Hello to everyone!!

[Georgina]

My name is Georgina,my beloved dog Sophi has recently been diagnosed with Cushing's,she is nine years old.She had almost all the symptoms,we did some blood tests and it showed the hepatic enzymes ALP and SGPT above normal,so next came the u/s which showed the adrenal glands oversized but without any tumor,her liver was a bit too..Sophi's behaviour is exactly the same as it was,she plays,goes for walks with me,she sleeps as usual,everything is fine.If you see her you can't tell that something is wrong.At first she used to drink huge amounds of water but know it is not so often,her apettite is enormous,but controlled,and her belly is a little bit swollen,that is all. I can really say that i am quite scared...I am a nurse and i only new Cushing's from books.Therefore i had to do a little research and i came across with your website...My options on Sophi's treatment are limited,Lysodren in Greece costs 1000euro,and online pharmacys from the US do not ship medicine outside the US.So i've done my research and found about Trilostane,which Sophie's vet wasn;t familiar with,but since it costs less,and more easy to find in large amounds from the UK,we decided to give it a try,and with the proper monitoring to see if it works for my Sophi.
Iam worried though because i don;t want to make things worse for her,and medication always seem to fix one thing and harm something else...
Wish me and my Sophi luck..:)

[littleone1]

Hi Georgina,

Corky and I want to welcome you and Sophi. Corky has been taking Trilostane for 16 months, and he hasn't had any problems with it. His quality of life has really improved since he's been taking it. You want to monitor any changes that occur. After his second dose, he seemed to be lethargic, but the next morning he was fine. It was a result of the cortisol level being lowered.

I hope Sophi does well on the Trilo.

Terri

[Harley PoMMom]

Hi Georgina and Sophi,

Welcome from me and my boy, Harley. I am so sorry for the circumstances that brought you here but glad you found this forum, we will help you in any way we can.

We tend to ask a lot of questions from our new members because the better informed we are about your precious furbaby, that is the best way we can give you proper feedback.

Could you tell us what test/s confirmed Sophi's Cushing's? What symptoms Sophi displayed that led you or your vet to test her for Cushing's in the first place? Could you post any abnormalities that were marked on her Chemistry/CBC blood panel. Is Sophi taking any herbs/supplements/medications?

We are definitely here for you, Georgina, and we will help you help Sophi.

Love and hugs,
Lori

[lulusmom]

Hi Georgina and welcome to you and Sophi.

Natalie at k9diabetes told us that you would be joining us so we've been waiting and we're really glad you finally made it.

I have two dogs with cushing's and I've been here long enough to know that whether you're in the U.S., the U.K., Greece or anywhere else in the world, the fright, frustration and confusion when receiving a cushing's diagnosis is universal. The good news is that we've all been down the bumpy road you're on right now and we can tell you that it gets a lot smoother. I sounds like you've done a lot of research on your own and it sure helps to have a medical background because it's not an easy concept to grasp. Cushing's is not that common in humans so I'm not surprised you've not dealt with it as a nurse. It is, however, quite common in dogs so you have quite a few of us here to help you get Sophi on the right track.

My dogs are tiny and both have treated with Trilostane and did well on it. Dechra, the manufacturer of Vetoryl has not changed their dosing recommendations on the packaging inserts but it's my understanding that they have revised their recommending starting dose to 1mg per pound. How much does Sophi weigh and what dose will you be administering?

Ace inhibitors and vetoryl are contraindicated but we've had dogs on both but they must be watched closely. If you have any concerns at all about the drug, Dechra has vets on staff that can answer any questions you may have. Your vet can call them as well. Here is a link to the UK contact information:

http://www.dechra-eu.com/contact-us.aspx

Please be sure to check out the information on Vetoryl in our Helpful Resources section. You will find information on proper protocol for monitoring treatment, which includes checking electrolytes every time an acth stim test done. Make sure the acth stim test is done within 4 to 6 hours of her morning dose.

