so worried advice please - now calcinosis (Vetoryl)

[tiggylola62]

Hello my name is Linda and my gorgeous boy is Tiggy he has just been diagnosed with cushing desease.
I am very worried as our vet has given us trilostane/vetoryl and said to give one 30mg capsule once a day and he weighs 9kg after reading up online I see it is recommened 1mg per 1kg of the dogs weight and to give twice a day which is 10mg more than the recommended dose I read about.
I have spoken to my vet today and mentioned this and I was told he goes by the instructions in the pkt (by the book as it were) he also said Tiggy's bloods were reading at 1100 which is very high as it should not be more than 600-700. Any thoughts would be so helpful as I am so new to this and am scared about giving the 30mg capsule incase it brings on the desease addisons which I read is the opposite of cushings and comes on if overdosed on trilostane/vetoryl.

Thanksfor taking time to read this. by the way Tiggy is a bichon.xxx

[Sage]

Don’t start Cushing’s treatment until YOU are positive
A) That the diagnosis is correct and
B) That you are 100% certain the dosage for the treatment (if/then) chosen is accurate and you have a full understanding of how you are to monitor the program.

There is no rush. Take a deep breath.
What behaviors make you think it is Cushing’s?
What tests were done? (And you will need to post those results here so these fantastic people can offer you their opinions.)
This website will help you tremendously…so get all your paperwork together and make a time line of sorts, and get ready for all the questions heading your way!

[tiggylola62]

Thankyou for your advice I will pick up information about results tomorrow my vet said he has 100% got cushings just concerned about dosage. x

[Sage]

What behaviors make you think it is Cushing’s?

What are the symptoms/behaviors YOU have seen at home that make you believe your dog has Cushing's?
Is the dog:
drinking a lot of water? accidents in the house? ravinous appetite? weakness in back legs?

[frijole]

Hello my name is Linda and my gorgeous boy is Tiggy he has just been diagnosed with cushing desease.
I am very worried as our vet has given us trilostane/vetoryl and said to give one 30mg capsule once a day and he weighs 9kg after reading up online I see it is recommened 1mg per 1kg of the dogs weight and to give twice a day which is 10mg more than the recommended dose I read about.
I have spoken to my vet today and mentioned this and I was told he goes by the instructions in the pkt (by the book as it were) he also said Tiggy's bloods were reading at 1100 which is very high as it should not be more than 600-700. Any thoughts would be so helpful as I am so new to this and am scared about giving the 30mg capsule incase it brings on the desease addisons which I read is the opposite of cushings and comes on if overdosed on trilostane/vetoryl.

Thanksfor taking time to read this. by the way Tiggy is a bichon.xxx
Hi from me as well. I would NOT start at that high of a dose. You are correct in your research and trust me, we have learned the hard way from helping dogs in distress that LESS is better with trilostane and you slowly tweek upwards if need be.

I used lysodren so I am hoping someone that has used trilostane will chime in. Kim

[frijole]

Thankyou for your advice I will pick up information about results tomorrow my vet said he has 100% got cushings just concerned about dosage. x

Please let us know if more than one test was done to diagnose cushings and if so what were they. We ask because it is quite often misdiagnosed... we just like to double check the testing as well as the dosage amounts for all new members... it has saved many a dog from distress, trust me.

Glad you found us - we are here to help, Kim

[Roxee's Dad]

Hello Linda and welcome to you and Tiggy :)

Symptoms are a very important part in the monitoring of the treatment of cushings. Sage has already mentioned a few of the symptoms.

Dechra the makers of Trilostane have some good information on their website that you may want to print out for your vet.


Starting dose

VETORYL Capsules should be administered orally once daily in the morning with food. Administration with food will significantly increase the rate and extent of absorption of VETORYL.

Ideally, the starting dose to aim for is 1.0 to 3.0 mg/lb (2.2 to 6.7 mg/kg) once a day based on body weight and capsule size. When calculating dosage, it is suggested to round down. Start at the low end of this range. If you have any questions on dosing, contact Dechra Technical Support at 866-933-2472 or support@dechra.com.

