Lysodren Overdose Possible in small Dog?

[DiorDog]

My little mini dasuchound 8lb very tiny was diagnosed with cushings last week.Thursday she started the lysodren treatment.It was to take one half pill once a day for a week.Then after half a pill once a week.All the vet gave was the lysodren.

Today my little dog started acting weird she had some labored breathing.No panting just you could see her tummy sucking in around her ribs and she was breathing heavy.She has not acted like her playful self at all very lathargic.She has not wanted to eat or drink or walk.She has fell up the tiny stairs to come inside the house =(.

I took her to the emergency vet.He told me to stop treatment for now.He said the dose her vet gave her seemed a little high due to her small size.He gave some predestorone(spelling?) half pill once a day till she snaps out of how she is feeling.He did a xray just to be sure and everything looked great inside.He did say her intestinal walls were a little thick.

Has anyone had this lysodren problem with there doggies?It really makes me sad/mad that she is going through this.

What are my options now.What should I ask her vet Monday when I call?

Thanks In advance.I will tell everyone hi later I am a little worried right now & going to go baby her.

[AlisonandMia]

Hi and welcome,

Both Lysodren and trilostane (the other Cushing's med) work to lower cortisol. Too much cortisol is the cause of the physical signs and symptoms of Cushing's. However, a small amount of cortisol is necessary for normal functioning so if too much medication is given the cortisol level can be reduced to the point that the dog becomes ill. How much is "too much" for a dog is an individual thing although dosing guidelines exist. I agree with the emergency vet that her dose was high for such a little dog - by my calculation that is about 70mg/kg whereas the usual dose is 50mg/kg.

When she was checked over by the emergency vet did they test her electrolyte levels? A severe overdose of Cushing's medication can result in a dangerous electrolyte imbalance as well as low cortisol.

When did she have her last dose of Lysodren? Has the dose of prednisone made her feel better? How many doses of Lysodren would she have had so far?

Here's a link to some info on Lysodren treatment: http://www.k9cushings.com/forum/showthread.php?t=181

Alison

PS: How big (mg's) are the prednisone pills?

[StarDeb55]

The information you have given us has thrown several red flags about your vet's experience in treating Cushing's. First of all, any vet prescribing lysodren should provide the owner with an emergency supply of prednisone in case there is problem similar to what your little one is experiencing. The vet should also have given you thorough instructions on what to look for with a lysodren overdose or low cortisol emergency, & when to give the prednisone. I take it none of this was done?

Lysodren dosage is based on weight, 25-50 mg/kg, to get to kg, divide your baby's weight by 2-2. I have done the math already, & the appropriate dosage range for your baby is 90-181 mg. If you have been splitting those large white pills, you were giving 250 mg. per dose. Also, the instructions you were given to do what is termed a lysodren loading are not proper protocol. Loading is done where you give the maximum daily dosage, split into 2 doses each day. Let's use 180 mg, for example, you would be giving 90 mg., twice per day. You are then to watch for signs of loading. These signs can be as subtle as the pup who has been inhaling their food in 1 minute flat, now, takes 2 minutes, & stops to look at you in the middle of eating. Any decrease in water consumption may be another sign. We also have a saying around here that during loading, if there is any change in your pup's behavior that makes you stop & go "Hmmm, that's different." That change could very well mean your pup is loaded. There other red flag is that your vet has stated you need to load for a specific number of days. You keep giving the medication until you see the above signs that I have mentioned. Some dogs may load in as little as 3 days, others can take upwards of a month. This depends on the dog.

The prednisone that you were given sounds like they might be 5 mg. pills. If that is correct, 1/2 tablet should be more than adequate for a rescue dose. You should see improvement in your baby within about an hour after giving the pred. You will need to contact your vet ASAP, & set up an ACTH test to see just exactly where your baby's cortisol levels to assess how much of an overdose may have occurred. It would be best to wait on the ACTH for 24 hours after the last dose of prednisone, as the pred can read as cortisol on the test, falsely elevating the result.

Right now, we need to get your baby feeling better. When you contact your vet, ask for copies of all the labs that were done to diagnose the Cushing's so you can post the results for us, so we can get a better idea of what exactly is going on. The only other questionI will ask you tonight is what were the symptoms your little one was troubled by that led you to go to the vet?

Also, please check your e-mail, including your junk mail, for an e-mail from the forum that you must reply to, so that we can get your membership approved. I manually approved your first post as I saw that your little one was in trouble.

Please keep us posted. We are here to help in any way we can.

Debbie

[frijole]

Just wanted to say how glad I am you found us and that the others are on the money - your original vet does not appear to have any experience in treating this disease. Your dog can lead a normal healthy life but, like any drug, the doctor has to follow protocol which he did not.