You can never give us too much information about Sophi so please post whatever test results you might have.

Glynda

[Georgina]

Thank you all for your worm welcoming!!Natalie told me how wonderful people you are!
Well i have to say that Sophi's syptoms started 2 years ago..Yes exactly as you read,so why it took me so long to start treating Sophi?Because the vet misdiagnosed what Sophi had.Sophi started drinking huge amounds of water and her urine were like water,colourless and too much for her size and in comparison to how it was before.I mentioned that to the vet,we did some blood tests about her kindeys and the blood sugar but they were normal,only the urine analysis showed the urine osmolality increased,so he reached to a conclusion that Sophi had Dibetes insipidus,if anyone is familiar with the term,and i started giving Sophi a hormone via her eyes,Defirin,to control her thirst,and for a while she was ok,until it started again.All this time he never mentioned anything about Cushing's.I got worried,because i was giving a medicine to Sophi without a result and the vet didn't seem to care why was that happening or what was really going wrong with the dog.He mentioned also about psychogenic polydipsia.Until i noticed that Sophi's belly was a bit swollen.
I took her to another vet and we did blood tests again and a urine analysis.I do not have the results with me but i will copy them from the file that Maria (vet) has and i will write them here.The blood test showed the liver enzymes,ALP and SGPT a little bit above normal.All the other reasolts were normal,the kidneys are ok and the blood sugar normal.I failed to mention that i had stopped Defirin 5 days before the blood test.So Maria said to start Sophi on a special hepatic diet and give her Denosyl,a dietary supplement that supports liver function,and then do some blood tests again and see how it goes.
After a month Sophi's hepatic enzymes increased.So we decided to do an u/s,and the vet saw that her adrenal glands were oversized so as the liver but without the presense of a tumor,thank God.So she said about Cushing's,and we did the ACTH stimulation test,and waiting for the results,but it is 95% certain.So this is our story.:)
I read about the syptoms and Sophi has almost all,polyouria,polydipsia,increased hunger,no period,her skin is dehydrated and her belly is swollen.
She is 9 y/o and she weighs 10.800kg,she doesn't take any other medication or supplements nor herbs,and she follows a special hepatic diet.
Tomorrow i will have the trilostane pills and the test results.Maria said that we should start giving Sophi 20mg per day,but her knowledge of the medication is pour(but she is trying hard),i will tell her about the dose you suggested 1mg/kg or per pound.So Sophi should start with 10mg per day and after 14 days make the blood tests again,i think...
I am sorry for the long details and for the spelling mistakes :)..I can't say how happy i am to have your support and help!
I will have more news tomorrow.

[Bichonluver3]

Hi Georgina!
I also want to welcome you. There are some incredible people here who will guide you every step of the way. I, too, am a nurse but dealing with a dog, and your own at that, is WAY different. I have Chloe who has Cushings and Sparky who has diabetes and, sometimes, I ask the dumbest questions. Then when I get the answer, I think "why couldn't I figure that out"? I think that it is because we are in a place of the heart and not the head. But, take a deep breath and relax. You will get answers and guidance here from the experts and love and support from the rest of us.
What a cute picture of Sophi. she is a doll. A big tummy rub to her.
Love,
Carrol & Chloe

[lulusmom]

Hi Georgina,

You aren't the first member whose vet was not familiar with cushing's and treated the dog for diabetes insipidus (DI). DI is actually more rare than cushing's so I'm not sure why gp vets are so quick to try to diagnose it instead of some of the other more obvious conditions. One of my cushdogs as DI and unfortunately, the desmopressin eye drops did not help. I was torn about that because on one hand, Jojo drinks voluminous amounts of water and pees buckets but the cost of those drops is ridiculous. No wonder they call it liquid gold. By the way, I've never heard of Defirin but assume that that desmospressin, it is a synthetic form of vasopressin.

