Hello all, looking for advice with our baby Minnie

[Minnie's Mom and Dad]

Thanks for the suggestion!

We did have a culture done prior to the new antibiotic but she'd only been off the other antibiotic for a few days and they were unsuccessful.

She's almost completed her 3 weeks of antibiotics too. She seems only slightly better today so we've continued the dosing. Will be anxious to get her test results to see where her levels are at.

[Minnie's Mom and Dad]

After the backslide she quickly rebounded and has been feeling better.

Today was her 1st ACTH test with a starting level of 2.6 and 5.7 after the hour.

The vet feels since she's done fairly well on the 10mg, that we continue with that dose. And that if we continue to see and symptomatic days, we can look at raising the dosage.

The vet also said Minnie should be retested again in about 3 months, sooner if we see any changes.

[Minnie's Mom and Dad]

Another backslide started last night with panting a good part of the night and lethargic all day and refusing to walk any more than going out to potty.
If we are at 10mg in the morning right now, what would be the next dosage to try?

As always, thank you for all of the advice and support!!

[labblab]

I’m really sorry you’re having such a rollercoaster ride with Minnie! However, I’m afraid I’m going to advise you to stick with the 10 mg. dose for another couple of weeks yet before considering adding in more. This is because cortisol levels can continue to drift downward during the first month of treatment, even when the dose has not been increased. Minnie’s behavior seems to be really variable day-to-day, so I think you’ll need to step back and see whether a genuine pattern emerges over the next couple of weeks.

Additionally, there’s an alternative monitoring protocol that your vet might consider using with Minnie at the 30-day mark. It is simpler than the ACTH, and only involves testing the resting cortisol level one hour prior to dosing. I’m giving you a link that describes this new protocol in more detail. Take a look, and you may want to share it with your vet, as well. It may end up providing a better guide as to the optimal dose for Minnie. Just so you’ll know, Vetoryl does come in 5 mg. capsules, too. Or if she ends up needing a dose other than what is available in Vetoryl capsules, compounding pharmacies can provide a “custom” dose of trilostane for her on an individual basis. Here’s the link:

http://www.k9cushings.com/forum/show...=1252#post1252

Marianne

[Minnie's Mom and Dad]

Im sorry i haven't posted in a while. It's been 4 weeks since Minnies last backslide and she continues to show slow improvement after a total of 6 1/2 weeks on the Vetoryl.

She's lost a pound (down to 10 1/2) and is back to our daily walks with plenty of energy. Sleeping all night and zero panting. She's been able to get up on the couch by herself but still hasn't attempted getting up on the bed. Eating and drinking also appear normal. I also haven't noticed much change in her skin or fur yet. The vet doesn't want to see her back unit early January, unless we see symptoms return.

We continue to watch her closely, and probably always will! I'm hoping to get her weight down to closer to 9 lbs eventually.

I am so thankful for this forum and all of the advice!

[Squirt's Mom]

I am glad to hear that things are settling down for your sweet baby girl!

[Minnie's Mom and Dad]

Happy New Year everyone!!

Just a little update. Minnie had her 3 month follow up ACTH test this morning. Pre 2.6 Post 8.2. Its higher than her 2 week test. The vet feels we should still stick with the current dose and retest in 6 months since she isn't showing any signs/symptoms.

She still has a little pot belly and her fur has thinned a little. She also still has what i believe is calcinosis cutis spots, about 15-20 spots all over her body with the exception of her belly.

The vet also mentioned test results showed she was lipemic and suggested a fast before her next ACTH test.

She still is at about 10 1/2 pounds, not easy getting much exercise when its too cold for walks.

She is also still not able to jump up on our bed but has no issues with the couch. Hoping the next few months will show improvement all around

[Squirt's Mom]

Hi,

Good to hear from you again but I'm not happy with the report unfortunately. The vet is absolutely wrong about fasting before an ACTH - fasting will invalidate that test. The drug MUST be given 2-4 hours before the ACTH and the drug MUST be given with a meal, not snack, meal. If you vet questions this, tell them to call Dechra, the drug manufacturer.

In addition since you are still seeing signs ( pot belly, thinning fur, inability to jump like before, cortisol increasing) at 8.2 ug/dl the dose should NOT be kept the same but increased, especially if CC has developed. The ONLY way to get CC under control is to get the cortisol into optimal range around 3.5 ug/dl. Other wise Minnie is going to suffer horribly and unnecessarily if it is CC you are seeing. The best to determine whether it is CC or not is to see a Derm vet. With CC things get worse before they get better even when the cortisol is under control, and Minnie's is not under control as evidence by the increased post # so if she does have CC it is going to get very very very bad and quickly if her cortisol is not brought down. Six months is much too long to wait.

Please find a derm vet who can test her skin for CC asap - that is the most crucial thing right now. Then her vet or the derm vet must work to get that cortisol into optimal range. Let us know what you learn about the skin when you find out!
Hugs,
Leslie

[Minnie's Mom and Dad]

Thank you Leslie!!

We've got an appointment with the dermatologist next Tuesday.

Our vet initially insisted that she be fasted on her 1st ACTH test 3 months ago until i pointed out that it specifically states on the Dechra website that the med MUST be given with a meal.

I've pointed out the lumps and bumps that she's been getting at just about every appointment and the vet never shows any concern and says "they'll probably go away on there own".

Even in the last day or two i've noticed a few more new bumps.

[Squirt's Mom]

Glad you made that appointment! Let us know what you learn!