Notice they say to start at the low end of the range. The link to their website is:
http://www.dechra-us.com/Cushings-Syndrome/Veterinarians/Prescribing-VETORYL-1.aspx

Looking forward to reading more about Tiggy and his cushings test results.:)

[tiggylola62]

Hello to all I am so glad I found you all this is so worrying.
I will try to answer your questions. Tiggy has been on the royal canin obesity diet for a couple of years as he was overweight (big tummy)although I give my babies treats I did not think it was justified that he remained the same or gained weight over this period i'm sure the vets and family blamed me for overfeeding, my poor boy was so so hungry. Tiggy seemed old (as he is a rescue we are not sure of his age recent vet is saying he thinks he is in double figures.

18 months ago he had ops on both his crucic's and slipping pattela's again this was put down to his weight which did not help because lack of mobility.

He has been drinking more and urinating more including during the night I would not have noticed his over drinking as I have another dog and have at least 4 bowls in the house.

Tiggy's had a nasty round sore on his tummy when it cleared up it left a black scar even though it was not deep. his hair is thinner on both sides and on mainly one side his skin has gone dark.

He had a blood test which was sent off this rang alarm bell which led to an acth test these came back for positive cushings here are the results of the tests that were high. started 30ml vetoril once a day yesterday. Alt88 Alp348 cholestrerol 9 platelets555 Cortisol base 116.0 Cortisol 1 hour post1139. thankyou so much. xxxxxxxx

[labblab]

Hello Linda,

Thank you so much for posting this additional info about Tiggy. All the symptoms that you have written about are indeed consistent with Cushing's, and the post-ACTH result of 1139 nmol/l (which converts to 41 ug/dl which is the measuring unit used in the U.S.) is definitely elevated and a "positive" indicator for Cushing's as well. So I do understand why your vet has chosen to start Tiggy on the Vetoryl.

As far as dosing -- I am guessing that you live in the U.K., and if so, your vet will be relying on a different product information sheet than the one that is included with Vetoryl sold here in the U.S. For the most part, all the information is the same or at least very similar. But there are a few differences in wording and content. Here is a link to a U.K. Datasheet for the 10 mg. size of Vetoryl:

http://www.dechra-eu.com/files/dechra/Downloads/Pharma/Datasheets/Vetoryl_10_mg_Hard_Capsules_for_Dogs_16-12-10.pdf

You will see displayed a prominent dosing chart that indeed lists 30 mg. as the recommended starting dose for a dog of Tiggy's weight. As a matter of fact, the chart in the U.S. Product Insert makes the same recommendation. So your vet is right by saying that he/she is going by Dechra's published recommendation. The difference is that the Dechra literature here in the U.S. additionally lists an initial dosing range with the advice to start at the lowest end to minimize side effects (as John has noted in his reply above). Dechra literature in both countries recommends starting first with a once daily dose, and only switching to twice daily dosing in the event that symptoms do not seem to be controlled effectively throughout a full 24-hour time period.

The bottom line is that there is still some variability in the dosing protocols that are preferred by different researchers and clinicians throughout the world. But your vet's recommendation is supported by the published Dechra literature. Having said that, it may well turn out to be the case that Tiggy will actually end up doing better on a different dose altogether -- either greater or smaller. The proof of the pudding will be your observations of his behavior as well as monitoring ACTH testing. The first ACTH test should be performed approximately two weeks into treatment. Has your vet talked with you about scheduling a monitoring ACTH? As long as Tiggy appears to be doing well, then I don't think you need to be overly worried about the starting dose, as long as the monitoring testing is also performed as recommended. But if he seems "off" to you in any way, then you need to temporarily stop the Vetoryl and notify your vet so as to lower the dose and/or speed up the monitoring test.

