Keiko, 12 y/o husky on Vetoryl - Keiko passed away

[Keiko's Mom]

Hi. Keiko's yearly vet check showed that her weight went from 63 to 73 pounds. We both had been slowing down and walking less so it didn't surprise me too much. She started drinking alot of water and peeing alot. She had an urinary infection that took two different antibiotics to clear, but drinking and urinating were still excessive. We had some blood work done and ruled out diabetes and infection. Vet took x rays and sent us to oncology/internal medicine vet who checked out x rays and did ultrasound. We went back to our primary vet and had ACTH test done (7.8 prior and 24.4 post). We did alot of reading (especially this forum) and decided to use Vetoryl. We spoke to Dechra and went with 30mg twice a day. The drinking, urinating and energy improved by the fourth day of treatment. She has had no side effects. We did a second ACTH two weeks later (1.5 prior and 3.8 post). We had Superchem and CBC tests as well (Dechra said to keep eye on potassium and sodium, especially).
She seems to be doing great and will be tested again in one month.

[labblab]

Welcome to you and Keiko (she is a beauty)!

We are so glad to have you here with us. And it is wonderful to hear that she is doing so well on the Vetoryl :). Thanks so much for posting her ACTH results, and telling us about her history. It sounds as though you two are definitely on the right track, and we'll be very interested in all your future updates. Keiko's two-week monitoring ACTH test sounds pretty nearly perfect, especially when coupled with her symptom resolution. But I agree that it is important to proceed with the 30-day test, as well, because our experience has been that the cortisol level can continue to drift downward during the first weeks of treatment. I'm also really glad to hear that you've already been in contact with the folks at Dechra, because I do believe they can be very helpful regarding a variety of trilostane questions or issues.

One quick question: did the ultrasound give an indication as to whether Keiko suffers from the adrenal or the pituitary form of Cushing's?

Best wishes, and please give Keiko a big hug for me!
Marianne

[Keiko's Mom]

Specialist didn't say much except she didn't see cancer, when she did ultrasound and looked at x rays. Our primary vet said that it must be pituitary form. He is not as up to date with cushings and treatment (only has one other dog with cushings in his practice...on Vetoryl and doing well). The specialist was kinda snotty when we decided not to use the lysodren, so we didn't go back to her.

[labblab]

Yes, I'm guessing that if nothing remarkable turned up on the imaging, then the conclusion would be pituitary Cushing's. I'm sorry that your specialist was not more willing to discuss alternative treatment options. But if your regular vet does not have a lot of Cushing's experience, then it makes it even more helpful that he has been having direct contact with Dechra. In that way, you all have somewhat of a safety net in place should questions or problems arise along the way.

Marianne

[Keiko's Mom]

Hi Marianne,
I'm Chris. My vet is keen on learning all he can to help us. Dechra has been really helpful. This forum has given us the most info and we really appreciate it.
Thank you for being so kind.

[Keiko's Mom]

Just an update....Keiko had more lab work done (day 43 of Vetoryl)
her pre cortisol was 2.1 and the post cortisol was 3.8

[Harley PoMMom]

Those are wonderful numbers! Have all Keiko's Cushing symptoms abated?

Keep up the great work and please keep us updated!

Love and hugs,
Lori

[labblab]

I agree that those are great results! :) Almost identical to the original 14-day ACTH monitoring test, so obviously Keiko is remaining very stable on her Vetoryl dose. :) :)

Yes, please, do tell us how she is doing in terms of her symptoms.

Thanks so much for this update,
Marianne

[Keiko's Mom]

She is pretty much symptom free. She has gained two more pounds...she has the energy back, so I guess we'll be taking longer walks. I am so glad that this forum exists with all of you in it. Thanks again.

[addy]

Great News!!!!!!!

This is wonderful to hear. Enjoy a nice long walk with your Keiko:)

Hugs,
Addy

[Keiko's Mom]

Just an update...approx. day 135 of Vetoryl. ACTH test came back at 1.4 pre and 1.3 post. Vet was okay with the figures, but we called Dechra to make sure. Dechra suggested changing from 30mg twice a day to 30mg morning and 10mg at night. ACTH and Superchem again in two weeks. Has anyone else had level changes like this?

[Harley PoMMom]

A post of 1.3 would be worrisome to me also, so I agree with what Dechra has said. In fact in Dechr'a U.S. Product Insert it says:
A post-ACTH stimulation test resulting in a cortisol of <1.45 μg/dL (<40 nmol/L), with or without electrolyte abnormalities, may
precede the development of clinical signs of hypoadrenocorticism. You can find this information and more here: Dechra's U.S. Product Insert. (http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf)

Treatment should be stopped if a dog's cortisol level is below 1.45 ug/dl and then restarted at a lower dose.

