New to this forum and to Cushing's (Bouncer) 8 y/o male boxer (Vetoryl)

[Clcorcoran22]

Hi,

My name is Cindy. I'm new to this forum and am hoping to find some words of wisdom and encouragement from fellow dog lovers who are also going through treating a dog with Cushing's. I have an 8 year old male boxer (82 lbs) who was recently diagnosed with Cushing's. (His name is Bouncer.) He first started showing signs of being ill back in November. He progressively got worse to the point where I had figured out that it was most likely Cushing's -- excessive drinking and urination, pot belly, joint and muscle weakness in the back end, and constantly hungry to the point where he was knocking down gates to get to trash cans.

My vet has done blood work as well as a low dose dexa scan to confirm that he has the pituitary type Cushing's Disease. He was started on Vetoryl 60 mg 2x a day about a month ago and had his first ACTH test on day 10 (I believe). He had his first ACTH test on day 10 which showed that his dose was too low -- not sure what the actual levels were. His dosage was then increased to 90 mg 2x a day. Right around that time, he started becoming lethargic and acting like the meds were not agreeing with him. He just had another ACTH test on day 13 after the increase. This time his post Cortisol level was 5.8 which my vet said was within a decent range and recommended continuing with the 90 mg 2x per day. I have a call in to the vet though because he has been becoming increasingly lethargic with the meds to the point where he's whining while laying down, sleeping most of the time, and doesn't even really want to get up for food until about the time when his meds are worn off and he's due for the next dose.

I've been researching the side effects of this medication, and I really believe he's having an adverse reaction to the meds? Has anyone else ever experienced this with Vetoryl? I've read some of the earlier posts and saw someone saying that the lethargy usually means that the meds need to be increased. However, I believe he's at the proper dose for his size and don't think he could tolerate anymore. I'd really appreciate everyone's advice and thoughts on this. Thanks!

Cindy
(Bouncer's Mom)

[AlisonandMia]

It sounds like his cortisol could be well too low. With trilostane (Vetoryl) it is not uncommon for the cortisol to keep dropping throughout the first month of so of treatment. For this reason the dose is not usually adjusted after the 10 day stim even if the numbers are still a bit too high. The reason for that stim (at 10 days) is really more to check that the numbers aren't too low or possibly heading too low. If there has been any appreciable drop, even if it isn't yet into the desired range, then the dose should be left as is and another stim done at 30 days. If the numbers are still a shade high (and the dog is symptomatic) then a careful upward adjustment of the dose may be done and another stim done 10 days after that.

To my thinking, going from 60mg twice a day to 90mg twice a day is quite a big jump in dosage, percentage wise, too.

Lethargy is usually a sign of low cortisol - especially when it comes on suddenly. Low cortisol is caused by too much medication rather than too little so increasing the dose would usually be the last thing you would want to do. Other symptoms of low cortisol can be weakness, loss of appetite, vomiting, diarrhea. Not all dogs get all the symptoms especially if the cortisol is not yet critically low.

Alison

[Clcorcoran22]

Hi Alison,

Thanks for your response. My vet consulted with another vet who specialized with Cushing's and Vetoryl in the UK. They both agreed after the first ACTH test that his levels had not dropped enough and that the meds needed to be adjusted since he was nowhere near the normal range (I'm not sure what his numbers were at that time). His most recent ACTH (on the 18th) which was performed on day 13 after the increased dose showed that his post level was still only at 5.8 -- and he was very lethargic that day as well even though I don't believe that number was too low. My vet said that it should optimally be below 5. Is that correct?

He's really been progressively becoming more lethargic since being on the meds -- even before the increased dose. That's why I'm thinking he's having an adverse reaction to the meds. I did read where some dogs aren't able to tolerate the meds. Has anyone on this board ever had an issue like this with the Vetoryl?

[AlisonandMia]

His most recent ACTH (on the 18th) which was performed on day 13 after the increased dose showed that his post level was still only at 5.8

Was this test done 13 days after the dosage increase or was it done 3 days after the dosage increase? I'm just not clear on this...

Alison

[Clcorcoran22]

It was done 13 days after the increased dosage. Also, he's now been on the Vetoryl for about a month now -- about 2 weeks at 60 mg 2x a day and then approx 2 weeks at 90 mg 2x a day.

