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Thread: Our 9 year old mutt, Penny, in the dx process - sweet Penny has passed

  1. #51
    Join Date
    Jun 2014
    Location
    Clio, CA
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    30

    Default Re: Our 14 year old mutt, Penny

    My vet discussed Penny's situation with an internist and they decided it would be better for Penny to remain on the Vetoryl since she is so well controlled. The internist said the issues with Vetoryl and the kidneys is in the case of an overdose.

    So we have been feeding Penny homemade chicken and rice for two days, then yesterday we started mixing it with chicken stew k/d. She ate pretty well so far. Every few days we will decrease the chicken and rice and increase the k/d. We also have been given a couple doses of an appetite stimulant called Entyce.

    Day by day. Smooches and walks and love.

  2. #52
    Join Date
    Mar 2009
    Location
    rural central ARK
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    14,549

    Default Re: Our 14 year old mutt, Penny

    Hi,

    I'm glad you discussed this with Penny's vet but this statement:

    The internist said the issues with Vetoryl and the kidneys is in the case of an overdose.
    is absolutely incorrect. The manufacturer of the drug, the one who MADE the drug, says in no uncertain terms that their drug should not be given to a dog with renal insufficiency and that certainly includes kidney failure. They make no mention of overdose with this warning. You are of course free to continue the drug in spite of the manufacturer's clear statement to the contrary but I want you to be fully aware of the choice you are making. Sadly, we have seen many dogs made sick(er) even to the point of death due to vets who refuse to follow the directives for this very powerful drug. Vets are not infallible so it is up to us to be our baby's advocate since they cannot read nor speak for themselves. Part of what we do here is educate the parents so they can make decision for their babies with eyes fully open. I hope I have achieved that with Penny.

    We will of course be with you every step of the way regardless but I couldn't stay silent in the face of this statement from Penny's misguided vets.

    Hugs,
    Leslie
    "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.

  3. #53
    Join Date
    Jun 2019
    Posts
    18

    Default Re: Our 14 year old mutt, Penny

    It may have been mentioned earlier (sorry if it has) but i just wanted to add that dechra who make the drug are happy to speak to vets re dogs taking vetoryl. My previous vet and current one have both spoken to them about Bo.

    It would be worth asking them to get in touch if they do not believe you when you get back in touch with them after Leslies informative post.

  4. #54
    Join Date
    Jun 2014
    Location
    Clio, CA
    Posts
    30

    Default Re: Our 14 year old mutt, Penny

    Sorry, I haven’t been back here in a while. Penny had repeat blood work and her CRE was back down to 1.2 so the vet now does not think her kidneys are failing. We have kept her on her regular dose of vetoryl.

    We have been dealing with Penny not eating ever since the vet tried to switch her to kidney diet. She has an appetite but turns her nose up at her (non-Rx) dog food. We got her eating a different brand. She refused that after a few weeks. We got her eating again by adding Stella and Chewys dehydrated chicken patties to her dog food. But over time she stopped eating that. She will no longer eat kibble. Appetite stimulants aren’t helping at all; they last for a day but it doesn’t kick start her into eating beyond that day.

    So now we are cooking for her and trying to keep her from getting diarrhea.

    She had blood work and everything is within normal ranges. A chest x-ray was clear.

    This dog amazes me every day. She is sweet and happy other than the eating and recurring diarrhea. She even took my on a half mile walk a couple weeks ago and ran all the way home.

  5. #55
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Our 14 year old mutt, Penny

    It’s so good to hear back from you, and especially to learn that Penny is doing as well as she is. What a relief to know that her kidney values have rebounded! I’m sorry about the lack of appetite and diarrhea, though. My biggest concern is that both of those problems can be caused by a cortisol level that’s dropping too low. Is Penny still taking her Vetoryl? If so, has her cortisol level been checking lately? You had written earlier that’s it difficult for you to have an ACTH stimulation test run in the area where you live. But barring that, another option would be to test her resting cortisol level one hour prior to receiving her morning dose of medication. Here’s a link to that can explain this testing method to your vet:

    https://www.dechra.co.uk/therapy-are...l-monitoring-1

    Either way, given her symptoms, I do think it’s very important to have her cortisol checked if she’s still taking the Vetoryl. If she worsens even more before the testing can be done, I’d stop the Vetoryl altogether, even if only temporarily. It’s much safer for her to have a break from the medication than it is to risk overdosing and triggering an Addisonian crisis. Please do let us know how things develop for you guys, OK?

