Dog got diagnosed with Cushing's - Chuck has passed

[randomguy]

Hello, i chanced upon this forum and am very grateful you guys are here. I have a 14 year old dog that has been diagnosed with Cushings. We suspected he would be for a while. Anyway, he weighs about 20 lbs and the vet is prescribing him with 20 mg of Vetoryl (then more blood work to see if it needs to change).

My question to you is: where can I get this medicine for as little money as possible? Also, should I get the 10 mg chewables and give him 2, or get the 30 mg chewables and give him 2/3rds? Thank you very much!

[judymaggie]

Hello and welcome to you and your pup! I have manually approved your membership so now all your posts will be seen right away.

To start off with your question re the chewable tablets -- I have never used the chewable tablets. You could call the pharmacy from which you are getting the tablets and ask them if they are scored. However, even if scored, I do not know how you would get an accurate "2/3". So ... I think your best bet is to give your pup two 10 mg. tablets. For future, if they are scored, and your pup needs to have an increase in dose based on the ACTH after the first month has gone by, you would be able to split the tablet in half and do a 5 mg. increase. It is always better to increase in small increments.

Okay ... on to other things. If you have spent any time reading other posts, you will see a pattern with new members. We love to ask questions and get lots of info -- in particular, testing results! In order for us to help guide you along the Cushing's path, please post the results of recent lab tests. With regard to blood tests, you need only post the highs and lows along with the stated range. Some urine tests will also have such highs and lows and others will have numbers (such as dilution factor). Please also provide us with the results of any tests that were done to diagnose Cushing's, i.e., ACTH, LDDS, ultrasound.

You say that you suspected Cushing's for a while -- what symptoms led you to this suspicion?

With regard to obtaining trilostane at the best price, many of us purchase it from pet pharmacies. They may offer Vetoryl at reduced prices or compounded trilostane. The compounding pharmacies are only allowed to sell the trilostane in doses not offered by Dechra, the manufacturer of Vetoryl. I purchase 10 mg. Vetoryl capsules from California Pet Pharmacy and 4.5 mg. compounded trilostane capsules from Diamondback Pet Pharmacy (in Arizona). Both of these pharmacies require a prescription from my vet (either faxed or provided verbally). We have heard from a few members here that their vet is not willing to work with these pharmacies. My vet, knowing that I need to save money as much as possible, very willingly works with me on this.

We have a great resource forum. Do spend some time reading -- here is a link to the section on trilostane:

http://www.k9cushings.com/forum/showthread.php?t=185

Within that section are the pamphlets from Dechra -- both the client brochure and the technical brocure provide outstanding information. Here is the link for the latter -- page 11 has a very useful flow chart:

http://www.dechrace.com/pdfs/vetoryl...alBrochure.pdf

Hopefully, I haven't overwhelmed you -- we are looking forward to learning more about your pup (name?)!

[randomguy]

Thank you for the well thought out and helpful post! My dogs name is Chuck. As far as blood work, unfortunately I don't have any. We had a full panel done about 7-8 months ago for cushings, and they told us that that while the pertinent liver enzyme levels were high, and above the limit, they were not as high as they would normally see in a dog with cushings. Two separate vets (going off the same blood work) told us that.

Anyway, we have suspected for, looking back, probably a year or two that something wasn't quite right. He first started losing hair (and it started becoming slightly lighter and flatter/less shiny) and the vet thought he had male pattern baldness (or something like that ). We also noticed his tummy was getting bigger even though we were giving him less food. The vets recommended a ACTH stimulation test when/if we noticed any other problems/progression of problems.

Lately his back legs seem to have gotten weaker and his belly seems even larger and he seems to have lost a lot of muscle. More hair loss, etc. He does pee a lot but he has always peed a lot. He was never trained very well so accidents in the house have always happened. Apparently he is supposed to be extremely thirsty, but he is consistent in the amount of water he drinks and has been for years, so no thirst issues i see. He doesn't pant excessively but he doesn't exercise a lot anyway.

