Me, my dog and Cushing

[Scoovale]

Hi everybody,
I am Valentina and my Dog Scooter has been diagnosed with Cushing. First of all I wish to thank You all for creating and maintaining this forum. It has been very helpful to me in many different ways! I know that being from Europe might not be the est option, maybe I will not be able to help you as the European reality is probably different than the American, but I will try. Scooter is the love of my life, we have been through so much together and it breaks my heart to see him suffer. I am doing my best to help him and it seems to work too. He is 12 years old, a dalmata mix, 55 ibs. I found him abandoned twelve years ago in the central station of Neaples, Italy. Since than we have been inseparable. One year ago I had the impression that he was not well and I asked his doctor about Cushing. She laughed at me and did not test him. But since than he had always various problems with his eyes, with his skin and hair. He started to drink a lot...A couple of months ago I decided to get rid of all this city doctors and went for a veterinary near Berlin, in the countryside. I have been reading about it. There is an old doctor with his staff and they treat different problems which makes it easier to get a complete picture of the animal's health condition. They told me almost immediately that my dog very likely had Cushing. I knew almost nothing about it. They have cured his skin infection with antibiocs and later, they tested him for Cushing. Now, one month later I know much more about it. I have been studying natural remedies, I compared various treatments, especially natural ones, and their components in order to find a good natural way to help him. I have searched Western nature medicine and I finally landed on the tRaditional Asian medicine. I am still having a bit of trouble understanding all the various medical terms and amounts, but I am learning still. Scooter started Vetoryl five days ago. I was so scared ad I feld I was poisoning my dog. When I gave him his first pill I started to cry and could not stop. I wanted him to start low so I told the doctor that I wanted 30 mg a day and not 60. She said that 60 is even too low for him. I said that probably is too low but I want him to get slowly used to it. She said that he needs 120 mg a day and I think that she did not really believe in this thing of getting the dog so slow in it. I actually wanted to give him the vetoryl in the morning and in the evening but the 30 mg capsule is difficult to share as you must open it. The pharmacy does not do that and I did not feel sure enough to do it myself. After few days of Vetoryl Scooter is doing much better. He drinks less (against urinary pressure he gets also pumpkin pills), he is more awake wants to go out and stay out, he plays, he is in a good mood. Still he gets tired very quickly but the difference is big. I give him daily an herbs mix, flaxseed, minerals, fish oil. In the evening he gets mostly 1 mg melatonin with Melissa (lemon balm), which helps him relax (really great). On Monday we will test the cortisol. I am very curios as the sympthoms seem so mild now. Actually I am searching for people who had experience with the TCM Rehmannia 14 formula. It seems to be extremely good for Cushing. Some dogs (and horses) can even quit the trilostane after a while. I searched some books of traditional Chinese medicine and I have found out that Rehmannia 14 or 11 are usually used together with Ophiopogon Formula (against thirst and drinking). I could convince my veterinary to try the Rehmannia. Have you any experience with it? Sorry for writing so much! I need somebody to share this huge thing...it is really blowing my mind thanks valentina PS sorry for the grammatic!

[DoxieMama]

Hi Valentina,

Welcome to you and Scooter! I only have a moment but wanted to reply and say I am very happy you convinced your vet to start with the low 30 mg per day dosage. Sometimes dogs need lower doses so it may be that Scooter will never need more Vetoryl to control his cortisol.

Do you have any of the test results that were used to diagnose him? The more details you provide, the better we can help you to support Scooter!

No need to apologize for writing so much. We love details!!

Hugs,
Shana

[Harley PoMMom]

Hi Valentina,

Welcome to you and Scooter from me as well! Bless you for giving Scooter a forever home, he is a lucky boy to have a pet parent so loving. I, like Shana, am so relieved that you listened to your intuition and started Scooter out at a lower dose. Dechra, the makers of Vetoryl, recommend a starting dose of 1 mg per pound of a dog's weight, so for Scooter's weight of 55 lbs that 120 mg would have been double of what's recommended, which is way too high.

Regarding daily dosing; the majority of dogs do fine on just a daily dose given in the morning with a meal, an exception to that rule is if the dog has diabetes than twice a day is required. Is the test on Monday the ACTH stimulation test? If so, than this test needs to be performed 4-6 hours after Scooter has had his dose of Vetoryl with a meal...I can't stress enough that the Vetoryl has to be given with a meal as it is not absorbed properly on an empty stomach. A dog's cortisol can continue to drift downward during the first 30 days of treatment so many vets are not increasing the Vetoryl dose at that 10-14 day test mark especially if there are any improvements in symptoms.

If you could get copies of all the tests that were done on Scooter and post those values that are abnormal with their reference ranges that would be great. We also are really interested in all test results that was done that diagnosed his Cushing's.

I'm not familiar with Chinese herbs so I can't offer any advice there, sorry.

We have a wealth of information regarding Cushing's; the medications used, and treatment protocols, which can be found in our Resource thread and it also includes articles written by some of the most renown veterinarians that specialize in endocrinology such as David Bruyette, Mark Peterson, and Edward Feldman. So please utilize it to educate yourself and if you have any questions do not hesitate to ask them. We all eventually figured out that safe and effective treatment is much easier facilitated if the vet is experienced and the pet owner is educated. Here's a link to our Resource thread: Helpful Resources for Owners of Cushing's Dogs

I am sorry for the reasons that brought you here but so glad you found us and we will help in any way we can.

