Newby - 11 y/o, 58 pound, female English coonhound (Vetoryl)

[jesse'smom1001]

Hello. I would like to introduce Jesse, my 11 year old, 58 pound, female English coonhound. Recently diagnosed with pituitary-type Cushings, we will be starting Vetoryl Friday. I am apprehensive.

She has a history of hypothyroidism, hypertension, and elevated liver enzymes. Liver values were held in check by Denamarin until our last visit. They were so high the vet determined it was time to retest for Cushing's. Jesse had ACTH pre- post- in august 2008. Results were normal per the vet. These were repeated this month and were still normal, although double the prior reading. However, since Jesse has all the clinial signs and symptoms and the vet states there is a 60% false negative rate on the lab, she determined we needed to do the next level of testing. Her dexamethasone suppression values are: pre 9.8 post, post 4 hr dex 0.5, post 8 hr dex 5.6. Vet says this indicates pituitary type. She is starting on 30 mg Vetoryl, lower than recommended, to avoid side effects. We will redo ACTH on day 10. The vet thoroughly discussed risk, benefits, lifespan. She gave me prednisone to keep on hand to use if Jesse gets into crisis, i.e. lethargy, vomiting, diarrhea, inappetance. I am to call the on-call vet, stop the Vetoryl, then administer the Prednisone.

Are we on track so far? Jesse has not had abdominal ultrasound and I wonder if I need to ask for that. She has a little arthritis for which she takes Glycoflex II and I am worried symptoms may worsen once her body undergoes the cortisol-withdrawal the Vetoryl will cause.

You all are so knowledgable I am anxious for your opinion about her treatment pan. Thanks so much.

[mytil]

Hi and welcome to our site.

I wanted to offer this link we have in our Resources section on Vetoryl - http://www.k9cushings.com/forum/showthread.php?t=185. I know other members who have direct experience with it will chime in shortly.

The ultrasound will determine the condition of the adrenal gland and other organs and is typically one of the diagnostic tools used. I think your vet is going by the statistic that 85-90% of the cases are pituitary dependent.

Terry

[labblab]

She has a history of hypothyroidism, hypertension, and elevated liver enzymes. Liver values were held in check by Denamarin until our last visit. They were so high the vet determined it was time to retest for Cushing's. Jesse had ACTH pre- post- in august 2008. Results were normal per the vet. These were repeated this month and were still normal, although double the prior reading. However, since Jesse has all the clinial signs and symptoms and the vet states there is a 60% false negative rate on the lab, she determined we needed to do the next level of testing.
Hello and welcome from me, too!

Thank you so much for what you have already told us. However, the one missing puzzle piece for me is a description of Cushing's symptoms other than the elevated liver enzymes. It sounds as though Jesse does have other classic symptoms? If so, then I do think your vet is "on track" procedurally. If not, then I would be more concerned about the possibility that some other illness may be causing the liver abnormality and falsely elevating the LDDS result.

What your vet has told you is correct. The LDDS is less likely to miss diagnosing Cushing's in a dog who really does have the disease (the ACTH is particularly bad at diagnosing adrenal Cushing's). Also, Jesse's LDDS results are indeed consistent with the pituitary form of the Cushing's. In my opinion, your vet's Vetoryl protocol is also exactly "right on." So as I say, my one real concern is in making sure that Jesse does fit the symptom profile of a Cushpup. Otherwise, everything else is more suspect due to the fact that the LDDS is the more likely of the two tests to be elevated in the presence of other nonadrenal illness. Since you have two diagnostic tests with two different results, the challenge lies in determining which one is actually accurate in terms of Cushing's.

I do agree that an abdominal ultrasound is also a very helpful test. Not only to help confirm the Cushing's diagnosis, but also to make sure that there are no other internal problems that may be contributing to Jesse's issues or that may present additional problems along the way. The adrenal glands are difficult to visualize accurately, however. So to be helpful, high-resolution equipment is required. And this most often necessitates a referral to a specialist. Have you talked at all with your vet about having an ultrasound performed?