Marianne

[addy]

Hi and Welcome,

Everyone has given you terrific information. My Zoe is on Trilostane. She has colitis/inflammatory bowel disease so we started on a low dose of Trilostane and kept increases to 25 % to 50%. While that worked for Zoe by avoiding side effects and keeping her colitis in control, it did not get her cortisol down to therapeutic range. We now uncovered allergies as well and I am in the process of bringing her cortisol down further.

Zoe is 18 pounds (she gained weight:rolleyes:) and I just bumped her to 40mg once a day. I admit my heart was in my throat yesterday and I had a knot in my stomach as the dose seems to be getting up there but I know if she has any kind of problem, I stop the drug.

I am sharing my story with you in hopes you can see you are not alone. Here in the states, the endocrinologists and internists are all over the place about what the correct dosing should be.

hugs,
addy

[tiggylola62]

Hi Marianne,

Thank you for replying. Yes Tiggy to go back for his second acth test in 10 day's time. Our vet started Tiggy on the 30m capsule because he is at the top end in weight(9kg)for this size capsule also the test for his cortisol level after 1 hour post was 1139 which is high. I thought his panting and big tummy were due to his weight gain I feel bad he has been poorly for so long he is a beautiful dog so sweet with everyone even stray cats that wonder in the garden he now shares his home with Lola a puppy farm mum who is in a terrible state even after 4 months she wont let me touch her(i will have to soon as she needs a bath and hair cut) but Tiggy is helping her and showing her the ropes he truly is a wonderful boy and although worried of adverse side effects of the medication I am exited he may feel better this is only his second day on vetroil.

thankyou
love from Linda x

[tiggylola62]

Hello Addy,

It is very worrying but we have to put our trust in our vets but saying that, I do not give my boy anything without research thank goodness for sites like this. Your boy on about the same dosage as mine but they all respond differently so I keep looking at him he is funny when I look at him he thinks I am going to give him food bless him. Let us know how he goes.

Love from Linda and Tiggy xx

[tiggylola62]

Hi I am rather confused and worried about Tiggy's future mobility as the information I have read states once on medication for cushings arthritis shows its self and as Tiggy has had major surgery on both of his back legs what am I to expect,will this become gradual or sudden
Please if anyone can give me some answers I would be very grateful.

love from Linda and Tiggy xx

[lulusmom]

Hi Linda,

I've merged your post in the How To subforum with your thread here so we have all of Tiggy's information in one place. Sometimes it's hard to find our original thread so what I've found works for me is to copy and paste the URL for my thread to a word document, or save the URL as a favorite on my computer. If you want to do the same, I've included the URL for your thread below. I'll also send you a PM which may be the handiest way to retrieve your thread.

http://www.k9cushings.com/forum/showthread.php?t=4160&page=2

Now, as to your question about arthritis. If a dog has serious arthritis, it will be unmasked rather quickly once cortisol has been brought down to an acceptable level. If Tiggy had luxated patella surgeries on his back legs, you shouldn't expect Tiggy to automatically have arthritis; however, if he had cruciate ligament repairs, arthritis is a pretty good bet.

[tiggylola62]

Hi Tiggy has had cruciat and slipping pattela surgery on both his back legs so your information is very worrying. Do you know if metacam or any painkillers are ok for Tiggy if his legs are very painful.

Thank you for your information

love Linda and tiggy xx

[lulusmom]

Tiggy is a little guy so he may not experience the same kind of mobility issues a big dog would have. My vet prescribed Metacam for my cushdog, JoJo. I'm not comfortable with NSAID's but I gave him a dose on his really bad days. In hindsight, I'm not really sure he needed it as once his cortisol was lowered and he built up some muscle mass, he never displayed signs of weakness again. I believe other members have used Metacam with good success. I have my dogs on Cosequin and you can start Tiggy on that right away. I asked my vet if all of my dogs would benefit from it and she said if it has a joint, give em Cosequin.

I know this is easier said than done but please try not to worry unless Tiggy gives you a sign that you need to.

