Buster, Baby & Chacha

[tatalits]

All three are related (brother/sisters) toy poodles ranging from 9 to 18 lbs, all born Feb 14, 2005. They are only 5 yrs old, diagnosed with cushings just today. Doc wants to start them on 60 mg Trilostane. I also just ordered a Cushing's Kit from Healthy Pet Solutions out of Tucson, AZ. I have been researching on cushings.
Doc does not believe they have tumors. Can someone tell me about trilostane?

[sunimist]

Hi and welcome to you and your babies from another poodle mom!

Your post blew me away! All three diagnosed with cushings? Bless you and them!

I am not very familiar with Trilostane because my girl was treated with Lysodren, but there are many others here who are well versed in using Trilostane and can help you, so hang on. Meanwhile, here is a link to our resources which gives lots of info about Trilostane usage.

http://www.k9cushings.com/forum/forumdisplay.php?f=10

If you could furnish test results that led to a diagnosis of cushings, it would be very helpful for us to offer input. If you don't have copies of those tests, I am sure you could obtain them from your vet for your own personal use. That's what most folks do here.

Again, welcome and please keep us posted on your girls. We will give you all the support available to us.

Shelba and Suni~~

[apollo6]

Welocme.
We will be asking you a lot of questions.
Please hold of on the Trilostane.
How much do they weigh? Which one's are taking?
My Apollo is 10lbs and is only on 10mg now 12.5 mg. Are you sure it is 60mg. Please read below dosage:

Table 1: Starting dose
Weight range (pounds) Weight range (kg) Starting dose (mg) ONCE DAILY
>3.8 to <10 >1.7 to <4.5 10
>10 to <22 >4.5 to <10 30
>22 to <44 >10 to <20 60
> 4 to <88 >20 to <40 120 (2 x 60 mg)
>88 to <132* >40 to <60* 180 (3 x 60 mg)

Do they have the pituitarycushing and have you had the right tests down?
Also we can suggest vet pharmacitical sites to get a good price on Trilostane.
Sonja and Apollo

[frijole]

Hi and welcome from me also! I am glad you found us. We tend to ask alot of questions at first because it really helps us better understand your dogs' situation and help you through the treatment process.

Sonja raised a REALLY GOOD point and that is the dosage. Did you type that right?! Your little ones are small and we have learned from helping lots of dogs over many years that with trilostane you want to start with a LOW dosage and adjust if needed. That dosage could be very harmful.

We have had lots of members with multiple dogs with cushings, myself included and some have had 3... but NEVER have we seen anyone who had all three dogs diagnosed at the same time. It would almost seem to be impossible?!!

Cushings can be very tricky to diagnose and it requires multiple tests. Typically dogs have a blood panel and perhaps a urine test. Then they go through a series of tests to confirm cushings.

Can you please tell us more about your three babies? I love their names by the way. What symptoms do they have and when did it start and what tests were done... the more info the better... Its important we get the whole picture of what's been going on.

Glad you found us... lots of experience here. Kim

[jrepac]

3 at once? all related and the same age?? that is shocking....have you confirmed with a 2nd opinion? have all been ACTH tested? UCCR screening, etc? I would want to be sure that this diagnosis is correct...it is kind of mind-numbing.

Jeff & Angel Mandy

[labblab]

Wow!!! I am struck as speechless as everybody else by the simultaneous Cushing's diagnosis in all three of your sibling dogs (I have never heard of such a thing happening before). And also by the excessively high dose of trilostane that your vet is prescribing. And also by the fact that your vet is telling you that "no tumor" is involved, because the elevated cortisol of canine Cushing's is always caused either by a tumor of the pituitary gland or a tumor of the adrenal gland...

All these things REALLY worry me about the accuracy of the diagnosis and also your vet's experience with the disease!! Can you please give us the specifics about your dogs' symptoms and also the tests that have been performed?

As far as the trilostane, initial dosing is geared to the individual weight of each dog. Dechra is the manufacturer of Vetoryl, the brandname version of trilostane. Per their published dosing chart that Sonja has written out above, your 9 lb. baby should be started off on only 10 mg. of trilostane, and your 18 lb. baby should receive no more than 30 mg. And Dechra is now verbally recommending an even lower dosing formula of 10 mg. per pound -- which would limit the dose even more for your 18 lb. pup (to around 20 mg).