Marianne

[Squirt's Mom]

Hi and welcome to you and Jesse! :)

I want to share with you our story. Squirt was diagnosed with PDH based on five Cushing's specific tests - LDDS, HDDS, ACTH, UTK panel and ultrasound...all positive. However, when I had a second ultrasound done a splenic tumor was found. Once that tumor and part of her spleen were removed, her cortisol returned to normal and has remained within the normal range since. The tumor was removed in Sept. of '08. Her last UTK panel did show that the cortisol is rising again but still within the norm.

IMHO, the abdominal ultrasound performed on a high resolution machine is one test all pups who are suspected to have Cushing's should have done. Not only will it allow the adrenals to be seen but other organs such as the spleen, liver, kidneys, intestines, stomach, and gall bladder can be seen as well.

Cushing's is probably the most difficult disease to diagnose as so many other conditions can cause the same signs seen in Cushing's PLUS cause the cortisol to rise, resulting in positive test results when it is a non-adrenal problem, like Squirt's spleen. Cortisol is the body's natural response to any stressor - external or internal - so ruling out as many other reasons as possible for elevated cortisol is vital IMHO. In my heart, I know if I had started treatment on Squirt based on all her positive tests, she would not be here today. That U/S saved her life. ;)

Squirt is also on the GlycoFlex but hers is the III. She has had 2 patella surgeries and has arthritis. It seems to help more than any other joint supplement I have tried. Of course, she is also taking fish oil and Vit E, which I also believe helps with her mobility. This HUGE bottle we have will last forever, it seems like, since she only gets 1/4 tab a day! You may see some increase in arthritis stiffness and pain as the cortisol is lowered since it is a natural anti-inflammatory so don't be upset if that happens. There are other things you can do to help Jesse with that like other supplement, herbs, acupuncture, and TTouch. ;)

You are off to a great start! It sounds like your vet is right on with the Trilo treatment protocol and I am so pleased to see they gave you prednisone and talked with you about what to expect! :) That is GREAT! Too many times we see where a vet has said your dog has Cushing's then throws some drugs at Mom or Dad and leaves it at that. It is so nice to see a vet who takes the time to help us humans help our babies! :D

Keep your chin up! Cushing's is NOT a death sentence. You have found a great bunch of folks here who have knowledge and first-hand experience they are happy to share. And you will find that the support from our members is unparalleled. You and Jesse are not alone. We will be with you every step of the way.

I am glad you found us and look forward to learning more about the both of you as time passes.

Hugs,
Leslie and the girls :D - always

[jesse'smom1001]

Thanks so much for the reply. I am so pleased to have your vote of confidence for my vet. Jesse's symptoms: polyuria, polydipsia, polyphagia, potbelly, multiple benign lipomas, panting, recent UTI, and numerous small, hard, keratinized growths all over. I know there is a technical term for these but I have forgotten it. She has not lost any hair yet but her elbows have always been calloused. Behaviorally she has always been thunderstorm-phobic. She has always been easily excitable. This has caused some pack-management issues but I don't want to get into that now. But it was those behavioral issues that prompted her first ACTH challenge 2 years ago. I forgot to mention that she had urinalysis with her recent tests and the specific gravity revealed she was not concentrating her urine. I don't have any of these specific values but I know my vet would be happy to give them to me. Again, thank you so much for your help. This site is great.

[jesse'smom1001]

@Squirt'sMom: The vet mentioned "Oh, we may need to get an abdominal ultrasound" at the end of our consult to discuss results. I didn't pursue it and should have--I think I felt I had taken enough of her time with my numerous questions. Also, I inherited my dad's toy poodle after he passed and last year, to summarize, she got into a crisis, had splenectomy for hemangiosarcoma and died right when she woke up from the surgery. So there may have been some denial on my part--wanting to avoid looking internally, fearful what else we might find. Denial is a powerful force!

