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Thread: New member - Staffie starting Vetoryl

  1. #11
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    Default Re: New member - Staffie starting Vetoryl

    Hi Sue,

    Please watch him extra close for any sign the cortisol is dropping too low. This increase is not in compliance with the very specific protocol for this drug and puts the dog at higher risk (info found in the drug insert we always hope the vets will read). If you see any of those signs listed above or any changes for the negative, please have another ACTH done asap if at all possible. I understand you don't have much, if any, say in his care but try to convince them of the seriousness of the situation should it occur. Most of the time simply stopping the drug for a few days until signs of high cortisol come back are enough but not always. IF Hendrix should respond negatively to this increase, make sure they do not put him back on the increased dose when he restarts. He needs to be on a lower, not higher, dose if he does react badly. I hope that doesn't happen and he continues to show improvements!

    Hugs,
    Leslie
    "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.

  2. #12
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    Default Re: New member - Staffie starting Vetoryl

    I would be watching him very, very closely, Sue. As closely as I watched Gable, he still crashed that one time and if I had not been paying attention to any little sign, it could've been an ER crisis instead of just a run to the vet. As I said before, a high cortisol is better than an Addison crisis.
    Joan, mom to my Angel Lena, Angel Gable, Angel Phoenix, Doree, Cooper, and now Sibble.

  3. #13
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    Default Re: New member - Staffie starting Vetoryl

    Quote Originally Posted by Sue G View Post
    Hi Leslie

    We have the results of Hendrix's bloods from last week. They are high at 176. The vet would like them sitting nearer to 138 as a baseline. He has had no reaction to the meds so far apart from drinking a little less. I know you advised against letting them increase the dose just yet but the rescue have the call on this. The vet has today increased the dose so he is now on 70mg a day. 1 tablet of 60 and 1 of 10 given at the same time bloods will be redone 2 weeks today. The vet is concerned that they feel that Hendrix has an underactive thyroid at the same time so they are going to run tests for that probably at the appt in 2 weeks. My poor boy's fur is thinning round his neck as well as his sides and tail. He is still his same sweet self that he always is just a little quieter in the last few months. I know its going to be a long journey with him but hopefully with a lot of TLC and help we will come out the other side more lively and feeling better than he seems to feel at the moment.

    Best wishes and hugs
    Sue
    Hi again from me, too, Sue. Like the others, Iím wishing the vet had held off on the dosing increase, but itís only a small increase and Iím relieved to know that Hendrix will be rechecked again in two weeks.

    To give some context for our U.S. readers, Iím going to convert Hendrixís result into the test units with which weíre most familiar here. His level of 176 nmol/l converts to approx. 6.4 ug/dL. For best therapeutic control, the preference is for a Vetoryl pre-pill cortisol level to be around 5.0 ug/dL. So thatís why the vet is slightly increasing his dose. Iíll give you a link to the recommended pre-pill monitoring protocol below. As youíll see, it does recommend waiting until the 30-day mark to make an increase. But weíll hope that this mild increase now will be a benefit and that his next test will show the level of improvement thatís optimal. Hereís that link:

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

    As far as his thyroid function, additional testing may indeed be helpful. Cushingís is a disease that can suppress thyroid levels as a secondary result. If Cushingís is the primary cause, then thyroid levels may normalize on their own once the elevated cortisol comes under control. However, some dogs may suffer from hypothyroidism as a primary problem all on its own. In that case, thyroid supplementation can be called for. Simple T4 levels alone (the single reading found on most general lab panels), canít distinguish between these two different circumstances. But more complete thyroid testing can offer better insight as to whether or not supplementation will be helpful to a Cushpup. So Iím hoping this is the kind of thyroid panel that your vet has in mind for the next visit.

    No matter what, please do keep us in the loop as to how Hendrix is doing!
    Marianne

  4. #14
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    Default Re: New member - Staffie starting Vetoryl

    As Marianne said above, some dogs have both hypothyroidism and Cushing's. Gable had both. We started with the thyroid meds to see if that was what was causing his symptoms, but they continued. When he was finally diagnosed with Cushing's and started meds for that, he was still showing low thyroid levels, so he was on Vetoryl and Soloxine for at least six years before his death this past November. That also took some tweaking to get the right level for both meds.

    Lena might have had both because her symptoms never really got much better, we never checked. We were still tweaking the Vetoryl doses, so low thyroid was never brought up, but she died only a couple of months after diagnosis and treatment. Gable most probably had Cushing's then, but his blood work didn't show it until after Lena had died.
    Joan, mom to my Angel Lena, Angel Gable, Angel Phoenix, Doree, Cooper, and now Sibble.

