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Thread: New to forum... difficult time

  1. #11
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    Jul 2021
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    Default Re: New to forum... difficult time

    Don't want to get too excited but things are FINALLY giving us some hope. I'm a "HOPE" guy so I tend to get too hopeful but I don't care, I'm going with it...

    Cooper seems to be tolerating the 5mg of Vetoryl ok. We're on day 5 now and he is eating well and showing a few signs of having his spirit improve. Water intake is still really high but he slept thru most of the night last night. He hasn't done this in months.
    Honestly, our real hope w/ the 5mg was just that he could at least tolerate it. He actually has an ACTH test scheduled in a couple weeks. I learned that when things went bad on his first round of Vetoryl, the Vet didn't even do the test and just wanted to get him off it (the 30mg round and some 10mg dosing). Our only discussion now prior to the ACTH is whether we try to inch him up to a 2nd 5mg pill per day (total of 10mg per day) if clinical signs are not moving along... or just stay at the 5mg and wait for the test.

    Thank you! I'm not sure we would have even tried the 5mg had it not been for this site. We had kinda written it off due to the initial trouble. Its WAY early to get too happy but at least there is a glimmer of light now when a week ago there really wasn't any.
    Last edited by Kevin; 07-23-2021 at 03:01 PM.

  2. #12
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    Default Re: New to forum... difficult time

    Hi again, Kevin, and truly I'm feeling hopeful right alongside you! Under the circumstances, I think your report is definitely a positive one :-))))

    As far as increasing the Vetoryl prior to the ACTH testing, though, I would not recommend doing so. I know how hard it is to stick to the status quo when you're hoping so desperately for more dramatic improvement quickly. But here's the thing. It is not uncommon for cortisol levels to continue to drift downward during the first few weeks of treatment, even when the dose remains unchanged. For this reason, the manufacturer generally recommends holding off on increasing a dose until a month has passed and a dog has presumably stabilized at that given dosing level. At that point, a more informed decision can be made in terms of the drug's effect and the desirability of an increase.

    It is true that exceptions are sometimes made if a dog has been started at a very low dose and there has been very little symptom resolution at the 14-day testing mark. However, given Cooper's specific history, I would be wary about increasing his dose at all during this first month. At a minimum, I wouldn't feel comfortable increasing it until that first ACTH test confirms that his cortisol level remains within a range of safety.

    Again, I know how much you are hoping to see him feeling better. MUCH better. But let's celebrate even these first few baby steps while minimizing the risk of backsliding again with an overdose. I must repeat that I am not a vet. But this would be my recommendation if Cooper was my own.

    Marianne

  3. #13
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    Jul 2021
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    Default Re: New to forum... difficult time

    Thank you so much Marianne. Yes, we will hold on the 5mg. We don't want to do anything that disrupts the positive start on the lower dose.
    thank you again!
    Last edited by Kevin; 07-23-2021 at 07:07 PM.

  4. #14
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    Default Re: New to forum... difficult time

    Hey Kevin, I just now saw your note on Betsy’s Mom’s thread reporting that you’re still not really seeing any improvement in Cooper. I want to talk a little more about the possibility of increasing Cooper’s trilostane dose after his monitoring ACTH test. If you’re still not seeing any improvement at that time and his cortisol level comes back in a relatively high range, it may be reasonable to increase his dose a bit. I don’t want to seem like I think that shouldn’t even be considered. So let’s see how the testing turns out and then go from there.

    Marianne

  5. #15
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    Jul 2021
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    Default Re: New to forum... difficult time

    Thanks Marianne. I have a sneaky suspicion that his UTI just isn't clearing. He has another few days of antibiotics to complete the 21d cycle (Doxycycline). Along with his ACTH, he'll get another urine culture to see if the infection is gone. My gut and visual cues are just telling me his infection is just not going away. UTI symptoms obviously just compound Cush symptoms so it makes it hard to assess. Lethargy, accidents, drinking... obviously all compounded with a UTI. So we've got that symptom overlap that could be going on which makes it very hard to assess the Vetoryl success.