[AlisonandMia]

OK - one possible explanation for his lethargy is something called "cortisol withdrawal". This happens when the body has got become accustomed to very high levels of circulating cortisol and, when the levels are lowered to a more healthy range, the dog (or human for that matter) feels yucky and shows signs and symptoms similar to lowish cortisol with lethargy being a big feature.

I've had mild cortisol withdrawal myself when I stopped a high dose inhaled steroid med for asthma suddenly (ran out). I felt "pleasantly tired" and my legs felt kind of weak. I didn't feel bad as such but certainly didn't feel like leaping up and climbing a mountain (or even going shopping)either!

The only sure way to differentiate low cortisol from cortisol withdrawal is doing an ACTH stim test.

Cortisol withdrawal does improve over time as the body adjusts to the new reality. How long it will take is variable.

Reducing the cortisol can also unmask arthritis which was previously being "treated" by the high cortisol level.

When dogs feel bad because of Cushing's meds it is almost always because of the effect of the medication on the cortisol level - either the cortisol is too low or it is just lower than the dog's body is used to.

Re the desired range for cortisol in a treated dog: With Lysodren treatment the goal is for a range somewhere between 1 & 5 on the post reading. Initially, when trilostane first began to be used this was also the target range with that drug. However in recent years the upper limit for a trilostane dog has been set somewhat higher and many vets will allow the post to be as high as 9 as long as the dog is asymptomatic (if the dog is still symptomatic then 9 would be considered too high). This is thought to be because of the different ways the two drugs work which results in the adrenals responding a little differently to the stimulating agent used in the ACTH stim test.

One more thing: Were the electrolytes checked at the same time the ACTH stim test was done?

It is also possible that the lethargy is being caused by something unrelated to either the Cushing's or its treatment. Have you mentioned your concerns about this lethargy to the vet?

Alison

[Clcorcoran22]

I don't think his electrolytes were checked this time with the ACTH but they were definitely checked at the time of the previous ACTH. I didn't actually get to talk to my vet about the results and my concerns yet. He had left me a message with the results of the ACTH yesterday, and I called back to talk to him and had to leave a detailed message with my concerns and asked for him to call me. I'm not sure that he got my message before he left the office yesterday. I believe he'll be calling me sometime tomorrow. Would it really be normal for him to not get up at all (other than at meal times and to potty once in a while) for weeks on end? This has now been going on for at least 2 weeks. He's been doing nothing but sleeping and whining -- and has even had a few rough nights of not being able to sleep through the night.

I believe he does have a bit of arthritis and has also had issues with his back end from the time he was a baby. He definitely has some "crunchy knee" on one of his back legs -- just had the vet look at that a couple weeks ago to confirm that's what it was. I really would like to start him on some natural supplements for that but don't want to be giving him anything new until it seems like he's doing better on the meds.

[AlisonandMia]

He's been doing nothing but sleeping and whining -- and has even had a few rough nights of not being able to sleep through the night.

I believe he does have a bit of arthritis and has also had issues with his back end from the time he was a baby. He definitely has some "crunchy knee" on one of his back legs -- just had the vet look at that a couple weeks ago to confirm that's what it was. I really would like to start him on some natural supplements for that but don't want to be giving him anything new until it seems like he's doing better on the meds.


It does sound like the poor fellow is in pain - very likely from these pre-existing issues. Unfortunately, it isn't that unusual to see a dog's arthritis etc become more of a problem once the Cushing's is addressed and many need ongoing management of their arthritis and pain just as other older dogs who never get Cushing's do.

Alison

[Cushpup]

Hi,

My name is Cindy. I'm new to this forum and am hoping to find some words of wisdom and encouragement from fellow dog lovers who are also going through treating a dog with Cushing's. I have an 8 year old male boxer (82 lbs) who was recently diagnosed with Cushing's. (His name is Bouncer.) He first started showing signs of being ill back in November. He progressively got worse to the point where I had figured out that it was most likely Cushing's -- excessive drinking and urination, pot belly, joint and muscle weakness in the back end, and constantly hungry to the point where he was knocking down gates to get to trash cans.

My vet has done blood work as well as a low dose dexa scan to confirm that he has the pituitary type Cushing's Disease. He was started on Vetoryl 60 mg 2x a day about a month ago and had his first ACTH test on day 10 (I believe). He had his first ACTH test on day 10 which showed that his dose was too low -- not sure what the actual levels were. His dosage was then increased to 90 mg 2x a day. Right around that time, he started becoming lethargic and acting like the meds were not agreeing with him. He just had another ACTH test on day 13 after the increase. This time his post Cortisol level was 5.8 which my vet said was within a decent range and recommended continuing with the 90 mg 2x per day. I have a call in to the vet though because he has been becoming increasingly lethargic with the meds to the point where he's whining while laying down, sleeping most of the time, and doesn't even really want to get up for food until about the time when his meds are worn off and he's due for the next dose.

