Poor appetite - Toby is now at peace

[LINDAP1]

I am new to this site and hope someone has some insight to what is going on with my pal Toby. He is a 7 year old shepard/lab mix and is the best family dog we ever had. He has had good health until about 1 year ago when he developed the classic cushion's symptoms-bloated belly,insatiable appetite,weight gain,drinking constantly and urinating in the house. I have medical background and researched info and found out that I thought he might have Cushings. We immediately had the bloodwork/stim test done which was negative and didn't show Cushings but with my persistence and additional testing he finally was diagnosed. He was started on Trilostane which we get compounded from Diamondback drug. He was 120 pounds and now down to 86 pounds. He is on 90 mg once a day and has had the followup bloodwork as recommended-3-6months and it has been perfect. About 1 month ago I notice he wasn't feeling quite right. You know your pet and when they are "off" but nothing drastic, you just know. I took him for a physical and the vet felt he was ok. We did electrolyte bloodwork which was normal also. We did the stim test again and the values were perfect. We also did a complete bloodwork panel and it was weird because looked like he was an untreated Cushing's dog even though he has been treated daily. So swim results perfect but bloodworm looking like untreated Cushings dog. His only symptoms now is poor appetite-does not really care to eat and very very picky and wants to be outside constantly-very cold out. He seems to not be tolerant to the temperature in the house(68-70) yet not panting at all. Very weird and so my vet consulted with a specialist at the Lab who suggested taking him off the trilostane-which I do not feel is a good is a good idea at his point because all his other symptoms will return and/or doing an abdominal ultrasound with he is scheduled for this week. Any ideas because I am going crazy!!! I do not want to wait until he stops eating all together. I read that trilostane can cause live issues and maybe the dose should be lowered but has anyone given this med every other day? I would like to try half the dose twice a day instead but right now I just got a 2 month supply(which isn't cheap) and they are capsules so I cannot cut in half. I thought of trying the 1 caps every other day to see if he feels better. What do you think. Thank you from Toby!!!

[LINDAP1]

I am sorry but I see that the auto-correct feature has changed some words but hopefully readers can figure it out..so sorry Linda/toby

[Joan2517]

Welcome Linda and Toby...yes, auto correct can really do a number on the posts, but we're used to it. Toby sounds like a great companion!

I don't have any answers, but others who are more knowledgeable will be along shortly to try to help you with some of your concerns. They will want to see the blood work results, so if you have them, please be ready to post what they ask for. If you don't, maybe you can get them from your vet.

We look forward to learning more about Toby~

Joan

[LINDAP1]

Joan,
thank you! I hope someone can help and yes toby is a love. Thanks linda

[Squirt's Mom]

Hi Linda,

I took the liberty of adding spaces between you sentences so my old eyes could read your post.

First, I would ask that you contact your vet and get copies of alll the lab work your baby has had done. Then post all the info from the ACTHs and post just the abnormal values from the other labs that look at things like the liver - it will show things like ALP, ALT, BUN, CHOL, etc. Be sure to include all the little letters and numbers after each abnormal value you post. It will look something like this -

EXAMPLE -
ALP 1551 ug/dl 150-300

The ACTH will have 2 values - a pre and a post number. If you are in Canada it will have 3 values. We want to see all of those numbers.

When you say your baby was "off" can you explain in deeper detail what you were seeing?

Has your baby been tested for diabetes recently and by recently I mean since he started losing weight? Weight loss is a hallmark sign of diabetes, as is loss of appetite, and it is not uncommon for cush pups to become diabetic or vice versa. IF that has not been checked, have his glucose checked asap.

For a dog that is not eating well taking a break from the treatment is recommended. These drugs must have fats to be absorbed so if he is not eating well the drug is not working properly. Also, that is one of the signs the cortisol has gone too low. That can happen at any time with dogs on Vetoryl (Trilostane) even if they have been stable for a long time. So I would probably stop the Trilo for now and see if his appetite picks up. Using this drug every other day is useless because it has a very short life in the body - from 2-12 hours in most dogs. So using it every other day just puts the dog on a roller coaster of high then low then high.... NEVER ever open the caps and try to divide them to use.

