenge/challenges at hand. If your bubble is what you need to get you through, then stay in it for now. Every once in a while, poke your head out and take stock of where you are, where you realistically can expect to be and how you plan on getting there. Small doses of reality a little at a time. I admire the way that you keep plugging on despite all obstacles. Tipper is very blessed to have you. Xxxxx

I think a split would be good to try. You have the 20 and the 5 now, so wouldn't hurt to get it a go and see if it changes anything.

If you want to know for sure, then you would need to have the ultrasound, about how fast the tumor is growing. If you want to just try and manage the symptoms and react with the dosage changes as needed, then you could go that route also. This is one of those decisions that you'll need to make. I don't think that there is a perfect answer to that question. There are just variables that you need to think about.

I think that what you want is the best quality of life possible for her for as long as she will have, however long that is and we of course all hope that is a very long time.

I don't know if this is necessarily a weight issue, or if it because the adrenal tumor pushes other things out and then with the muscles not being as strong, it makes the stomach look bigger. Just something to think about.

How did the car drive go yesterday? Did Tipper enjoy getting out and about and not ending up at a vets office? do you take Toby and her both for the drive?

Hang in there,
hugs,
Sharlene and Molly Muffin