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  1. #1
    Join Date
    Jul 2019
    Location
    Stoke on Trent, England
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    20

    Default Advice for a newly diagnosed pooch in the UK

    Hi all, hope everyone’s well? Thanks for letting me join 😊.
    My boy Louis was diagnosed just over four weeks ago. He’s a Staffy Collie X, aged 10 and has been prescribed 30mg Vetoryl as a starter dose, probably to be increased to 50mg following a repeat blood test which I’m taking him for tomorrow. His main symptom is fatigue although I’ve noticed he’s drinking and weeing less too. He’s eating less but I’m not sure if he’s not eating enough now.
    My main question at the moment is how to best give him his pill in a morning. He’s a grazer so he has dry food down all day and just picks at it but this means he doesn’t have a proper breakfast as such. What can I give him with his tablet that counts as breakfast and how much food should I give? I’m thinking maybe chicken or fish and rice then reduce the amount of dry food for the rest of the day. I’m getting the feeling he’s feeling a bit of colour in a morning and I’m wondering if this is because he’s not having the correct type or enough food with his Vetoryl and it’s making him a bit queasy. Any general advice would be great too! 😊 x

  2. #2
    Join Date
    Apr 2009
    Location
    Georgia
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    Default Re: Advice for a newly diagnosed pooch in the UK

    Hello and welcome to you and Louis — we’re so glad you’ve joined us! You are correct that Vetoryl needs to be given along with food in order to be metabolized most efficiently. In conversations that I’ve had with Dechra, the maker of Vetoryl, I’ve been told that a full meal is best. However, if Louis simply won’t eat that much in the morning, you can only do your best to get as much inside him as you can. Vetoryl is a fat-soluble medication, meaning that it especially needs to be given along with some fat to aid its absorption. So first off, if Louis will accept the pill wrapped in some cheese or a small amount of other fatty material, that will be a good start. Here in the U.S., peanut butter or cream cheese can be a good coating for the pill, although I don’t think peanut butter is as common a favorite there in the U.K. Anyway, wrapping the pill in something fatty is a good start, followed with at least a bit more healthy food that Louis will eat.

    Having said all that, I do need to backtrack, though, to find out more about Louis’ picky appetite. Has he only become picky since starting the Vetoryl, or has he always been picky? The reason why I ask is because most untreated Cushpups have ravenous appetites. Along with excessive thirst and urination, it is one of the “hallmark” symptoms of the disease. There are always exceptions, but I’m anxious to find out more about the symptoms that originally led to his Cushing’s diagnosis. You mention that his main symptom is fatigue, and that he’s drinking and weeing less. By this, do you mean these are changes you’ve seen since Louis started the Vetoryl, or was he like this beforehand? Telling us more about his overall health history will help us a lot.

    For instance, if the reduction in appetite, thirst, and urination have all resulted from the Vetoryl, then I’m wondering why you’re necessarily expecting his dose to be increased even more right now, as it would sound as though the medication is doing its job to curb those excesses. And if he’s appearing to be especially fatigued, you may well not want to be upping the dose at all at this time.

    So once again, we’ll really appreciate learning more about Louis and any abnormalities in labwork, appearance or behavior that led to his diagnosis. And also once again, welcome!

    Marianne

  3. #3
    Join Date
    Jul 2019
    Location
    Stoke on Trent, England
    Posts
    20