So I would appreciate your advice--the vet scheduled us to start the Vetoryl the Friday after Thanksgiving so we would not be in the middle of that holiday if Jesse experienced a crisis. Should I postpone starting the protocol and ask for the ultrasound? Can I start meds Friday and do the ultrasound next week?

I don't know if her equipment is high-resolution. I live in a community of 200,000 and I do not believe we have an internist here. Most of our docs are Texas A&M grads and I know other owners who have been sent there for sophisticated treatments we don't have here. But in the past Doc has done ultrasounds of Bitsy poodle's abdomen and Zoe dachshund's heart and bladder. So what do you think? Thanks so much for your reply.

[Harley PoMMom]

Is Jesse's hypothyroidism and hypertension being treated and controlled by medication?

[jesse'smom1001]

@Harley PoMMom: Yes. Levothyroxine 0.6 mg bid and Amlodipine 5 mg bid. I checked to make sure the Amlodipine is not an ACE inhibitor which would be contraindicated with Vetoryl.

[jesse'smom1001]

"numerous small, hard, keratinized growths all over."

sebaceous adenoma

also history pyoderma, rashes, pruritic dermatitis

[Harley PoMMom]

Ultrasound (U/S) - I feel the ultrasound is one of the most useful diagnostic tools, especially considering it's non-invasive. There is no other tool that can provide so much info and an "inside look" so simply. The U/S is used to evaluate the size and shape of the adrenals, and check for symmetry. If bilaterally normal-sized or large adrenals are visualized in a dog diagnosed as having Cushing's, this is considered strong evidence of Cushing's due to PDH. If one, large, irregular and/or invasive adrenal is visualized and the opposite is not seen, adrenal tumor may be suspected. If adrenal tumor is identified, it's an excellent screening test for hepatic or other organ metastasis, or invasion of the vena cava. In addition, it evaluates the abdomen for any unexpected abnormalities urinary calculi, masses. It views the liver, gall bladder, etc; many Cushing's dogs have gall bladder sludge.

Not all ultrasounds are created equal. A good quality ultrasound/interpretation depends on a few things; the tool used, the technician performing it, and the physician interpreting it. There is a great difference in the quality of U/S machines. Is it a human grade (Phillips, GE, Siemens) My gen vet had an old (? brand) that just doesn't have the power to capture crisp, high-resolution images. Some studies are technically difficult anyway, and that accompanies with a poorer quality tool, results in a poorer image. The technician; most will perform their own and therefore, it should be those most experienced with capturing good windows and images. That would be a board certified radiologist or board certified Internal Med Spec. Likewise the one interpreting it should be the most experienced as well, and that's one of the 2 above. In addition, you could get a copy on disk and always have it over-read by another. Just my opinion.

Love and hugs,
Lori

[Squirt's Mom]

Hi again,

As for whether you should start the Trilo before having an U/S is something you and your vet will have to decide. If they and you are confident in the diagnosis and fairly sure there is nothing else going on internally, then you can be pretty comfortable not having one done prior to starting treatment. If you would be more comfortable covering your bases before starting treatment, then there is no reason to rush as Cushing's is a slow progressing condition giving you plenty of time to have an U/S done.

I am just a tad bit anal about things and wanted to make sure of what we were dealing with before I started Squirt on either drug so I had her tested from A-Z and back again. :rolleyes: In light of everything, I am very glad I did.

I don't know if the Trilo would have any affect on the appearance of the adrenal glands like the Lyso would or not. I expect it could change the size of them once treatment starts (shrinking them some).

As for dreading what the U/S might disclose, I so understand! I was feeling the same way and a friend here told me that it is always better to know more than less. ;)

Hugs,
Leslie and the girls :D - always

[Harley PoMMom]

Ultrasonographically, adrenal glands increase in size during trilostane therapy, a not
unexpected finding as the negative feed-back mechanism is lost during decreased cortisol production.
This is in contrast to the reduction in adrenal gland size that was observed in dogs treated with mitotane

http://www.fincaverde.de/Pics/study/AMantis.pdf

Also wanted to add that my boy Harley's pancreatitis was dx'd via an ultrasound...talk about a shocker! He showed no symptoms of pancreatitis and the U/S showed that he had prior bouts of it. I had a spec PL test to confirm the pancreatitis and those results were 528 ( 0-200) :eek::eek:

Harley has elevated blood pressure which is being controlled by Amlodipine and Benazepril.