    Do you have any thoughts on the UTI? I should be clear, I can't say for CERTAIN his UTI isn't clearing. It may be. Haven't seen any blood in his urine nor any horrible smell from it. Just what I mention above.

    And yes, regarding the increase to Vetoryl, we're kinda thinking everything hinges on that ACTH test. Good news is that he's still eating and taking the Vetoryl.
    Last edited by Kevin; 07-28-2021 at 10:19 AM.

  6. #16
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    Default Re: New to forum... difficult time

    Hey Kevin, no I’m afraid I can’t add much to the UTI picture that you don’t already know. You’re so right, though, that the overlap of symptoms is a real bummer from a diagnostic standpoint. But hopefully as Cooper’s cortisol lowers, those UTIs will come under better control, too.

  7. #17

    Default Re: New to forum... difficult time

    Kevin, as a human nurse practitioner, just adding a couple comments but you’ve probably already thought of this. If the dog is having a urinary track infection at the moment I believe any testing for cortisol levels might be thrown off? The other thing is if you are using any holistic supplements or any supplements at all be sure your doctor knows about those because they could potentiate or lessen the effect of vetoryl ( just my guess as a human nurse practitioner, I am not a veterinarian, but we are constantly looking for what supplements or meds are affecting other meds.) good luck, I am on my second and third, of four pitbull‘s total Who have lived in my family. I adore them and pit mixes. ( The first died at age 12 of a brain tumor, the second and third are three and five years old, the fourth was a homeless pitbull I took in during Covid who died after seven months here. She was very old and very sick.)
    Thanks,

    Betsy’s Mom, Cathy

  8. #18
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    Jul 2021
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    Default Re: New to forum... difficult time

    thanks guys. Having a hard day. Noticing alot of circling the last few days with Cooper which leads us to think things may be evolving into a neurological deal w/ the Pituitary tumor growing. We just can't win and starting to fear the worst.

    BM, we stopped all holistic stuff completely minus a cranberry supplement the Vet actually gave us with hopes it may help with UTI's.

    Not in a good place to type much more but I thank you all for the support.

  9. #19
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    Default Re: New to forum... difficult time

    Aww Kevin, I’m so sorry to hear about the circling and I understand why you’d be scared and worried right now. Whenever you feel like writing more, though, we’ll be right here for you. When we love them so much, it’s torture to see them doing poorly, and to know they can’t talk and tell us what’s wrong. But you can always talk to us, whenever it feels like it might help.

    Sending big hugs to Cooper, you and your girlfriend.
    Marianne

  10. #20
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    Jul 2021
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    Default Re: New to forum... difficult time

    So we got Coopers two week test results, Marianne. Well, we got them informally over the phone from the Vets office. These are quotes from the Vet so I have absolutely no clue what they mean. "His first reading was 2.9 and the 2nd reading was 8.7 which is perfectly in the range we want to see (1.5-9.1)" This was the quote from the Vet so forgive me for not having more information.

    Sadly, his clinical symptoms are not improving much. His lethargy, muscle weakness and neurological symptoms aren't good so we're struggling to stay optimistic. We're only a bit over 2 weeks on the 5mg Vetoryl dosage. Vet wants to stay on the 5mg and refer us to a specialist to maybe assess the neurological stuff. I know radiation to the Pituitary tumor is a treatment option for some dogs but no clue if he'd be a candidate. She seems to believe some of the clinical stuff just takes more time so we'll keep at it.

    We also think he still has the UTI which we KNOW wreaks havoc on his behavior. He's going to get another culture next week. If his Cortisol is finally getting under control, we might have a prayer to get the UTI's to stop.
    So thats our sad update but I guess at least maybe the Cortisol is showing some improvement? hope those numbers make some sense to you.

    thanks so much.
    Last edited by Kevin; 08-05-2021 at 03:48 PM.

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