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Thread: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

  1. #51

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    Quote Originally Posted by Budster's Mom View Post
    Dr. B. Is amazing! He has helped many of us! Did he advise you to stop the metronidazole, or was that your decision?
    Just wondering because two days of a normal stool isn't very long. My dog was on a course of metronidazole for 10 days. The diarrahea stopped on the second day of treatment, but I was told to continue it for the entire 10 days. 5 days after finishing treatment with the met, the diarrhea started again. We followed up with another 10 day round of met. Finished the second round 17 days ago. Infection has finally cleared. So, again two days of normal stools aren't very long. Yes, it could be caused by the Vetoryl, or could be an infection, or both. If Dr. B. Advised you to stop the Met, I would absolutely follow his advice. If he didn't, I'd Think twice about it. Did your regular vet suggest that it be stopped? If I was going to the vet on Tuesday, I would probably keep my dog on the Met until that appointment, at least. Then again, I am overly cautious.
    Thanks

    The metronidazole was solely given to help with the diarrhea caused by vetoryl. She didn’t have an infection

    Dr B said we shouldn’t have to give metro in order to treat with vetoryl and she may be intolerant to vetoryl. I stopped the metro to see if that’s the case. If she can’t take it there’s no point in increasing the dose.

    Anyone have experience with anipryl. Vet will NOT give Lysodren.

    I’m so sad. I just can’t believe she’s intolerant to potentially the only thing that can help.

  2. #52

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    Quote Originally Posted by Maggiemoo1 View Post
    Thanks

    The metronidazole was solely given to help with the diarrhea caused by vetoryl. She didn’t have an infection

    Dr B said we shouldn’t have to give metro in order to treat with vetoryl and she may be intolerant to vetoryl. I stopped the metro to see if that’s the case. If she can’t take it there’s no point in increasing the dose.

    Anyone have experience with anipryl. Vet will NOT give Lysodren.

    I’m so sad. I just can’t believe she’s intolerant to potentially the only thing that can help.
    I'm so sorry she is intolerent to it. I think they make a generic to it which you may want to ask about. Also, I'm going to start Vetoryl with Pookie next week and I hope it helps. You can try the supplements and VitB12 shots I mentioned before and see how she does.

  3. #53
    Join Date
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    Georgia
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    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    Hello, and welcome to you and Maggie from me, as well! I’m sorry this has been my first chance to write, but I’ve been out of town and away from the forum for awhile. I surely understand how frustrating the diarrhea has been for you girls. But hopefully it was only a temporary problem that will resolve after Maggie’s system becomes accustomed to the Vetoryl. This is indeed a possibility, so I do believe there’s still reason to hope that the treatment will remain a viable option. However, if not, Dr. Bruyette would be a great resource for you in terms of giving Anipryl a try. He is very knowledgeable about its use and efficacy. Apparently only a minority of Cushpups respond with symptom resolution, depending upon the exact location of the tumor within the pituitary gland. But we have seen a few success stories here, so it may indeed be worth a try if both Vetoryl and Lysodren are ruled out.

    Just to clarify, there is no true generic form of Vetoryl available for sale at this time. In the U.S., generic medications are mass manufactured by pharmaceutical companies under the same FDA regulations as brand name meds, and must conform to the same efficacy requirements. No generic form of Vetoryl is currently being marketed here. However, “compounded” versions of trilostane (the active chemical in Vetoryl) can be created by individual compounding pharmacies when an owner needs a dose or form of the drug that is not commercially available in the form of Vetoryl. Theoretically, a compounded version of trilostane probably shouldn’t be any easier for Maggie to tolerate since the active ingredient remains the same. But I suppose the inactive “fillers” might differ somewhat. That I wouldn’t know. But, in general, unless a dog’s specific dosing needs require a compounded substitution, some clinicians look less favorably on compounded products because they are not subject to the same safety and efficacy testing as are mass produced meds.

    In looking back through your thread, it seems as though Maggie’s loss of hind end mobility is her most troubling external issue. As you already know, Cushing’s can certainly cause muscle weakness. However, just as a warning, that is one of the symptoms that can take a longer time to improve even with effective Rx treatment. Also, given Maggie’s age, there may be arthritic or orthopedic changes that are not directly related to Cushing’s. If she cannot tolerate the Vetoryl, I’m wondering whether your specialist might consider a trial of a pain-killer or anti-inflammatory in order to see whether that improves her mobility at all. I’ve been the lucky owner of three beloved Labs, now. My first was my Cushpup, and he definitely exhibited the associated muscle weakness. However, my subsequent two non-Cush girls have suffered from equally debilitating hind end mobility issues that did show improvement with painkillers. I know the combination of uncontrolled high levels of circulating cortisol are not a good combination with traditional NSAIDS. But I believe there are some newer, safer versions that might be considered appropriate to try with Maggie. Certainly you don’t want to confound the issue or present any new GI challenges right now. But again, if the Vetoryl is ruled out, perhaps her mobility might still be amenable to some improvement through alternative treatment.