We are here for you, so ask all the questions you want, ok?

Love and hugs,
Lori

[jesse'smom1001]

Jesse's first dose of Vetoryl was 2 hours ago. So far no incident. I mistakenly quoted her dosage. It is 60 mg which is half of the insert's recommendation of 120 mg.

[Squirt's Mom]

Let us know how things go for Jesse with the treatment as you progress! I am sure you will do just fine.

Hugs,
Leslie and the girls - always

[apollo6]

Welcome from Sonja and Apollo
Apollo has been on a very low dosage of TRilostane since June 2010 and is doing well. Just some encouragement. It can get very overwhelming at times.
Hugs Sonja and Apollo

[jesse'smom1001]

Thanks, Sonja. That helps a lot. Your Apollo pic looks just like my Zoe dachshund!

[jesse'smom1001]

Just wanted to check in and say we are on day 4 of Vetoryl with no problems. It may be wishful thinking, but I believe Jesse has slowed down a bit on her water consumption today. She is still spending her mornings "treeing" squirrels and birds (in the absence of any raccoons, LOL) in "her" magnolia tree. So far, so good. I do have one question. It seems an unintended consequence of therapy is possible growth of the pituitary tumor. Does this happen always? And with both benign and malignant growths? Is there any way to predict the path this will take? Any diagnostic tool ? I am wondering about somehting less than an MRI. I just hate to think about her developing neurological symptoms so I am wondering about prevention. Or is this inevitable?

[labblab]

I'm so glad to hear that Jesse is doing well! I'll be keeping my fingers crossed for continued success...:) ;)

As for pituitary tumor growth, I don't believe there are yet clear answers to your questions. For example, here is a link to a fairly recent Japanese research study that does suggest the possibility of a correlation:

http://www.ncbi.nlm.nih.gov/pubmed/19041802

But as of yet, I don't think enough research has been completed to thoroughly understand or assign actual increased risks for neurological abnormalities to develop in any given dog. If an owner does want more feedback about the size of their own dog's pituitary tumor, I believe that CT scans or MRIs are currently the only available imaging tools.

I am especially understanding of your concern in this regard, because I lost my own Cushpup to what we believe was an expanding macrotumor. After several months of effective trilostane treatment, he developed serious neurological abnormalities that became life-threatening. Although we lost him before completing imaging diagnostics, we and the vets assume that a macrotumor was the issue. Although there are times when I wonder whether his treatment may have hastened the tumor growth in some way, I would still have opted for Cushing's treatment, regardless. Prior to treatment, his quality of life was degenerating daily. He was miseable, and losing energy and muscle mass before our eyes. That was a certainty. And so in my mind, the good days that we gained through treatment more than offset any days that we may have lost through tumor growth.

Marianne

[jesse'smom1001]

Thanks, Marianne for the article and the info. And thanks to the moms of Mytil, Squirt, Harley, and Appolo for the support and info. Thanks for your willingness to share your knowledge and experiences with all of us who are new to this insidious, grim disorder.

I think I am wanting a crystal ball and a magic wand. It makes me feel helpless to realize I must take a deep breath, trust the vet, and wait for the disease to evolve. But you all are so great for pointing out where I can be proactive and where I have to be still and wait.

Marianne, that must have been tough to see some improvement then have new problems crop up. Thanks for sharing what must be a painful memory. I am anxious to report back on Monday and share the updated lab values and get your opinion. And thanks to you and the others I can speak more coherently and intelligently to the vet about Jesse.

