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

  1. #1
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    Feb 2019
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    Default Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    Hello and thank you for this forum.
    My 77 lb 11.3 year old Lab (Buddy) was diagnosed with Cushings about 25 days ago. He had been on Vetoryl for 24ish days now. At the 2 week point we had him tested again and the vet said the meds were doing great to keep his levels in the right range. She said it would take about 4 weeks (total on the pills) for the symptoms to begin to go away.

    We are only seeing a minimal change, if at all. Buddy still drinks a large amount of water and is up 2 - 3 times in the night. Also, we give the pill to him in the morning. If we gave it to him more toward evening would it help him sleep?

    The only symptoms he has is the excessive drinking and urinating. He also shows signs of weakness in his back legs, but overall he is still in great spirits and healthy for an 11+ year old dog.

    All his other blood test have come out normal.

    Any suggestions as to how we can help with the excessive drinking and urinating? Also, does it take big dogs longer to minimize some the symptoms?

    Thank you in advance for your help!

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

    Hi and welcome to you and Buddy!

    First I am going to ask a few questions - what dose of Vetoryl is Buddy taking?

    What were the results of that 2 week ACTH?

    There were no changes in his appetite, no hair loss or failure of hair to regrow if shaved? Any panting for no reason or pot belly?

    What tests were done to determine he has Cushing's? Would you please get copies of those test(s) and share the results with us? That will help us give you more meaningful feedback. Include any testing that shows things like BUN, CHOL, ALT, etc. - btw it is unusual that all the results in this test will be normal in a dog with Cushing's so your comment that all other tests were normal is bit concerning to me.

    Does Buddy have any other health issues that you are aware of?

    Is he taking any other medications and if so, for what?

    The more you can tell us about your sweet boy the better we can help. We LOVE details so don't be shy!

    As for when to give the med, mornings are best unless his vet can see him at night. The ACTH must be given 4-6 hours after the pill has been given. The pill MUST be given with a meal, not a snack, a meal. If your vet tells you to fast Buddy for the ACTH then that test will not be valid and can put him at risk so never ever fast him for the ACTH. If his vet questions that tell them to contact Dechra, the manufacturer.

    As for how it takes to see improvements, some are almost immediate and some take time...and some never completely resolve in some dogs. The drinking and appetite are usually pretty fast in most pups while the return of muscle mass can take a long time in some dogs. Time is the best thing to see resolution of the signs...time, an accurate diagnosis, and the correct dose of medication is what is needed to see improvements. A caution - do NOT restrict his water. A cush pup doesn't pee so much because they drink a lot - it is just the opposite. They drink so much because they are going to pee a lot regardless. Restricting water will cause them to quickly dehydrate so don't withhold or restrict water. Look into a belly band if he is having accidents but make sure he always has plenty of fresh water available.

    I'm glad you found us and look forward to learning more soon!
    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.

  3. #3
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    Default How long should it take for the Vetroryl to reduce the symptoms?

    My 77 lb lab was diagnosed with Cushings about 25 days ago. We started him on Vetoryl (120mg) about 24 days ago and on the 14th day he was tested. It was determined that he was responding to the meds and it was the right dosage.

    At the time the vet said it would take Buddy about 10 more days to respond to the meds and we would see less symptoms. At this point, we are seeing minimal improvement in his thirst and frequent trips to urinate. At night he is up about 2 Ė 3 times.

    He is still very happy and healthy for an 11+ year old lab. At what point do you see an improvement on the Vetoryl? Is it just that he is a bigger dog that it is taking so long? Also, we give him his meds with breakfast. If we gave them to him later in the day would he have a better chance of making it through the night. He has to go out about every 2 hours during the day.

    Any suggestions would be helpful so we could get some sleep. 😊

    Is there more we can do to help with the frequent urination?

    Thank you in advance for your help.

  4. #4
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    Default Re: How long should it take for the Vetroryl to reduce the symptoms?