  5. #15
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    Default Re: New member - Staffie starting Vetoryl

    Morning ladies. Firstly my apologies for not replying to your messages. I didn't realise there was a second page opened up on my thread.
    I had a huge message written but then it said I wasnt logged in so I will start again and hope to send it before I time out. Hendrix is a mystery to us at the moment. Alison who is from the rescue has started a thread on here asking for advice as Hendrix's cortisol numbers are rising despite a second increase up to 80mg a day. This is fed to him in his meal at lunchtime. (I split his food into three meals a day) The vet has been in touch with the laboratory to, I think, clarify what might be going on with his results. Currently Hendrix still has all the classic signs of Cushings apart fom excess panting, he has so far never had that. He still loves to go for his walks, which includes one longer off lead walk. At the vets he is taken into a separate room for the tests to be done, which I guess adds to the stress for him.

    The vet is considering changing Hendrix to half a dose twice daily which hopefully might improve his levels. Currently they are doing a cortisol monitoring test which takes place before his next dose of Vetoryl is given. If they do an ultrasound to find out if there is a tumour on his adrenal glands will that also tell them whether the tumour is benign or not? So many questions. Currently Hendrix has had 4 blood tests for Cushings since beginning of March so is well monitored in that respect. He is fed a good quality pate type food which is 85% meat protein, very few treats and no kibble.

    He is certainly brighter in himself and some of his cheeky behaviour has returned, that may be in part due to the fact that he is having a free run in fields now, where in the winter it was so awfully muddy and wet that we stopped going there. He has always had 3 walks a day though and still wants to go every single time unless its raining!

    The rescue myself and the vets are working together to try and find out what is happening with him. The thyroid test still isnt done as they are hoping that it might stabilise a little once the Cushings is stable. Sorry this is a bit of a ramble but trying to get as much information in as possible.

    Thanks for any help you ladies can give us
    Best wishes
    Sue and H

  6. #16
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    Default Re: New member - Staffie starting Vetoryl

    Morning ladies. The vet has asked to increase the dose for H to 60mg twice a day! I am not happy at all with that and am going to quickly print out all the resources I can which I can give physically or speak about on the phone when he calls later. today. For now I am not increasing the dose as I have a much brighter boy than I did at the start of his Cushings journey. I will let you know later the outcome of this. Thank you for all your help
    Sue and Hendrix xx

  7. #17
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    Default Re: New member - Staffie starting Vetoryl

    Hi Sue,

    What was the result of the test that this increase is based on? Were you still seeing signs of high cortisol? When a dose is split you don't increase the dose UNLESS the testing and signs indicate that is needed. Typically you simply divide the current dose into two doses AM and PM so on 80mg a day he would take around 40mg AM and 40mg PM. Please do let us know what the vet has to say when you can.

    You are doing a good job with this sweet boy!
    Hugs,
    Leslie
    "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.

  8. #18
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    Default Re: New member - Staffie starting Vetoryl

    Oh...about the ultrasound. Being on Vetoryl will change the appearance of the adrenal glands so unless he is looking for tumors on those glands an ultrasound at this point would be worthless. It wouldn't tell them anything about his Cushing's UNLESS again they are checking to see if he has the adrenal based form - ie a tumor on one or both adrenal glands VS the pituitary.
    "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.

  9. #19
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    Mar 2022
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    Default Re: New member - Staffie starting Vetoryl

    Morning Squirts Mom.
    Thank you for replying. I spoke with the vet by phone and then emailed the advice and guidance about waiting 30 days before increasing a dose, also the 'bigger dogs smaller doses' information. The Rescue and I have both spoken to him but he said he had spoken to a consultant who wanted Hendrix on 60mg twice a day. I have been giving this dose for two days now and so far no problems that I can see. He has developed awful dandruff, maybe combination of Cushings and low still undiagnosed thyroid problems. The rescue have suggested I get some coconut oil and add a small amount to his food to help with this. I realise that there are different dog foods around the world. Am I right in thinking that a high protein, low fat, low fibe diet is best for Hendrix. I am constantly looking for ways to improve the things that I can for him. He has so far shown no reaction to the medication, the vet says he is not going on bloods alone but also on clincial signs. He is very good and checks Hendrix physically, heart, temperature and gives him a good physical hands on particularly around his little pot belly. Currently his bloods were showing as high levels as when he started on the Vetoryl, retest in 3 weeks time. Thanks for all your help

  10. #20
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    Mar 2022
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    Default Re: New member - Staffie starting Vetoryl

    Just one last question please. Now we are doing two doses a day do they have to be exactly 12 hours apart. I will do my best to keep to that but will it make much difference to Hendrix if they are, for example 11 hours apart during the day. Still trying to work all this out in my head and not wanting to do anything to make him ill while he is doing well at the moment. We will be seeing the vet in 3 weeks but thought I would ask you ladies before then. Thank you Sue and Hendrix

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