Any steroid, whether it be drops, oral, or topical can cause and/or exacerbate Cushing's symptoms so please keep that in mind.
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Any steroid, whether it be drops, oral, or topical can cause and/or exacerbate Cushing's symptoms so please keep that in mind.
Hi! Mia has been doing well, at least she's drinking less water, the nailbed infection is gone and her elbow sore is slowly getting better. She still has the rest of Cushing signs though, I know 2 weeks is not enough time to see more results.
Yesterday I took Mia to the vet to take the tests and after 2 weeks with Vetoryl (and 3 weeks with ketoconozale before that) there have been some improvements in some levels and not so much in others. These are the results:
Weight is 18.6 pounds.
Glucose 133.5 mg/dL (normal range 60-117) Last time 118
Alkaline phosphatase 460 u/L (normal range 10-100) Last time 441
SGPT 168 mg/dL (normal range 10-94) Last time 306
SGOT 109 U/L (normal range 10-62) Last time 104
Total cholesterol 334 mg/dl (normal range 116-317) Last time 342
Pre Vetoryl Cortisol 10.8 ug/dL or 298 nmol/L Last time 17 ug/dL
After this the vet decided to increase Vetoryl dose from 5 mg twice a day to 15 mg only once a day.
And now I ask for your opinion as usual, do you think it's good to change from twice to just once a day? Is the increase in the dose OK?
Let me know what you think and I will discuss it with the vet, I have told her about this forum and that you guys know a lot about Cushing, so she's kind of open to any advice I get from here.
Thanks.
Normally the recommendation is to leave a starting dose of Vetoryl unchanged during the first month of treatment because cortisol levels tend to continue to drift downward even when a dose is left unchanged. However, given the fact that you started Mia at a dose that was well below the typical starting formula of 1 mg. per pound — and additionally, her pre-pill resting cortisol is still really high at almost 11 ug/dL, I’d think you could safely increase now to the 15 mg. daily total. As to whether or not you want to stick with twice daily dosing vs. consolidated once daily dosing, I really have no strong opinion about that. Once daily dosing is typically an easier regimen for an owner to follow, so if a dog responds favorably to once daily dosing, I’d tend to go with that. If you do want to stick with an unequal divided dose, though, Dechra recommends giving the larger dose in the morning (that is to say, give 10 mg. in the morning and 5 mg. in the evening).
Marianne
Is she still getting the medication with the steroid in it?
Ok, thank you labblab.
I think I will divide the dose, I feel safer that way.
Hi everyone!
I'm back with an update. Mia has been 1 month on a daily Vetoryl dose of 15 mg. She's drinking less water (about 30% less than before Vetoryl), her skin has improved and there have not been any infections, her coat is still thin but new hair is growing back in some bald spots like her elbows and face and she still has a great energy and is very playful, she even has been able to jump on beds with some difficulty but a few months ago it was impossible for her. Some symptms that remain are excessive hunger, pot belly, excessive panting (especially at nights before the 2nd dose of Vetoryl) and a few indoor accidents.
We went to the vet last weekend to do the medical tests and most of the results were very good except for resting cortisol which contradictory went very high again.
Weight: 21.3 pounds, last time 18.6 pounds
Blood chemistry
Alkaline phosphatase 80 u/L (normal range 10-100) Last time 460
SGPT 60 mg/dL (normal range 10-94) Last time 168
SGOT 51 U/L (normal range 10-62) Last time 109
Creatinine 0.4 mg/dL (normal range 0.5-1.4) Last time 0.5
Pre Vetoryl Cortisol 17 ug/dL or 469 nmol/L, last time 10.8 ug/dL or 298 nmol/L
Urine test
Density 1.012 (normal range 1.008-1.012), last time 1.006
ph 8 (normal 7)
No crystals were seen.
The vet suggested we should increase the daily dose to 20 mg because she has increased her weight to 21 pounds but I'm reluctant to do it and I want to see if she starts to eat less and her weight stabilizes. I'm giving her a little less food, this last month she has been eating 1 1/2 cups of food daily, now I'm giving her 1 1/4 daily.
Your opinions are very welcomed as always.
By the way, today's Mia's 4th birthday and I'm planning to celebrate it next weekend, I wil try to share some pics here.
Happy 4th Birthday, Mia!!!
Since she is still symptomatic and her resting cortisol is high you could increase her evening dose by 5 mg so that would be 10 mg in the morning and 10 mg in the evening. Man oh man, look at the drop in her liver enzyme levels in chemistry panel, that is great!!!
PS...I changed her thread title to reflect her new age, hope that was ok.
Happy Birthday, Mia!
Gable's belly took a while to disappear. He started the Vetoryl in May and I don't think we noticed the belly gone until around the end of August or beginning of September.
Happy 4th Birthday, Mia!
And many more!