[Cyn719]

Hello to you and Keikio - what a beautiful dog for sure!! My Penny is on Vetoryl - she is holding her own right now - she had her ups and downs but the problem was more with my vet giving her to much medication and I did not know to call Dr Allen at Dechra or Dr Peterson in NY but since I did hopefully Penny will be on the right dose now - Dr Allen is so great I spoke with him on the phone and when I email him he answers me back within an hour or so!!! All my credit goes to all the cush angels on this forum!!!! If it was not for all of them my Penny wouldnt be here today!! She was very sick one night and I came on and posted and everyone was there to tell me what to do and to pass on all their thoughs love and support!! They told me what to do - not my vet - so you know how knowledgeable they are and how concerned they truly are! Keikio seems to be doing really good!! Just keep up on those ACTH tests - thats the other thing my vet did wrong - waited to long to test her -- but you seem to be in good hands!! :)

xoxo Cindy & Penny

[littleone1]

I agree with Lori. I would also be concerned with a post stim of 1.3. The reference range for a cushpup being treated with Trilo should be between 1.5 and 5.5.

Terri

[Cyn719]

Hi Sorry I missed a post along the line - Yes Penny had results that dropped also - she was on 120 mg of trilo and she dropped to post .9 from 2.3 - she was on to much medication and my vet did not check the ACTH soon enough - Penny finally showed signs of being very tired and walking like she was drunk - then was totally legarthic so I insisted on the test and thats when we found her post way to low - so she had to go on predisone and stay off the trilo for awhile then she went back on 30 mg of trilo and still to much so now she is on 10 mg 2xs a day - Did you speak to Dr Allen at Dechra? He was so helpful ! :)

xoxo Cindy & Penny

[Squirt's Mom]

I am very confused....a reading of post 1.3 is below the recommended level for a Trilo pup so why would Dechra recommend an INCREASE in dose? Their own papers say that with a reading below 1.45, treatment should be stopped. Before I gave any more Trilo, I would verify that Dechra understood the test results and that the information was translated to you correctly.

Those results may be considered non-stimulatory but I will have to check on that.

Hugs,
Leslie and the gang

PS....correction...The dose hasn't been increased but decreased...so that is a bit better. :o I misread that as they wanted you to go from 30mg once a day to 30 am and 10 pm.

[Squirt's Mom]

Via the manufacturer of Vetoryl (Trilostane brand name)


“In the event of non-stimulatory ACTH test during monitoring, treatment should be stopped for 7 days and then re-started at a lower dose. Repeat the ACTH stimulation test after a further 14 days. If the result is still non-stimulatory, stop treatment until clinical signs of hyperadrenocorticism recur. Repeat the ACTH stimulation test one month after re-starting treatment.”

A non-stimulatory result means that when the adrenals were stimulated via the agent used in the ACTH the post results are lower than the pre results. The stimulating agents, cortrosyn and etc, make the adrenals release all the stored cortisol they are holding...one of our admins describes is as squeezing all the water out of a sponge. Too much "water" means too much cortisol. When the post number (stimulated adrenals) is lower than the pre number (non-stimulated adrenals) that means the adrenals are not holding enough cortisol. This can be a precursor to a crash - the cortisol going too low.

If I were you, I would follow up on the info about the results you were given to make absolutely sure everyone is on the same page. If they insist this is what they want to do, I would insist her electrolytes be checked before I gave another dose. Then I would argue with them about their recommendation to increase his dose. :o;) Dechra says these results mean all treatment is to be stopped, the pup retested when signs reappear, then the dose adjusted.

Hugs,
Leslie and the gang

[Cyn719]

Leslie - Hi - was just checking in on Addy - I was reading your post to her mom and I may of missed something but when Addy was 1.3 she was on 30 mg 2xs a day so didnt they decrease her does to 30 mg morning and 10 mg evening? I may of missed a post cause I am jumping around - just trying to figure out the dose - :)

xoxo Cindy & Penny

[Keiko's Mom]

Hi. The test results came back Aug 9th. We do ACTH, CBC and SuperChem tests. We spoke to Dr. Allen at Dechra, especially about potassium, sodium and whatever. She has been on just the 30mg in the morning, because it will be a few days yet for the 10mg to come in. Our vet doesn't stock the meds...we buy from Fosters and Smith. We'll do the tests again as soon as she's on the two strengths for 2 weeks. I'd be lost without this forum and all of you wonderful people! I'll give another update, when we know more. Thanks again.