[jesse'smom1001]

ALKP ALT Pre-ACTH Post-ACTH T4 B/P Weight

11/20/2007 347 194 49.8
6/11/2008 427 155 51
8/22/2008 4.2 13.1
9/15/2010 848 187
11/9/2010 9.6 17.9 4.2 5 8.8
11/16/2010 5 7.8
12/6/2010 992 167 8.5 10 175/90 59.4

[jesse'smom1001]

Please ignore previous post. I tried to clean it up, then edit, then delete and obviously I do not know how to do any of these things.

bottom line: blood pressure is high, liver enzymes have not improved.

ACTH stim as follows: Pre Post
11/9/10 9.6 17.9
12/6/10 8.5 10

Doc says stay on Vetory 60 mg, retest in 10 days.

Jesse had UTI--it has cleared up but now we suspect bleeding from vaginal vault. Next time we will do ultrasound of bladder. There are droplets of blood after she urinates.

What else can I do for my Jesse girl?

[labblab]

I'll leave it to others to comment about the blood pressure, because I'm not very knowledgeable about high blood pressure in dogs. As for the liver enzymes, they can take some time to improve after a therapeutic cortisol level has been obtained. And some dogs never have levels that return to normal, even after extended treatment. That usually does not cause big problems, though.

However, the key here is reaching a therapeutic cortisol level. And at this point, after a month of trilostane treatment, Jesse's post-
ACTH cortisol level has dropped from 17.9 to 10 ug/dl. We do know that cortisol levels continue to drift downward during the early days of treatment, but the manufacturer of Vetoryl recommends a dosage increase in the event that the cortisol level has not dropped into therapeutic range after the passage of a month. So I am wondering as to why your vet is wanting to continue with the 60 mg. for another ten days. ACTH tests are not cheap :(, so I just hate to see you shouldering that expense without the benefit of having altered Jesse's dose at all...

How are her symptoms of thirst, urination, hunger, etc. doing? Per Dechra's U.S. Product Insert, the ideal post-ACTH treatment range falls within 1.45 - 5.4 ug/dl. But as long as symptoms are well-controlled, a result up to 9.1 ug/dl does not necessitate a dosing increase. So if Jesse's overt symptoms have all resolved, perhaps your vet is thinking that she may end up being close to that 9.1 ug/dl ceiling in another ten days. But if Jesse's symptoms are NOT yet resolved, then I'd wonder why her dose isn't being increased now. We may have already given you this before, but here's a link to that Product Insert with Dechra's dosing and monitoring guidelines:

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

Marianne

[jesse'smom1001]

Thanks, Marianne. I left out the fact that Jesse was only on day 11 of Vetoryl when tested yesterday. (I tried to put this info in my edit of my previous post but screwed that up somehow.) Vet told me she started low because of all of Jesse's other medical problems. But, yes, the test is expensive! Doing lab tests this year instead of the week at the beach I had hoped for!

Her water consumption and urinating has decreased somewhat. Still wants to eat everything that isn't tied down. Her liver enzymes: ALKP 992, LT 167. I will be patient and not worry about those.

BP was 175/90, even after increasing her Amlodipine a bit, so we are increasing it again.

Thanks again, Nancy

[labblab]

I left out the fact that Jesse was only on day 11 of Vetoryl when tested yesterday. (I tried to put this info in my edit of my previous post but screwed that up somehow.) Vet told me she started low because of all of Jesse's other medical problems. But, yes, the test is expensive! Doing lab tests this year instead of the week at the beach I had hoped for!

Dear Nancy,

Thanks so much for clarifying! Then, yes, I agree that your vet is on exactly the right track as far as leaving the dose alone for the time being :).

Marianne

[jesse'smom1001]

Thanks Marianne. In the battle of wits between me and technology, I lost again today. I hope I will learn how to post on this forum soon.

FYI I spoke with vet at length about Nelson's syndrome and she gave me a list of neurological signs to watch for. Said she has never had this complication occur. She was so kind to sit and answer all my questions while her busy practice was whirling around her. I feel fortunate to have her as an ally.

