Odie Over Dosed

[Michelle&Odie]

My German Pinscher 7 yrs old was diagnosed in January with Cushings .. He did respond to Vetoryl slightly and 3 weeks ago seemed to be getting worse. Insidently the cost of the prescription had gone up by $40.00 every 15 days. After stewing about the cost for the past 4 weeks I contacted the Vet. It seemed the assistant had made an error ... what was to be a prescription for 10 ml (2X a day) with a 30 day package was turned into a 30 ml (2X a day) with a 30 day package. For the past 4 weeks I have been giving my Odie 3 times his normal dose. He has been really lethargic, week hind end (actually crawled up the stairs) and has been dry heaving and not a very good appetite. He has also been shaking like there were fireworks going off. The vet down played this and now I am concerned as to what permanent damage may have been done. Any feed back on this?

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[Squirt's Mom]

Hi and welcome to you and Odie! :)

Is he still on the Vetoryl? When did he have his last dose if so? Do you have any prednisone? If so, give him the appropriate dose now. If you do not have pred, the second point below is even more critical.

First and foremost - do not give any more Vetoryl to Odie for now.

Second - get him into your vet for an ACTH and check of his electrolytes today, now. It sounds like Odie is in crisis and may need life-saving intervention immediately. DO NOT let your vet blow this off. This is critical. If they refuse to work you in, go to the closest ER facility asap...then find a new vet.

Let us hear from you after you see a vet.

I don't mean to scare you but this is dangerous and he needs to be seen asap.

Hugs,
Leslie and the gang

[labblab]

If Odie has been given three times his normal dose, your vet ought to be very concerned given your description of Odie's behavior!!!! I would think that Odie should be given no more trilostane until blood testing is performed to check his cortiosl level and status of his blood chemistries (electrolytes). Overdosing can have very serious, even life-threatening consequences. What has your vet advised you to do?

Marianne

[Michelle&Odie]

Thank you so much for your response. I have contacted the Vet and have made arrangements to get him in immediately. Will let you know the results. Thanks again.

[labblab]

I'm very relieved that Odie will be tested. By the way, I think your vet ought to be providing the tests free of any charge to you given the magnitude of the dosing error committed by his office!

Marianne

[Michelle&Odie]

Well, Odie went in and had his Electrolytes tested. It all came back good .. liver was normal, which it wasn't when this all started, kidney function OK the one thing that showed up was Anemia. This was not present before. We had always suspected that the Cushings was not his only issue but thought that we would treat this first and see where things would lead. He has had issues breathing which was thought to be part of the Cushings and had developed a lump between his shoulder blades. This lump has increased in size in the last 4 weeks or so. The Vet decided to do an xray on his lungs and abdomen ... his lungs came out fine but there is an issue with his abdomen. I was unable to go to the Vet's myself and had my Mother take him. Kept in touch with the vet by phone getting the results but she would not tell me on the phone the issue. She wants me in the office when I finish work. I am concerned but I believe that things work out the way they are suppose to whether its what we want or not. Keep your fingers crossed for him, and thanks for the support.

[labblab]

Michelle, I'm very sorry that it sounds as though there is some additional problem going on with Odie. But as far as the trilostane, testing the electrolytes alone is not enough if you suspect an overdose. An ACTH stim test also needs to be done in order to check Odie's cortisol reserves. If they have dipped too low, he needs supplemental prednisone until his adrenal glands rebound. At a bare minimum, a baseline cortisol needs to be measured now and it needs to be safely above 2.0 ug/dl. Before any trilostane dosing is resumed, however, a full ACTH has to be done.

[Squirt's Mom]

They are doing an ACTH, right? This is important and I am very glad his electrolytes are alright. Please be sure to get copies of the tests today and post the results for us, if you don't mind. Also get copies of all the tests that were done to diagnose the Cushing's and post those results as well. You will ask for the actual results, not the invoice they give you at the end of your visits that show the amount due and paid.

Let us know what you learn from the vet this afternoon and, if at all possible, as much as I hate to say this, based on their abysmal lack of attentiveness to and apparent lack of concern over Odie's recent dosage screw-up, don't make any decisions about doing anything else today.

And until you get the ACTH results back, do not give any more Vetoryl regardless of what the vet tells you. I have serious concerns about the level of experience your vet has with Cushing's and the drugs used to treat it. This is not a judgement against your vet. It has been our unfortunate experience that many well-loved and trusted vets were simply over their heads when it came to Cushing's and our babies paid the price.

It is a great relief to hear the electrolytes are alright. That truly surprises me based on your description of his behaviors and I am quite pleased to be surprised. :)

Hang in there!
Hugs,
Leslie and the gang

[Squirt's Mom]

Hi Michelle,

How is Odie doing today? Hope to hear from you soon...worry-wart here. :o

Hugs,
Leslie and the gang

[Michelle&Odie]

Well we treated Odie with prednisone started on Friday, by Saturday he perked up quite a lot. I was really surprised by his response, he was actually barking at the dog next door and went for a walk with me and just hung out outside .. it was a good day. As was my fear, Odie's problem is not only his Cushings, he was given xrays Friday and has 4 tumours. 2 on his liver, 1 large one on his lower back causing his bowel to be pushed down and the one between his shoulder blades that we did know about and have debated on having it removed. He does not seem to be in pain, just somewhat uncomfortable. I have made an appointment with an acupuncturist on Wednesday in hopes that she will be able to tell how much pain he may actually be in. This will help with my future decision. I am heartbroken and having a hard time talking about this ... thanks again.

[Squirt's Mom]

Hi Michelle,

I'm glad the pred perked him up. No doubt his cortisol was much too low.

If I were you, I wouldn't worry about Cushing's right now. With the stress from the tumors any testing you might do for Cushing's will more than likely be skewed - inaccurate. So just forget about it for now.

I can imagine how scared and upset you are to hear this news about your sweet boy. When they told me about Squirt's tumor on her spleen, I think I stopped breathing for a while after - then went into full panic mode. Waiting those few days between learning of it and having it taken out seemed like years and I was terrified the whole time. We were lucky - it was benign and she has been fine since.

Has your vet given you any idea of the type of tumors they are? Are they operable? Is that something you can or want to consider? We may not have the answers you seek about this but we are always here to listen.

I hope the acupuncturist can help you both.
Hugs,
Leslie and the gang