New here - Louie age 13 small poodle (mix?) with Cushings

[mojomom77#]

Hi, again - back with update and question on Louie. He did have the ultrasound and it was consistent with Pituitary form of Cushings - increased size in both adrenal glands. Vet wanted to start on Vetoryl last fall but we delayed due to his eye problem - that's been under control now for a while but life just got in the way!

He's going back to the vet this week and will likely get started on the Vetoryl. Just want to be sure I have my ducks in a row - my understanding is he should have the ACTH stim test at 14 days and again at 30 days, but wait until the 30 days to make any dosing change b/c it can take that long to see the effects of the meds? Am I getting that right?

Has anyone had trouble with Addison's disease after starting Vetoryl and what should I be on the watch for? Overall have your dogs managed side effects of the vetoryl well? He has to pee a LOT and drinks a LOT so those are 2 main symptoms we are hoping to improve for him and for us.

Thank you for advice and support!

[Joan2517]

Hi, again - back with update and question on Louie. He did have the ultrasound and it was consistent with Pituitary form of Cushings - increased size in both adrenal glands. Vet wanted to start on Vetoryl last fall but we delayed due to his eye problem - that's been under control now for a while but life just got in the way!

He's going back to the vet this week and will likely get started on the Vetoryl. Just want to be sure I have my ducks in a row - my understanding is he should have the ACTH stim test at 14 days and again at 30 days, but wait until the 30 days to make any dosing change b/c it can take that long to see the effects of the meds? Am I getting that right?

Has anyone had trouble with Addison's disease after starting Vetoryl and what should I be on the watch for? Overall have your dogs managed side effects of the vetoryl well? He has to pee a LOT and drinks a LOT so those are 2 main symptoms we are hoping to improve for him and for us.

Thank you for advice and support!

This is exactly correct. My Gable was very sensitive to Vetoryl and started at 40mg (he was close to 80lbs.), but ended up on only 5mg twice a day. The symptoms are tricky to notice, but NO appetite is the biggest. He never really stopped eating, but started drinking and peeing more again, which made us think he needed a higher dose, but thankfully we did the ACTH and found his numbers way too low and we stopped the meds until his adrenals rebounded. We had to do that a few times before ending up on the 5mg.

[labblab]

Welcome back to you and Louie from me, as well! I agree with Joan that your understanding of things seems to be spot on :-). In case it’s additionally helpful to you, though, here’s a link to a thread on our “Resouces” forum that offers an informative set of guidelines associated with Vetoryl (trilostane) treatment.

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

You’ll see that two important recommendations are that initial daily dosing not exceed a formula of 1 mg. per pound, and that the medication always be given alongside a meal in order to be metabolized most efficiently.

I know you’ll be watching Louis like a hawk, so if you should see any indication that he’s reacting poorly to the medication (e.g., loss of appetite, vomiting, diarrhea, general lethargy, etc.), you’ll know to stop the Vetoryl and to contact your vet. Sometimes dogs who have been overdosed require some supplemental prednisone while their adrenals rebound. But most often, just discontinuing the medication for a while and then subsequently lowering the dose will be the solution. You’ll find more info about all this in that link that I’ve given you above. If you’ve not already seen it, do look it over and feel free to ask us any questions.

Please give Louis a hug for us, and good luck to you both!
Marianne

[mojomom77#]

Thank you!

[mojomom77#]

Hi, again,

Well Lucky is still not on the Vetoryl after having blood work done last week, the vet called to say the following about his bloodwork compared to @ 6 months ago:
1) Liver values elevated (perhaps not surprising?)
2) Platelet count low
3) Kidney values elevated
4) Anemia - perhaps due to some internal bleeding, bone marrow not producing enough red blood cells, or intestinal parasites - unclear the why but is concerned about the anemia and would like to do additional workup for anemia and kidneys before starting vetoryl.

This was all on a voicemail so including this info now while I concurrently try to reach the vet to discuss.
He is definitely low, low energy most of the day, but especially in the morning. Whereas he used to be hungry all the time and eat the food as soon as put down, now he eats most of his breakfast closer to lunchtime. Does a belly splat on the floor often times when he does the 'doggy shake', and having trouble getting up the one step from our garage, so definitely his hind legs at least giving out/struggling.

Focus for us is on quality of life at this point but any ideas on the anemia, etc. welcome :-)

[labblab]

Hello again, and welcome back, although I’m surely sorry to hear that Lucky is having these additional problems. I absolutely agree with your vet’s decision to further pursue the kidney/anemia issues before introducing any Vetoryl. There are specific warnings about the use of Vetoryl in dogs suffering from kidney dysfunction, so that will be an important puzzle piece to investigate. I believe kidney dysfunction can also be responsible for anemia, so perhaps there’s a linkage between those two issues. Please continue giving us updates. And definitely please give Lucky a big hug from his family here. And the same to you, as well — I know these new developments have to be very stressful for you, too.

Sending healing wishes to sweet Lucky, and my warm thoughts to you.
Marianne

[mojomom77#]

Thank you Marianne, appreciate the kind thoughts and advice. Haven't heard back from vet yet so will wait to find out more.