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Thread: New Diagnosis and 7 day update

  1. #41
    Join Date
    Mar 2018
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    24

    Default Re: New Diagnosis and 7 day update

    Happy New Year! So here we are closing in on two years living with Cushing's. Overall, I think my girl Macie has done very well. We have had a few ups and downs and I have learned that is to be expected. She has had a couple of UTI's along the way and a flaking skin incident that was quickly resolved with meds. At the start of 2019, we upped her Vetoryl from 15 to 20 mg/day to lower her cortisol values as determined by the ACTH testing. In early May, Macie started losing her hair again. This got progressively worse throughout 2019. Her thyroid levels were checked and all are in order. We had her cortisol levels checked again today and they came back great (pre 4.4, post 4.0). So the vet is strongly suspecting food allergies and we have started her on a strict diet of Purina HA that limits the animal proteins which is the suspect allergen resulting in hair loss.

    I really don't have any questions for the message board as this is just an 2 year update on our journey. If anyone has any thoughts on the hair loss or results with Purina HA, feel free to comment and as always thanks for reading. Good luck on your journey and remember, with dedication, discipline and the help of a good vet, you and your pup can get through this.

  2. #42
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,347

    Default Re: New Diagnosis and 7 day update

    Happy New Year to you and Macie, too!! I’m so glad to know the Cushing’s treatment is remaining stable for you guys. I know the hair loss has been an ongoing issue for you, and I wish I had some brilliant suggestions to make — but unfortunately, I don’t. I’ll keep my fingers crossed for you that the new Rx food may finally help. In the meantime, I can’t tell you how much we appreciate hearing back from you with updates. The Cushing’s journey is definitely one that can proceed along many different paths, and as time goes on, we all learn together. So please do let us know whether or not the dietary change makes any difference, OK? And in the meantime, please give Macie a big pat from her family here :-)))).

    Marianne

  3. #43
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    14,226

    Default Re: New Diagnosis and 7 day update

    Good to hear from you and so glad to hear Macie is doing well! Keep up the good work and do let us hear from you when you can!
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  4. #44
    Join Date
    Mar 2018
    Posts
    24

    Default Re: New Diagnosis and 7 day update

    Hello everyone. So we endured 11 weeks on Purina HA as a diet trial to isolate any potential food allergies. Macie tolerated the food and we were diligent on restricting her diet as recommended. In the end, we did not see any difference in hair loss or re-growth and she has developed two very small sebaceous cysts on her head. We were then referred to a veterinary dermatologist. We had that visit yesterday and they do not suspect food allergies or any type of allergies. Their thought is an imbalance in hormone levels. Also, there is a suspicion that her cortisol levels may be spiking only to be brought under control with the morning dosing so a new stimulation test conducted in the morning before her Vetoryl dosing will give us an indication of what her cortisol levels are doing. If this is the case, we may be changing her to 10 mg of Vetoryl twice daily. Lastly, the use of lignans were recommended but I will hold off on that until we test the cortisol levels pre Vetoryl. One change at a time!

    In spite of her thinning hair, she is still normal in all ways. Good appetite, very playful with good energy levels and still looking forward to the 1 mile walk every evening. BTW, we have switched back to The Honest Kitchen Grain Free Chicken which she loves! Will report more as things develop and we hopefully get some answers.

    Stay safe out there everyone.

  5. #45
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,347

    Default Re: New Diagnosis and 7 day update

    Thanks so much for this update. It sounds as though the food trial was a major pain, but at least now you know you can finally rule out food allergies as being the culprit. Under the circumstances, I agree that checking Macie’s cortisol level prior to her morning dose may provide some useful information, and a shift to twice daily dosing may indeed be helpful. We’ll definitely be curious as to how that testing turns out. In the meantime, we’re so glad to hear that your little girl is otherwise doing so well!

    Marianne

  6. #46
    Join Date
    Mar 2018
    Posts
    24

    Default Re: New Diagnosis and 7 day update

    Thanks Marianne. Any thoughts or history from board members on dosing 2X daily? It seems like that would be the standard as Trilostane does not stay in their system too long.

  7. #47
    Join Date
    Apr 2009
    Location
    York, PA.
    Posts
    10,740

    Default Re: New Diagnosis and 7 day update

    With diabetic dogs, it is strongly recommended that the Vetoryl be given twice a day so as to keep the cortisol on a more even level. When starting treatment with a dog that does not have diabetes, once a day dosing is endorsed because it is felt that this is easier to do.

  8. #48
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,347

    Default Re: New Diagnosis and 7 day update

    Lori is exactly right. Twice daily dosing is indeed recommended for diabetic dogs in the effort to keep both cortisol and glucose levels controlled as consistently as possible at all times.

    For nondiabetic dogs, several research studied throughout the years have compared the effects of once vs. twice daily dosing. For some dogs, it does seem as though twice daily dosing aids in symptom relief. However, other dogs show significant improvement with just one dose each morning. Since trilostane must be given along with a meal in order to be metabolized properly, it’s easier for many owners to dose only in the morning, along with breakfast. So as long as a dog is doing well clinically on a single daily dose, the manufacturer of Vetoryl still recommends starting off in that manner. If symptoms do rebound later in the day, however, then the shift to including an evening dose can certainly be considered.

    Marianne

  9. #49
    Join Date
    Mar 2018
    Posts
    24

    Default Re: New Diagnosis and 7 day update

    Thanks for the responses. Macie has always only been given the Vetoryl with her morning meal. The only symptoms she currently has is the thinning hair/bald spots. The veterinary dermatologist drew a blood sample today before she had her Vetoryl at breakfast and will be checking her resting cortisol levels just to be sure they are not climbing abnormally throughout the day. I will share more when we have answers. Stay safe out there.

  10. #50
    Join Date
    Mar 2018
    Posts
    24

    Default Re: New Diagnosis and 7 day update

    Hello, we're back for a quick update. The results came back from the blood drawn at the dermatologist. She was just checking the resting cortisol level and to my surprise, the level was well within the "controlled" range at 2.9. I was really expecting her level to be much higher but it appears that the Vetoryl is doing its job. So at this point, the dermatologist is thinking her hair loss is a result of hormones. She has suggested we put her on 40 mg/day of lignans which we have started. If anyone has any experience with the use of lignans, I would be interested in hearing the results you may or may not have had. After 60 days, we will re-visit the dermatologist if there is no improvement in her hair loss.

    Fortunately, the hair loss is only an appearance issue and there is no danger or medical concern.

    Stay safe everyone.

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