I'm glad you found us and look forward to seeing those test results very soon! They will help us help you by giving more meaningful feedback.

Hugs,
Leslie and the gang

[LINDAP1]

Squirt's mom-
thank you for your response. when i say toby is a little

"off" i mean he acts like he is depressed,not lethargic but

very quiet and resting alot. although when i tell him he is

going for a ride he will jump up and follow me because

that is his favorite thing to do. the fact that he always

wants to be outside even in this cold new england

weather is new for him also. as soon i get him inside,

within a few minutes he is back at the door again. i watch

him and he just lays down on the deck. it is not because

he needs to go to the bathroom. we wanted his weight to

stay around 90 pounds but still losing due to his poor

appetite. so taking him off trilostane all together won't

harm him? I am including his labs-

electrolytes were all normal

alk phos 848 iu/l normal 5-131

cholesterol 331 mg/dl normal 92-324

urine ph 8.0 normal 5.5-7.0

protien 1+ normal negative

cortisol sample 1 2.6 <font face-"symbol" verified

cortisol sample 2 2.3 verified

i am so glad i found your website as well. i really trust my vet but worried because you can tell he doesn't feel well and there are so many complications that can occur. this is my fist experience with a cushings dog so from the bottom of my heart....thank you! Linda and toby

[LINDAP1]

Hi everyone,

I have posted about my Toby who was diagnosed with Cushings over 1 yr ago.We have had all the required bloodwork, rechecking every 2-3 mos and also an ultrasound because Toby's bloodwork results looked like he was an untreated Cushing's canine. Presently we have decreased him to 25 mg trilostane bid from 90 mg daily.He did not do well on the higher dose so symptomatically he did better in the morning(after med) than later on in the day.Presently his appetite has continued to decrease.I try everything to get him to eat..even changed foods to find the best one with highest protien,grain free and nutritous.My Vet recommended Wellness so he is now on Wellness RawRev.I mix cooked hamburg,turkey,chicken as a topper to entice him to eat.Literally I have to hold his bowl and encourage hjim to eat.I am wondering if he has a mild chronic pancreatitis from his Cushings.When he was treated for his Cushings he was very overweight, ate everything in sight,drinking excessively,peeing in the house, panting and pacing.None of those symptoms are present now.The only negative issue besides his skin issues is that his appetite is so poor.He was 120 pounds when we diagnosed him and we got him down to a heathy 90 pounds. He now is 75 pounds and I am worried.I have another appointment this Sat with my Vet and wanted to know if anyone has been through this?Very worried and frustrated..no other issues.Thank you Linda and Toby

[labblab]

Hi Linda, welcome back to you and Toby, although I'm surely sorry that you two are still struggling with appetite issues. You'll see that I've merged your new post into your original thread on our main forum -- this way we can keep all Toby's info and health history consolidated in one place.

I see that you have decreased his trilostane dose, and I'm wondering how recently he's had an ACTH test. It may be possible that this current dose is still too much for him to tolerate.

Also, I wanted to let you know that we've just now launched a new thread that deals with appetite issues, generally. Here's a link so that you can take a look and see if there some ideas there that may be a help to you:

http://www.k9cushings.com/forum/showthread.php?t=8565

Marianne

[molly muffin]

Hi, it does seem that loss of appetite has been occurring more and more frequently in our cush pups.
In my case it was due to kidney issues popping up, but it can be many things.

Can you post the latest high/low lab work and what date they were done? Maybe that will give us some ideas of what might be going on.

[LINDAP1]

Thank you Marianne. Toby had his last ACTH test about 3 mos ago so he will be due again.However those results appeared strange. They looked as if Toby was an untreated Cushing's dog.My vet consulted with an internist who suggested the lower dose with BID dosing.If we were not giving him a high enough dose of trilostane I would imagine he would be symptomatic like he was before we started treatment. Now it just his appetite that poor.We have an appointment this Saturday and wanted to discuss herbal natural treatments for cushings.I am thinking maybe the trilostane is making him feel ill and not like eating.I read ginko and san mao herbs help lower the cortisol levels naturally but wanted to talk to my vet first.Has anyone had any experience with this route? Thank you