I've been researching the side effects of this medication, and I really believe he's having an adverse reaction to the meds? Has anyone else ever experienced this with Vetoryl? I've read some of the earlier posts and saw someone saying that the lethargy usually means that the meds need to be increased. However, I believe he's at the proper dose for his size and don't think he could tolerate anymore. I'd really appreciate everyone's advice and thoughts on this. Thanks!

Cindy
(Bouncer's Mom)

As you know, we can only tell you our stories, but cannot diagnose your baby.

My baby had strange affects while she was being loaded on Trilo and Soloxine (Hypothyroid). She wasn't that bad BEFORE the meds. I thought she was just "getting old". She would stop while I walked her. She would walk slower. She had a sagging belly. Her adrenals were portruding a bit (elevated both sides of her back). She was gaining weight. She was not the typical drinking/peeing a lot Cushing dog.

When we placed her on Trilo she was sleeping more, drinking MORE, and her appetite went down. Her back legs would shake. Occ. her legs would give out and she'd fall while walking....I was frightened that the Trilo and Soloxine were having a weird affect, and that her kidneys were going... It took about a month to see results. Her stomach pulled in. Although she never drank a lot(except when she was ebing loaded on Trilo), her drinking lessened. Her walks improved. She was fine for 19 months...until NOW with an additional diagnosis of IBD. I'm reading that many Cushings dogs have digestive problems later on...

My Vet said that the extra cortisone pumped by the adrenals give the dogs a false 'feeling good'. It masks many allergies, arthritis issues etc. IMO, your baby is adjusting to Trilo, and the lowering of cortisol is making him feel crappy. I gave my dog a few weeks to adjust to Trilo. Not sure if you're panicking or if things will normalize. You may have to place him on something for his arthtitis when all this is settled.

[Clcorcoran22]

I do believe that it's going to take him some time to adjust and definitely read that it will take a few months until you see the full effect of the Trilostane. I'm just scared for him because right now, he doesn't have much quality of life at all and is obviously not feeling well. It makes me feel so helpless because he's looking to me to make him feel better. I was just hoping to see him up and bouncing again like his normal self -- and instead, it seems like he's feeling worse than what he was.

I'm still waiting for a call back from my vet too -- maybe he'll have a suggestion or give me the okay to try to give him some natural supplements for the arthritis.

It breaks my heart to see him not feeling well like this. Just a few months ago, he was running around in the yard playing with his great dane sister. Now, he can just barely get himself out to go potty. I feel like I'm losing him.

[labblab]

Hi Cindy,

I'm really sorry that Bouncer is feeling so poorly, and I agree with you that I'd also be feeling concerned about his reaction to the Vetoryl. Even if this extreme lethargy is just the result of cortisol withdrawal, I'd want to see him feeling better now, even if that means "slowing" the course of Cushing's treatment by lowering his cortisol level more gradually. It may even be the case that his Cushing's symptoms could be controlled effectively on only a single dose of Vetoryl daily, rather than twice daily dosing. And if that's the case, the longer interval between dosing might keep him from becoming so lethargic.

Dechra, the manufacturers of Vetoryl, continue to recommend that dogs be started with once-daily dosing and a switch to twice-daily dosing only comes into play if once-daily dosing "fails" (i.e., the drug's effectiveness seems to be wearing off too quickly and symptoms rebound again by evening). I know that some specialists do prefer to start out with twice-daily dosing right from the get-go. But given Bouncer's reaction to the medication, if he were my dog, I'd ask my IMS about cutting back to a once-daily 90 mg. dose, at least temporarily, to see whether he shows improvement. And if he doesn't, honestly if it were me, I'd want to try discontinuing the Vetoryl all together to see if he rebounds once off the medication entirely. I just find this extreme lethargy worrisome. It sounds like more to me than unmasked arthritis...

Marianne

[Cushpup]

I do believe that it's going to take him some time to adjust and definitely read that it will take a few months until you see the full effect of the Trilostane. I'm just scared for him because right now, he doesn't have much quality of life at all and is obviously not feeling well. It makes me feel so helpless because he's looking to me to make him feel better. I was just hoping to see him up and bouncing again like his normal self -- and instead, it seems like he's feeling worse than what he was.