    Default Re: Advice for a newly diagnosed pooch in the UK

    Hi Marianne.
    Thanks for the lovely welcome and the reply.
    I’ll start from the beginning then ��. Hope you don’t mind a good read!
    Early December last year I took him to the vet as his breathing had gotten a bit noisy, seemed to me like it was in his airway rather than lower down in his chest. As he’s now 10 the vet wanted to do a routine basic blood test checking his kidneys and liver before prescribing anything. His kidneys were fine but one of the two liver enzymes that were tested was raised a little but not enough to warrant action at the time. I may get a little vague with specifics as I don’t usually get any hard copies of results from my vet so I couldn’t tell you off the top of my head which enzyme was raised.
    We agreed to re-do the blood test after a few months. I took him back in April this year where the test showed that the raised enzyme had gone up even more. He had a liver function test done, which was fine, and a scan which showed an area brighter than the surrounding tissue. The vet managed to get a needle sample from this area (all while he was awake, he’s such a good boy!) and this showed an increase in vacuolar hepatopathy. The vet said early on these could all point to early signs of Cushings but he wanted to be cautious and try a more conservative approach so he was put on Denamarin for two weeks and the bloods re-tested. The levels came back higher still so we went over all of his symptoms over the previous few months. I’d monitored his water intake and it wasn’t sky high, we both agreed on that. He’d put weight on, starting to show a bit of a pot belly, he was going out for a wee every 90 minutes - 2 hours in the early part of the night. Once we got to about 2am he’d settle until morning. The area that the vet had shaved for his scan wasn’t growing back, and still hasn’t (the scan was done in early May I think). The main thing for me was that he’s been extremely quiet and not himself from around March/April I would say. A friend summed it up quite nicely when she said he looked shattered.
    After we had a chat the vet decided to do a ACTH stimulation test for Cushings. I’m not sure if you guys have the same units of measurement over there but I remember the vet said if a result came back at over 600 (again, I’m not sure 600 of what, sorry!) then they could be quite confident it was Cushings. Louis’s result was in the low 800’s.
    So we get to where we are now. He’s due to go back for his first monthly blood test tomorrow and that will be dead on 28 days that he’s been on 30mg of Vetoryl. I should mention he weighs 26kg now but is usually stable at 22-23kg. He is drinking and weeing less, but he’s also eating less. I am mindful that if it is indeed Cushings he would have been over eating and I admit I was probably over feeding him and not noticing. Now I think about it he was eating anything and everything when we went for a walk over out local fields, including fox poo (eew! ��) and I’m wondering if that could have been because of his appetite.
    He’s never been a fussy eater but he will only touch his regular dry food when he’s ready, that’s how he’s always been and still is. He will still eat in a morning if I offer him a treat or a left over bit of my breakfast. This is still broadly the same but he seems a bit more reluctant this last two weeks or so. His appetite gets a bit more back to “normal” later in the day which is what’s making me wonder if he’s not having enough food in a morning with his tablet. I think this spell in a morning is meaning that his overall amount for the day is maybe not as high as it should be. I’ve been measuring out his food (around 300g) for the day and he’s probably eating between 200-250g this last two weeks. I’ve been cooking him a small potato and a bit of carrot and peas to have his tablet with but if he needs some fat in there, as you said, then that’s not going to be doing the job. He does love cheese however, and can hear me open the fridge and the cheese wrapper across the other side of the house!
    I’ll mention all this to the vet tomorrow but as you guys have so much experience do you think I’m on the right track with the feeding in a morning? It’s such a rollercoaster isn’t it? This morning I was firmly convinced the vet had it wrong and the Vetoryl was causing his loss of appetite then I sort of calm down and get back to trying to think rationally, I’m up and down and all over the place! Thanks goodness I’ve got you guys to bounce things off �� x
    Last edited by clairebear; 07-08-2019 at 10:52 AM.

  4. #4
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Advice for a newly diagnosed pooch in the UK

    Thanks so much for all this additional info, and I hope that all went well at your vet appointment. We’ll surely be anxious for an update! It sounds to me as though you’re doing a great job with things, and your suspicion may be correct that the Vetoryl may be upsetting his tummy a bit. I know your vet visit is now behind you, but you could always call back and ask if you might give him a stomach soother of some sort in the mornings, as that might make him feel more comfortable. Anyway, we’ll be waiting to hear any additional news.

    Marianne

  5. #5
    Join Date
    Jul 2019
    Location
    Stoke on Trent, England
    Posts
    20

    Default Re: Advice for a newly diagnosed pooch in the UK

    Thanks Marianne!
    Vet visit this morning was very quick. Louis’s not had the full ACTH test but a pre pill cortisol test and they’ve sent a sample off for an enzyme check as well to see if those numbers have changed from his previous tests. I think before I go down the route of more meds to settle his stomach I’ll try feeding him something different with his tablet. What would you guys recommend and roughly how much so it constitutes a proper meal rather than a snack? I’m thinking chicken or fish and rice maybe? x

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

    Default Re: Advice for a newly diagnosed pooch in the UK

    Yes, our understanding is that the pre pill cortisol check has become a much more common general monitoring approach over there in the U.K. Some vets are also using that approach now in the U.S., others are still sticking with the full ACTH. Either way, we’ll be anxious to see how things turn out.

    As far as the food, I think either the chicken or fish with rice in the morning sounds great. As long as he gets at least a small bowl full of it, I’d think that would be good as well as a wee bit of cheese or something similar along with the pill ;-).

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