Nancy

[jesse'smom1001]

GOOD NEWS

We are on day 21 of Vetoryl 60 mg qd.


ACTH stim as follows: Pre Post
11/9/10 9.6 17.9
12/6/10 8.5 10
12/16/10 Invalidation 5.6
lab will rerun

Instructions are to remain on same dosage for 10 days, then start 2 days on 1 day off schedule of administration. Retest in 30 days.

Yay!

The droplets of blood I have observed after she urinates are decreasing. Doc says it could have been secondary to hypertension or just irritation from sheer volume of liquids passing though. We are doing watchful waiting on that problem.

I am very encouraged by her progress. Water intake has greatly decreased. It's all good!

[Squirt's Mom]

Hi Nancy,

Great news! :cool::cool::cool::cool: So good to hear that Jesse is doing so well! :D I hope you continue to see improvements all 'round!

Hugs,
Leslie and the girls - always

[jesse'smom1001]

Thanks Leslie! I am breathing a sigh of relief right now.

Thanks,

Nancy

[BestBuddy]

Hi Nancy,

Did you gt told why the last test was invalidated? Regardless it is looking good that Jesse is improving.

Unusual with the 2 days on and one off but I have heard that this regime has been used on a couple of dogs. Was there any reason why this was the plan?

Jenny

[jesse'smom1001]

Re: invalidation It was an error message generated by the equipment used to run the results. No explanation beyond that but a sample will be rerun this afternoon. I will call for those results tomorrow. For about 2 weeks Doc has done the ACTH in-house. The first couple had to be sent off.

Didn't really discuss the rationale for the 2on/1off plan. When I had my first consultation with Doc she stated Jesse would be maintained on the lowest dose possible. Stated might try every other day dosing eventually. If this is so unusual do I need to question Doc further? I have noticed on this forum other dogs are on b.i.d dosing. Now I am wondering how many have experience with this on/off schedule.

Man, there is really a steep learning curve on this Cushing's stuff!

[Harley PoMMom]

BP was 175/90, even after increasing her Amlodipine a bit, so we are increasing it again.

Thanks again, Nancy

Hi Nancy,

My boy Harley has high blood pressure that is being controlled by amlodopine and benazepril.

Does Jesse get nervous or antsy at the vets? There is a condition called "white coat syndrome" where patients have high blood pressure in the doctor's office but nowhere else or their blood pressure is higher than it normally would be, still high but not as high.



We are on day 21 of Vetoryl 60 mg qd.


ACTH stim as follows: Pre Post
11/9/10 9.6 17.9
12/6/10 8.5 10
12/16/10 Invalidation 5.6
lab will rerun

Instructions are to remain on same dosage for 10 days, then start 2 days on 1 day off schedule of administration. Retest in 30 days.

I am very encouraged by her progress. Water intake has greatly decreased. It's all good!

I, too, am concerned with this protocol of 2 days on and 1 day off, did your vet go into detail as to why they are doing this?

Love and hugs,
Lori

[labblab]

Hi Nancy,

I, too, am really glad to hear that Jesse's symptoms continue to resolve. But like Jenny and Lori, I'm puzzled by the new dosing protocol, especially since it seems as though you are still awaiting the actual results of this most recent ACTH test. Given our experience here, it is really an unusual dosing schedule, and I do believe I would question your vet further as to the rationale. We have had a couple of instances of every other day dosing, but to be honest -- that really didn't make sense to me, either. If it seems as though Jesse's dose is too high, I don't know why your vet wouldn't want to just lower the daily dosage while still keeping it consistent from day to day. :confused:

Is your trilostane in the form of 60 mg. capsules/tablets, and do you have a whole bunch of them? Maybe the on/off dosing is a way to keep you from having to reorder a new batch of meds in the event that the dose is too high? But the other part that also seems weird to me is how your vet would decide to make this shift before she even has the ACTH results. As I say, if it were me, I'd want to know the purpose of this dosing change...

