Spencer, Chihuahua just starting treatment

[Melsteele]

Hello! I’m new to this site! My chihuahua, Spencer, has just been diagnosed with Cushings. Hopefully everything goes well with his new medication. He’s only been on it since Tuesday, and so far he’s still eating good and acts as if he feels fine. But something a little strange is going on. He seems a little clumsy. When he wakes up, and shakes off when he gets up, he’s falls down (maybe not every time) but usually this doesn’t happen. He seems a little weak in his back legs. He’s kind of starting to walk a little different. Is it just a coincidence that this is starting to happen or could it be his medication causing this? Thanks!

[labblab]

Hello, and welcome to you and little Spencer! You'll see I've moved your post in order to create a new thread that is your very own. This way, it'll be easier for our members to reply to you directly.

Can you tell us which Cushing's medication Spencer is taking? Also, it'll help a lot if you can tell us more about Spencer's overall health history, as well as the symptoms and testing that led to his Cushing's diagnosis. It is possible that Spencer is having a reaction to a quick drop in his cortisol level. Finding out which medication he is taking, as well as the dosage, will help guide us with suggestions.

We're really glad you've joined us, and look forward to learning more about Spencer!

Marianne

[molly muffin]

hello and welcome from me too. As Marianne inquired, can you tell us what medication he is on and what the dosage is?

If it is vetroyl a good starting dosage is 1mg per lb, to see how he reacts to the medication.

I just want to throw out that if he starts to vomit, can't stand up, gets diarrhea, then stop medication and contact your vet. We always want to error on the side of caution with our furbabies.

We'd love to hear more about Spencer and how he is doing.

I

[Melsteele]

Spencer has been prescribed Trilostane suspension 180ml. He’s taking .5ml every 12 hours with food. He was just diagnosed with Cushings this week and he’s been taking his medication since Tuesday. My little man will be 15 yrs old this coming July. He was diagnosed with heart disease several years ago and is taking benazapril daily for that. Last year he was having some bladder issues (leaking uncontrollably mainly while sleeping) and drinking excessively, and we found out he had a urinary tract infection. He recently started with the same symptoms but it ended up not being a urinary tract infection this time. He’s even started having accidents inside when he’s never done that before (unless he was mad with us ha!) This is when they decided to do the ACTH stem test to determine if he had Cushings. .... and here we are! The last several weeks he’s been a little clumsy— like stumbling when coming up the steps into the house (which I’m sure is his age), but the last couple of days he’s seemed more clumsy. Like falling down when he shakes off. His back legs seem a little weaker than normal. I called my vet to see if it could by any chance be some kind of side effect of his new medication. Mine wasn’t in so the one that was in the office suggested that I not give him his medication over the weekend to be sure it wasn’t some weird side effect that they aren’t aware of. Spencer is acting completely normal as usual, happy and eating fine. My husband seems to think I’m being paranoid about him seeming more clumsy than normal and thinks I should just continue giving him his medication, since he appears to be fine other than that. All of this is new and it’s just making me nervous I guess. And also, we are going on vacation next weekend and I just want to be sure things are ok while someone else is taking care of him while we are away. Thanks for your support and input!

[Squirt's Mom]

Hi and welcome to you and Spencer!

Would you look on the Trilostane bottle and tell us what it says? It will read something like 50mg/ml. That will let us know the actual amount of the dose he is taking. It is not uncommon for vets to start Trilo at a dose much too high because they are not aware that Dechra, the manufacturer, has changed the starting dose. So we always like to double check the dosage. Thanks!

Glad you found us!
Hugs,
Leslie

[labblab]

Thanks so much for this additional info — Spencer sounds like a little sweetheart!

One thing I’m still wondering about is the exact dose of trilostane that he’s receiving.

Spencer has been prescribed Trilostane suspension 180ml. He’s taking .5ml every 12 hours with food.

In order to figure out the dose, we need to know how many milligrams (mg.) of trilostane are in each milliliter (ml.). I’m hoping you’ll find that info somewhere on the bottle’s label. If you can find “mg.” noted anywhere, let us know what that says.

Also, I do want to point out that the combination of benazepryl and trilostane can create problems for some dogs. We do know of dogs that are able to take both successfully, but the blood chemistry levels must be watched very closely in dogs who are taking “ACE inhibitors” such as benazepryl. Here’s a warning from the U.S. Product Insert for Vetoryl (brandname trilostane):

Angiotensin converting enzyme (ACE) inhibitors should be used with caution with VETORYL Capsules, as both drugs have aldosterone-lowering effects which may be additive, impairing the patient's ability to maintain normal electrolytes, blood volume and renal perfusion. Potassium sparing diuretics (e.g. spironolactone) should not be used with VETORYL Capsules as both drugs have the potential to inhibit aldosterone, increasing the likelihood of hyperkalemia.

https://www.dechra-us.com/Admin/Publ...ack-insert.pdf

If Spencer was mine, I believe I would indeed hold off on giving the trilostane over the weekend in order to see if you notice improvement. I would also want to check with your own vet next week in order to make sure he/she is aware of this warning about combining trilostane and benazepryl. Last but not least, I’d probably actually hold off on restarting the trilostane at all until you’ve returned from your vacation. Cushing’s is typically a very slowly worsening disease, and you won’t be losing much ground to wait a while longer before beginning treatment. At Spencer’s age, your main goal is to make him more comfortable, and I wouldn’t think you’d want to risk him developing any ill effects while you’re away. In fact, his comfort level may be the ultimate deciding factor in terms of any treatment, at all. For some elderly dogs, arthritis and other inflammatory conditions may actually worsen once cortisol levels are lowered. That may even be what’s going on with him now — underlying arthritis may be “unmasked” as you bring down his cortisol level.

So in summary, I’d follow the stand-in vet’s advice and hold the trilostane for now. See how Spencer does, and then check back with your regular vet next week. Oh, and let us know about that dosing info ;-).

Marianne

[DoxieMama]

Welcome to you and Spencer! I would just echo what the others have said, so I'll spare the repeat. I just wanted to say hi and I look forward to learning more about your sweet little guy!

Shana

[Melsteele]

Ok so the label says 180ml 10mg/m ... then there’s a typo.. so I’m assuming the next letter should be an l .... someone had donated a new bottle of medication to their office, so that’s what I have. They were gracious enough to give it to me to save some money for the time being. It’s not the original label. They reprinted a new label for Spencer and that’s probably when the typo happened. Thank y’all so much for your thoughts and advice. I’m definitely going to take y’all up on them and not go with my husband thinking I’m being paranoid ha! Keep em coming!

[Squirt's Mom]

Ok so with 10mg/ml that means at .5ml Spencer is getting 5mg of Trilostane which would be right for a 5lb dog. Can you tell us how much your sweet boy weighs? I may have overlooked this info but didn't see it when I scanned back thru your posts.

[Squirt's Mom]

Oh and ditto to everything Marianne had to say!