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

  1. #31
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    Apr 2021
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    We finally got Mia’s cortisol test results back today: It came down from 173 (2 months ago) to 111 (after 30+ days of Vetoryl)! I know it’s not accurate like an ACTH stim test, but still seems like great news. Our vet was excited, and so are we.

  2. #32
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Woo Hoo!!!! I think that’s terrific news! For our U.S. readers, that translates into approximately 4 ug/dL, and according to the pre-Vetoryl monitoring protocol, that is right within the desired range for a dog who appears to be feeling good and for whom symptoms are significantly resolving. I’m so happy for you guys!! Under these circumstances, I’d definitely keep on with the status quo. It’s possible that a slight dosage increase might be warranted in the future if some symptoms do linger, especially the CC. But for the moment, I think you have every reason to celebrate!

    Marianne

  3. #33
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    Apr 2021
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Thanks, Marianne! Yes, the vet says to continue what we’re doing. It’s great to know the “translation” since that’s how I always see the numbers represented and, more importantly, to know we’re within a good range. We will continue to keep a close eye, esp on the CC which has been so problematic for Mia. Seems like it’s taking forever to resolve, but I understand it usually does take a few months. We are so happy…just 6 weeks ago we were agonizing that we may be losing our pup in days. Now we know we have more time with our sweet girl, what a blessing.

  4. #34
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    Apr 2021
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Hi Marianne - You mentioned that we may need to consider a slight increase in dosage if the CC doesn’t improve, and I’m wondering when we should discuss that with our vet? The reason I ask is that Mia’s CC not only persists (which we expected since we’re just at the 2 month mark on 15 mg of Vetoryl, then trilostane) but seems to be worsening on her head. On her body, the scabs/lesions etc seem to be drying out and a bit of fur is growing back, signs of a slow recovery at best or status quo at worse. Her head, however, has gotten worse in past 2 weeks. The pustules and lesions etc continue to push through and she wakes up with a bloody head on a daily basis now; it also seems to be really itchy as she is constantly trying to roll around in it to get relief. All her other symptoms seem to be under good control, but we’re starting to worry about the Cc on her head. Appreciate any advice you can share. Thank you!
    PS. I tried to add a photo of her head in my album, if that helps.
    Last edited by Mia’s Momma; 06-01-2021 at 11:33 AM.

  5. #35
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Oh gosh, I just now saw your photo of Mia’s little head and I feel *so* badly for her and for you guys! So this is what I’m thinking about as far as a dosage change. First of all, here’s that link to the pre-Vetoryl monitoring chart that I’ve been relying on in terms of recommendations:

    https://drive.google.com/file/d/1gqU...L9Y6RtbrcaKAE8

    I’m thinking that her situation falls within the first category on the left-hand side of the page: pre-Vetoryl cortisol level between 40 - 138 nmol/l, but still suffering from unresolved Cushing’s symptoms. As you’ll see, the recommendation in that situation is to increase the dose and/or frequency. As long as Mia isn’t exhibiting any symptoms of *low* cortisol (lack of appetite, lethargy, etc.), I’d be inclined to ask your vet about going ahead now with an increase. It sounds as though perhaps you’ve now gotten in a supply of compounded trilostane? How much flexibility do you have in terms of dosing? If it was me, I’d be inclined to increase from 15 to 20 mg. if possible. And if it’s feasible to break that into 10 mg. twice daily, that might help Mia even further by maintaining a more consistently low cortisol level throughout a complete 24-hour cycle. I realize that may not be possible, however, depending on what form your current med supply is taking. Also, if you do switch to twice daily dosing, bear in mind that each dose should be given with a meal and that may or may not suit your household schedule.

    So let us know how things stand in terms of your trilostane supply, though, and then we can scheme together a bit more. And please do give sweet Mia a gentle hug from her family here!

    Marianne

  6. #36
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Thank you, Marianne. Your advice is helpful, as always. We now have a vet appointment Friday and will ask him about upping dose and/or frequency. We do have a supply now of compounded trilostane (15 mg tablets), which I assume we can cut up (though not sure about exactly 20 mg)? She’s fed twice a day so we could change the frequency to twice daily dosing if we can get the quantity right. Poor Mia, her head is really bothering her- breaks my heart to look at her, sweet girl. Thx.

  7. #37
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Under these circumstances, I might be tempted to give her the full 15 mg. tablet in the morning, and then add a half tablet of 7.5 mg. in the evening. If her weight is still around 8.5 kg. (approx. 19 lbs.), then the daily total of 22.5 mg. doesn’t seem really excessive, especially since the flowchart states that the dose could be increased up to 50% in the event that symptoms remain uncontrolled. Also, in the past, Dechra has advised us that it’s OK if the daily total is not evenly split in half for twice daily dosing. When that’s the case, though, they say the larger portion of the dose should be given in the morning.

    Of course, the other option would be to simply give 1.5 tablets in the morning. But if you can handle the twice daily dosing, I think I’d give it a try if Mia were my own dog. Of course I know you’ll be watching closely for any ill effects, but hopefully an increase will only prompt positive changes. If not, you’ll know to quickly back off from the higher dose.

    Marianne

  8. #38
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    Apr 2021
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    Thank you for the good advice. Her weight has actually gone back up a little to 8.8 kg, which is great. We will propose your idea to the vet tomorrow. Hopefully, he will agree and it will help. Will keep a good eye on her for sure. Thank you.

  9. #39
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    Apr 2021
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    The vet agreed with your recommendation so we started Mia on 15 mg in am and 7.5 mg in pm yesterday. We’re keeping a close eye - so far so good. (She seemed to sleep better her first night and wasn’t trying to itch as much…we might be reading too much into it too early, but are optimistic). Thx!

  10. #40
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    Dec 2020
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    Detroit, Michigan
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    Default Re: New here, 11 year old sweet JRT mix just diagnosed with CushingÂ’s

    After reading this thread....I cant even begin to say how impressed by the support given.
    And bless you, Mia and her Momma!
    In Loving Memory - Gigi (2006-2018)
    - Had a great quality of life as a "Cushings Dog"
    - And passed non Cushings related...

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