I truly cannot imagine how or why your vet would prescribe a 60 mg. starting dose for your 9 lb. baby!!! It is very important for you to have the chance to read all this information for yourself. So here are some links for you to follow. The first is to the U.S. Product Insert for Vetoryl:

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

The second is to a thread on our "Resources" forum that contains lots of helpful information about diagnosing Cushing's and trilostane treatment and monitoring:

http://www.k9cushings.com/forum/showthread.php?t=185

PLEASE take a look at this information, and hold off on starting the trilostane until you have the chance to clarify your vet's diagnosis and prescription recommendations.

Marianne

[Squirt's Mom]

Hi and welcome to you and your babies! :)

~~GASP~~ THREE at one time! And all from the same litter! WOW! If your vet isn't writing a paper about this, they are missing a HUGE opportunity! There have always been questions as to whether Cushing's is genetic and your babies could contribute to furthering our understanding of this disease.

But, THREE at one time! :eek: Bless your heart, honey! (old lady fainting icon!) :p

I hope you have stopped the Trilo, or have not started it yet as that dose is unbelievably high for your babies weights! :eek: If you have started it, are you seeing any loose stools or diarrhea, lethargy, vomiting, or an increase in weakness? Did your vet give you any prednisone? If not, INSIST he give you some...pred is not an option when treating with either Trilo or Lyso, it is a necessity. Please let us know how your babies are doing today. We worry when we see so many red flags as in your post and like to keep in close contact. Red flags = HUGE dose, saying there is no tumor involved, and their ages (they are awful young for Cushing's, but it does happen).

I am glad you found us and hope to hear from you again soon!

Hugs,
Leslie and the girls :D - always

[tatalits]

Hi Squirt's mom, Labblab, Jrepac, Frijole, Apollo 6 & Sunimist,

Thank you, thank you all from the bottom of my heart!!!! First, the issue with the trilostane dosage: we started them yesterday 1 tablet each when my husband got home from the doctor's office with the trilostane. The directions in the bottle says 1 capsule once daily. And of course the bottle says 60 mg. This morning after reading all your info I became panicked and called the pharmacist at the vet's office who informs me IT WAS A TYPO!! Do you believe this? Since it is the weekend I cannot reach the doctor. Buster (18lbs, male), Baby (9lbs, female), and Chacha (12 lbs, female) are thankfully acting normal today and we are gonna keep a close watch. I am waiting for one of the vets to give us a call regarding this unforgiveable error. I will ask the doctor all your questions when he gets back on Tuesday. I am so blessed to have found all of you and this site is God-sent.

Angie

[frijole]

Whew.. so relieved they are OK. Angie, since you aren't sure what the dosage is in those pills... my two cents...I would not give any more meds until I knew what the actual dosage of those pills is.

When you have time - it would be helpful to know more about the tests done... as you can see... we are all scratching our heads and like :eek: :confused: at the fact that 3 dogs could be diagnosed at the same time.

Because it is often misdiagnosed, for our sanity, please tell us about the symptoms and the testing for your babies.

This is a long shot but we have recently seen a couple incidents where dogs got cushing's from an owner that was using hormone cream. Obviously the cure was to cease using the cream (or put it on a pot that doesn't rub the dogs). Just throwing it out to be safe...

Glad you checked in today. Looking forward to learning more about your little ones. Thanks. Kim

[tatalits]

Its me again, Angie, Buster's, Baby's and Chacha's mom. The doctor tested Buster this way: bring him in the morning 8am for a cushing's disease blood test, dexamethasone injection, cortisol levels x3. We had to leave him there for 8 eight hours. The next day doc reports the results as congenital cushings. All 3 have the same symptoms, loss of hair, thinning skin. Both Chacha (female) and Buster (male)
have pot bellies. Buster, Baby(female) & Chacha are siblings. We got them at 8 weeks old. We noticed the father had hair loss on the back of his thighs, and thought nothing of it. In the meantime we are NOT giving any trilostane until the doctor says otherwise with the right dosage. I just hope they'll be all ok after we gave them 60mg each yesterday!!!

I will be asking our Vet a lot of questions thanks to all of you!!!!

[k9diabetes]

Hi Angie,

When you talk to the vet, ask him to provide you with the actual test results for each dog - preferably copies of the printouts with all of the information included. And then post the results here.

