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Thread: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

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  1. #1
    Join Date
    Apr 2021
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    25

    Default New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Hi everyone,
    Our vet has just told us that our sweet little Mia (11 year old jack russell terrier mix) likely has cushings. She started having the classic symptoms in November and has deteriorated since : excessive thirst (like 5-6x her normal amount) and urination, accidents (v uncommon for her), muscle loss (canÂ’t jump up on bed or couch anymore), panting, and loss of her beautiful fur. Over the past 2 months, she has also started developing these awful scabs and hard bumps all over her body (looks just like pictures of calcinosis cutis) and theyÂ’ve gotten worse and worse. We gave her an anti fungal bath today (per vets instructions) and a bloody flap of skin just peeled off her head, it was awful.
    The biggest challenge is that we live overseas in a country with very limited health facilities, and basically only 2 vets. They ordered blood work (which took 3 weeks to get results) and found sky high levels of cortisol and ALKP and GGT, which led the vet to conclude - along with all the symptoms - that itÂ’s cushings. They donÂ’t have the capacity to do any more complex tests, and they donÂ’t have access to the meds normally prescribed for cushings. They are basically giving her vitamins, fish oil and researching ways to support her liver functions.
    We are heartbroken and not sure what can be done to help Mia, given all the constraints. (We are here for a couple more years, and donÂ’t think she would make it on long flight back home anyway.). IÂ’ve been reading the posts and this seems like such a knowledgeable and supportive community. If anyone has any advice on how we can make her more comfortable (esp the CC) or any other suggestions, I would be grateful. Thank you.

  2. #2
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,738

    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Hello, and welcome to you and sweet Mia. I’m so sorry to hear of her symptom progression — there’s nothing worse than feeling helpless in the face of worsening illness in our loved ones! Mia does indeed sound as though she suffers from the classic symptoms of Cushing’s, including calcinosis cutis. And sadly, we’ve found that CC can be the single Cushing’s symptom that can create the most physical discomfort for a dog. However, here’s a link to a thread here that hopefully may offer you some useful suggestions in that regard:

    https://www.k9cushings.com/forum/sho...eatment-thread

    From the experience of our members, though, we’ve learned that it’s very difficult to gain significant control of the CC unless cortisol levels are lowered significantly. In that vein, I’m wondering if it might be possible for your local vets to obtain access to Vetoryl (the Cushing’s med that is most widely used worldwide), even though they’re not currently aware of it. Dechra is the company that manufactures Vetoryl, and here’s a link to their worldwide distribution map:

    https://www.dechra.com/dechra-busine...ibutor-network

    You can check this map to see whether you’re in a country that has access to the medication. If so, there’s contact information provided that might allow your vets to actually obtain Vetoryl on your behalf. If so, there is a new Vetoryl monitoring protocol that only requires a periodic single blood draw that simply measures a dog’s cortisol level immediately prior to taking their daily Vetoryl capsule. So if you can just get your hands on the medication, the monitoring may not be that difficult for you.

    We can talk about all this in more detail later on — the first step would be checking the map and finding out if you’re living in a country with a distributor. So take a look and let us know, and we can continue from there. And once again, welcome to our family!

    Marianne

  3. #3
    Join Date
    Apr 2021
    Posts
    25

    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Dear Marianne,
    Thank you so much for the quick reply, warm welcome and helpful information. It’s such a relief knowing there are so many out there who are so supportive and knowledgeable (though sadly I’m sure that knowledge is gained through difficult experiences). The distribution map shows that we have access to vetoryl here in east Africa! I didn’t think it would be possible to monitor/adjust though given the limitations of the labs (the vet needs to send out the blood work and it takes several weeks to come back)... but perhaps I’m wrong about that given the new protocol you mentioned? We will raise with the vet and hopefully he can offer some insights. (They don’t seem to have any experience trading cushings). Thank you!

  4. #4
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,738

    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    It’s so good to hear right back from you, too! Here’s a link to a chart that discusses the new monitoring protocol that I’m referring to:

    https://drive.google.com/file/d/1gqUchP2gvFIyG8udZgNS1bWfppWW6fin/viewfbclid=IwAR2DelBbsQeFErzcG9ZODzfWJnFdlbMmZz49p 8wpQPcumL9Y6RtbrcaKAE8

    The chart is embedded in this more extensive post about general guidelines for the use of Vetoryl (trilostane):

    https://www.k9cushings.com/forum/sho...TH-Stimulation

    A lengthy delay in getting blood test results would obviously be far less than ideal. But given your circumstances and your description of Mia’s worsening symptoms — most importantly, the worsening CC — it may be a risk that you’d be willing to take. I don’t mean to scare you, but we’ve had dogs here who have had to be euthanized due to the discomfort caused by uncontrollable CC. If I was in your shoes and I could actually obtain Vetoryl there in Africa, I think I’d be tempted to go ahead and start with a very low dose while watching very carefully for ill effects. If any appear, you can always discontinue the medication, especially during the time period that the blood test is pending. Please know that I’m not a vet myself, and normally I would not recommend treatment without the benefit of speedy testing. But I do think your situation is out of the ordinary. So I’d definitely show this info re: Vetoryl to your vet, and see whether treatment may be a possibility.

    Do let us know about any additional questions. We can supply you with more info and more links if you think that might be helpful. Dechra is also very happy to directly consult with vets. That might be the very first step, if your vet is willing to contact them for additional info and support.

    Marianne

  5. #5
    Join Date
    Apr 2021
    Posts
    25

    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Thank you, Marianne! Showing this info to our vet and seeing what may be possible sounds like a good first step. Fingers crossed.

  6. #6
    Join Date
    Apr 2021
    Posts
    25

    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Hi Marianne,
    The vet just contacted us and said they got Vectoryl and would like to start Mia on it ASAP! My concern is that they only have 30 mg capsules (leftover from another patient, they can’t import anymore. And when I reached out to the distributor, they confirmed that it’s not available here...despite what the map says). Mia is only 8.5 kg and the vet knows that the recommended dosage to start her on would be 17 mg or so. But he says it’s important to get some meds in her asap given her condition, and strongly recommends we open up/split the capsule and give her half the powder (buried in some minced meat) once a day. While we all keep working on trying to import at the right dosage.
    This will of course be very imprecise. (And given the lag time and inability to get blood work done, we know it will be a big challenge to try to fine tune the dosage going forward as well.)
    I know it’s not fair to ask this of you since you’re not a vet, but I would love your thoughts on this. Thank you!
    Last edited by Mia’s Momma; 04-08-2021 at 07:23 AM.

  7. #7
    Join Date
    May 2021
    Location
    Hattiesburg, MS (unfortunately)
    Posts
    12

    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    If you don't mind ..What is CushingÂ’s???

  8. #8
    Join Date
    Mar 2009
    Location
    rural central ARK
    Posts
    14,329

    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    bichons9, When you see Cushing's with the capital A and weird markings it has something to do with texting on a phone I think. It is not a separate form of Cushing's. It's some sort of typo or autocorrect or somesuch.
    "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.

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