Re: 15 yr old Maltese just diagnosed. So overwhelmed! Vetoryl questions
Hi and welcome to you and Maggie!
I understand very well how terrified this diagnosis can be. When I first heard that word in connection with my Squirt in 2007 I thought my world was ending. I spent countless hours scouring the internet trying to learn all I could about this disease and what I needed to do to help my Sweet Bebe deal with it. I rarely slept, had a hard time choking down food, and basically withdrew from everyone and everything except my computer and dog. I joined several other online forums and what were called "lists" back in those days hoping to find support and knowledge. They all failed on both points. One woman told me I might as well put a bullet in Squirt's head if I did what her vet was recommending which was to start treating with ligans and melatonin. By the time I made it to this forum I was a complete basket case. A dear friend here said I reminded her of a woman with her finger in a light socket - sputtering gibberish and hair standing on end. She kindly left out the parts about wild eyes and flying slobber! In short order the kind folk that were here had me calmed down and almost to the point where I could breath a bit so I could start to learn in earnest. They taught me then and continue to teach me to this day.
My Squirt was 7 when she was first diagnosed and lived to be a little over 16. Cushing's is NOT a death sentence. So take a deep breath, roll your shoulders, shake your head, and try to start relaxing. When you can, take some time to start reading in the Helpful Resource section of the forum found here:
https://www.k9cushings.com/forum/for...Cushing-s-Dogs
Not everything you find there will apply to Maggie and her journey. It is rare for any 2 dogs to follow the same path with this disease but the more we know about Cushing's and it's treatments the better off our babies will be regardless of their own path.
The starting dose for Vetoryl is 1mg/lb so at 4kg Maggie weighs 8.8kg (4 x 2.2 = 8.8). So the starting dose of 5mg is a great place to start for your baby girl. Her vet is supposed to follow up with an ACTH in two weeks after she starts. If all looks good then meaning her signs are no worse and the post number is good (between 1.45 - 5.4 ug/dl) then things stay the same. IF the post, or second number, is below 2.0 then the dose will be lowered. The dose is NEVER raised in the first 30 days because the cortisol will continue to fall on the starting dose. 30 days later another ACTH will be given. If the post number is within optimal range things will stay the same. Her vet should discuss what if any signs you are still seeing and if they are stronger or weakening. That second or post number can go as high as 9.1ug/dl if ALL signs are well controlled.
The most common signs for Cushing's which indicate the cortisol is too high are:
Increased thirst and urination (polydipsia and polyuria, respectively)
Urinating at night or having accidents
Increased hunger
Increased panting
Pot-bellied abdomen
Obesity
Fat pads on the neck and shoulders
Loss of hair
Lack of energy
Muscle weakness
Infertility
Darkening of the skin
Thin skin
Bruising
Hard, white scaly patches on the skin, elbows, etc. (associated with the disease calcinosis cutis)
Not all pups have all these signs but we almost always see a huge appetite and thirst, excess peeing, panting and hair loss or failure of the hair to regrow after being shaved. A word of caution - our pups are not peeing so much because they are drinking so much. It is the exact opposite. They are GOING to pee and have to drink a lot to keep themselves hydrated. So never withhold water. Always make sure Maggie has plenty of fresh water so she doesn't dehydrate.
Once treatment starts you also need to know the signs that the cortisol is too low. Those signs are:
Nausea/vomiting
loose stool/diarrhea
lethargy
loss of appetite
If you see ANY of these signs do not give any more Vetoryl and contact her vet to let them know what you are seeing. The good thing about Vetoryl is that it has a very short life in the body and if the cortisol does go to low most of the time simply stopping treatment for a bit will set things right. Her vet may want to check the cortisol via an ACTH and run a test to look at electrolytes just to make sure she doesn't need a little help getting that cortisol up. Of the two sets of signs the set that indicates the cortisol is too LOW is the most crucial because low cortisol can be life threatening very quickly while high levels are not life threatening until they have been present a very long time. A lot of cush pups have had the disease for many years before they are diagnosed which proves the point that high cortisol is rarely life threatening.
Well that should have your head spinning! But it is what you need to know today. Well most of what you need to know. You also need to know that you are not alone. You and Maggie are part of our little family here at K9C and we will walk every step of this journey with you. Never hesitate to ask questions, we will do our best to help you understand. If you simply need to chat, have at it! This thread will serve as a sort of diary of Maggie's journey so you can look back at any time to reread something someone else has said or to refresh yourself on something concerning her journey like when testing was done or doses changed. So come back to this thread and talk away!
I am glad you found us and look forward to learning more as time passes!
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.