[cerndo]

Hi everyone, I just lost my Bichon, Ginny on Monday and she was a Cushing's dog for about 5 yrs. She was the same weight as Tiggy and was started on 30mg of Trilostane at the beginning, which was the recommended amount for a dog that weight. Eventually, she was increased to 35 mg a day i.e 15mg in AM and 20 mg in PM and her clinical signs were controlled beautifully. I think expert endocrinologists like to recommend twice a day dosing due to the short half life of the drug. At the beginning of Trilostane therapy, it took about 4 weeks for the clinical signs to dissipate in Ginny. Her hair started to grow back, pot belly decreased and PU/PD came back to normal. It is important to get the follow-up ACTH stim tests done after a couple of weeks to see the response. From there, you can fine tune the dosage, prob in 5 mg increments up or down. Hope this helps.

[mytil]

How are things going?

Terry

[frijole]

Hi! I saw you asked about loading. Vetoryl is the same as Trilostane. It is different than lysodren and works differently. Lysodren requires what is called loading but your drug does not so don't worry. Kim

[tiggylola62]

Hello I have been trying to understand this horrible illness but I was wondering if you lovely people could give me a bit of advice.
Tiggy is on his 6th vetoryl today this is the question,before Tiggy was diagnosed last week he had a surface sore on his tummy it was about the size if a penny after it heald up it has left a black scar I have read a little about the calcium sores in cushings dog and do think it was this but over the last 2-3 days Tiggy has developed 2 more one is only very tiny the other one is similar to the first one I am worried as these have shown thenselves since the medication started but is this because the meds have not had time to work:confused: If anyone can shine some light on this I would be so grateful also what to put on his sores to help them heal (he does not seem to bothered by them) thanks for reading.

Love from Tiggy and Linda xx

[tiggylola62]

Hello and thankyou to...Lulusmom,Cerndo,Frijole and Mytil and everyone on this sight for supporting each other. Firstly I would like to say how terribley sorry I am for your loss of your dear companion Ginny words can not express the sadness I feel for you. Your advice about vetoryl was interesting thank you especially as your little girl was a bichon to of the same weight, Our vet is very nice and a good doggy doctor but as I mentioned before he goes strictly by the instruction in the pkt which I was told vary in different countries.

Tiggy is on his 7th 30mg capsule today and no change for the better yet but my vet said it would take some time as Tiggy's readings were so high infact I am a nervous wrek to be honest as sores are appearing on his tummy and he is urinating more twice in the night over the last 2 nights and panting at night would the cushings advance that quick he is also wheezt when resting I just don't know maybe he is stressed as his dew claw is sore and he keeps licking it I put a bandage on it so maybe it was this why he was panting(Tiggy has seen the vet several times about this dew claw and has had antibiotics. I was wondering if he may have a urine infection as he tried to urinate after he had been if you know what I mean I am watching him closely today to see if I need to visit the vet before thursday which is when he is having his 2nd ACTH test well guys that about sums it up thank you if you have read all of this;)

Love to all your furry children from Linda and Tiggy xxxxxxxxxx

[labblab]

Dear Linda,

I am sorry that you are not seeing improvements for Tiggy. But like you, I have to wonder whether he might have a UTI. That could certainly account for some of the ongoing issues. Please keep us updated as to how he is doing, and whether or not you feel he needs to be seen before Thursday.

Please give your sweet boy a cuddle for me,
Marianne

[busyman370]

And remember, do every ACTH test at the same time span after her morning dose.

I have seen it recommended that tests be done at three hours after the morning dose.

My literature from Dechra says four to six hours after the morning dose.

I started out doing the test at five hours after the morning dose, and have been advised to continue with that regarding the consistency of each future test result, and I agree.

You may want to investigate this and decide how long after the morning dose you feel is the best time period, then stick to it with all the following ACTH tests.

I think this important and wanted to mention it to you.

Fred.

[tiggylola62]

Hi and thank you Marianne and Fred,

Tiggy seems a little calmer so will wait till thursday my poor little boy just hates the vets and as he gets so stressed out but any change we will get there before thurs the sores are looking peculier sort of dry black and white with pink:rolleyes:

Fred you have got me concerned about timing for the vetoryl as Tiggy has no appitite in the mornings and refuses food hence he has it between 5.30 and 6.00pm this was arranged with our vet. Tiggy had his ACTH test about 10am the first time and also thursdays is also 10am so I am guessing that will be ok.