[Cyn719]

Re my 8/13 post to Leslie about Keiko -- sorry I called the dog Addy I meant to say Keiko!!:o:o So many dogs get confussed sometimes:) How is Keiko doing???

[Keiko's Mom]

Hi....don't worry about the names....I stay confused in this forum with so many different puppy problems. Keiko started 30mg morning and 10mg evening on the 17th. Panting, thirst and weak legs started to return and it's just about back to normal again. We get get her retested on 1st of September and hope this does it. ACTH, CBC and Superchem run $316.00, but gotta do it for my baby. I see where other people are struggling with the costs. I'm fortunate that Keiko doesn't have diabetes or other health problems on top of this, like some of the others do. I really appreciate the support from all of you. Thanks again. I will let you know new tests results.

[addy]

Wishing you good luck on your stim, hope Keiko continues to feel well. How are pups feel on a dose is sometimes more important than the number on the stim.

Crossing all our paws:D:D

Hugs
Addy

[Cyn719]

Good thoughts for you and Kieko on the 1st!! I know it is so expensive but we have to do it for our fury little ones for sure! But with bills and college OMG it is overwhelming for sure!! Peny is still adjusting on the meds - she is down to 10 mg a day but I think shes going to have to increase?? Thirst and hunger kicking in but nice to see her happy and have more energy!!:) Her stim is either next week or the 6th - they changed the meds so much figuring out when to do it -- looking forward the you posting the results!! Fingers and paws crossed for sure!!!!:)

[Cyn719]

Just checking in on Keiko - did you get the stim results back?? Hope Keido is feeling good and things are ok:)

[Keiko's Mom]

Thanks for thinking of us. Vet's office cancelled last Friday's appt, because they forgot to order the injection. She got testing done today and we will know in the morning. I'll post the numbers and call Dechra, as soon as I know.

[Cyn719]

We are right behind you - Penny is going tomorrow for her test - fingers and paws crossed for both our babies!!!:D I will be looking for your results tomorrow - :)

[Keiko's Mom]

Keiko got stim results today. Pre was 3.1 and post was 4.9 We are good for another 90 days. This is with 30mg in AM and 10mg in PM for 75 pound dog.

[lulusmom]

If all symptoms have resolved and Keiko is doing well, I believe you've found the right dosing regimen. Congratulations!

[Squirt's Mom]

Wonderful results! :D I know you are happy!

Hugs,
Leslie and the gang

[Cyn719]

I am so happy for you and Keiko!! :D:):D:) I know you are so so relieved!!!:cool: Its so good to finally hear some good news!!!! Hopefully you will have no worries over the next 90 days - and I will be praying for that!!!! HUGS KISSES AND PRAYERS --- AND A BIG WET LICK FROM PENNY TO KEIKO!!:D:D

[addy]

This is good news for Keiko. Good job Mom!!!!!

Hugs,
Addy

[labblab]

Dear Chris,

Congratulations on this very good news! :)

Please give Keiko a big pat for me, OK? ;)

Marianne

[Nika'sMom]

congratulations on such fantastic numbers!!! Must be a good week for stim tests :D...(your Keiko is beautiful ).. it makes me happy to see that she is doing so well:)...many hugs Lynda and Nika

[Cyn719]

Hi I was just checking in on Keiko since we had that good week when we all had good numbers!! how are things going - I hope well - give me alittle update if you have time would love to hear how keiko is doing since then:)

[Keiko's Mom]

Latest ACTH 1.8 for pre and 2.1 for post Spoke to vet at Dechra and now have single 30mg dose in the morning. Keiko lost 4 pounds, superchem and cbc results look good. Daily walk and S3 soft chews (joints) seem to be helping alot. We are good for 90 days again. I do not get in forum much, most conditions are too complicated for me to understand...hope hearing good news and someone more to track helps yall. Thanks again for this forum.

[Cyn719]

Thinking of you and Keiko

Merry Christmas love and hugs xo

[Keiko's Mom]

Hi, as of March 14, Keiko is now down to 65 pounds and doing well. Her pre was 2.6 and her post was 2.7 We spoke to Dechra to go over the labs and were surprised to find out Dr Allen has retired. Keiko has been on 30mg of Vetoryl in the am and will continue. She also is still on the S3 soft chews for her joints...it does seem to help. She cheerfully walks about a mile every day. I do not get to the forum often, but wanted to pass some good news to yall.....there is hope for our babies and alot of support here. Thanks.