For now the focus is on how the prednisone is working. Please read the links and ask us questions - we are here to help get you up to speed. You are your dog's voice in this and as you just learned, not all vets know how to treat it.

Hang in there & keep us posted on how your dog is doing. Kim

[DiorDog]

Thank you all for the quick and caring reply ;).


AlisonandMia-
When she was checked over by the emergency vet did they test her electrolyte levels? A severe overdose of Cushing's medication can result in a dangerous electrolyte imbalance as well as low cortisol.

When did she have her last dose of Lysodren? Has the dose of prednisone made her feel better? How many doses of Lysodren would she have had so far?

I don't think he checked her electrolyte levels.Scary wish I would have thought of asking about that.

Her last dose of Lysodren was at around 8:00 am Saturday.

It does seem that the prednisone has helped she was kinda acting a little more lively.

My little dog has had one full pill and half of one all together through the end of this week so 3 days.Since the vet told me to medicate her at half a pill a day once a day for a week.

StarDeb55-Thank You for all the helpful info.I think I might need to change vets asap.Yes she was given 5mg of the presidone from the emergency vet.I feel bad for the other dogs he is treating with this.I will post the results after I pick them up.


The only other question I will ask you tonight is what were the symptoms your little one was troubled by that led you to go to the vet?


I don't know if you mean the main one or emergency one:)?
Here is how I found out about her cushings
My little dog Amy had been missing hair,was getting more thirtsy,mainly at night all through the night,I got no sleep she was peeing in the house.She was eating a lot,she had a pot belly.I thought it was just old age.I first seen cushings when I was looking it up thinking I had it I ended up having Pcos.I seen a dog that looked just like my dog on the internet.I took her to the vet for a ear problem.The vet said that it looks like your dog has cushings.So I set up a appt.They did a blood they had her there from 8:00 to 5:00.The vet called and all he said is your dog has cushings come pick up the meds.I asked if the meds were safe and he said yes very safe.


frijole-Thank You for the kind reply.I will keep everyone updated.

Anyone know if I should still give her more presidone on Monday?It says to give one a day as needed?

Hope I didn't miss anything.I am so stressed right now with all this.Blessings to all your pets going through cushings its so hard to see our little pets like this.

[StarDeb55]

Sorry, meant the the Cushing's symptoms. When it comes to giving the prednisone, I think you will need to see how Amy is doing. If she continues to act like her usual self, great, but if she starts acting lethargic, nausea, diarrhea, or any symptoms like she has already had, give her the prednisone. As I mentioned, the prednisone should give her relief in about an hour.

Debbie

[frijole]

If you don't yet have them you will want to get copies of all tests done to diagnose. If you keep records of all of this it will really help you in the future. Did they do a complete blood panel? The test you described sounds like the low dose suppression test. It is a good test to do for cushings, however, they should also have done an acth test prior to starting lysodren to confirm that the diagnosis. Also since this test measures cortisol, it is used to see how the dog is doing AFTER lysodren as well.

We will help get you up to speed on all of this. Hang in there. Kim

[tango]

I just have to post be very careful with the lysodren and make sure you are watching her very closely and do your research. Our dog Tango was diagnosed with cushings about a year ago and we tried Trilostene first but it just wasn't working so about 1 month ago our vet recommended that we try Lysodren. We did the loading and then he was taking it 2 times per week. His first stim test after the loading looked really good but then he started to get really sick, really fast. I brought him to my vet and they just said that maybe he had too much meds so to give him the Predisone. I was back at the vet 3 days in a row to the same explanation and then the 4th day I had to take him to the emergency vet hospital because he could no longer keep anything in his stomach and he was very unsteady on his feet. Well at that point we were told that he was given way too much lysodren and had was in addison crisis. And to top it off, we were giving him predisone and medicam together (which were both prescribed by our vet) which completely destroyed his stomach. After staying in the hospital and looking like he was getting better and then numerous trips to the vet we had to say goodbye to him 10 days later because his stomach was just too badly damaged. So I can't say enough to be very careful. I know my dog was 14 years old but it sure wasn't his time to have to go if it hadn't been for the mistakes that took place.

[molly muffin]

I am so sorry to hear about your precious Tango. What a terrible thing to have happen.

I hope you don't mind, that I have set up a new thread for you and Tango using this post. Let me know if you would like the title changed. Your experience could help others.

Your thread is located here: http://www.k9cushings.com/forum/showthread.php?t=5720

[frijole]

I'm glad you found us and please know we will honor your Tango's memory forever.

I used lysodren for 4 1/2 years and without a doubt getting the dose right and following instructions and testing are very important. Like any drug - even aspirins - too much can be fatal. It's so hard to look back but know that you did all you could and Tango is now free of any and all pain. Thanks for sharing your story. Kim