And ask for copies not just of the Cushing's test (LDDS) but any other testing that he did, including full blood panels. You don't have to post all of those results - start with the Cushing's testing and then folks may be interested in other test results later.

All three dogs had the LDDS test that Buster had?

Any other testing done to rule out other possibilities like thyroid disease?

You mentioned diabetes when we initially emailed - is that in the picture too?

Natalie

[tatalits]

I guess the word diabetes was included there when I went to the website, unaware that there is a k9cushings.com. But diabetes is not being mentioned by the doc. Natalie, I'll make sure that all your concerns are addressed by the doctor on Tues. I thank you for making me AWARE! I will post everything the doctor did.

Angie

[tatalits]

Hi Kim,

I am staying home all day just watching my babies closely for any reaction to the trilostane dosage. Also waiting for one of the doctors at the clinic to call so that I can be assured my babies are OK.
He just called and other than diarrhea he says they are fine. So far no diarrhea. Your reply is very helpful and I will leave no stone unturned on further testing. Thanks!!

Angie

[tatalits]

Hi Lesli and the girls,

So far so good, no bad reaction from the trilos, I thank the Lord!!!
Thank you, I'll keep you posted. I am feeling better as I read all the knowledge you are all imparting to me. Thanks!

Angie

[Harley PoMMom]

Hi Angie,

A belated welcome from me and my boy Harley!

Trilostane/Vetoryl has a short half-life and its enzyme blocking abilities start to diminish after 8 to 12 hours.

Diarrhea is one of the adverse symptoms to look for but also look for weakness, lethargy, and/or vomiting.

We are here for you and your precious furbabies so any questions you have, ask them!

Love and hugs,
Lori

[sunimist]

Hi Angie! What a relief to read your post letting us know the babies are alright. What an ordeal to put you through!

I know we all have lots of questions and I know when you are able you will answer all of them, but just a small one right now...were all three dogs given the low dose dex test (8 hr. test), or did the vet base diagnosis of the other two on symptoms Buster was tested for? Just curious.

I think your babies will be OK, but take a little time and evaluate all testing and results and know for sure all three do indeed have cushings disease before treating them. Post your test results as soon as you can and we will help you understand and move forward with confidence. Don't hesitate to ask for copies of all tests done so far. You are entitled to them.

Hang in there..we are here for you.

(((HUGS)))

Shelba and Suni~~

[Squirt's Mom]

Hi Angie,

So good to hear from you and to know that the gang is doing alright! :D

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

[tatalits]

pethelper.com advertises products for canine cushings. I have 3 toy poodles all related and are 8 years old who have been on trilostrane and thyrosine for the past 2 years due to cushings. A year ago, Baby, female, developed diabetes. She gets a daily humulin n insulin once in the morning since June, 2011. 3 weeks ago Chacha, female, suffered low potassium and sodium. The doctor treated her and due back for another blood test. Doc also stopped her trilos and thyrosine. He said chacha's illness is a side effect of trilos and he e's only has seen 2 cases in 13 years, Chacha is the second one.

I wonder if you might have any info on natural treatments for pethelper.com. Thanking you in advance!!!!

[doxiesrock912]

So far, there are no known natural treatments for Cushings. I asked the same question when Daisy was diagnosed.

Some members use supplements in conjunction with prescription meds. I'm sure that they can give some advice though :)

[lulusmom]

Hi and welcome to the forum.

I had two dogs with cushing's and it took a lot of dedicated effort to keep them well controlled so I can't imagine how tough that must be with three of them. I'd really like to hear more about each one of your pups and the problems they've had along the road these last two years. Since all are related and 8 years, would I be correct in assuming they are litter mates? Were all diagnosed at the same time and did they all have the same symptoms associated with cushing's? Was Baby diagnosed with cushing's and on an effective dose of Trilostane prior to the diabetes diagnosis? By effective dose, I mean were acth stimulation tests done to make sure her cortisol levels were within an acceptable range? Acceptable range for Trilostane would be between 1.5 ug/dl and 9.1 ug/dl with resolution of all symptoms? I believe Poodles are high on the list of breeds who are predisposed to diabetes as well as cushing's so it's possible that Baby was just unfortunate enough to be diagnosed with both; however, an uncontrolled cushdog is at very high risk for diabetes.

