Darby - (13 y/o female cocker spaniel)

[teri]

Hi! I'm new on here but glad I found you. Have 13yr. old female cocker spaniel. Noticed increase in appetite, thirst, panting and more frequent pee trips. Panting got worse so consulted vet. He ran a bunch of te$t$ and kept wanting to do yet one more te$t and another. I finally switched vets and he suggested they do the ACTH test. Got that done and her cortisol level was 74.1 started her on Vetoryl 60mg. one daily. got retested and level had dropped down to 24.1 normal rate should be 5.1 to 22 (so they said). Last Wednesday evening she didn't eat all of her meal. Now, this is a food aggressive dog and doesn't miss ANYTHING! I knew this was not normal behavior but she repeated this for her evening meal thru Sunday. Then today (Monday) she didn't eat her breakfast meal. I called the vet and they asked to bring her in. Did that and after doing some blood work found out her body had over corrected itself and now she has Addisons. Kept her for the afternoon to have some i.v. fluids. Brought her home this evening with same panting, thirst, outside trips, but she did eat her dinner meal. Have to take her back in tomorrow to have another i.v. drip again. Need to start her on prednisone 2 1/2 mg. every day and also Florinef every day. Will start the prednisone but will get the rx for other filled Tuesday and will start. I'm wondering if she'll be o.k. for awhile. Learned so much from reading comments on here. Darby is resting, has been barking at me (for no reason but I enjoy it) still pants while awake. She sleeps with me and we've been going 7-8 nights without sleep. Now I need to be medicated...zzzzz Got some sleep this weekend but from what I'm reading it kind of sounds like Addisons can be reversed back to Cushings? I'm a little confused about all this. Need a little support group to help me with this. Any info would be greatly helpful. Will talk to vet again tomorrow. Many thanks and God Bless all of your dogs and their humans......teri

[sunimist]

Hi Teri, and welcome to you and Darby.

Could you give us the last ACTH results? How low did her cortisol drop? And more importantly, what were Darby's electrolytes? If the vet didn't check them, it would be a good idea to get that done really soon. If the electrolytes are normal and have not been affected by the drop in cortisol, I would think prednisone would be all that's needed right now. However, it sounds like maybe they were affected since she is on IV and is prescribed Florinef. Anxious to know.

It's hard to say how quickly the numbers might rebound. When my girl turned addison's, she never did rebound, so it's just a wait and see cause every dog is different and reacts differently.

Please post as much information as you can with actual numbers and if you don't have copies of the test results, you might want to ask your vet to fax them to you. We are great believers of keeping a personal file for our own review.

Please keep us posted.

Shelba and Suni~~

[Casey's Mom]

Hello Terri, welcome to you and Darby. Glad you stopped the Vetoryl and that you took her to the vet today. We have all learned to read our dogs and go by what they tell us because we are their advocates and their first line of communication.

The others will be along to offer more knowledge and advice, just wanted to welcome you and tell you that you are not alone on this journey.

Love and hugs,

[teri]

Thank you for the warm welcome. The vet said her potassium was out of kilter so I assumed they gave her potassium but after reading more on the addisons and some of these comments, I'm wondering if the potassium was too high. I'll find out this morning what i.v. she is getting. She seems to have improved some. Definitely inhaled her breakfast (as usual) this a.m. and not panting quite as much now. Thank you for your kindness, support and information. Will try to find out more of the figures and post later. Have a sunny day! teri & darby

[Casey's Mom]

Good luck today Teri - let us know what happens.

Love and hugs,

[Squirt's Mom]

Hi Teri,

Welcome to you and Darby! :)

Wow! Ya'll have had a rough start! :eek: I am curious about the tests the first vet ran and what those results were as well as the ACTH's he has had done to date...the actual results of those tests. Please include the units of measurement (ug/dl, mnol/L, ect) and the normal ranges for each value that either high or low.

It makes me very nervous when a pup starts treatment based on only one test. Cushing's is a very difficult condition to diagnose for several reasons. One is that many other conditions mimic Cushing's like diabetes, hypthyroidism, liver disease, and other non-adrenal illnesses. My Squirt had every test available for Cushing's and all were positive - BUT an ultrasound found a splenic tumor and once it was removed, her cortisol returned to normal. So even with multiple positive testing, she apparently does not have true Cushing's.

We have seen many pups misdiagnosed over the years and for this reason, among others, we really like to see the actual test results. Cushing's is not a condition that progresses rapidly so there is usually plenty of time to make sure of what you are dealing with. Yes, the initial testing is expensive but once a firm diagnosis has been made, costs drop.

Addison's is the opposite of Cushing's. A Cushing's pup's body is over-producing cortisol or other hormones, causing damage to organs, muscles, etc. In an Addison's pup their body is incapable of producing cortisol and cortisol in correct levels is vital to the functioning of the body. In a cush pup, the goal is to lower the cortisol to a more normal level; in an Addison's pup, the goal is to create imitation cortisol with the use of prednisone and other steriod meds along with electrolytes of which potassium is one. In Addison's, the electrolytes are also out of whack.

