suspected Cushings

[Jan W.]

I just returned from the regular vet and she was very receptive to Dr. Peterson's article and she wanted to keep it and read it more at her leisure. She was not aware of this routine. She has no problems with following those guidelines and she was comfortable with compounding pharmacies and wrote down all the information from my trilostane bottle so she could have the information for Diamondback. They have used compounding pharmacies and had not heard of Diamondback.
We discussed possible other health problems and she did not feel the things I mentioned could be a possible cause of false positives for Cushings and I was pretty sure she would feel that way but just wanted another opinion. One of the things I brought up was the lipomas they found on her spleen and she felt that they were able to distinguish between a lipoma vs a tumor and the lipomas would not cause the cortisol issues.
She was in agreement with my wanting a B-12 and folate level done and understood why I wanted it - I don't anticipate any problems but will relieve my mind. I will feel good if her bowels have no malabsorption issues. So I am awaiting those results and the ACTH results. If ACTH is positive then we will begin the trilostane on Monday. She wanted to wait until Monday so she would be available. We discussed the prednisone issues and dosage if I determine we are in trouble.
I think she will work with me well. I left the clinic feeling up. If the trilostane doesn't work out for us, we could try the other or just let it go. One step at a time!! I will let you know the outcome. Jan W.

[Squirt's Mom]

I'm so glad you had a good chat with the vet! That feeling goes a long way in helping us become more comfortable with all of this. We had a great vet when we started this journey and I couldn't be more grateful to her.

You done GOOD, Mom!

[Jan W.]

I think you guys done good!!! You guys have been a big help. I think a lot of people don't know about this site. I am so fortunate that I did. Although, I just about choked when I got my bill yesterday - Not a good time to run out of your blood pressure medications. Fortunately they give me a senior discount. My bill included their senior 6 month check ups etc.
The vet told me yesterday that they don't see a lot of Cushing's but I"m not sure people are really aware of what is going on and just consider it aging problems and they don't really have the money to help their pets so don't go to a vet unless they have to.
I will let you know what happens in the next few days. Jan W.

[goldengirl88]

Jan:
So glad to hear your vet is willing to learn form all this and work with you on it. It is so much better to know your vet is on your side and willing to get caught up to speed on things. This forum is a life saver and I literally mean that. Blessings
Patti

[Jan W.]

I just got a call from the vet and Cinder's b-12 level was elevated so we do not have bowel disease causing malabsorption- I can quit giving her the oral B-12 and her ACTH was almost double of the last one - last one was 24 and this one is 47 with anything over 22 being probable cushing. So we are even more elevated - I will start the trilostane on Monday and if we have no problems I will get another ACTH test 1-2 weeks out. The IMS vet talked about 10 days so I'm not sure - I guess I will just see how she does and if I feel uncomfortable it will be done sooner. I'm not one to sit and wonder - I feel it is worth doing the labs sooner than too late especially on the first go around. I'm still not sure if I want 1 dose the first day or go to the Q12 hour dosing right away. I guess you get less side effects with the Q 12 hour dosing.
Keep your fingers crossed - my son is saying prayers and will be out here visiting on Monday and will pray with us. My prayers are there for all of those going through the same thing. And bless all of you involved with this site - Jan W.

[molly muffin]

I like the first test around 10 - 12 days from starting. That gives it enough time to show what it will do. Too soon and you won't see where the range might settle at, too late and you get the risk if the cortisol is dropping too much.

It depends on the dog, everyone is different in how they react, but if you notice a lot of symptoms at night, then twice might be the way to go. If more in the morning, then it could be that a once daily will work fine. It is for those that don't maintain control throughout the entire day and night that double dosing works best. This is something you'll know better what should be tried as you see how she is during the day and night.

Drat that she doubled almost in that time.

hugs,
Sharlene and Molly Muffin

[Jan W.]

I was just wanting to give the trilostane the first day once just in case I saw a reaction - but the vet had ordered twice a day dosing. Cinder really doesn't have much problem during the night as their beds are in our bathroom and she doesn't drink water and need to run outside during the night. She has not been incontinent yet, but when she goes -- well lets just say she has a bladder large enough that my husband actually stands there and counts the seconds off. And sometimes her legs won't hold her up so she has to stand up and is still peeing or she will walk around a little then go at it again. She will head for the water first thing before she goes outside also.
I'm not sure how much longer it will be that she would be able to keep good bladder control. She doesn't get stressed during the night and sleeps good (doesn't whine or act like she is in trouble) - but she snores and gags sometimes. Which we have discussed with the vet. Lately her gagging is more after she drinks water rather than at night.
Speaking of it - she just got up and went to the water bucket. I must have given her the idea with mental telepathy!!
Jan W.

[Jan W.]

I want to be sure about my first ACTH test - I feed my dog in the morning and give her the trilostane say at 5AM then I take her to the vets and they can start the pre-dose and ACTH dosing at 9 AM but no earlier than 4 hours? But we are ok if started between 9 AM and 11 AM.--- If this is correct - I may have to adjust my feeding time if the vet office wants to start earlier. I'm ok with that, I just want things to be correct. Jan W.

[molly muffin]

You want to start to finish in the 4 - 6 hour period after giving the trilostane. Optimally, you feed her and give the trilstane and they take the first draw 4 hours later, and the second draw an hour after that at 5 hour mark. That should give the most accurate result.

Sharlene and Molly Muffin

[addy]

Dechra states 4-6 hours after dosing, UC Davis says 3-4 hours after dosing.

Whatever you do this time is what you want to do ALL the time when the ACTH test is done so you know the test was done with consistency. I make sure the test is started 4 -4 1/2 hours after dosing, I always have to calculate about 30 minutes of them doing other things before they do the first draw. I never want Zoe's second draw at six or more hours.

So if possible try to time it so that first draw is 4 hours always. Zoe too gets fed around 5:30am so I try to push it as close to six as I can which usually means 5:45 She's a hungry girl in the morning!!!

Always give food with the dose, I usualy just give her normal breakfast or a tad less and then no more food until after the test.

I would schedule the test for about 10 -12 days out the first time. Keep in mind you can always reschedule if you think there is a problem and do it sooner. If in doubt about possible side effects you may see withhold the pill. Usually starting at a lower dose split twice a day minimizes side effects but every dog is different.

Zoe was about 45 post ug/dl when she started on only 10 mgs and she was about 20 pounds. Her cortisol dropped like a ton of bricks that first week. Sometimes we see them having cortisol withdrawal and they dont feel all that great.

Just check in with us and you will be fine.