    Marianne

  6. #56
    Join Date
    Jun 2014
    Location
    Clio, CA
    Posts
    30

    Default Re: Our 14 year old mutt, Penny

    Thank you, Marianne. That is good information and I will talk to the vet.

  7. #57
    Join Date
    Jun 2014
    Location
    Clio, CA
    Posts
    30

    Default Re: Our 14 year old mutt, Penny

    Penny has had diarrhea for a month. Every time we think it’s resolving, she decides not to eat that food (whatever it was this week) anymore.

    So we are doing more extensive GI testing and sending that and fecal samples out (instead of in house). She had fasting blood draw this morning and depending on the results, we might take her to Reno for an ultra sound with a vet that our vet says is fantastic at it. Another $500+ today, but our girl is worth it since she is still bright and happy in spite of her issues.

    We did decrease her vetoryl to 30mg from 40mg.

  8. #58
    Join Date
    Apr 2009
    Location
    Georgia
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    Default Re: Our 14 year old mutt, Penny

    Has Penny’s cortisol level been checked yet? For all the reasons we discussed above, I do believe this is critically important if you are going to continue the Vetoryl at any dosage at all. For safety’s sake, I do believe that you need to make sure her adrenal function is not being oversuppressed. For a dog with diarrhea and lethargy, this really should take precedence over all other testing. Please, please let us know whether or not it’s been done.

    Marianne

  9. #59
    Join Date
    Jun 2014
    Location
    Clio, CA
    Posts
    30

    Default Re: Our 14 year old mutt, Penny

    Don’t worry. Appropriate testing is being done. She is not overdosed and is in no way lethargic. Just recurring diarrhea.

  10. #60
    Join Date
    Apr 2009
    Location
    Georgia
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    Default Re: Our 14 year old mutt, Penny

    Sorry, I mistakenly wrote “lethargy” instead of “inappetence.” It’s the combination of inappetence and diarrhea that has me concerned about Penny’s cortisol level. I know her ACTH results back in August were within the ideal therapeutic range, even while she was already exhibiting loss of appetite. So the two issues may well be unconnected.

    But cortisol levels often change over time, even when the Vetoryl dose is unchanged. That’s why the manufacturer recommends testing every 90 days, even when a dog shows no visible symptoms of oversuppression. Given Penny’s persistent issues with appetite and diarrhea, it seems as though cortisol testing is even more important. Simply checking blood chemistries is not enough. The blood chemistries (including electrolytes) may remain within normal range even when cortisol has dropped too low. Here are the specific monitoring guidelines given by the maker of Vetoryl:

    Long term monitoring:
    Once an optimum dose of VETORYL Capsules has been reached, re-examine the dog at 30 days, 90 days and every 3 months thereafter. At a minimum, this monitoring should include:
    • A thorough history and physical examination.
    • An ACTH stimulation test (conducted 4-6 hours after VETORYL Capsule administration) - a post-ACTH stimulation test resulting in a cortisol of < 1.45 μg/dL (< 40 nmol/L), with or without electrolyte abnormalities, may precede the development of clinical signs of hypoadrenocorticism.
    • Serum biochemical tests (with particular attention to electrolytes, and renal and hepatic function).
    Good control is indicated by favorable clinical signs as well as post-ACTH serum cortisol of 1.45-9.1 μg/dL (40-250 nmol/L).
    If Penny’s cortisol has been retested and remains within therapeutic range, then you can ignore everything I’ve just written. But if your vet is relying on blood chemistries alone to monitor the Vetoryl dosage, that is not enough. As I wrote earlier, even a resting cortisol level taken right before Vetoryl dosing would be better than no cortisol monitoring at all. If this testing has already been done or was included in yesterday’s blood draw, of course we’ll breathe easier if you’ll tell us the actual numerical result. But either way, I do indeed hope that the testing has been done.

    Marianne

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