Question about Athritis and Cushings

[Beausmom]

My precious Beau baby boy has recently been diagnosed with Cushings. He was taking 60 mg of vetoryl and yesterday we upped the dosage to 90 mg.
As a new cushings mommy i have done some reading online and was so glad to see some horrors dispelled here.
On our first visit to the vet he did an xray to check for tumors. None were found but we did get a chance to see how bad Beaus' arthritis really is. In my research i read somewhere that if a dog has arthritis it is sometimes better not to treat the cushings. Does anyone have any experience with this?
I have noticed that Beau is shaking alot now and have been told that this is a sign of severe pain. It is so heartbreaking to watch him shake and see the look in his eyes :(
I did speak to the vet and he was perplexed about the shaking but he didn't mention anything about pain.
I think between the information overload and lack of sleep (Beau still need to go out every 2/3 hours day and night) I am just confused and not sure what is the best thing to do for my baby boy.

[frijole]

Hi - you have definitely come to the right place for help! :)

You said you went from 60 to 90 mgs of vetoryl... could you confirm that an acth test was done before making the switch to check cortisol levels? That is a fairly high dosage - but it depends on your dogs weight.. can you please tell us how much Beau weighs?

Tell us the whole story - all the symptoms, all the tests, the results, etc so we can make sure we give you good advice.

Keep a close eye for vomit, diarrhea, decrease in appetite or thirst. If that happens it is a sign the dose is too high. Do you have prednisone on hand in case of emergency?

I ask this because the shaking could be due to the vetoryl. Its hard to know - depends on when it started. Regarding arthritis - most of us had old dogs when they discovered the cushings and cortisol eased the pain. When you reduce the cortisol the aches are no longer treated. Many use adequan injections - I did for years. I also gave glucosamine chond, fish oil.

Looking forward to learning more. Kim

[Beausmom]

Thanks for your response!
The first thing i noticed was that Beau was drinking alot more water than usual and wanting to go out more often and he seemed very lethargic. We took him to the vet and she did some blood and urine tests along with an xray to check for tumors. She mentioned his "pot belly" which i hadn't noticed. (as a younger dog Beau was very muscular and trim but with age and arthritis he has lost a lot of his muscle tone). The x ray didn't show any tumors but we did see just how bad is arthritis is. She talked about the possibility of Cushings and we schedule a acth test. Before the test was done i noticed a small round bald patch on his side, about the size of a quarter. (it has since grown to aprox. 6 inches.)
The test confirmed Cushings and he was put on 60 mg of vetoryl and scheduled for another test 2 weeks later. I don't have the lab results, my husband took him to the vet both times and didn't get copies of them. Honestly i didn't even think to ask for them. In the 2 weeks between he seemed to be drinking a little less but was still very lethargic if not even more so. I noticed several times that when he was lying down his whole body would shake and he looked completely miserable. I thought may be cold so i tried covering him with a blanket but it didn't help. after the second test I asked the vet about the shaking and she said that it wasn't a side effect of the medicine but wasn't sure what it might be. She asked me to look up hypothroidism which i did but although some symptoms do overlap Cushings, it didn't seem to fit.
Beau weighs aprox. 70 lbs. according to the pamphlet that came with the medicine 90mgs is within the limits.
I've never heard of prednisone? what is it for? I will go pick up some, just in case. I have noticed that in the last couple of days Beau isn't eating as much and i am keeping an eye on that.
Thanks again for your help. I'm just a confused, sleep deprived, worried mommy lol.

[Bo's Mom]

Hello and welcome to the group. I don't have any answers for you but I can assure you that there are lots of wonderful caring and very knowledgeable people who will be chiming in to answer any question that you may have regarding the treatment of your Beau. My dog is also named Bo and we have been dealing with the ups and downs of this disease for over a year now.
Again...welcome and ask away!!