It would be great to see the abnormal bloodwork. Dogs with cushing's need to be on a good quality protein, low fat diet. What kind of liver diet has your vet prescribed. Since it appears that only the usual liver enzymes associated with cushing's are elevated, I'm not sure Sophi should be on a low protein diet. The old school of thought was that if a dog had abnormal liver enzymes, protein should be restricted. They know now that that is not the case. As a matter of fact, dogs need protein to help regenerate liver cells. It is only after a dog loses a good deal of liver function that restricted protein diets are prescribed. Did your vet do a bile acid test? Liver biopsy? FYI, a lot of dogs with cushing's have bile acids, both pre and post meal as high as 75 but the majority are well under 50.

I personally feel better starting Vetoryl on the low side and work my way up if increases are necessary. Every dog is different and to give you an idea as to just how different, my first cushdog, Lulu only weighs 4.5 lbs and she was on 30mg once a day for two years. My other cushdog weighs 6.5 - 7 lbs and he did beautifully on 15mg twice daily. You just never know.

When you have the acth stim tests done, make sure you have them done within 4 to 6 hours of dosing. Dechra considers this to be the peak effective period for Vetoryl. However, UC Davis, a reknown veterinary teaching hospital, who conducted their on studies on Vetoryl, instructs their pet owners to bring the dog in 2 to 4 hours after dosing. It can be confusing so to make things easier, I usually recommend somewhere in the middle like 3 to 5 hours. :)

We'll be here to get your updates when you start treatment and to answer any questions you may have.

Glynda

[clydetheboosmom]

Ti Kanis!

I remember helping out another previous member (was is Costas?) who was in Greece and had a Cush pup, too.

I hope you are feeling all the warmth this group has to offer and if I can add anything, I will...

In the meanwhile, from an American Greek to you - Welcome!

Lynne, Bailey, and Angel Clyde

[lulusmom]

Lynne, you are correct. It was Costas and his dog Lambros and you were wonderful with him. As if that should surprise anybody. NOT! :D

[Georgina]

Hello again,
Today Sophi took her first Trilostane pill,we started with 10mg per day..It's been 12 hours since she took it and she is ok!!I know it's to early to tell,but i am crossing my fingers!I will be watching her very closely!My vet said to have dexamethasone with me,so if something goes wrong,i whould contact her and give Sophi a shot...
These are her blood results and acth test result :
SGOT-ALT 173 IU/L
GLUCOSE 85 mg/dl
CALCIUM 4,8 mmol/l
KREATININE O,81 mg/dl
SODIUM CHLORIDE 155 mmol/l
OURIA 63mg/dl
SAP 881 IU/L

ACTH stimulation test
Cortisol in first sample 2,43
Cortisol in second sample (after 1 hour from the ACTH shot) 41,68


In ten days we will have our ACTH test and electrolytes checked..
Sophia eats Royal Canin hepatic dog food!

Hello Lynne, Bailey, and Angel Clyde :)
Thank you for your compliment Carol!!

[Georgina]

Hello again,
Sophi took her first Trilostane pill three days ago,we started with 10mg per day..She seems to be doing fine!!I know it's to early to tell,but i am crossing my fingers!I will be watching her very closely!My vet said to have dexamethasone with me,so if something goes wrong,i whould contact her and give Sophi a shot...
These are her blood results and acth test result :
SGOT-ALT 173 IU/L
GLUCOSE 85 mg/dl
CALCIUM 4,8 mmol/l
KREATININE O,81 mg/dl
SODIUM CHLORIDE 155 mmol/l
OURIA 63mg/dl
SAP 881 IU/L

ACTH stimulation test
Cortisol in first sample 2,43
Cortisol in second sample (after 1 hour from the ACTH shot) 41,68


In ten days we will have our ACTH test and electrolytes checked..
Sophia eats Royal Canin hepatic dog food!

Hello Lynne, Bailey, and Angel Clyde
Thank you for your compliment Carol!!