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

[Mia’s Momma]

Thanks, Jonathan. And I 100% agree with all the support here - I honestly don’t know what we would’ve done so far without all the insights and support from this group! We are so grateful.

[Mia’s Momma]

Hello Marianne and all,
Checking in to get your advice on a new disturbing development with little Mia. She’d been doing so well on trilostane with her fur growing back etc (though still some stubborn CC on her head). But 5 days ago, she started having very labored breathing. Her breath is so shallow and she often seems to be in respiratory distress. One night it was so bad we didn’t know if she would make it. Everything else still seems ok: good appetite, etc. though a bit of difficulty chewing/swallowing . We plan to take her to the vet soon , but given his lack of knowledge, I wanted to check in with this group to see if any advice (or things we should ask him about? Eg upping her dose?). She’d been doing so well, not sure what’s wrong now. Am a worried mama. Thanks for any advice you can offer.

[Mia’s Momma]

Hello Marianne and all,
Checking in to get your advice on a new disturbing development with little Mia. She’d been doing so well on trilostane with her fur growing back etc (though still some stubborn CC on her head). But 5 days ago, she started having very labored breathing. Her breath is so shallow and she often seems to be in respiratory distress. One night it was so bad we didn’t know if she would make it. Everything else still seems ok: good appetite, etc. though a bit of difficulty chewing/swallowing . We plan to take her to the vet soon , but given his lack of knowledge, I wanted to check in with this group to see if any advice (or things we should ask him about? Eg upping her dose?). She’d been doing so well, not sure what’s wrong now. Am a worried mama. Thanks for any advice you can offer.

PS. For reference, she is breathing quite rapidly at app 60 bpm even when resting.

[labblab]

I’m so sorry to hear about this setback for Mia! One possible explanation that occurs to me is a blood clot in her lungs (“pulmonary thromboembolism”). Unfortunately, Cushing’s can make dogs more vulnerable to developing clots, and her symptoms do seem consistent with that possibility. Here’s a link to an article that gives more info:

https://vcahospitals.com/know-your-p...-lungs-in-dogs

According to this article, there may not be a safe intervention aside from trying to keep her quiet during the time it takes for the clot to dissolve. But I confess that I’m not familiar with treating this condition, so you may want to try to research it further if it seems like a possibility to you.

I’m just so sorry to hear about another complication for little Mia after she was finally doing better. Hopefully, whatever it is that’s causing this episode will pass and she’ll stabilize once again. I’ll surely be keeping my fingers crossed!

Marianne

[Mia’s Momma]

Thank you for the quick response, Marianne. This is worrying indeed. (I had hoped it might be something we could address with adjusting her trilostane dosage). We will ask the vet about this tomorrow and will keep fingers crossed in meantime.

[Mia’s Momma]

Hello Marianne and everyone! Hard to believe it’s been almost a year. I am happy to report that after a very rough patch in July where she was diagnosed with congestive heart failure on top of her cushings, Mia has been doing very well! (in fact, we’ve been calling her our little miracle baby, such a gift that she is still with us.) She is on 30 mg of trilostane a day (split b/w am and pm, 15 mg compounded pills) + furosemide for her heart. She’s been happy and active and all her Cushings symptoms (even cc) controlled…until app 2 weeks ago. We noticed those stubborn cc bumps and eruptions starting to appear on her head and behind her ears again and she has been drinking more and more water and is seemingly more lethargic. We are considering upping her dose of trilostane.
As you may recall, we are in Africa with no ability to do laboratory tests in real time (several weeks to get blood work back from labs outside country) so need to go by clinical signs. Would greatly appreciate your thoughts on this, including whether it’s common to adjust dosage at this stage and how much we should consider upping. (She is about 8 kg). You’ve provided such a great advice in the past and we credit this forum with helping little Mia come this far! Thx.

[labblab]

Welcome back, and I’m so happy to hear that Mia has had such a good year! But at the same time, I’m so sorry to hear that some problems are resurfacing. It definitely looks as though her cortisol is elevating once again, and yes, dosage readjustments can be needed at any point in time. So even though it’s frustrating, it’s not unusual for this to be happening.

I do remember all your testing challenges, and also all the hoops you had to jump through to get the medication. You are such good advocates for Mia! And although the lack of the ability to test is not ideal, I really believe the reemergence of her CC is pretty much a guarantee that her cortisol is running too high once again. I know you’ll want to nip that in the bud before it has a chance to really settle in and worsen. I don’t know how quickly you would be able to order some additional compounded meds. In an ideal world, if it was me, I’d probably hope to get some new pills with a dosage strength of 7-8 mg. If I could, I’d probably start out by adding one of those pills to her morning dose. If her symptoms didn’t improve, I’d add another one of those pills to her evening dose.

If you can’t get more pills easily, though, I think I’d go ahead and add another 15 mg. in the morning. In the past, Dechra has advised us that if uneven twice-daily doses are given, it’s best to give the larger dose in the morning. Giving Mia a full 15 mg. increase does seem like quite a jump (50%), but it’s actually within the published guidelines for the Vetoryl pre-pill monitoring protocol when cortisol levels are remaining too high and dogs are symptomatic.

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

Whatever you end up doing, I know you will be watching her like a hawk. So if the increase seems to be creating problems rather than helping, you’d immediately stop it. But if I was in your situation, I believe this is the approach I’d take. I’m certainly wishing you well, and we’ll be so anxious for additional updates when you’re able to give them to us.

Marianne

[Mia’s Momma]

Thank you, Marianne! So helpful, as always. I appreciate the quick and thorough response. Our vet took mias blood today and said the lab situation has improved and we can get results in 3 days now. He suggested we hold off on upping the dose until then. (The results may be generally helpful but she hasn’t had blood work done since last August so not much to compare). Our compounded trilostane pills are scored, so should be easy to cut in half so we can up her dose by 7.5 mg when we hear back. I don’t want to wait too long though - the CC was a nightmare we don’t want to repeat! Thanks, again.

[Mia’s Momma]

Mia is responding well to the increased dose so far. (Drinking less water, scratching less, more energy…and no negative side effects.). Fingers crossed we keep moving in this direction. Thank you, again, for the good advice!

[labblab]

This is such good news — thanks so much for the report! I’ll surely be keeping my fingers crossed that sweet Mia continues to do well.

Marianne