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Thread: Bad effects from Vetoryl

  1. #21
    Join Date
    Jul 2018
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    23

    Default Re: Canine endocrinologist?

    If I could be sure that Zimmy didn't have Cushing's, I could rationalize that the money I'd invest in that care could go into the surgery. But alas, I'll have to take my chances if I move forward with surgery. Hopefully, the right decision will be clearer after I learn more at the surgery consult. I need to find out more about the progression of hyperparathyroidism among other things as well as the surgical risks.
    Last edited by Eve; 08-05-2018 at 03:33 PM. Reason: typo

  2. #22
    Join Date
    Jul 2018
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    23

    Default Re: Bad effects from Vetoryl

    Dr. B recommended a surgery practice that partners with the IM doctor you recommended. So vetted, so to speak!
    Thanks for your input.

  3. #23

    Default Re: Bad effects from Vetoryl

    Hi Eve,

    I'm wondering what happened re: the surgery consult for Zimmy. My dog Yogi has some similar characteristics and the forum recommended Dr. B may provide a helpful consult for me as well.

    Angie

  4. #24
    Join Date
    Jul 2018
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    23

    Default Re: Bad effects from Vetoryl

    The endocrinologist and the surgeon I consulted both think it's a no-brainer to get the parathyroid surgery because it is low risk and high success. That said, it is expensive for an 11-year-old dog ($3000-$5000) plus a $275 ultrasound beforehand. Nor is there any certainty the condition would progress to the point it did damage.

    For now, Zimmy is great and not experiencing symptoms. The surgeon said his calcium level had not reached a dangerous level and couldn't say how fast or how slow that could happen. So, I've decided to sit tight for now until symptoms resume or a blood test shows the condition is progressing. I'm not ruling out surgery because treating the fallout of the condition (ongoing kidney and bladder stones, ER visits for renal failure) could end up being more expensive than the surgery.

  5. #25
    Join Date
    Jul 2018
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    23

    Default Re: Bad effects from Vetoryl

    By the way, the surgery I discussed is for "hyperparathyroidism" -- not Cushing's disease.

    It is still not clear whether that condition replaces the Cushing's diagnosis or it is in addition to it.

    What's odd is that since Zimmy was taken off the trilostane, his original presenting symptoms have not come back. The excessive drinking and peeing he was experiencing are signs of both hyperparathyroidism and Cushing's. Dr. B said he can't determine whether he has Cushing's until the other disorder is treated.

  6. #26
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Bad effects from Vetoryl

    Thank you so much for your update. I think your current strategy makes a lot of sense, and I’ll surely be hoping that Zimmy remains stable now for a long, long time!

    Marianne

  7. #27
    Join Date
    Jul 2018
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    23

    Default Re: Bad effects from Vetoryl

    If I had to guess now, I'd say that Zimmy does have Cushing's in addition to the other condition. Clues: his hair has barely grown back from being shaved for the ultrasound and the IV on his leg 5 weeks ago, plus the hair on his lower back is a little thin. I see him panting at times and sometimes ravenous for food in a way he wasn't before. Another behavior change: he's more territorial. What's really strange is that his original presenting symptoms that were pronounced -- excessive drinking/peeing/accidents in house -- have not returned since he went off the trilostane in July.

    I'm noting all these things now and will go back to the vet if I see more decisive signs of a problem. But since he has had a bad reaction to trilostane, I'm wondering what can be done. Would it be safe to halve his previous dose? When he had the bad reaction to the medicine, it wasn't because the dose was too high, going by the ACTH test. Or are their alternative treatments people have used which might not be as effective but have some value?

    I'm also wondering what I will do with 59 Vetoryl capsules worth $130 or so if I don't use them. Can the capsules be compounded into a lower dose if the vet thinks we should try it? Do you know if local shelters accept that type of donation?
    Last edited by Eve; 08-25-2018 at 08:57 PM.

  8. #28
    Join Date
    Apr 2009
    Location
    York, PA.
    Posts
    11,037

    Default Re: Canine endocrinologist?

    Could you post those monitoring ACTH stimulation test results? If we know what his cortisol levels were we'd be able to give you our best possible advice regarding the possibility of restarting the Vetoryl.

    A compounding pharmacy may be able to reconstitute those unused Vetoryl capsules, is there one in your area that you could call and ask? And I do believe some shelters will take the unused medication, I'm pretty sure we have had members do this before.

    Lori

  9. #29
    Join Date
    Jul 2018
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    23

    Default Re: Canine endocrinologist?

    Dr. Bruyette saw the ACTH results and said it was impossible to determine if Zimmy has Cushing's until the hyperparathyroid surgery is performed since some of the pathology overlaps. His results were mixed. He said that if clinical symptoms cropped up following the surgery, that would be the sign he has Cushing's, too.

    If I observe definitive and worsening symptoms that are only related to Cushing's, however, I'll talk to the vet about trying a much smaller dose of trilostane or an alternative treatment. Until then, I'm going to sit tight since Zimmy is energetic and eating well again. (He had lost his appetite and become weak in addition to vomiting and diarrhea from the proper dose of trilostane). And I don't plan on doing the surgery for the other condition unless his calcium level rises to a more dangerous level.

    Thanks for the heads up that it may be possible to compound Vetoryl capsules or that a shelter might accept them. For now, I'm holding on to them in case a Cushing's diagnosis becomes definitive.

  10. #30
    Join Date
    Apr 2009
    Location
    York, PA.
    Posts
    11,037

    Default Re: Bad effects from Vetoryl

    I'm not sure if you have seen the thread we have on other medications that are being looked into for the treatment of Cushing's so I'll attach a link to it: http://www.k9cushings.com/forum/show...g-s-treatments

    I'm glad to hear that Zimmy is doing well and hope it continues.

    Lori

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