I'm still waiting for a call back from my vet too -- maybe he'll have a suggestion or give me the okay to try to give him some natural supplements for the arthritis.

It breaks my heart to see him not feeling well like this. Just a few months ago, he was running around in the yard playing with his great dane sister. Now, he can just barely get himself out to go potty. I feel like I'm losing him.

Sorry to hear about your baby. It's difficult to deferentiate whether your baby is suffering from Trilo lowering the CORTISONE(feeling good) withdrawal, or not tolerating the Trilo well. All I can say is watch him closely and do the ACTH as soon as suggested. I recall being anxious, too. While initially adjusting on Trilo mine would get hungrier at night when the Trilo (9pm) would wear off. I dosed her 1x a day at 7am....then in a few weeks things normalized. I held it together because her weight was ok because what she didn't eat during the day, she made up for it at night. Also, I knew that the Thyroid adjustment was driving her crazy. I also did a Chemistry profile 2 weeks into the dosing, esp. checking her kidney and liver values . Hope that helps.

Just a question: Has your baby been checked for Lyme? Many times they feel "arthritic", and it's an incidental finding while checking for Heartworm...

I purchased DURALACTIN(My Vet recommended it) for my dogs' arthritis in her bad leg. It smells yummy. I held off giving her while she's having a bout of IBD.......but I read that it's good for "whatever" is inflamed, including IBD. I started her on it yesterday. So far, so good ;)

[Clcorcoran22]

I just spoke with my vet. He agreed that Bouncer's lethargy is not normal at this point with his Trilostane treatment. He wants me to drop his dosage back down to 60mg 2x a day and let him know in a week if he's doing any better. He also told me to go ahead and start him on some natural supplements to help with the Cushing's. I already have the Pet Alive Cushex Drops -- is anyone familiar with using these? It's supposedly safe to use in combination with Vetoryl. Also, did I read somewhere that Milk Thistle also helps with Cushing's -- for the liver and alk phos levels? I think I may also order in some joint supplements and have them ready for him to start once things settle down with him and his condition improves some.

Thanks for your suggestions and support! I really appreciate it -- especially since I'm a bit stressed and worried over my boy.

[lulusmom]

There are a number of online products claiming to be effective in treating cushing's. I wrote to all of them and asked them very directly if they did any clinical trials/testing on their products that support their claims. Most were honest and said no but Native Remedies simply dodged the question and plied me with the same bogus claims their ads contain. I also specifically told these companies that I had two dogs with cushing's and was looking for a more natural treatment that works so I could get them off of the conventional drug, Lysodren. Again, Native Remedy evaded the very direct question. I already knew that none of these companies could support their claims so I was not surprised by any of the responses. With the exception of Native Remedy, the ones that responded were honest. Others didn't respond at all. A lot of us call Cushex Drops and others snake oil. You may want to consider saving your hard earned money. At the very least, you should write to them yourself and ask them point blank what testing was done to prove that Cushex Drops help reduce circulating levels of corticosteroids. I can almost guarantee you won't get a satisfactory answer. I doubt that you would get a satisfactory answer if you asked about any of claims they make regarding the benefits of Cushex Drops. To see which claims I'm referring to, see Native Remedy's crafty response to my inquiry below:


There are a number of benefits to be had from the Cushex Drops which are quite safe to use together with the conventional treatment from the vet.

These include:

To support the health of your pet’s adrenal glands and encourage normal functioning
To help reduce circulating levels of corticosteroids
To encourage a healthy coat and prevent hair loss
To balance blood pressure and blood sugar levels
To reduce excessive thirst and urination
To promote optimal strength and health of the skin
To improve digestive functioning
They could also consider using the GlucoBalance for the diabetes. This can be used;
As a regular supplement for pets with Type I and Type II diabetes
To control and balance blood sugar levels and improve insulin production and bio-availability
To reduce high cholesterol
To boost immune functioning and protect against disease
To assist in the treatment of diabetes-related conditions including circulation problems and eye disease
To promote wound healing
To increase energy levels and reduce fatigue

It is important to notify your vet should you choose to combine the natural remedy with the vet's prescription medication. In this way your pups can be monitored and prescription meds can be reduced safely as the Cushex Drops start working.

