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Thread: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

  1. #51
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    Michelle, I am really worried about your vet’s approach to this whole situation. I have no idea as to why she would consider cancer to be the most likely cause of Buddy’s inappetance. I think you need to start reading about Vetoryl treatment yourself, because it does not seem as though your vet is familiar with the potential side effects and the need for cortisol testing if a dog who’s been taking Vetoryl becomes unwell. There ought to be a printed product insert in Buddy’s box of Vetoryl, but if you no longer have that to look over, here’s a key excerpt:

    WARNINGS: Hypoadrenocorticism [Addison’s] can develop at any dose of VETORYL Capsules. In some cases, it may take months for adrenal function to return and some dogs never regain adequate adrenal function...Owners should be advised to discontinue therapy immediately and contact their veterinarian if signs of potential drug toxicity are observed (see INFORMATION FOR DOG OWNERS, DOSAGE AND ADMINISTRATION, PRECAUTIONS, ADVERSE REACTIONS, ANIMAL SAFETY and POST-APPROVAL EXPERIENCE). In case of over dosage, symptomatic treatment of hypoadrenocorticism with corticosteroids [such as prednisone], mineralocorticoids and intravenous fluids may be required...

    ... The most common adverse reactions reported are poor/reduced appetite, vomiting, lethargy/dullness, diarrhea, and weakness...

    ...If the ACTH stimulation test is < 1.45 μg/dL (< 40 nmol/L) and/or if electrolyte imbalances characteristic of hypoadrenocorticism (hyperkalemia and hyponatremia) are found, VETORYL Capsules should be temporarily discontinued until recurrence of clinical signs consistent with hyperadrenocorticism and ACTH stimulation test results return to normal (1.45-9.1 μg/dL or 40-250 nmol/L). VETORYL Capsules may then be re-introduced at a lower dose...
    Here’s a link that will take you to a brochure published by Dechra, the maker of Vetoryl. It contains the info I’ve given above, with a lot more in addition. Your vet has prescribed quite a high dose of prednisone for Buddy — much higher than is necessary if the cause of his inappetance is low cortisol, and can actually cause gastric upset in its own right. At that high dose, unfortunately you’re likely to see a rebound of unwanted Cushing’s symptoms such as excessive thirst and urination. If Buddy’s problem is low cortisol due to the effects of the Vetoryl, much lower doses of prednisone would be adequate to replace the cortisol that he’s lacking.

    http://www.animalhealthinternational..._20HighRes.pdf

    Once again, it’s indeed possible that there is some other issue that’s causing Buddy’s inappetance. But as I think you’ll see from the published info above, if a dog taking Vetoryl loses its appetite, low cortisol and/or imbalances in blood chemistries due to overdosing always have to be suspected. You want to check out that possibility first. If that turns out not to be the problem, then you know to look elsewhere. But that’s really the first place to start.

    Marianne

  2. #52
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    I am going to go a step further and beg you to take Buddy to another vet asap to have him checked out...one who hasn't apparently already made up their mind about what is wrong with him and who has completely ignored everything related to Vetoryl. What reason for thinking this is cancer has his vet given you other than the appetite? Any labs to support this suspicion? Any ultrasound or xrays? Anything? Please get him to another vet for a second opinion, please.
    "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.

  3. #53
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    Hey Michelle, just thinking about you and Buddy, and surely hoping that he’s doing better. We’ll love to see an update whenever you might have the time to write.

    Marianne

  4. #54
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    Feb 2019
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    Hi all,
    Sorry for the delay in responding. We thought we were going to lose Buddy again this weekend.
    He vomited fluids this weekend and now I am seeing a pattern. When that happens he stops eating for a whole day. He has only vomited twice in this journey, so I am not overly concerned about it. Most of my Sunday was in tears for my poor puppy, but then he started to rebound again.

    It seems like we are able to get him to eat 4 times a day - small meals only.

    I am afraid to take him off of Predisone because he is eating and drinking water. Not too excessively with the water. Has to go out 2 times in the night, but when his Cushings was the worst, he was out every hour.

    He will take peanut butter, chicken, rice, soup...

    I will read the material above. I am thinking about going to a specialist, but the cost of one visit is $163 for just the exam. Crazy expensive. I have also been emailing a friend of mine who is a vet. She feels like if it was Addison's, on the pred he would be rebounding by now. She too suspects Cancer.

    I fear if I take him off the pred, and he stops eating it will be impossible to get him back to eating given his weaken thin state.

    Yesterday, my hubby took him for a walk just to give him some exercise outside our home and something new to sniff. He did okay.

    But for now, he is eating small frequent meals. I have a call into my vet for the name of a specialist.

    Thank you and keep the suggestions coming.

  5. #55
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    Feb 2019
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    Had a long talk with the vet.
    We are keeping him on the pred for two weeks to see how he does. Thankfully his appetite seems to be increasing daily.

    He is also more alert and looking more for food.

    After two weeks we will slowly begin to wean him off of the pred to be able to to repeat the ACH test. But not at the risk of him stopping eating again. So only time will tell, but for now I am glad I have him with me and he is eating great.

    He is also sleeping very comfortably and not in pain. So taking it one day at a time. I would like him to gain some weight back. He is also going for short walks which have to be good for his spirits.

    Thank you to all. I would like to get to a point where he can see his pool open this summer and get to swim again.

  6. #56
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    Thanks so much for these updates, Michelle. I’m so glad to hear that Buddy is improving! The fact that he’s doing increasingly better while taking the prednisone does lead me to continue to suspect that low cortisol may have been playing a part in his inappetance.

    Here’s one important note that you can discuss further with your vet. Dexamethasone is another corticosteroid, just like prednisone. However, it does not skew the results of an ACTH test in the same way that prednisone does. I’m guessing that Buddy could be shifted pretty easily to dexamethasone, at least for a couple of days. That way, you could proceed with the cortisol testing without having to wait on a prednisone taper, or without having to discontinue his steroid supplementation at all. So that could be another option for you to consider in your effort to figure out exactly what’s going on with him.

    Either way, I surely hope you’ll see continuing improvement.
    Marianne

  7. #57
    Join Date
    Feb 2019
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    27

    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    Good evening,
    Still at a loss about Buddy. He takes pred 20mg in the morning and 10 mgs at night.

    He is weak, but not in any pain.
    We backed off some of the pred. I would like to see him off it all together, but not sure if he will stop eating.

    He is not eating a lot. And when he tries to run he falls and has to do a bunny hop to get going again.

    I will be calling the vet again on her day back in the office for advice. He is still going out multiple times a night. And is very picky about his food. Today he liked bagels, ham and chicken and rice.

    Praying for an answer, but I think it is beyond Cushings.

  8. #58
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    I wish I had an idea to offer but I just don't. The pred will cause him to drink and pee more and I am glad he is eating some at least but wish, like you, that his appetite would pick up. I offer my prayers along with yours for your sweet baby boy.
    Hugs,
    Leslie
    "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.

  9. #59
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    Apr 2009
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    York, PA.
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    I think you should really give Marianne's suggestion about switching from prednisone to dexamethasone as dexamethasone doesn't interfere with cortisol assay so an ACTH stimulation test could be performed.

    Lori

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