    OK, I guess that’s all I can think of to write at the moment. Hopefully, Maggie’s tummy has settled down and you’ll have a better update for us very soon!

    Best wishes,
    Marianne

  4. #54

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    Thanks Marianne! I’m Marianne too!

    I’ve added pumpkin to her diet. She eats freeze dried raw and it doesn’t have a ton of fiber so vet suggested adding some fiber. We took her off the metronidazole completely if you have any helpful dietary suggestions they would be much appreciated!

    Her stim test is Tuesday. I’m hoping the vetoryl is doing something!

    I understand about the muscle weakness being the hardest to correct. She also has high cholesterol triglycerides and blood pressure so I’m hoping treating the cushings brings these down. If vetoryl isn’t tolerable I will ask Dr B about the efficacy of anipryl. He was so kind to us. What an amazing human.

    Maggie is on a CBD chew for her arthritis. It’s one that was tested by Cornell vet school and works great for her aches and pains. I’m beginning to think the hind leg weakness may not be all cushings related and is neurological but we will not MRI her bc we wouldn’t treat at this point in life. I just want her to be comfortable and feel ok. It’s so terrible that she has to spend whatever time she has left with runny poops and stim tests I guess if things don’t subside I will decide not to continue but I want to make a good faith effort.

    Your labs are very lucky to have such a great knowledgeable mom!

  5. #55

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    Quote Originally Posted by fkhan View Post
    I'm so sorry she is intolerent to it. I think they make a generic to it which you may want to ask about. Also, I'm going to start Vetoryl with Pookie next week and I hope it helps. You can try the supplements and VitB12 shots I mentioned before and see how she does.
    I hope Pookie tolerates it well! What dose will you begin at?

  6. #56
    Join Date
    Apr 2009
    Location
    Georgia
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    15,292

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    How great to meet another member of the Marianne sisterhood — there aren’t a whole bunch of us around! ;-)))))))))))

    We’ll certainly be wishing you girls well on your stim test tomorrow, and we’ll be watching for your update. I wish I could give you some great dietary advice, but our experience here throughout the years has been that there doesn’t seem to be any one particular type or style of food that works better or worse with Cushpups — it all comes down to individual health profiles and tolerances.

    I do want to offer one cautionary note about the pumpkin. Paradoxically — and again, depending upon individual tolerances — fiber can help with both diarrhea and constipation. With some dogs, it helps firm up stools, but it can make stools even runnier for some dogs. I have irritable bowel episodes myself, and a high-fiber diet is helpful to me. However, my own dogs have never responded well to pumpkin during episodes of diarrhea, and if anything, it’s made things worse for them. I am not a vet, so I don’t mean to challenge your vet’s recommendation. However, if Maggie’s stools were A-OK prior to the Vetoryl, I don’t know that I would want to introduce any new dietary variables right now when you’re attempting to determine whether or not Vetoryl will be an ongoing culprit. In other words, if she starts having diarrhea again after starting back with the Vetoryl and also beginning the pumpkin, how do you sort out the genuine cause? If it was me, in terms of dietary additions, I believe I’d try to stick it out with the Vetoryl alone for at least a week or so, in order to see whether or not her system adjusts on its own. Just a thought for you to consider...

    One question for you, though. Can you tell us more about her CBD chews? I’d love to find a CBD option with some firm research backing for my own arthritic girl.

    Marianne

  7. #57

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    Quote Originally Posted by Maggiemoo1 View Post
    I hope Pookie tolerates it well! What dose will you begin at?
    Pookie is in a good place right now and her only clinical sign is her hair loss all along her back, which includes plenty of black pigmentation changes. The only reason I'm going to treat is to try and keep her organs and immune system from being harmed by non treatment. It was an awful experience to deal with, but I'm glad she survived it and is doing pretty good right now. I am really scared to start the Vetoryl, but I'm afraid what would be the next infection or organ to be the victim of cushings. Since her hair and skin are screaming for treatment, I'm thinking she needs treatment. She has been dealing with cushings for over a year. I'm waiting on her base level cortisol today, but we will start with a low dose of 5mg once or twice a day. Before I start, I wanted to know her base cortisol, because last time the base was 181 and post was 494. When that stim test was done to get those numbers, she crashed and I thought it was adrenal fatigue or addisons. The really strange thing is that her clinical sign for a year of dealing with cushing's was panting and hair loss/pigmentation. After Pookie crashed, she does not have the panting clinical sign anymore, but her hair loss continued to get worse. Really strange.

