Page 3 of 7 FirstFirst 12345 ... LastLast
Results 21 to 30 of 64

Thread: Poor appetite - Toby is now at peace

  1. #21
    Join Date
    Jun 2012
    Location
    Canada
    Posts
    16,150

    Default Re: Poor appetite

    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.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  2. #22
    Join Date
    Jan 2017
    Posts
    29

    Default Re: Poor appetite

    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

  3. #23
    Join Date
    Apr 2008
    Location
    Tennessee
    Posts
    6,593

    Default Re: Poor appetite

    Hi Linda,

    You mentioned that an ultrasound was done recently. Do you have a copy of the interpretation that you could share with us? Was your vet looking for an gastro intestinal problem that would explain Toby's lack of appetite? I would be very interested to know if there was any mention of the adrenal glands in the interpretation. It is well known that trilostane can cause varying degrees of adrenal necrosis which can be seen on imaging. Trilostane is anything but predictable and unfortunately, the acth stimulation test is profoundly limited in scope when trying to figure out the root cause for the rare and very highly irregular response to treatment. It's no secret that most of the renowned and well published internal medicine experts of the world agree that the acth stimulation test is not optimum for measuring effective treatment of trilostane but until someone comes up with a better idea, it's all we have.

    I've attached an interesting case study of "Persistent isolated hypocortisolism following brief treatment with trilostane". I follow Professor Ian Ramsey at the University of Glasgow and have saved many of his research papers over the years. Professor Ramsey has done extensive research and has conducted many clinical studies on trilostane in the treatment of canine cushing's so he is an unquestionable expert on the drug. While Adrenal necrosis can happen at any time in treatment, this particular study involves dog(s) on short term treatment. Adrenal necrosis may not be Toby's problem but his circumstances are certainly similar to those of one of the dogs discussed in this study. It's hard to not leave stones unturned in dealing with this disease so I want to provide you with any plausible information that may be of value to you and your vet in trying to figure things out.

    It would be helpful if you could provide us with the actual results of the last acth stimulation test.

    Adrenal Necrosis by Trilostane_Ian Ramsey.pdf

    Glynda

  4. #24
    Join Date
    Jan 2017
    Posts
    29

    Smile Re: Poor appetite

    Glynda,

    Thank you so much for your information.I do have the report at home(at work at the moment) and I will post the ultrasound interpretation.Hopefully tomorrow.

  5. #25
    Join Date
    Jan 2017
    Posts
    29

    Default Re: Poor appetite

    Toby had his ultrasound on1/19/17 and the interpretation was the following:Mil diffuse hepatomegaly,gallbladder is mildly distended and small amount sludge.No evidence of a mucocele.Spleen-a small 5.5 mm hypoechoic nodule seen,kidneys-NSF, Bladder-NSF, Pancreas-not seen well,Adrenals- bilateral adrenomegaly-left cranial pole-1.4 cm,caudal-1.4 cm and right 1.4,stomach-NSF,Intestine-NSF,lymph nodes-NSF and other-NSF.Conclusions-Bilateral adrenomegagaly consistent with PDH. Normal UCCR is very unusual in a dog with HAC.PU/PD-r/o cushing's, primary renal,DI psychogenic,dietary,other.It is possible that the trilostane does bring down the cortisol levels early ion the day and the 4-6 hr test shows adequate levels but that the levels actually rise later in the day-recommended bid dosing of trilostane.I appreciate any insight and advise. Thank you Linda and Toby

  6. #26
    Join Date
    Jun 2012
    Location
    Canada
    Posts
    16,150

    Default Re: Poor appetite

    Reading the interpretation I can see why they would want to try the twice a day dosing to see if they can keep levels steady.

    Did they say anything about that nodule on the spleen? We did have a member, one of our moderators, whose dog has a tumor on the spleen and had high cortisol till that was removed at which time the cortisol went back to normal levels.

    Just might be something to ask your vet about.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  7. #27
    Join Date
    Jan 2017
    Posts
    29

    Default Re: Poor appetite

    Thank you for that info and I am taking Toby tomorrow to his vet and will mention it.Interesting how differently the response is to treatment on all cushing's dogs.No definite course of treatment I guess...very frustrating to watch your pal not feeling well and not living to the quality of life he should.Thank you and I will post after we meet. Linda and Toby

  8. #28
    Join Date
    Jan 2017
    Posts
    29

    Default Re: Poor appetite

    Hi everyone,
    So we went to the vet on Saturday with Toby and she agreed to stop the trilostane all together. It seems to be making him worse that the original cushings symptoms.He lost another 7 pounds since January.I am going to start him on pepcide-ac bid to help encourage his appetite. I gave her info on the harmony adrenal gold drops(natural way to decrease the amount of cortisol in his bloodstream) and she wanted to research the ingrediants more before I start it. I have another appointment in 1 month to check in.The way he is reacting to the trilostane is making him feel so bad that his quality of life is poor.Hopefully this holistic med will work.I dont know what to do anymore because he has been a very difficult dog to treat...certainly not textbook.Love him dearly! Thanks Linda and Toby

  9. #29
    Join Date
    Jun 2012
    Location
    Canada
    Posts
    16,150

    Default Re: Poor appetite

    Poor Toby. He sure doesn't sound like he is feeling very good. Let us know what your vet says about the harmony adrenal gold drops.

    Also let us know if his appetitie perks back up once off the trilostane.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  10. #30
    Join Date
    Jan 2017
    Posts
    29

    Default Re: Poor appetite

    Hi everyone,

    We took Toby off everything including trilostane 2 weeks ago and have been giving him pepcid AC to help his appetite. He is eating a little better with much encouragement. We have him on Wellness RawRev topped with cooked turkey/beef/chicken.Normally he would eat all of his food but with him off trilostane, his appetite is probably 50-75%.He is drinking more water so we are seeing signs of cushings returning.Saturday we starting the Adrenal Harmony Gold Natural drops twice a day.He is taking 1 ml BID but for his weight, he should be getting 1.5 ml BID.He is so sensitive to medications so I felt better trying this a a lower dose. Today is day 3 and my husband and I feel he is a little better having more energy.Hopefully this will continue but time will tell. Thank you for all your support and advice. I don't know where I would be without all of you! Linda and Toby

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •