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Thread: Junior - 6 year old lab mix - Vetoryl twice daily

  1. #171
    Join Date
    Apr 2009
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    York, PA.
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    Default Re: Junior - 6 year old lab mix - Vetoryl twice daily

    I'm so sorry that you are having all this trouble with purchasing the Trilostane and trying to get Junior's cortisol at an optimal dose.

    Could you find out what stimulating agent the vet is using? With his numbers being indicative of Addison's you are absolutely doing the right thing in taking him off the Trilostane and having those electrolytes checked. A dog in an Addison's crisis wil have increases in drinking and urinating. How is his appetite? Any diarrhea or vomiting?

    Keep us updated, ok

    Hugs, Lori

  2. #172
    Join Date
    Feb 2013
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    Ontario, Canada
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    Default Re: Junior - 6 year old lab mix - Vetoryl twice daily

    He is doing fantastic, has absolutely no signs of over suppression. Not now, not when he was tested, not ever, in the almost 4 years he's been being medicated. He is, however, already showing the signs of not being suppressed enough. It's maddening. All I can do is wait for the electrolytes results, and monitor how much he backslides into cushings symptoms I guess.

    We had been using the synthetic version (Synacthen), as it was much cheaper. When the company was taken over by another, the price went through the roof. So my vet office had to switch to Cortosyn. With the synacthen, his post was done 2 hours later, and I could take him home in between. Now, the post is just 1 hour later, and as it's a bit of a drive for me, we end up hanging out walking about, or sitting in the car.
    His last 2 stims have been with the newer protocol/stim agent, and those are the tests that gave extremely unexpected results.

    I had his electrolytes tested the first time we switched stim agents, and they were fine then.
    Last edited by Junior's Mom; 04-22-2017 at 10:40 PM.

  3. #173
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    Default Re: Junior - 6 year old lab mix - Vetoryl twice daily

    I agree that is very strange.
    I remember when they switched to Cortosyn, here in Canada. My IMS did the ACTH test and we had not problems with it. Are they doing the vile splitting? My IMS at Mississauga Oakville Emergency Hospital said they were doing the splitting of the vile based on instructions from the lab, but I wonder if all vets are doing this or not and if it would make a difference.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  4. #174
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    Default Re: Junior - 6 year old lab mix - Vetoryl twice daily

    Quote Originally Posted by Junior's Mom View Post
    He is doing fantastic, has absolutely no signs of over suppression. Not now, not when he was tested, not ever, in the almost 4 years he's been being medicated.
    So glad to hear that Junior is doing so well!!

    Quote Originally Posted by Junior's Mom View Post
    We had been using the synthetic version (Synacthen), as it was much cheaper. When the company was taken over by another, the price went through the roof. So my vet office had to switch to Cortosyn. With the synacthen, his post was done 2 hours later, and I could take him home in between. Now, the post is just 1 hour later, and as it's a bit of a drive for me, we end up hanging out walking about, or sitting in the car.
    His last 2 stims have been with the newer protocol/stim agent, and those are the tests that gave extremely unexpected results.
    I'm a bit confused as why the vet did only a post draw 2 hours later when using Synacthen as the stimulating agent, I think an 1 hour post draw is usually done too. When researching the ACTH stimulation test protocol for Synacthen I find it is done the same way as Cortrosyn which includes a pre and an 1 hour post. And if I'm understanding correctly from the articles I've read, Cortrosyn and Synacthen are basically the same.

  5. #175
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    Feb 2013
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    Ontario, Canada
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    Default Re: Junior - 6 year old lab mix - Vetoryl twice daily

    I think some vets in Canada were doing a 1 hr and 2 hr post draw with the synthecyn. Mine only ever did a 2 hr post draw. I don't know the protocols regarding the different stim agents, I'm only going by what my vets office has said and done.

    Just to reiterate, Junior showed no signs of over suppression. I only had him stim tested because it had been a while. Now, I'm kind of sorry I did.
    At my vets urging, do to his really low results, I quit giving Junior the trilostane, and had him tested again after 4 weeks off of it. His pre was 80 (2.899) and his post was 137 (4.965) He also had complete blood work done, and nothing was of any alarm. All his cushings symptoms are back, and my vet will not prescribe any more trilostane. I'd asked to cut his dose in half, but she refuses. She has spoken with other vets through a board she is on. They all suggest something else is going on with him, so I should spend more $ on tests, ultrasounds etc.

    It's extremely frustrating to me, and I can't afford to start back at the beginning again. I know Junior's safety is of utmost importance, hence no trilostane, but his hunger, excessive thirst and peeing only reappeared when the trilostane was removed. I just don't know what to do next.

    Any (cost effective) suggestions would be much appreciated.
    Last edited by Junior's Mom; 06-20-2017 at 04:40 PM.

  6. #176
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    Default Re: Junior - 6 year old lab mix - Vetoryl twice daily

    Those are perfect stim numbers for a dog on Trilostane but what has me concerned is that Junior has been off the Trilostane for over a month and although those stim numbers show his adrenal glands are producing cortisol they aren't as high as I would expect them to be in a dog that is off Trilostane.

    Was Junior checked for an UTI via an urine culture? If not I would start with that so an UTI can be ruled out, and a culture is recommended when their urine is diluted because a regular urinalysis may not be sensitive enough to pick up the bacteria.

    Are you seeing any other symptoms besides the increased drinking and urinating?

    Lori

  7. #177
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    Default Re: Junior - 6 year old lab mix - Vetoryl twice daily

    I know some areas of Canada are really remote but if there is another vet in the area I would be darkening their door asap. Yep, finding a new vet for Junior would be my highest priority. That is ridiculous they way this one is acting.
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  8. #178
    Join Date
    Feb 2013
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    Ontario, Canada
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    197

    Default Re: Junior - 6 year old lab mix - Vetoryl twice daily

    He had a urinalysis done the same time as his blood work, but not a urnine culture. That might be my next time.
    Apart from the drinking and peeing, he is hungry. Constantly licking the floor looking for crumbs, munching on all the grass he can grab when I'm not looking, inhaling his meals...

    I don't blame my vet. With his stim numbers, she could potentially be doing harm if she agreed to put him back on trilostane. It would mean putting her faith in me to watch him closely. It's just so frustrating. He was perfectly fine, until the meds were removed. And as I said, I can't afford to start back at the beginning, with ultrasounds, more blood work etc.

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