    I have merged your most recent post, almost a duplication of the first, into Buddy's original thread. We like to keep all posts about each dog in one thread. That way it is easier to look back thru the history if needed....this thread will also serve you as a sort of journal for Buddy's Cushing's journey. I have also taken the liberty of including his name in the title so it will be easier for to find from now on.
    "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.

  5. #5
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    Default Re: How long should it take for the Vetroryl to reduce the symptoms?

    Thank you so much for all of the questions. I will reply, but first I want to get his medical records from the vet.

    His only symptoms have been the drinking and urinating. He was great in October and this started in November. We did a total blood and urine test early on, that indicated it could be cushings then we did the test for where he stayed at the vet for the day and his levels did not drop. So the vet was sure it was cushings and they tend to see a lot of it. Oh and we also check his kidneys...Anyway, I will get all the tests emailed to me and post here.

    He did not have a pot belly, and he is a lab so he never lost his appetite LOL. He has lost muscle mass, but I am not over concerned about that as he is still very active.

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

    Whenever I see that the primary signs in a dog diagnosed with Cushing's have to do with drinking and urination my mind goes to a rare form of Diabetes called Diabetes Insipidus. It has nothing to do with blood sugars or diet and doesn't require insulin, etc. Rather it has to do with how the body processes water. It can be confused with Cushing's and cause false-positives on the cush tests. Here is a link on DI for you to read and see if you see your Buddy in it -

    https://vcahospitals.com/know-your-p...ipidus-in-dogs
    "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.

  7. #7
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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?

    What food is your dog on? Mine was on Hillís dry food. When I stopped the food his Calcium levels dropped and he stopped drinking and peeing so much. Still starving though.

    Waiting for the vit D test bc the drinking and pering are consistent with the vitamin D toxicitu. Hillís says dry food not affected, but I am seeing signs to the contrary.

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

    Okay,
    I have Buddy's test results from his various tests.

    11/2/18 They did a complete blood count, T4 and urinalysis.
    The Urinalysis came out fine. We did put him on a dose of antibiotics just in case, with no results.
    Also, regarding his dog food, his older sister is on the same dog food Nutro dog food. They have been on it for their whole lives.
    From the CBC, I will only report out on the abnormal ranges.

    AST (SGOT) 148
    SLT (SGPT) 297
    Cholesterol 344
    Neutrophils 78

  9. #9
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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?

    1/23/19
    Cortisol 3 DEX test
    Pre Sample 1 6.6 (normal 1 - 5)
    Cortisol Sample 2 5 (Normal 0 - 1.4)
    Cortisol Sample 3 6.0

    His cortisol levels never went down through the whole day.


    2/8/19 Cortisol ACTH test
    After being on the meds for 12 days
    The next test was
    2 ACTH test
    Time 1 was a 7 (normal was 1 - 5)
    Time 2 was a 6.7 I think the normal range is 8 - 17?

    I was told after this test on 2/8 that his levels were normal and that it would take another 2 weeks for his symptoms to get better.

    Curious about the diabetes suggestion someone made?

    Thank you for all your suggestions. We need it.

  10. #10
    Join Date
    Apr 2009
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    Default Re: Buddy - How long should it take for the Vetroryl to reduce the symptoms?

    Hi and a belated welcome to you and Buddy from me as well!

    I am concerned with the dose of Trilostane Buddy is taking as it is strongly recommended that the starting dose of Trilostane be no more than 1 mg per pound of the dog's weight and there is one study that suggest that larger dogs may need lower doses of Trilostane per pound than smaller dogs to control clinical symptoms, and we have witnessed this on the forum too.

    Even though his ACTH stim test results were great a dog's cortisol can continue to drift downward during the first 30 days of treatment so please keep an eye out for symptoms of cortisol dropping too low which are: diarrhea, vomiting, lethargy, inappetence, or Buddy simply not acting himself, if any one of these symptoms are observed the Trilostane needs to be stopped and an ACTH stimulation test should be performed.

    Cush dogs are notorious for UTI's and a regular urinalysis may not pick up any bacteria in the urine so it is recommended that an urine culture and sensitivity test be performed instead.

    Lori

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