[Harley PoMMom]

What a wonderful update on Keiko and thanks so much for letting us know this great news!

Unfortunately, Dr Allen has retired from Dechra and he will be missed tremendously.

Please do keep us posted!

Love and hugs,
Lori

[Cyn719]

So glad Keiko is doing good. Glad you updated:) what kind if chews do you use? Penny doesn't like the dasaquin chews at all. So nice she can still go for her walks.:)

Hugs xoxo

[Altira]

I can't help but smile when a read good news and that of a dog who's face is so familiar as your Keiko's. We have had huskies for 34 years. (Six all together) Kira will be twelve next week and Neeka is one. Kira had adrenal cushings and was cured but she suffers many aches and pains now probably from the cushings. She went from 74 pounds to 52 pounds. We go on daily walks too, I try to go 2 miles. They are beautiful to watch in stride arent they? I let mine walk infront of me just so I can watch them walk.

Keiko is very beautiful.........

[Keiko's Mom]

Just an update...have not been in forum for quite awhile. Keiko passed away March 11th, but not because of her cushings. She did two years on 30mg Vetoryl and it worked wonderful for her at 63 pounds. Her health failed very quickly and she passed before we could get a good diagnosis, but my vet figures cancer and her age for her size. I want to thank all of you in this group. I always felt like Keiko and I were getting hugged when I logged in here.

[doxiesrock912]

Keiko's mom,

we're all so very sorry for your loss. Virtual hugs coming your way!

[labblab]

Oh, my goodness, I am so sorry to read this news but also so very grateful that you've returned to let us know. I hope you will feel the warmth of so many hugs as you continue to log in here. We will always be here for you, and we will always remember and honor Keiko. She has now joined our other beloved babies on our special memorial thread:

http://www.k9cushings.com/forum/showthread.php?t=4794

Please let us know how you are getting along. You and Keiko will forever remain members of our family.

Sending my thoughts and sympathy across the miles,
Marianne

[molly muffin]

I'm so sorry to hear that Keiko has passed. Really big hugs to you.

Sharlene and Molly Muffin

[jmac]

I'm so sorry to hear about Keiko. We're thinking of you and sending you lots of hugs.

Julie & Hannah

[Jenny & Judi in MN]

I'm sorry for your loss

[bgdavis]

I'm so sorry to hear about Keiko. She has joined my Criss Ann at the Bridge and they share the same anniversary of their passing. It takes a long time to begin to mend the tear in your heart.

Peace,
Bonnie and Angel Criss Ann

[infoviewer]

So sorry for your loss. Keiko is running free at the Rainbow Bridge and free of pain. Our love for our sweet furbabies is never ending. My heart aches for you. Love, JoAnne

[addy]

Hugs being sent to you. I'm sorry for your loss. You gave Keiko a wonderful life.

[Squirt's Mom]

Dear Chris,

I am so sorry to hear about Keiko. You worked so hard to give her the best possible life, something I know she is very grateful to you for. Your baby girl will always be near, watching over you with the same love and devotion you gave to her.

Today, she is strong and as she was when young again, chasing rabbits and hearing the wind sing in her ears. Keiko carries in her Heart a love for you that will remain for all time and when it is your turn to cross that Bridge, she will be waiting to fly into your arms once again.

We are here for you any time you wish to talk, to cry, to share memories of your lives together.

Our deepest sympathies,
Leslie, Squirt, Trinket, Brick, Sophie, and our Angels, Ruby, Crystal and Tasha


FRIEND

I lost a treasured friend today
The little dog who used to lay
Her gentle head upon my knee
And shared her silent thoughts with me.

She’ll come no longer to my call
Retrieve no more her favourite ball
A voice far greater than my own
Has called her to his golden throne.

Although my eyes are filled with tears
I am thankful for the happy years
She spent down here with me
And for her love and loyalty.

When it is time for me to go
And join her there, this much I know
I shall not fear the transient dark
For she will greet me with a bark.

~Author Unknown

[Nika'sMom]

I am so very sorry to hear about the loss of your Keiko. I am sending you many hugs and lots of love to help you through your pain,
Lynda

[Bo's Mom]

So very sorry to hear the news of your baby Keiko. Strength and prayers sent to you and your family at this very difficult time.

[Simba's Mom]

So sorry to hear about Keiko, sending hugs and prayers!