Tiggy is such a lovely boy and is a great roll model for Lola my rescue from a puppy farm she was a mother and has so many litters at the young age of three I have had her for three months now and am still unable to touch her although she will take a treat from my hand Tiggy is so sweet with her and lets her in his bed aww so sweet.

Love from Tiggy and Linda xxxx

[labblab]

Oh Linda, I too am now concerned about Tiggy's ACTH testing schedule. Since your vet is following the dosing information in Dechra's product datasheet, I am very surprised that he/she is scheduling the testing in this timeframe. Dechra is VERY specific that all monitoring ACTH tests should be performed 4-6 hours after dosing. Otherwise, the results cannot be assessed according to the published monitoring guidelines. Theoretically, Vetoryl has a very short effective life in the body -- no more than approx. 12 hours. So if Tiggy is getting his medication at 6:00 in the evening and not being tested again until 10:00 the next morning, the effect of the medication may very well be totally gone and the cortisol level may have rebounded back up again. As a result, it may erroneously appear as though Tiggy needs an increase in dosage when that is not the case at all.

The point of the ACTH monitoring test is to capture the cortisol level at it's LOWEST, at the time that the medication is working most efficiently. If Tiggy will not eat anything at all in the morning, that is indeed a problem because the drug is not metabolized as efficiently without food. But would he at least eat a few special treats in the morning along with the medication? Of the two issues, my own lay opinion would be that, even without much food, it would still be better to dose Tiggy in the mornings (or at least early enough in the afternoon) so as to be able to perform the ACTH testing within the desired 4-6 hour timeframe. Even if flawed, I think the results would be more meaningful than waiting until 16 hours after dosing. Neither option is ideal, but I think it comes down to picking the lesser of the evils. And that is something I'd want to discuss in more detail with your vet.

Here's the relevant quote from Dechra's U.K. Datasheet:


Administer orally, once daily, with food. Dosing in the morning is preferable as this will allow your veterinary surgeon to perform monitoring tests 4-6 hours following administration of the dose.

Marianne

[labblab]

I wanted to stop back and also give you a quote regarding the length of time that Vetoryl typically remains active in the body:


Trilostane absorption is enhanced by administration with food. In healthy dogs, maximal plasma levels of trilostane occur within 1.5 hours, returning to baseline levels within twelve hours,although large inter-dog variation occurs.

This quote appears in the U.S. Product Insert, which your vet may not have seen. So here's a link to the complete U.S. Product Insert:

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

From a safety standpoint, the biggest concern for a dog taking Vetoryl is to make sure that the cortisol level is not dropping too low -- to make sure that the dog is not being overdosed. So that is why it is particularly important to perform the monitoring ACTH tests at the time of day when the drug is having its maximal effect, not the time of day when the effects of the drug have likely worn off.

Marianne

[tiggylola62]

Hi and thank you Marianne

I have left a long message with the secretary and stressed how concerned I am so I am waiting for phone call as the vet goes by the book it is strange I am wondering if he was listening to me (as I do ramble)when I said Tiggy will not eat in the morning so he will have the vetoryl at tea time WHY was'nt he or maybe he is new to cushings what ever Tiggy comes first so I just hope he will not try to justify this if so I will ask for a 2nd opinion. I guess if he has his ACTH test tomorrow evening the first one will not count so am I right in saying he will need a 3rd ACTH test in a further 10 days we are so glad we have found you thank you so so much.

Love from Linda - A big kiss from Tiggy my sweet boy x

[tiggylola62]

Hi again I have spoken to our vet who was not agreeable but I insisted Tiggy is to have his ACTH test 2pm on tuesday as I missed veterol on purpose yesterday then started him with the capsule 9.30 am instead of 5.30 pm I was told at the begining of all this it did not make any difference am or pm Tiggy does not always want breakfast so I chose pm. I bought some pate which I smeared on the capsule well little tiggy,s face he just could not resist.