The drugs used to treat Cushing's, Trilostane (Vetoryl) and Lysodren (Mitotane) can cause Addison's if the dose is too high by damaging the adrenal glands. Sometimes that damage is temporary and the glands regenerate but sometimes it is permanent. This is why thorough testing and a cush savvy vet is so important.

You have found the very best place to learn about Cushing's. The collective knowledge and first hand experience here is astounding and the support is unmatched. I don't know what Squirt and I would have done without the many hands holding us up over the last 2 years. We are a family here and I am glad to have you and Darby as members of our family. :) You and Darby are not alone; we will be with you every step of the way.

Keep your chin up!
Hugs,
Leslie and the girls - always

[jrepac]

usually, they bounce back after stopping the meds and administering the IV fluids

sounds like you may be better off with a lower dose of vetoryl...

which would not be uncommon

some feel it is better/easier to let the cortisol level run a little on the high side rather than over-correct, which results in Addison's and a dog that cannot move...

again, every case is a bit different

[MyRudy]

Teri:

You have come to the right place! I am new here too and my dog, Rudy, was on Vetoryl 60 mg for 11 days when I had to stop the medication because he appeared to crash from too little cortisol. I believe his dosage was too high and am now going through round 2 of tests with another vet and closing in on $2,000 spent trying to figure out this danged disease.

My dog also had a post-stim of 42, which from what I understand so far is pretty darned high, but your dog had a 72????. Yikes! How old is Darby and what is his weight?

We'll be interested in your numbers and further results and best of luck!

Donna

[apollo6]

Dear Teri
Welcome read my thread-Apollo trilostane. It concerns me also that the vet would put your dog on this medications with out the correct tests:
a full blood panel, an adominal ultrasound, then determine if and what kind of cushing Darby has? It took me from September until June until I even considered Trilostane, not without researching, getting the right tests and see an internal medicine specialist knowledgeable in Cushing. Only when you can diagnose which form of cushing Darby has then do the ACH STIM test to decide on treatment. I looked at the company's web site Decha, researched dosage, side effects, etc.
We'll will ask how much Darby weighs, this is very important as to dosage. But once again it surprises me that Darby was put on Trilostane so fast. Side effects are loss of appetite, if over dosage, to fast a drop in cortisone. I discussing with Vet. The vet wanted to start Apollo on 30mg, after members said felt too high, consulted with Decha vet and said to start at 10mg.
We are here to help.

[addy]

Hi Teri,

Hope Darby is feeling better today. I have not yet had a chance to say hi and welcome so wanted to do so now.

I am very good at moral support so whenever you need some, just let me know:) Actually, everyone here is so great at being supportive, so just remember we are only a click away. Well and then sometimes we all feel like we are only a "tick" away. Just kidding, but I could not resist the pun.:D:D:D

Addy

[Harley PoMMom]

Hi Teri,

A belated welcome to you and Darby from me and my boy Harley! I am so sorry for the circumstances that brought you here but so very glad that you have joined our family, we will help you and Darby on this journey.

It would really be a great help to us if you could post the dates and the results of all tests done on Darby. This enables us to give you better feedback about your precious girl.

According to Dechra's Product Insert Label:

PRECAUTIONS:
Hypoadrenocorticism can develop at any dose of VETORYL Capsules. In some cases, it may take months for adrenal function to return and some dogs never regain adequate adrenal function.
http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

Please know we are here for you and Darby so ask all the questions you want and we will answer them the best we can, ok?

Here is a link from our Resource Thread with info about Vetoryl/Trilostane: http://www.k9cushings.com/forum/showthread.php?t=185

Love and hugs,
Lori

[teri]

