Trying to help a friend (possible calcinosis cutis)

[Cyn719]

Hi

Welcome - Isnt this forum great Its the best group of people I have met!! You ask something and they are there with tons of advice and support!! Glad you are so comfortable here -- will be looking forward to the flea recipe - my brother has a golden/lab with ton of skin issues and would be interested -- love the picture!!

hugs xo

[4Vicki]

Jeanette: Yes, she is a Choc Lab........I can see why you love them! Yuk yuk. Her name is Hannah, better known as Hannie Wan. Don't ask me where that came from but that's what I call her.

The flea spray recipe is now in Everything Else. Just posted. I have to make more today but I've had pretty good luck w/it. Sometimes in the summer if we are having an exceptionally bad flea month, I will put the drops on much as I hate to........but I can't stand to watch her scratch. Plus that, they get on me & that makes me mighty unhappy.

My friend, Janice, is the one who is the humommie to Vicki & why I started this thread in the first place. Never realized what a great group of people are here........but I know now........

I will continue to pass on info to her & as soon as there is any additional info on Vicki's condition, will post.

Thanks again to all of you.......

[4Vicki]

Janice called me because she got the results of the latest test. She gave me two numbers: flat 1.7 & post 2.6........the numbers are right but I wasn't sure if she did say flat & post. You already know that this is like another language to me!

Was also very surprised that she could go from 17 down to 1 or 2 in such a short period of time. Is that the norm????

She said the cal cutis doesn't appear to be spreading any more but it still looks really bad. Vet said he was going to order DMSO (I think that's what she said) to be applied topically. Again, foreign language.

I hope my dog never gets Cushings but if she does, I know where to go for help!!!!!!!!!

So that's where things stand for Vicki as of Friday.........

Thanks again for all of your input. Appreciate it.

[Squirt's Mom]

Some links on DSMO for you and Janice -

DSMO info

http://www.dmso.org/

http://www.dmso.org/articles/information/muir.htm

http://www.herpes-coldsores.com/dmso.pdf

http://www.bevanpotter.com/DMSO_bp.html

http://www.ncbi.nlm.nih.gov/pubmed/1124535

http://curezone.com/forums/am.asp?i=1249191

http://books.google.com/books?id=CvH...0cutis&f=false

http://books.google.com/books?id=x6c...0cutis&f=false

http://www.itchnot.com/images/_7_Endocrine_Alopecia.pdf

[4Vicki]

Thanks for all those links. I did try to get info for her because she doesn't know much about it either but I really couldn't find anything worthwhile.

Will check those links. She was most interested in how it's used, if there are any side effects........that kind of stuff.

Hope vet will instruct her in its use......

[Harley PoMMom]

J
Was also very surprised that she could go from 17 down to 1 or 2 in such a short period of time. Is that the norm????

We have seen many dog's cortisol get lowered significantly in a short amount of time. Could you remind us of the dosage of Vetoryl your friend's dog is on and the dog's weight?

Many dogs have had their cortisol drop even lower while on the same dosage, so please ask your friend to keep a watchful eye out for any adverse reactions of low cortisol.

You're such a special person and a very good friend to be helping your friend like this.

[4Vicki]

You're such a special person and a very good friend to be helping your friend like this.

Thank you for saying that. You are too kind........

Vicki is on 40 mg once a day.........she's a Boston Terrier & off hand I don't know how much she weighs. I can find out if you need that info. She's not fat or underweight, I think she's at a perfect weight for her size if that helps........but I also haven't seen her since all this has happened to her.

What are the "adverse reactions" of low cortisol so I can tell her?

Thanks again for all the great tips.

[Harley PoMMom]

The initial starting dose of Vetoryl/Trilostane is based on the dog's weight. UC-Davis recommends a starting dose of Vetoryl/Trilostane at 1mg per kg of a dog's weight. Dr. Tim Allen, who was a vet tech from Dechra's Kansas office, verbally was recommending a starting dose of Vetoryl at 1mg per pound. If you could find out your friend's dog weight that would really help us.

Adverse reactions are, but not limited to: lethargy, vomiting, diarrhea, loss of appetite, and/or a dog just not acting like him/herself. If any adverse reactions are seen, the Vetoryl/Trilostane should be stopped and an ACTH stimulation test and the checking of the electrolytes should be performed.

[4Vicki]

I just called Janice: 20 lbs. That's what I thought but I wasn't sure so I didn't want to give you incorrect info.

If this is the case (not sure if it's 1 mg per kg or lb), sounds to me like 40 mg is kind of a high dose.........ya think? I will have to give her info on low cortisol because she may just have that problem, esp if this is too much for her.

I don't want to scare her but if this dosage is too high, I will print out the info on low cortisol so she can watch for that. This is why I wish she'd go to a specialist but they are expensive around here.......

[labblab]

Vicki has been on Vetoryl for approx a month, a higher dose was just prescribed about a week & a half ago (she wasn't sure what the dose is). The ACDH was 17.1, it was the liver enzymes that were high, not kidney (sorry), she had a skin biopsy to confirm the cal cutis, ultrasound of the liver & adrenal & that particular vet said everything looked ok.

You posted your reply above on 1-27, so it sounds as though Vicki was on a lower dose for about 2 1/2 weeks, and was then increased to this higher dose of 40 mg. which she has been taking for 3-4 weeks? Does that sound about right? If so, a post-ACTH result of 2.7 sounds like a good result -- right in the middle of the desired ideal therapeutic range between 1.45 - 5.4 ug/dl. And if she has already been on this higher dose for nearly a month, it is more likely that this is a good dose for her to remain on -- assuming she is behaving normally with none of those problems that Lori spoke about.

It is true that the Dechra technical reps have recommended an initial starting formula of approx. 1 mg. per pound. But that is just a starting point and dogs of any size can end up needing to be dosed with higher or lower amounts. The "proof of the pudding" is really the ACTH monitoring testing and the manner in which the dog is behaving. So from what you've told us, it sounds as though there was a reason why Vicki's initial dose was increased (maybe that's when the ACTH was approx. 17? -- if so, that's too high for a Cushpup being treated with trilostane), and that the 40 mg. dose has now lowered her cortisol into the desired range. And what with the calcinosis cutis, I'm guessing her vet was anxious to lower her cortisol as rapidly as was safely possible.

Lori is right that dogs can continue to require dosing changes throughout the time they remain on trilostane. So it will be important for your friend to always mention any physical or behavioral changes to the vet. But from what you've told us so far, it sounds as though this is curently a good dose for Vicki.

Marianne