We wish you all well.

For more info, please go to:

Cushex Drops

Please let us know if there is anything else we can assist you with.

Warm regards,

The Native Remedies Team
www.nativeremedies.com
Phone: +1 (253) 620-4542
Fax +1 (928) 832-4552

P.S. I forgot to mention that I did write back and tell them that they could assist me with something else, like answering my original question about clinical trials or anything that would support their claims. Not surprisingly, I never received an answer.

[Clcorcoran22]

There are a number of online products claiming to be effective in treating cushing's. I wrote to all of them and asked them very directly if they did any clinical trials/testing on their products that support their claims. Most were honest and said no but Native Remedies simply dodged the question and plied me with the same bogus claims their ads contain. I also specifically told these companies that I had two dogs with cushing's and was looking for a more natural treatment that works so I could get them off of the conventional drug, Lysodren. Again, Native Remedy evaded the very direct question. I already knew that none of these companies could support their claims so I was not surprised by any of the responses. With the exception of Native Remedy, the ones that responded were honest. Others didn't respond at all. A lot of us call Cushex Drops and others snake oil. You may want to consider saving your hard earned money. At the very least, you should write to them yourself and ask them point blank what testing was done to prove that Cushex Drops help reduce circulating levels of corticosteroids. I can almost guarantee you won't get a satisfactory answer. I doubt that you would get a satisfactory answer if you asked about any of claims they make regarding the benefits of Cushex Drops.


Hi,

Thanks for your response about the Cushex. Honestly, I never take the manufacturer's word on anything. Typically, I won't order a product unless I've read multiple reviews on it -- the website I order my products from allows for customers to review the products. The only reason I was interested in trying this product in combination with the meds is because I read people's reviews of the product on Amazon.com. There were many people who claimed that they saw wonderful results with their dogs after using the product so I figured it was worth a shot. I use various herbs myself on a daily basis to treat different issues I have, and I swear by them -- especially after going the traditional medical route for my issues with rx drugs and having problems with side effects. Did anyone on this board ever try the Cushex Drops at all and have any negative side effects from its use? Typically, I order human grade herbals/vitamins for use on my dogs but I couldn't find a human Cushing's formula and didn't want to have to guess at dosages for use in this scenario. I definitely wanted to give some herbals a shot. I don't think the herbs will be able to treat the Cushing's by themselves but thought there would be some benefit to using them in combination with the meds.

Regarding my question on the Milk Thistle, I did go back and search for threads regarding it's use and believe I found my answer. I think I'm going to add some Milk Thistle into his daily regimen and see if his condition improves.

[lulusmom]

Yes we have had a few members who used Cushex Drops but I'm not sure if they were on this forum or our predecessor forum which is now inactive. I'll try to do a search here to see if I can find any threads you can read. One member in particular was very interesting because I saw her rave review about Cushex Drops on Native Remedy's website but I can only assume her review was a bit premature because she showed up here months later after her dog's symptoms had become much worse.

Glynda

P.S. Here's a few things I found on Cushex Drops.

http://www.k9cushings.com/forum/showpost.php?p=33490&postcount=101

http://www.k9cushings.com/forum/showthread.php?p=43799&highlight=cushex+drops#post43799

[Clcorcoran22]

Glynda,

Thanks again for your response. I did read the threads but wasn't clear whether there was any benefit from the Cushex or not. It actually sounds like the dog Sadie was having the same issues with the meds that my Bouncer is having -- lethargy, sleeping constantly and leg shaking. Bouncer is actually having this involuntary leg tremor/movement while laying down and sleeping. My vet agreed that he's probably not tolerating the meds well and told me to decrease the dosage to the 60mg 2x a day. I'm not sure that will make much of a difference though since he was starting to have these issues before we increased the dosage of the meds. I'm sure the Cushex Drops won't do all that much for him but even if it helps him to feel a little bit better, I'd be happy. I'm going to have to try to figure something out for him because right now he's not doing well on the meds and has no quality of life. I guess dogs are like people -- everyone reacts differently to the meds.

Is there anything else I could be doing for him to help him adjust to the meds?

[labblab]

I'm really glad that your vet is decreasing the overall dose. But if this doesn't help, I still would pursue cutting back to dosing only once daily. It doesn't seem to me as though you have anything to lose and possibly something to gain.