Hugs, Lori

[Allison]

Valentia, hi.

Welcome to the forum! Bless you for rescuing Scooter twelve years ago. Also, thank you for being so diligent with his care.

My experience with Cushings is limited. Our adopted dog only had it for a few years, before he developed other ailments.

There are many here with plenty of experience will be able to help! As others have suggested, posting test results will give ones the ability to give the best advice. Hang in there!

[Scoovale]

Hi guys, thank you for your replies. These are the results that we have got the first time we tested for Cushing:
Dexamethason screening test:

Cortisol basalwert (base value): 53,7 von (of) 5 bis (to) 65;
Cortisol supp. Wert:
50,8 ◀ 10 ng/ml
Cortisol 2 supp. Wert:
60◀ 10 ng/ml

Hope it makes sense, because is in German.

Scooter got half of the starting dose proposed by the doctor, 30 mg instead of 60. She aims to 120 mg but I do not think that I will ever give him so much. I have the impression that he needs a little bit more to be completely well. He is already good. He wants to play.
I am checking out this Rehmannia 14 trying to get more info's. But I guess I will make a post specifically about it.

See you later,
Valentina

[Harley PoMMom]

Hi Valentina,

Looks like a LDDS (low dose dexamethasone suppression) test was performed, which includes 3 blood draws, and I'm going to convert Scooter's results into the units more commonly used here in the U.S:

baseline ~ 5.37 ug/dl
Cortisol supp. ~ 5.08 ug/dl
Cortisol 2 supp. ~ 6.0 ug/dl

Those results are indicative for Cushing's but they do not differentiate between the adrenal or pituitary form and that can be very helpful to know.

I'm happy to hear that he is improving so much on the 30 mg dose and will be anxious to see those ACTH stimulation results, just a reminder; their cortisol levels often continue to drift downward during the first 30 days of treatment so even if Scooter's results are not within the therapeutic ranges you may want to hold off on increasing his dose especially since his symptoms have improved.

Hugs, Lori

[dsbailey]

Welcome to the group,

Please read my thread "Lolita" our stories are similar. My 57 lb girl started on 60 and that was way to strong. She finally stabilized on 30 mg. If she would have continued on 60 mg things would have turned out badly. It would also be helpful to determing if this is Adrenal or Pituitary based Cushings. I feel the next step after the ACTH test should be an abdominal ultrasound. That should provide you with the type of Cushings and a lot of other useful information.

Darrell and Lolita

[Scoovale]

Hi guys, so much thanks for the datas translation.
the doctor said that even with the ultrasound we night not be able to find out. She said that he most likely has an adrenal malignant tumor. As far as I have understood, pituitary tumor is more common however, that is especially for smaller dogs. Bigger dogs has often adrenal tumor. As soon as I have paid these bills I will make an ultrasound. I am so glad that I have found tho doctors. Also, in Berlin city, the same tests would cost double and I could have never afford that much so often. What I like of this veterinary staff is that because they live on the countryside, they are much more in contact with animals and have a wider experience.

Which test do you usually do in the Usa to find Cushing?

My question is, is it possible that a dog that basing on test needs 120mg, actually gets better with 30 or less than 60 mg? How is that possible?

Could I apply 30 mg in a long time period obtaining the same effect only in longer time span, but with less risk?

[labblab]

Hello and welcome from me, too. First of all, you are doing a wonderful job of writing in English! I would never be able to write so clearly in a different language, myself!

Secondly, in answer to your question about dosing -- every dog processes the medication differently. The manufacturer suggests a starting dose based on weight alone, using a formula of 1 mg. per pound, or 2 mg. per kilogram. But the true test is then to see how the body responds to the medication. This is judged by how well symptoms improve and also by testing of the cortisol level. I am very glad to hear that Scooter seems to be feeling better, and I am assuming he will have an ACTH stimulation test tomorrow to check his cortisol? At that point you will have a much better idea as to how well this dose is working. And it is entirely possible that the 30 mg. daily dose is all that Scooter will ever need. We have seen large dogs who only needed small doses to control their disease, and small dogs who needed much larger doses. It all depends on the individual dog.

Also, overall it is true that pituitary tumors are far more common than adrenal tumors. In our experience here, we have not seen any correlation between a dog's size and whether they develop a pituitary or adrenal tumor. That part really seems to be random. Here is the U.S., the LDDS is also used as a diagnostic blood test for Cushing's. The ACTH stimulation test can also be used for diagnosing in addition to monitoring treatment. Trilostane is a recommended treatment for both types of tumors, so regardless of whether Scooter's tumor is pituitary or adrenal, it is a reasonable choice.

I need to go and walk my own dog right now , but once again, welcome!

Marianne

[judymaggie]

Hi, Valentina! I just wanted to add my "welcome" to you and Scooter. I also think you are doing a fantastic job posting in English. Not only is it a hard language to master, you are adding in medical terms as well! Looking forward to learning more about Scooter!