It sounds as though Chacha's cortisol levels dropped too low which can cause potassium to spike and sodium to drop. You mentioned that both potassium and sodium were low so I'd like to make sure you typed that correctly. I am assuming that your vet prescribed prednisone and florinef? Yes? If her cortisol was too causing an addisonian crisis, it is very important that she not get any more Trilostane until she is symptomatic again and post stimulated cortisol levels have regenerated to at least 9 or 10 ug/dl.

Can you tell us how much each dog weighs and what dose of trilostane they are or were on? If you have copies of test results from when all three were diagnosed, it would be great if you could post them here. By all means, please post the last acth stimulation test results for Baby and Chacha. The more information you can give us, the better able we'll be to try to understand why Baby and Chacha had complications. How about the third sibling? Is he/she doing okay and when was the last time an acth stimulation test was done.

I see that your dogs were diagnosed with low thyroid too. It is very common for a dog with cushing's or diabetes to have low T4; however, most of these dogs do not have primary hypothyroidism but rather something called sick euthyroid. With sick euthyroid, the decrease in thyroid hormone is transient and normalizes once the high cortisol is addressed with treatment. Did your vet wait until your dogs' cortisol was adequately controlled before doing thyroid testing to make absolutely certain they needed to be put on thyrosin?

Sorry for asking so many questions before I answer yours about pet-helper.com, but as Valerie has already mentioned, there really are no effective natural treatments, especially for Baby. I would be very concerned about losing complete control of the diabetes if you were to take her off of Trilostane. I detest these online companies who take advantage of pet owners with their lofty allegations of efficacy for their so called natural products so I have made it my mission to write to every one of them and ask for supporting documentation. So far I've not gotten a single satisfactory response from any of them. That's not to say that their product may not alleviate symptoms but even then, it's only temporary and it never addresses the real culprit, high cortisol. I have not heard of pet-helper.com or their products so I wrote them an email tonight. I've copied and pasted it below. I don't hold out much hope that I will get a response but if I do, I'll post it here. Please note that my two precious pups have passed but they don't need to know that. I want them to think they have a live one willing to pay almost $80 a pop for each dog. ;) Also note that their "Testimonials" should be singular as they only have one and I seriously doubt that particular dog had cushing's. These companies are so bogus!


I have two dogs with cushings who have been treated with Lysodren and Trilostane over the last seven and five years respectively. They have done very well on both but nonetheless, I continue to search for a natural product that will maintain circulating cortisol at therapeutic levels so as to see complete resolution of symptoms and mitigate the adverse impact of excess cortisol on internal organs. Have your products been thoroughly tested for safety and efficacy by way of formal clinic trials, the results of which support your claims? Can you tell me about how your products help improve Canine Cushing Disease symptoms and what you mean by "it helps to rebalance the body"?

I checked your testimonials in an effort to get more information and was disappointed to see only one testimonial about a dog who lost all her hair, was very sick and was not eating well. This is definitely not the profile of a dog with cushing's. Dogs with cushings, not suffering from a concurrent condition, are not sick per se, and they almost always have a huge appetite. Did you verify that this dog was properly diagnosed with cushing's because if not, that testimonial would be highly suspect to anybody who has first hand experience and knowledge of the disease.

Looking forward to hearing from you. Thank you for your time.


Looking forward to hearing lots more about your precious trio.

Glynda

[Squirt's Mom]

Hi Angie,

Welcome back! Man! It's been a while since we heard from you! I merged your new post with your original thread. We like to keep all info about each situation in one thread so it is easier to look back through the history if needed.

Since it's been 2 1/2 years since we heard from you, would you mind filling us in on everything that has been going on with your gang? All test results for each, any problems that may have come up prior to this most recent one, any new meds, supplements, herbs, etc - all the info you can provide would be great!

Hugs,
Leslie and the gang

[Budsters Mom]

Hello and welcome from me too! :)

You have come to the right place! There is a huge arsenal of K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better.

So again welcome to you and Buster,

Kathy and Buddy

[molly muffin]

Hi Angie! Wow, long time, and 3 cushbabies. Holy cow, you must be exhausted sometimes. LOL :)
So fill us in. How have things been doing?

hugs,
Sharlene and Molly Muffin