New to k9 Cushings - Sebastian has passed

[champ]

Hello, my dog Sebastian has recently been diagnosed with k9 cushings. Sebastian is a miniature pinscher, 15 years old weighing in at 15 1/2 lb / 7 kg)
He started treatment of Vetoryl 20 mg once daily, after 7 days I was having trouble getting him to eat his food. At day 10 he had to spend the night at the vets on a drip due to acute pancreatitis and presumably due to the Vetoryl. At this time he is not taking any medication for treatment of his cushings condition. I have finally been able to get him interested in food again and is taking anti nausea medication.
Has anyone else out there experienced a similar situation with their fir friend, is there any other treatment anyone knows about ?
Any input would be most appreciated, thank you, Kevin.

[Harley PoMMom]

Hi Kevin,

Welcome to you and Sebastian! I sure am sorry for the reasons that brought you here but glad you found us and we will help in any way we can. Now, in order for us to provide you with our best possible feedback we'd appreciate it if you would share with us more about your sweet boy's medical history. Could you tell us the test/s that were performed that diagnosed the Cushing's and would you post those results? What symptoms did Sebastian display that led you or the vet to test for Cushing's in the first place? Did Sebastian have an ACTH stimulation test done when he was admitted to the vets, and if so, what were those results? Were his electrolytes tested to make sure that they are normal? Besides the Cushing's and pancreatitis, does Sebastian have any other health issues that he is taking medication for?

The recommended starting dose of Vetoryl is 1 mg per pound so the 20 mg may have been too much for him and stopping the Vetoryl was definitely the right thing to do. We have seen on the forum that some dogs are sensitive to Vetoryl and may even need to take a lower dose than what is recommended which could be the case for Sebastian. How is his drinking and urination? Does he have diarrhea?

I'm sorry for all these questions but the more we know about your precious boy the easier it is for us to help you help Sebastian, ok?

Lori

[champ]

Hi Lori,

Sorry for taking so long to reply to your post. Never the less, I took your questions into the Vet treating Sebastian. However he has pretty much avoided answering those questions for me to post and advised that this forum is not the place for me to get answers. HMMM ....Do you think he may have incorrectly diagnosed Sebastians condition ?

The reason Sebastian had the test to begin with was due to having blood tests done every 6 months as he was on anti inflammatory, metacam. Sebastian's last test being in April this year which showed elevated Creatine and Urea levels, and the vet suggested checking for cushings.

Besides having a very bad reaction (Acute pancreatitis) to the Vetoryl, Sebastian was also prescribed the ace inhibitor, Vetace, which was prescribed at the time off first blood test showing kidney anomalies and before cushings test. From what I have learned, Vetoryl and Vetace should be given with caution.

Interesting thing is that Sebastian did not show any noticeable signs of cushings that most report. His Drinking and Urination are what I would consider to be normal, no diarrhea, lost his appetite and has been eating very little since reaction to Vetoryl.

In the mean time Sebastians is deteriorating and Im just about besides myself, Im in the process off seeking help in treating Sebastian with natural remedies.

Kevin.

[labblab]

Hello and welcome from me, too, Kevin. I’m sure Lori will be returning to address your questions, as well, but I’m going to add some thoughts. From what you’ve written thus far, I’m very concerned that Sebastian may have been misdiagnosed with Cushing’s. Elevated liver markers, not elevated kidney readings, are typically associated with initial diagnoses of Cushing’s. If Sebastian’s liver enzymes were all within normal range (ALKP, ALT, GGT) and he was not exhibiting any external symptoms consistent with Cushing’s, then your vet’s decision to test for Cushing’s is puzzling to me. The problem is that the two diagnostic blood tests for Cushing’s — the ACTH and LDDS — can both return “false positives” in the presence of significant stress or other nonadrenal illnesses. That is why clinicians caution that those test results are questionable unless a dog is exhibiting symptoms that are genuinely consistent with the disease.

However, even if we were to assume that Sebastian does have Cushing’s, there are specific warnings against giving Vetoryl to a dog with compromised kidney function. Depending upon the degree of elevation in Sebastian’s creatinine and urea (BUN for our U.S. readers), this would have been yet another reason for concern and caution in addition to the ace inhibitor.

Since Sebastian responded so poorly to the Vetoryl, I really hope you have not restarted it. In honesty, if he were mine, I believe I’d seek a second opinion about his situation — especially his kidney issues — from another vet. I understand your desire to shift to natural remedies, but he might really benefit from prescription medication as long as it correctly targets his true diagnosis. Sadly, from what you’ve written, I fear your current vet has missed the mark and I’m not surprised he’s avoiding your questions. I’m thinking he may not have good answers for you :-(.

Marianne

[champ]

Marianne,

Thank you for your post regarding Sebastian’s situation. I am totally in agreement with you that the Vet has really missed the mark by a long shot. The research I have done also points out the possibility that Cushings is not the issue and Sebastian should not have been prescribed Vetoryl and the ace inhibitor.

Getting a second opinion is great advice to which I have already acted upon. Further blood tests from a different Vet / clinic shows that Sebastian is in chronic kidney failure, no wonder the little guy doesn’t want to eat his food.
I’m taking him back in tomorrow (to the new vet that is) and they are going to run IV fluids thru him for the day. I’m really concerned about his weight, dropping from 7 kg’s in may, and his weight today is 5.9 kg’s.

Kevin.

[labblab]

Dear Kevin,

I’m so relieved to hear that you’ve sought out the second opinion! It’s definitely true that kidney problems can cause nausea and lack of appetite, so hopefully your little boy will be feeling much better once he’s had the IV treatment. As it turns out, I think they may want to leave him on an ace inhibitor since that class of drugs can be helpful in treating kidney problems. The problem was pairing it with the Vetoryl! For the life of me, I just don’t know why your first vet was suspecting Cushing’s.

Anyway, I truly hope that Cushing’s is off the table for you guys. Regardless, though, we also hope you’ll continue to update us as to Sebastian’s progress. You all are family now, and we’ll remain anxious to know how things are going! We do have other members who have dealt with kidney issues, so we may even be able to still help out a bit.

Please give Sebastian a big pat for us, and I surely hope his day at the vet will go well.
Marianne

[Harley PoMMom]

Dear Kevin,

I am also so relieved that you received a second opinion for Sebastian, great job!! My Harley had kidney issues so if I can help in any way please don't hesitate to ask.

Lori

[champ]

Hello Lori and Marianne,

Sebastian is at the vet, I dropped him off at 8:15 this morning. It's really difficult as you most likely will be aware to see a "best friend" go thru these difficult times. I thank you for your support and will keep you updated on Sebastian's progress.

Be well,

Kevin.

[Harley PoMMom]

How's Sebastian doing?

[champ]

Hi Lori,

Really sad news, and my heart is broken. Sebastian passed away. I'm still in shock and trying to figure out what happened and whats is next. I have had a meeting with the Vet who diagnosed Sebastian with the cushings , I politely confronted him regarding treating him with the Vetorly and Ace inhibitor at the same time, as well as the likely misdiagnose off cushings. I have a funny feeling that he knew after the fact, those two medications together can be fatal. I'm in the process of seeking disciplinary action, even though it will never bring Sebastian back, I feel its the right thing to do.

Thanks Lori.

Kevin.