Does anyone know if Tiggy will not take anything at 9.30 am is it ok to give it a bit later maybe up to 11am then the next morning at 9 .30 am this would only be occasionally if he will not take food after tempting him.

Tiggy was given a 10 day coarse of antibiotic this morning for the sores on his tummy vet seems to think it is caused by hair folacauls(spelling sorry) as his calcium levels were not raised in his blood?but I think it is the cushings calanosis cutis as the sores are like the ones people have described on this forum.

When I went to the vets this morning I took a urine sample with me even though I was not asked to vet is sending it to the lab for a PLN test as the protien was raised quite a lot higher than he would have expected all this worry I was wondering if the cushings would be responsible for this vet said Tiggy may have to go on a drug ( I think he said anapril for his kidney,s even though the drug is perscribed for hearts but he said we will wait to see what the lab comes back with
Thaank you so much everyone.
Love from Tiggy and Linda xx

[lulusmom]

It is important that the acth stimulation test be done within 4 to 6 hours of dosing so if you give Tiggy a dose at 11:00 you will have to make sure you have him to the vet by 3:00 or 4:00. Have you thought about switching his feeding time from evening to morning? If you skip his dinner, he's likely to be hungry in the morning.

[cerndo]

Hi again I have spoken to our vet who was not agreeable but I insisted Tiggy is to have his ACTH test 2pm on tuesday as I missed veterol on purpose yesterday then started him with the capsule 9.30 am instead of 5.30 pm I was told at the begining of all this it did not make any difference am or pm Tiggy does not always want breakfast so I chose pm. I bought some pate which I smeared on the capsule well little tiggy,s face he just could not resist.

Does anyone know if Tiggy will not take anything at 9.30 am is it ok to give it a bit later maybe up to 11am then the next morning at 9 .30 am this would only be occasionally if he will not take food after tempting him.

Tiggy was given a 10 day coarse of antibiotic this morning for the sores on his tummy vet seems to think it is caused by hair folacauls(spelling sorry) as his calcium levels were not raised in his blood?but I think it is the cushings calanosis cutis as the sores are like the ones people have described on this forum.

When I went to the vets this morning I took a urine sample with me even though I was not asked to vet is sending it to the lab for a PLN test as the protien was raised quite a lot higher than he would have expected all this worry I was wondering if the cushings would be responsible for this vet said Tiggy may have to go on a drug ( I think he said anapril for his kidney,s even though the drug is perscribed for hearts but he said we will wait to see what the lab comes back with
Thaank you so much everyone.
Love from Tiggy and Linda xx


Good day, Linda

In my experience with my Bichon, Ginny, I think the first ACTH stim test after starting Trilostane is the most important to get a good reading to determine how to proceed with the dosing.

If I can recall, I started out with 20 mg once a day then increased to 30 mg once a day. Eventually, we split that dose in two to 15 mg BID then finally settled at 35 mg, 20 mg in the AM and 15 mg in the PM. Her Trilostane was made at a Compounding Pharmacy, therefore had better choice for size of capsules.

This was her final dosage for the last 3 years. I was happy with control of all her clinical signs especially the panting and drinking. It may take 4 weeks or so b4 these subside, so hang in there.

As well, any ruptures, hot spots, scales she had, I treated with Polysporin Cream (not ointment- too messy) and bandaged them with breathable gauze and breathable gauze tape (even going around her body lightly to ensure it stays on). Any really itchy spots I sprayed with Benadryl spray prior which is an over the counter product.

Also, Ginny stressed out while left at the clinic for her ACTH test so I took her home in between needles so she wouldn't have to stay in the clinic alone. I'm not sure if the stress of being left alone would skew cortisol levels so I didn't chance it.

I hope this helps. Robert

[tiggylola62]

Hello and thank you Robert the information is very helpful I was thinking that by the time Tiggy gets his blood samples taken he will be so stressed as he shakes as soon as we walk in the door so I am concerned about his cortisol levels.