For what it's worth, my own Cushpup also experienced odd tremoring episodes at the beginning of trilostane treatment (and also during the month immediately preceding treatment, although nowhere near as severe). It looked as though he was shivering across his shoulders, even though I do not believe he was cold. Also, the episodes occured most often when he was resting or asleep. They were very strange. After a couple of months, the tremoring ceased and we never did have an explanation for what had caused them, although tremoring is now listed as a possible side effect of Vetoryl.

Anyway, I truly hope that Bouncer will show some improvement on the decreased dosage. I can imagine how upsetting it must be to see him not not doing well when you had high hopes for improvement once the treatment began.

Marianne

[zoesmom]

Hi and welcome -

I can tell you about my Zoe's experience with trilostane. She was about the same size as your Bouncer when she began tx. I think she was 82 lbs. then - a lab, boxer, pit mix. And she had lots of concerning symptoms in the beginning.

She was started at a dose which was way too high and developed diarrhea and vomiting right away. That caused us to stop the trilo and restart at a lower dose. We actually had to stop, wait, and then lower the trilo two or three times. Finally, at just 45 mg, she was able to tolerate the drug. But on all the ACTH tests in the early days, she still never had numbers that were considered too low. A fewweeks or so into it, she also developed that extreme lethargy and the shoulder tremors. To me, she also seemed very depressed. She would just lie around, in unusual corners and places where she never went before. I'd go to talk to her and try to coax her up with 'bye-bye' and other enticing things and she'd just lay her head back down (if she even bothered to pick it up.) Still, her numbers did not drop to where they needed to be.

So......we gradually had to increase her dose back up. We did this over about 3 mos. time with increases every 3 or 4 weeks. We worked her back up to 120 mg and her cortisol finally dropped to around 5.

Long story short. Her doses were definitely too high to start and even as we were dropping her dose, she still experienced cortisol withdrawal syndrome. It seems to me that oftentimes, the larger dogs do need to start off much lower and have their dose increased very gradually over time. The lethargy and depression did subside in a matter of weeks and she perked back up. Of course, tx also unmasked arthritis (which she'd shown no signs of, prior - and she was 9) as well as IBD (which she had shown signs of before). So I think she just felt really crappy all around.

But it all got better and we got our Zoe back for quite awhile. In fact, the Zoe that could not tolerate more than 45 mg initially . . . well, she went on to take a much higher dose than that initial dose that made her so sick (180 mg once a day.) Her last two years, she was getting 180 mg twice/day (total of 360) with no side effects. It was just a matter of taking it very slowly with her in the beginning.

So maybe backing way off on Bouncer's dose and then reintroducing it more slowly would help him adjust. I do agree that no increases should be made until after that first 30 days (decreases are a different story.) So many times, we've seen dogs whose vets increased their dose after the first 10-day ACTH and then the dogs ended up too low a few weeks later. I feel that's because there's a slight cumulative effect with the drug when starting and that must be taken into account. Sue

[Clcorcoran22]

Thank you so much for sharing your experiences and advice with me. I'm feeling a little bit more hopeful today about his treatment. I still don't think the 60mg 2x a day is going to work for him -- at least not initially anyway. I'll be calling my vet next Monday to let him know how he's doing. If he's not doing any better by then, I think I'm going to ask him to decrease the dose to 30mg 2x a day -- at least temporarily anyway to see if he responds any better to that dose.

At least I know now that other dogs have had this same issue with initially starting the Vetoryl. I was thinking he may not be able to tolerate the drug at all, but I guess I just need to hang in there with it and find the dose that will work for him.

[Sanja]

Hi there,
I am a proud owner of a beautiful boxer, Rio (we have our "page" on this forum). We live in Croatia, Europe and I buy Vetoryl by web, in UK. Rio is 9 yrs and 10 months. Last April he started with Vetoryl (120 mg) and his status was improved - his coat is shiny again, without loosing, he is happier and in better mood than before. But, still drinks a lot, a lot, a lot... In the combination with incontinence (unfortunatelly) it is complicated sometimes (we get him for a walk every 2 hours, in the night we have only 5 hours of sleep - from 1a.m. to 6 a.m.). He has also a medicine for incontinence, but drinking so much.... This April his cortisol was low and - as producer of med suggested - we paused with Vetoryl for 5 days. Today we started with half dose (60 mg). If you have any questions, please mail me (sanja@datapress.hr) because I have so reduced free time and I am not visiting this site as often as I want, because of job, dogs, family...
Best wishes and kiss to Bouncer.