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Thread: My dog has had Cushings for over a year...high dosage...would love information!

  1. #11

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    Hi Marianne! Thank you so much for the Ellevet information. Thought I replied earlier but maybe not. I will look into it again - there was a reason I went with NuLeaf Naturals and that was after I did some online research and found the below woman's article. I wonder if her research is all true, but it seemed like she was legit? She didn't have ElleVet rated well. Just curious if you had any thoughts on this but probably not!

    https://www.seniordogdays.com/wp-con...gcalm.cbd_.png
    https://www.seniordogdays.com/cbd-fo...evet-kingkalm/

    Also, Jet's test is tomorrow - I called the vet and she said it is ok to give him his Galliprant in the AM with the Veteroyl as it will not impact the test. Do you agree with this? Just curious.

    Thank you!!!

  2. #12
    Join Date
    Apr 2009
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    Georgia
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    15,292

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    Hey there, Jennifer! Good luck with Jet’s testing tomorrow! I have to defer to your vet re: giving the Galliprant tomorrow because I just don’t know very much about that medication. I don’t think you’d want to give a med that is either a sedative or a stimulant in conjunction with an ACTH test. But I’d assume an NSAID like Galliprant would be fine, and especially since your vet has said so. Just be sure to give the Vetoryl along with breakfast, OK ;-))).

    Thanks so much for the CBD links. I’ll definitely be interested in looking them over. At first glance, there are considerations re: selecting an oil of which I was unaware. So I’ll welcome the chance to learn more, myself. I’ll let you know if I have any new thoughts once I have a chance to review the info.

    In the meantime, surely hoping all goes well tomorrow.
    Marianne

  3. #13

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    Thank you so much as always. Me too and I will report back with the results!!

  4. #14

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    Hi everyone!
    So Jet's results just came back today and numbers look great but have definitely lowered a lot over 3 months!

    Pre - 3
    Post - 2

    The doctor seems to think (after I asked) that we could possibly lower his dose (woohoo!) but I said let's test him again in 3 months and see? What would any of you do with these numbers?

    Bloodwork looked good for a dog his age. Liver a bit elevated but due to the Cushings.

    They took a free catch urine sample but it was of course cloudy and had some protein in it so it was hard to tell and when I bring him back he may need to have a sterile urine sample so I am hoping they can get this. Stinks that I had to pay for the free catch when it didn't even do anything! Ugh!
    (Total bill for the day was $770 - thankful for my Nationwide plan!!!!)

    He is also now on Gabapentin and Galliprant for the limping and literally the day after I started the Gabapentin he stopped limping. SO, I decided to stop the CBD for now because I wasn't sure if it was really helping and how many things can I give this dog?!? She told me I could try stopping the Gabapentin in a month and see how he is doing.

    Any feedback on any of this would be appreciated!

  5. #15
    Join Date
    Apr 2009
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    Georgia
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    15,292

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    Hi again, Jennifer, and sorry for the delay in getting back to you. But I do want to say that, if Jet were my dog, I’d definitely want to lower his Vetoryl dose given how much his cortisol has dropped during these past three months. I would be very worried about leaving the dose “as is” without another ACTH test before three months from now. At 2.0, his post-ACTH result is almost at the very lowest point of the safe therapeutic range, so you really don’t want to risk having it drop any lower at all. And it seems possible to me that his increasing mobility issues may be worsened by a cortisol level that is too low for his comfort right now. The very low cortisol may be “unmasking” arthritic issues that were being soothed somewhat by a higher cortisol level.

    I know you’ve been slogging through a whole series of testing and dosage changes, but for safety’s sake, a somewhat higher cortisol level is preferable to risking a treatment overdose and Addisonian crash. So if he were mine, I’d try lowering his dose right now rather than waiting.

    Marianne

  6. #16

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    I really appreciate your reply. I have been debating what to do since I got the diagnosis! The vet said it is up to me...she didn't take a ton of time on the phone to really think it through but did say we could try going with a lower dose. I wish she was a bit more concerned but I also know I'm not her only patient. I know my dog and I feel like he has been a bit "off lately" with this arthritic stuff.

    So, he is on 120 in the am and 60 in the pm. What do you think about doing 60 and 60? OR should I just do the 120 in the am (I just got brand new box, ugh) and nothing in the PM?? The split dose sees better though. I got reimbursed 90% for the new box so not the biggest deal.

    And of course, I know you can only suggest and I will always check with my vet before I do the change. If I do change the dose, is it ok to get him tested in 3 months or I need to after the 2 week period again? That's only if you're increasing dosage, correct?

    And one last question....I decided to change Jet's food to Nutro Ultra. Jet was on a grain free kibble diet most of his life after his allergies and as most of us know it seems these diets are no longer good due to the heart disease. So, I am going to change his kibble over to this Nutro after doing some research. This will go along with the Hills wet food. I debated doing the Hills dry food but all the reviews over the past year said that they changed their formula and the owners hate it!

    So, lots of changes for Jet
    Thanks for your help.

    Best,
    Jennifer
    Last edited by jenner1026; 12-07-2020 at 09:20 AM.

  7. #17
    Join Date
    Apr 2009
    Location
    Georgia
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    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    I really don’t have a strong opinion either way regarding the 120 mg. once daily or the 60 mg. twice daily. In looking back, it seems as though he was being dosed once daily until this latest addition of the 60 mg. in the evening. Once daily dosing always seems easier to me, but if you are able to feed him along with his medication both morning and evening, then the split dose remains a reasonable option, too. So I’d leave the decision up to you and your vet (how’s that for not being very helpful...;-).

    As far as retesting, I’d maybe split the difference and recheck again in six weeks or so? Theoretically, lowering the dose should allow his cortisol to rise again. But longterm adrenal suppression can occur such that dogs may remain more highly responsive to lower doses, and again, you really don’t want his cortisol to continue to drop any further.

    Marianne

  8. #18

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    You are always very helpful. I totally understand these things are confusing.
    I reached out to both vets and seeing what they say regarding once daily vs twice daily and I agree with you that I do think the current dosing may be a bit too much. Really hoping this all works out

  9. #19

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    As a follow up, I also wanted to show you all the results of his Stim tests....here is a list:

    (also, i can't really remember dosing for each Stim but I will try to mark it)

    9/26/19 - 8.8
    13.4
    (believe he was on 30mg)

    10/08/19 - 9.6
    8.0
    (believe we moved him to 60mg)

    10/21/19 - 8.5
    7.1
    (believe we moved him to 120mg)

    11/14/19 - 6.5
    11.9 (odd Post STIM in my opinion)

    04/27/20 - 8.1
    11
    (moved to 120mg AM and 60mg PM)

    06/08/20 - 7.3
    5

    08/27/20 - 4.1
    6.7

    11/25/20 - 3.1
    2.0
    (want to move him to 120mg TOTAL and re-test)

    Now of course it all depends whether or not the test results aren't totally accurate because of the time of testing or Jet's anxiety levels, but it is interesting to see how the numbers moved.

    Best,
    Jennifer

  10. #20

    Default Re: My dog has had Cushings for over a year...high dosage...would love information!

    Hello,
    Spoke to specialist vet today and she said to put him down to 60AM and 60PM (split dosing) so I will be starting that tomorrow.
    She wants to test him in one month so I will go for the next Stim test on January 6th.

    Best,
    Jennifer

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