Zoe By My Side- Our Journey with Cushings

I just lost it and had another Shirley Mclain moment, screaming in to the phone becuase I missed the vet tech's call and she went home.

I asked for Zoe's test results as I did not understand the message that was left and the girl refused to give them to me so I screamed into the phone I dont need a damn doctor to interpret them just give the damn numbers I WANT THEM NOW>

she is having an er doctor call me back. All I know is she still under 2 ug/dl pre and post.

what is happening? we cut her dose from 50 to 40 all the way down to 20 SID and she is still under 2.

something is wrong

Worry will bring out the Shirley McClain in all of us! :) :)

Her numbers started to go down after the vulva surgery if I remember correctly. So, if I think out loud here for a moment. Tumor, cortisol high, tumor gone, on high dose of vetroyl but body not producing as Much cortisol anyhow, numbers dropping.. hmm do you think her adrenal glands might not be able to produce as much cortisol now? Would an ultrasound show that?

What happens when you with hold vetroyl? I'm thinking the peeing might not be so much cortisol raising related, as leg hurts don't want to move related.

Does that makes sense in the grand scheme of things?

Stay warm up in those frigid temps. Another snow storm here this weekend and then next week again. Can you imagine!!! gads

hugs,
Sharlene and Molly Muffin

(((((hugs)))))

Quote:

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Even even if the prednisone isn't having any effect on cortisol measurements, a post-ACTH stimulated cortisol value of 2.0 µg/dL is too low for me (1,2). I'd recommend that you decrease the trilostane (Vetoryl) dose down to 30 mg once a day, and repeat the ACTH stimulation test again in 2-4 weeks. If the post-ACTH serum cortisol value remains less than 2-2.5 µg/dl on the lowered Vetoryl dosage, I'd even stop the drug completely for 2 weeks to see if the cortisol concentrations will go back up (generally to above 10 µg/dL), as an untreated dog with Cushing's disease should do within a few hours to days.

In many dogs that I treat with Vetoryl, the dose can be decreased over time. In some of these dogs, the dose can even be permanently stopped, and their cortisol secretion remains "normal" and never goes up high enough again to cause signs of Cushing's disease (3,4). The aldosterone secretion is not affected in these dogs, and they never develop any serum electrolyte changes associated with hypoadrenocorticism. This "cure" presumably is the result of mild adrenal necrosis, but we don't know for certain. In any case, when it does happen it certainly is not a bad thing, and the owners are generally thrilled!

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According to this- I should stop the Vetoryl and retest her in 2 weeks.

If her numbers are <2 than if this were me, I would stop the Vetoryl. It could be that the Vetoryl is having a cumulative effect on Zoe, so stopping the Vetoryl would help her feel better. This happened to Princess, right?

Loving hugs to you both, Lori

All I have to offer is my love and support and a hug.
Love,
Sus

If it were me, I would stop the Vetoryl as well and test in two weeks. It is not uncommon for a dog on Vetoryl to go into remission and some never need treatment again. I think you'll get your answer in two weeks, if that's what you decide to do.

Er vet called pre is 1.5 post is 1.7 after lowering her dose by 1/2.
If I stop the Vetoryl, I cant try the Metacam. We had planned to try the Metacam for 4 days but I dont think any of us expected her to be lower.

Wow, so even with the decrease in vetroyl, the cortisol levels is still dropping?

How risky would it be if you didn't give her the break from vetroyl?

You might want to look into what molly is currently taking for her spinal injury, which is Tolfedine. It does make a difference and is an anti-inflammatory. The thought being to treat inflammation and the pain will decrease and we do see that. There is an injection on the first day of treatment, then 4 days of tablets, then a break of 3 days, then another 4 days of tablets and reevaluate.

hugs,
Sharlene and Molly Muffin

With her cortisol level this low now, I'm not sure what the risk would be of trying the Metacam for just four days even if you do halt the Vetoryl. Of course, your vets will know better, but bear in mind that the cortisol range for a "normal" dog goes clear up to the high teens with no contraindication to the Metacam. I find it hard to imagine that Zoe's cortisol would explode above that to uncontrolled levels so quickly when her adrenals seem to be so oversuppressed right now. Just a thought.

For what it's worth, if it becomes a choice between the two, I believe I would still opt for halting the trilo. Something is definitely going on with her adrenals for her to be this sensitive to continually lowered doses.