Marianne

[BestBuddy]

I think doing the lowest dose to give good results is great.

I am not sure who here has done the on and off schedule and I only know because when we were treating Buddy his specialist said he had a few dogs on strange dosage schedules. It was an option for us to consider and with Buddy's other health issues may have worked for him.

I don't even know if there are any testing results documented but like everything each dog is different and it is great if you have a vet who is willing to work with you and Jesse to get the right results.

It will be interesting to see those numbers from this last test.

Jenny

[Squirt's Mom]

...then start 2 days on 1 day off schedule of administration

I just flat missed this part! :rolleyes: This is not typical protocol for Trilo treatment. Once a pup is on Trilo, they stay on it daily so this is a bit odd. Did you vet say why they were going to use this approach VS the established protocol? Not to say it won't work, it just isn't what the manufacturer or UC Davis recommend.

Hugs,
Leslie and the girls - always

[jesse'smom1001]

Marianne, the pre test is the one that invalidated, the post result ws 5.6. To everyone--there really was not an explanation about the rationale for the dosing change. How aggressive do I need to be to question her about this? Am I the only one who has ever been told to do this?

Lori--I don't think Jesse has white coat syndrome but she is just jittery in general. And--if there are yappy dogs in her immediate vicinity it makes her really nervous. The vet tech always documents if Jesse was upset by a neighboring yapper. I asked the vet if dogs are like people in that the first number often reflects anxiety, and she said somewhat but it was still way too high for her comfort.

[BestBuddy]

I think it would be a good idea to at least ask why this dosage schedule. What reasons there are and if there are studies about it.

I tried searching for info on vetoryl dosages and couldn't find anything other than the usual once or twice a day online. I am only going on memory about the different dogs my specialist had many years ago, I do remember he had one dog on an every 18 hour. When this was happening it may have been before trilostane could be compounded here.

If it is that Jesse needs less than 60mg daily then the best solution would be to get it compounded into smaller tablets, eg 40mg.

Jenny

[jesse'smom1001]

Thanks, Jenny. I have a call in to the vet but I may not hear from her until Monday. I will keep you guys posted. Thanks for all the info!

Nancy

[labblab]

Hmm....if the "post" result of 5.6 was accurate, that is a GREAT result. So coupled with Jesse's symptom resolution, I'm even more puzzled as to why your vet would not want to just "stay the course" on her current dose. But she's the one who is aware of Jesse's whole big picture, so maybe there's a piece of the puzzle that we're missing. I'll really be interested in finding out what she says.

Marianne

[jesse'smom1001]

The vet just called saying she re-ran Jesse's samples from last week and they are right where she wants them to be: Pre 5.8 and Post 5.6 on her last ACTH stim. I am taking Finley dachshund in Thursday for annual exam and will have a chance then to ask about the Vetoryl dosing schedule. I am so pleased with Jesse's progress clinically-she has cut her water consumption and is a little less aggressive attacking her food. I don't hear her up in the middle of the night taking long slurpy drinks of water. So far so good! Thanks again everyone for the info and support.

Nancy

[jesse'smom1001]

Been a while since I last checked in. Jesse is recovering from surgery 2 weeks ago--had half of her bladder removed to resect transtional cell carcinoma at apex of bladder. My doc and 2nd opinion vet said we were very lucky--those usually occur at the neck of the bladder and are inoperable. Next step is chest xray to rule out lung mets. On deramaxx until then. She is back on her daily Vetoryl--liver enzymes are slowly coming down and blood pressure is back in normal range. Has next ACTH stim and T4 mid-May. It has been quite a ride but I am pleased with her progress so far. She is playing like a pup again. THANKS to everyone for the concern and support!

[lulusmom]

Hi Nancy,

Thanks so much for the wonderful update. I am thrilled to hear Jesse is doing so well. You've made my day!

Glynda

[jesse'smom1001]

Thanks Glynda!