[Squirt's Mom]

Hi and welcome to you and Beau! :)

I'm a bit concerned after reading that your vet says trembling isn't a side effect of Trilostane (Vetoryl)....because it is. It can cause trembling simply from the drug and the drop in cortisol PLUS cause serious trembling and weakness when the cortisol goes TOO low - which can and does happen if the dose is too high or there has been a misdiagnosis. Another thing that bothered me is them telling you to go research a disease rather than simply test for it as it is very easy to test the thyroid function. Hypothyroidism is one of many conditions that mimic Cushing's so it is important to rule it and things like diabetes, liver disease, kidney disease, and so forth out before arriving at the diagnosis of Cushings...and certainly before starting any treatment. So, I am very anxious to see those test results. ;)

Please post all labs that were abnormal along with the ACTH and any other Cushing's test like the LDDS, HDDS, ultrasound, or UC:CR along with units of measurement and the normal ranges for each value. This will help us a great deal is helping you and Beau. He did have more than just the ACTH to diagnose?

Did you noticed any increase in appetite before starting the Trilo? What about panting? Has he been seeking out cool places to lay, avoiding the heat?

As Kim said, cortisol acts like a natural anti-inflammatory so while it is running rampant in the body, it is "treating" inflammatory conditions like arthritis, allergies, etc. Once treatment starts and the cortisol is lowered back to more normal levels, the inflammation often rears it's ugly head. There are several things you can try to help alleviate his pain. But first, let's see those test results and make sure we are actually dealing with Cushing's. ;)

If you see loose stools/diarrhea, loss of appetite, nausea/vomiting, lethargy, increase in trembling - stop the Trilo and call the vet for an ACTH asap. These are all signs that the cortisol has dropped too low and it can be life-threatening so we don't take chances. ;)

I'm glad you found us and look forward to learning more about the both of you as time passes. I want you to know that you and Beau are no longer alone on this journey - we will walk with you every step of the way. Please ask all the questions you may think of and we will do our best to help you understand - or we will learn about it together. Ya'll are part of our family at k9c now. :)

Hang in there!
Hugs,
Leslie and the gang

[molly muffin]

Hello and welcome!

Leslie and Kim have given you the pertinent facts, so I'll pipe in with a warm welcome and a hug.

This is an awesome group of really knowledgable people. So many have been living years with cushings and figuring out what works, what doesn't. So, any time you have a question or how about just dropping by to tell us how you and Beau are doing. It does take a toll on both the momma and her baby getting through all this medical stuff.

The vet should just print off copies of any lab results. Just start keeping your own file at home, so you can easily reference it when you want to. You Will want to. You'll read something or someone will say something and you'll definitely have a desire to pull out the folder and see if it pertains to Beau to. At least that has been my experience.

I'm so happy you found us. I can't tell you the calmness that knowing there is someone out there who is dealing with the same thing or has done so in the past, ready to pass what they have learned.

Hugs,
Sharlene

[Squirt's Mom]

Hi Mom,

How's Beau this morning? How is MOM this morning? :D Let us hear from you when you can.

Hugs,
Leslie and the gang

[Beausmom]

Thank you everyone one for all your help. sorry it's taken me so long to respond but i have a torn rotator cuff and sorta out of commission lately.
Beau is doing soooo much better! I still haven't gotten copies of his test results but i plan to when i can drive again. He is drinking less water and even though he is still going out a lot i think that some of it is just habit now. He has also perked up significantly. Actually this morning around 7 am i heard him upstairs barking at my husband to wake up and let him out. He has also been barking at things outside. I didn't realize before how long it had been since i had heard his bark. I haven't seen him shaking in several days but i have to admit i am not as observant right now as i could be. We are continuing to watch him and he goes back to the vet in a few weeks to check his progress.
I'll check back in soon and again, thank you all for your help. What a wonderful group of people here. you are such a blessing.

[molly muffin]

oh really sorry to hear that you are having rotator cuff problems. Did you have to have surgery?

I'm really glad that Beau is doing better. :)

hugs,
Sharlene

[Squirt's Mom]

Oh, bless your heart! I can barely imagine what you are going through with your shoulder. I hope your doc(s) can bring you some relief soon.

I am really glad to hear that Beau is doing better. The barking sounds like a really good sign! :) I can just hear him waking your hubby! :p We have Barkfest at every meal in our house and I can't imagine those times being silent so I know how wonderful that bark sounded to you and your hubby.

Keep in touch as you can and let us know how Beau, and YOU, are doing.
Hugs,
Leslie and the gang