Tiggy's skin is crusty and black the sores are very strange looking they start off a small red spot then over two days they become red and black the crust is sort of whitishand black as I said he is on antibiotics vet says its not caltosis cutis as he took a look on line and Tiggy's are nothing like it but I disagree.

Thanks for the info love from Tiggy and Linda xx

[tiggylola62]

Hi I am little confused where/how to start a new thread but will carry on anyway and hope someone will reply to me. Tiggy has had cushings for approx 18 months he has just spent a morning at vets for his ACTH test I phoned for results and could not get a vet to talk to me but the nurse said his levels are acceptable and continue with the 2x30mm of vetoryl a day one morning one evening. some time ago he had an MRI scan (very expensive)but I wanted to know what I was dealing with the test was no tumour to be seen but the specialist hospital are saying it must be a micro tumour which can not be seen. With that outcome I was pleased it was not a large tumour BUT still not convinced as Tiggy having small fits which infact he had one last night he allways pee's himself so each day I check all the places he sleeps for wet patches I actually watched him last night and the fit lasted only seconds then he pee's. The fits I know he has had works out to about one every 3 weeks vet says no treatment as the side effects are not good. I'm just wondering why these fits if cushings under control vet said maybe his blood pressure as it was high when it was tested son he is on an 8th of an amolodapin at night and he must lose weight so now got to grips with a diet for him and he lost 9lbs in one month which vet was pleased about poor Tiggy he is always hungry which I thought would subside once cushings was under control. So the fit he had last night was a surprise as with losing a bit of weight and being told cushings under control why the fits. Tiggy also on 1 denamarin daily to support his liver(aftertaking this his liver was improved in his last test!!)Tiggy weighs 10 kgs and has been on a diet for a month. thanks to anyone who has any veiws on this. Linda x

[Harley PoMMom]

Please get copies of that ACTH stim test and post the results here. We have seen many times a vet say that a dog's cortisol is within the acceptable range when in fact it is not. Did the vet run a chemistry/CBC blood panel on Tiggy, and if so could you post anything that is marked abnormal?

Other issues can contribute to urine accidents other than the cortisol not being controlled such as an UTI, or bladder/kidney stones. Was an urinalysis done recently?

Once those test results are posted it will give us a better perspective and then, hopefully, we can provide you with more meaningful feedback, ok?

Love and hugs, Lori

[frijole]

Please describe what you are referring to as a 'fit'. This isnt necessarily something we see with cushings. If you can it would be nice to video the episode and so we can see firsthand. It also is very helpful to show vets so they know exactly what you are talking about. Kim

[tiggylola62]

Thank you Lori and Kim for your reply's I will phone my vet for results after the bank holiday but I know Tiggy only had ACTH test this time but 3 months ago he had his bloods ect taken which were all ok even his liver had improved slightly this is why it was 3 months before this one as prieviously he was in vets every month it has taken nearly 14 months for the vet to be happy with his results except his blood pressure which the vets put them down to these fits very hard to record them as they only last approx 30 seconds when having these turns he holds his head back and shake and pees it always happens when in deep sleep his gums go white it all happens so fast he had one last night the one before this was 3 weeks ago the only time he pee's himself are at these times.I am being careful with his diet as hopefully if I can get his weight down the fits may stop this is what my vet said anyway but very hard as Tiggy so hungry all the time which is why I will talk to the vet as I thought his hunger would die down once ACTH test was acceptable I feel so sorry for him wanting food all the time. thanks again xx

[molly muffin]

Hi, it really doesn't sound like his cortisol is controlled if he is still ravenously hungry.
His ACTH post number can be as high as a 9 if symptoms are controlled (doesn't sound like the are completely) or 1.5 - 5.4 if they are not. This is in ug. Your results are probably in nmol, so you divide that number by 27.59. We'll know better once you have the actual numbers.
No 'fits' aren't something we usually see with cushings or as a side affect of medication. So, that is a bit confusing.