We got the ACTH stim test last week and the results came in this week. Vet wants to start with 20 mg (he weights 20 lbs). He is generally a very happy dog and gets around just fine (but can't jump as well, like I mentioned earlier). He does seem more lethargic. But he doesn't seem to be in pain. Honestly he just seems like hes old, but the stim test, plus the hair loss, plus the huge belly and muscle weakening all seem to be cushings. The vet said he's been in practice for 20 or so years and sees about 5 cushings cases a year.

So that's my story! Hopefully we can control this thing and allow him to have a good life. I really was hoping to not have to get the 10 mg version since that'll be like...$100 or so a month (who knows what the final dosage will be). Thanks for any and all info--I'm very grateful to have this forum as a resource.

[MyBabyScooter]

Hello... I joined a few days ago too. I'm sorry to hear about Chuck. I am undecided if my dog has Cushings, as when he had a blood test, all readings were normal except for the ALP. As for symptoms, he has extreme hunger, a pot belly that changes in size and isn't really too bad most of the time, and possibly thinning hair. He still has lots of energy, no weakness, and very soft, glossy hair.

What has made me optimistic that it might not be Cushings is lack of drinking - he only drinks twice a day, about a cup at the absolute most. But now I have read Chuck doesn't drink much, I am more worried that he may have it, and really may have the ACTH test done

Thankyou for your post - it's the first time I've read drinking little is not proof they don't have Cushings. Best of luck with your dog

[DoxieMama]

Welcome to you and Chuck, though I'm sorry for the reasons that brought you. Judy mentioned it but I wanted to reiterate - you may be able to save money by purchasing Trilostane instead of the brand-name Vetoryl. You could get compounded Trilostane at 20mg which I am certain would be less than $100 for a month's supply (even with shipping).

I would also highly suggest asking your vet for copies of all test results done on Chuck, for a couple reasons. First, it is a good idea to keep those copies in a file... if you ever need his history for an emergency or a pet sitter, it's really handy to have available. Also, though I'm sure your vet is very good, if you can share the results here then our admins and other knowledgeable folks can review and support you and Chuck best. As your vet only sees 5 cases per year, you may benefit from having the support of those that "see" a lot more than that... and have been doing so for years. Not only that, but I found it invaluable to be able to look back on past results and compare them, research and ask questions here, to gain a better understanding of what is going on with my own dog.

Shana

[randomguy]

I will try to get the blood work--is it ok that it's probably 7-8 months old? My vet said he sees about 5 cases a year (I asked him how rare the disease is) and he said he has probably dealt with dozens of cases in his career. So I'm confident that he has a good idea what he's talking about, but I'd definitely be thrilled to get some other opinions from people on here if I can!

I asked him about compounding trilostane and he told me about an I think, 2013 study that looked at the doses of compounded trilostane and found them to be variable so he doesn't recommend it. I can see that the people on this forum have good luck with them, though, so I may switch in the future!

Thanks for the information everyone!

[kanga]

Hello, welcome to the forum!

Sorry to hear about Chuck health situation right now, I know it's hard to you to see your doggy suffer with this kind of disease. I just want you to know that you and Chuck are always in my thought, hope you get some good information & advice on the other member. I pray for you and Chuck, keep us update.

[DoxieMama]

Sure, it's okay that they're 7 or 8 months old if that's what you've got. I find it curious they didn't perform more recent tests. You only need post the blood test results that are abnormal, along with the reference ranges. Include all results for the ACTH.

[molly muffin]

20mg per lb would be the recommended starting dose for a dog with cushings with a retest in about 10 - 14 days. To see how the cortisol is doing.

I think the key to using trilostane compounded is making sure you use a reputable pharmacy. Some have good luck with it and others not so much and some do a combination, with the majority being vetroyl and then a compounded to go up in smaller increments.

[Harley PoMMom]

20mg per lb would be the recommended starting dose for a dog with cushings with a retest in about 10 - 14 days. To see how the cortisol is doing.

I think what Sharlene meant to post was that 1 mg per pound is what's recommended so for Chuck's weight of 20 lbs the 20 mg of Vetoryl is a great starting dose.

Hugs, Lori