  8. #58

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    Just got a call from my vet and said her base cortisol level is now under the normal range at 1.7. Pookie was given a trazadone the day her blood was drawn. I don't know if Trazadone could be the cause or not. Now that her cortisol is low, we were thinking of waiting to start Vetoryl. Her clinical sign of Cushings for the past year have been panting and hair loss/skin pigmentation, back leg weakness/loss of balance, increased appetite with a little thirst increase. Now after Pookie crashed/Pancreatitis over a month ago, her only clinical sign is hair loss/skin pigmentation with a little weakness/balance issues. We decided to wait a week or two and run another ACTH stim test. I'm concerned now, because her cortisol level is low. All tests in the past year have shown High cortisol and the vet said it could just be a fluctuation that occured. Pookie has had consistent high levels over 3-4 tests and now low, which has me putting on the brakes.
    Last edited by fkhan; 09-16-2019 at 03:07 PM.

  9. #59

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    Quote Originally Posted by labblab View Post
    How great to meet another member of the Marianne sisterhood — there aren’t a whole bunch of us around! ;-)))))))))))

    We’ll certainly be wishing you girls well on your stim test tomorrow, and we’ll be watching for your update. I wish I could give you some great dietary advice, but our experience here throughout the years has been that there doesn’t seem to be any one particular type or style of food that works better or worse with Cushpups — it all comes down to individual health profiles and tolerances.

    I do want to offer one cautionary note about the pumpkin. Paradoxically — and again, depending upon individual tolerances — fiber can help with both diarrhea and constipation. With some dogs, it helps firm up stools, but it can make stools even runnier for some dogs. I have irritable bowel episodes myself, and a high-fiber diet is helpful to me. However, my own dogs have never responded well to pumpkin during episodes of diarrhea, and if anything, it’s made things worse for them. I am not a vet, so I don’t mean to challenge your vet’s recommendation. However, if Maggie’s stools were A-OK prior to the Vetoryl, I don’t know that I would want to introduce any new dietary variables right now when you’re attempting to determine whether or not Vetoryl will be an ongoing culprit. In other words, if she starts having diarrhea again after starting back with the Vetoryl and also beginning the pumpkin, how do you sort out the genuine cause? If it was me, in terms of dietary additions, I believe I’d try to stick it out with the Vetoryl alone for at least a week or so, in order to see whether or not her system adjusts on its own. Just a thought for you to consider...

    One question for you, though. Can you tell us more about her CBD chews? I’d love to find a CBD option with some firm research backing for my own arthritic girl.

    Marianne
    Ohhhhhh Marianne, how I wish I read your post before giving the pumpkin!! Maggie was up all night with diarrhea and while we were at work had an accident again. I’m so stupid!! The vet didn’t suggest it I just thought it would be a good idea and now I made her suffer more.

    I’m going with your recommendation. Only vetoryl and blood pressure med. nothing else. We need to see if her stools get better or if the vetoryl is the problem. My hope is she will adjust to it. Any idea how long that could take?

    Im worried for the stim. I hope she doesn’t have a bad reaction. Is this possible? I haven’t discussed any specifics with the vet regarding the stim. What is it? Can she get sick!?!

    The cbd chews are from Ellevet. Ellevet and Cornell vet school did a clinical study together which was the study that established that cbd helps osteoarthritis in dogs. You can read the study online which was published and widely discussed. The chews are great. Maggie has very bad arthritis in her elbows and woul limp all the time. Since giving the chews she hardly limps! They also have the oil but I prefer the chews.

    Several vets I have spoken with know the product and the study and think they are a great choice. Maggie loves them! They are expensive but in my opinion well worth the money. Btw for a larger dog the oil may be more economical.
    Last edited by Maggiemoo1; 09-16-2019 at 08:17 PM. Reason: Additional content

  10. #60

    Default Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions

    https://ellevetsciences.com

    The website. I’m not affiliated employed or anything else!! I just did a bunch of research and this was the only cbd product backed by firm research performed by a leading vet school.

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