Sharlene and Molly Muffin

[frijole]

The reason why we want the actual numbers on the tests vs taking the vet's word that the test results are "ok" or "normal" or "acceptable" is because mistakes are often made. There is a normal cortisol range for normal dogs and there is what is acceptable for dogs with cushings. Those numbers are lower and sometimes labs, vets, and the front desk people mess up.

Regarding the fits you describe - that isn't a cushing's thing. I would highly recommend you video it the next time it happens and show it to your vet. If possible it'd be helpful to link it here (via utube) so we could see it as well.

Hope this helps - Kim

[tiggylola62]

|Hi can anyone advise what to put on the skin problem of my dog tiggy he has cushings and is a bichon he is on 30 ml vetoryl twice a day and only had his atch test 4 weeks ago which my vet was happy with but the skin prob is called cacitosis sorry not sure how you spell it i would be so grateful if anyone could advise me what to put on these sores. thank you Linda and Tiggy xx

[molly muffin]

Can you tell us what the result of the ACTH test was, particularly the post number?
That can be very helpful of seeing where your dog is at with cortisol control. Having cortisol controlled I believe is fairly essential to helping to get the cc under control. It can be very difficult to do. Have you tried any of the vet prescribed medicated shampoos. I am currently thinking of ketochlor. This has been prescribed for some dogs with cc.
Coconut oil rubbed into the skin (pure coconut oil) has shown some benefits also.

Sharlene and Molly Muffin

[Peety's Fur-mom]

Hi Linda and Tiggy, I am so sorry to hear about your lil fur baby and all the reasons that brought you here. I will let others talk about the Cushing's. My lil guy is still undetermined for Cushing's, but he does have Calcinosis Cutis, so that I can talk about. I cannot see the Cushing's, but I can see the CC and it is pitiful. Heartbreaking to see my lil guy so messed up. :( I don't have any magic treatments. I understand with the Cushing meds the skin responds as well. I'm not there yet and my lil guy has a very severe case of it. I am doing mostly home remedies. I will not go into my hodgepodge of concoctions, the main thing I have found is to keep them clean. I bathe him in Hibiclens (from the drug store) every other day. It is actually a surgical scrub and has anti-everything that is good for their skin. He is kinda past the scratching, he does it just a little. But he does wear a cone all the time just to prevent him from making matters worse. I shaved him because his hair was falling out and it helped me to be able to see all the bad places.

I am seeing an Internal Medicine Dr. in another week regarding the Cushing's and hopefully they will have some ideas about how to clear up the skin. It's not pretty, but so far it is not adversely affecting him. He still plays and eats and is happy and makes me happy everyday. But I will be glad to have another opinion about what is going on internally. Hang in there, and just make sure you are keeping him clean. I use Neosporin on any bad places. Can you post pictures of Tiggy? If I find anything magical I will pass it along. Hugs to you and your lil fur-baby.

Pat Peety's #1 fan

[addy]

Here is an article about a severe case of calcinosis cutis most notably on the face. You will see all the different treatments they did and after six months it did resolve so there is hope.


http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=659278&sk=&date=&pageID=3

It really depends on if you have open sores, etc. My Zoe has a mild case of it, no open sores and she also has crusty spots which are seborrhea dry and oily with mild bacteria and yeast which is on the skin surface, not deep into the skin-we did a scraping to diagnosis- so that is why I am using Ketochlor Shampoo which is helping her skin improve. She is not itchy or scratching at all and the Ketochlor is getting rid of the surface bacteria and yeast as well as the oily build up.

I don't know the severity of your dog's calcinosis cutis so am reluctant to advise using Ketochor. I tried a non prescription shampoo for dandruff on Zoe with the active ingredient of miconazole and salicylic acid- her skin turned bright pink like a bad sunburn after 2 uses and we had to discontinue it.

Not all internal medicine specialist are good with skin issues so you would want to ask that question before going that route.

Hang in there. I would try to research as much as you can.