Hello all! First of all I do need to let you know that Darby was going to a vet we've been seeing for about 9yrs. He did lab work (blood & urine) ultra sound and x rays. I kept spending more $$ and more $$ and wasn't getting any answers and worst of all, Darby wasn't getting any better. I decided to go to another vet who is absolutely wonderful in every meaing and respect of the word. Took all of her history, tests etc so I could see what someone else would think. He examined Darby and the results previously taken and asked about doing the Cushings test. The test result came back that her cortisol level was 74.1 Before I got the test results back a friend gave me a product called Equisano (mushroom powder for horses) so I gave her 1/2 tsp mixed in water and for the first time in some nights she actually stopped the panting and seemed to rest better. I checked out the mushrooms and from what I could tell they were o.k. for dogs to have. I know some are toxic to dogs but they are using some for cancers and having healthy positive results in some cases. Not knowing anything about the Cushings, I was willing to step outside the box and try this product. I didn't think I would have anything to lose and what if it helped? Maybe I could help someone elses' dog. Consulted the vet about this but he couldn't see anything wrong with it but admitted he didn't know anything about hollistic products so it was my choice to try this. That weekend I started giving her EquiSano, she seemed to be a little better. Monday we got the results of the test and started the Vetoryl 60mg. (Darby weights 30lbs.) Now we're treating Addisons with Prednisone and Florinef. Darby seems more alert but of course the water intake is back up again (assuming due to the meds). I have to take her back to the vets office next week to get a recheck. Will get the test results from them then and will post for you to see. Saturday is my 54th birthday and all I want is to have my girl with me. What a great gift!!!! We are going to visit my family in Virginia as the vet said she could travel. My mom is going blind due to diabeties so I think it will be good for all of us to have a nice weekend with family.
According to what I'm reading about Addisons it seems like dogs should avoid stress. And, the the cushings may/may not return. I feel like we're about to get on a roller coaster. At times I feel like I'm circling the drain just waiting to get sucked under. I put on a happy face and enjoy absolutely every second I have with my dog. We have great memories together and we're still making more and more everyday. Might sound a little whacky but really I'm not. Darby is my family. She's the child I never had. Darby taught me to open my heart, learn about dogs, become the truest dogaholic you would ever meet and know and feel what "unconditional love" is. It's never been what I could teach her but what she could teach me and it's volumes! Other humans have told me many times that I have a gift with dogs. It's because of her that I have tapped into it and do things that come naturally to me with dogs.
Thank you all for your interest and support. Will post her results next week when I get them. It's nice to talk to people that know and understand what we're all going thru. A lot of people I speak with just give me the "poor thing" and sympathy trip like Darby is already dead. She's not!!! I know the time will come one day but it's not yet. Each and every dog and case is different but it's comforting to know that there is someone out there that understands my heart and love for my best friend. I hope I can repay your kindness as you have done for me. Truly appreciate all of this! teri & darby

[StarDeb55]

Teri, I want to offer you & Darby a belated welcome! Talk about a rough road, you guys have had one. I have been following your thread since you joined. Unfortunately, now that you have posted Darby's weight & her starting dose of trilostane, it appears she was put on a whopping big dose for a pup her size. Yes, Dechra's recommended range is 1-3 mg./lb body weight, but I believe they are even backing off on this dosage. The Univ. of Calif. at Davis vet school which has one of the world's foremost experts on Cushing's, Dr. Edward Feldman, has developed their own trilostane dosage protocol which is a starting dose of 1 mg/kg body weight, to get kg divide by 2.2. For Darby, this works out to be 13.6 kg, & based on the UC Davis protocol, she probably would have been started on only 10 mg trilo daily. Davis has found that it's much safer to start at a lower dose & work up, than start high. We have also seen in this group that pups who are started on these large doses seem to have a bigger chance of running into trouble. It might be a good idea, if you would take a look at the trilostane information from the important information section of the forum that Lori has already provided you the link.

I'm glad that Darby does seem to be doing better, but want to emphasize the point that there is a distinct possibility that she may be permanently Addison's.

Debbie

[teri]

Took a break from the 'puter as I was getting more and more depressed and stressed with all of this overwhelming information out there on the internet about this disease. Darby is now off of the Vetoryl 60mg. as her potassium bottomed out (had to have two consecutive days of i.v.'s) and her body over corrected itself so now we have Addisons. Taken off of the Vetoryl completely.Now taking Prednisone 2.5mg. every other day and Florinef 0.1mg. daily. Seems to have stabilized except for the panting. Besides my dog, Ambien has become my new best friend. I went eight consecutive nights being up all night, working all day until I was ready to pop! If I were a banjo string and somebody plucked me, I would have just been the loudest BOING you'd ever hear. So now I'm resting better, she still has evenings of panting but I awaken to comfort her, put her out, have water, watch some really, really bad movies on tv at 2-5 a.m.( trust me, you'd be better off to lay in bed and stare at the ceiling most nights), Darby still panting most of the time but she is practically on top of me so I try to get a little sleep. Have turned down the a/c (I'm freezing and paying the increa$ed electric bill) but doesn't seem to matter about the coolness in here. Have all of the fans on 24/7 as well. She does enjoy laying under them (always has) but some days are better than others. We can walk around the apt. complex some nights then other nights are a no go. All in all, every second counts and I realize she's not going anywhere yet. We both can handle what we're doing at this point. She's just happy and looks like she smiles alot so why shouldn't I follow her lead and do the same? We check back with our vet in a couple of weeks.Cushings can return. So for now, ..... Just thought I'd give a little update for now. Thank you! teri

[addy]

Hi Teri,

Glad you checked in. Yup, sometimes putting Cushings in the drawer is the best thing for you. I understand only to well about having to walk away from it all for awhile.

I hope you are getting some sleep. I know I was threatening to take Zoe's melatonin for awhile:D

Hang in there and hope you catch some zzz's tonite.

Addy