Newly Diagnosed - 8 y/o Yorkie

[abbey]

My 8 year old yorkie was just diagnosed with cushings. We currently have her on the vetoryl. She had 5 doses so far and no side effects as of yet. Can she still have a reaction to the medication or are we ok thus far.

Thanks for any help!

[addy]

Hi and Welcome,

I am so glad you found your way here. Could you tell us a bit more information? What does your Yorkie weigh? What is the Vetoryl dose? Are you giving it once a day? Has your vet scheduled an ACTH test sometime within two weeks of starting?

Could you also tell us how your pup was diagnosed? What symptoms have you been seeing?

Wow, lots of questions, dont run away, it just helps us understand the situation.

In my opinion, I would watch my pup like a hawk. My Zoe has been on Vetoryl for just over a year. I just had to change her dose and I am still watching like a hawk. You just never know.

Others will be along soon to help answer your question. We have quite a bit of info in our Resource section to get you started reading if you have not browsed through the articles. The more you learn, the better and you are off to a good start asking a question:):):)

[Squirt's Mom]

Short answer - you can never totally relax when a pup is on treatment for Cushing's whether treating with Vetoryl (Trilostane) or Lysodren (Mitotane). Both are life-time treatments and both require diligence on our part - always. ;)

Have you been told the signs to look for that would indicate the dose is too high, or the cortisol has gone too low? Just in case here they are - loose stools/diarrhea, nausea/vomiting, loss of appetite, lethargy, weakness. If you see any of these signs, stop the Vetoryl and call your vet asap for an ACTH to check the cortisol level. It may be necessary to also check the electrolytes at that time.

Hugs,
Leslie and the gang

[mytil]

Hi and welcome from me too.

Here is a link you will find very informative about Trilostane/Vetoryl - http://www.k9cushings.com/forum/showthread.php?t=185.

As Addy mentioned, let us know the dosage.

And also, will you be having an ACTH test perform in about a week?

When you can, post the results of the tests performed to diagnose Cushing's.

Terry

[abbey]

Hi, Thanks for responding so quickly. Abbey is a 22 lb. yorkie believe it or not. We were told she would only grow to be about 7 lbs. She is on 10 milligrams twice a day. She was just diagnosed this past week. She went in for the day long blood panel and her level stayed at 5.3 after the third time blood was taken. For about 6 or 7 months she's been panting all the time and we didn't think anything of it until about 2 weeks ago she vomited and the next day was crying all day and her skin turned red. We rushed her to the emergency room. But that same day I took her to our own vet and they suspected cushings and started the testing process. She is such a wonderful dog and from reading online about cushing, it states that even on the meds. life expenctancy is about two years. I hope this is not true. Our vet said they have good results with this medication. Can anyone else share there experiences with this medicine?

[mytil]

Hi again,

Does the dose total 10mgs? and it is split into 5mgs given twice daily?

Please do read through the link I mentioned above. It mentioned the starting doses as well as a 14 day recheck (the ACTH test I mentioned above) to check to see how the cortisol levels are.

The 2 year life expectancy is really not true - we have had many here who have treated for much longer than 2 years.

Did your vet check for any other conditions with the vomiting and red skin - these are not the usual symptoms of Cushing's.

Please post those test results.
Terry

[Squirt's Mom]

...we didn't think anything of it until about 2 weeks ago she vomited and the next day was crying all day and her skin turned red. We rushed her to the emergency room. But that same day I took her to our own vet and they suspected cushings and started the testing process.

Did the vets tell you what caused this episode? This is not what is typically seen with Cushing's. In addition, Cushing's is a disease in which cortisol is abnormally elevated but the problem is that other things besides Cushing's cause the cortisol to rise - and having Cushing's testing done at the same time another illness/crisis/etc is going on can easily result in false-positives. Any stress, internal or external, can cause the cortisol to rise as a natural defense against the stress. As the stressor is removed, the cortisol goes back down in a normally functioning body. Since it doesn't sound as if her body was functioning normally when the testing was done, it concerns me just a bit whether her diagnosis is correct.

What other signs did you see, or are you seeing, in Abbey that are not normal for her?

Please, do get copies of the tests done and post them as soon as you can and keep a very close eye on your baby girl for the signs I gave you earlier.

Hugs,
Leslie and the gang

[Squirt's Mom]

BTW, no one is trying to scare you...we are natural worry warts and we absolutely LOVE details so we play 20 Questions and hound you until we get the answers we need. ;):D But at the same time, we do want you to be fully aware of what should be going on, how, when, why, and so forth, so you can be the very best advocate for your sweet Abbey that you can. We are the only voice they have. ;) So keep one eye peeled on her at all times, one eye peeled on the site here, and someone else to do anything else that requires eyes for a few days. :p We will be right here by your side day in and day out.

Hugs,
Leslie and the gang

[lulusmom]

Hi and welcome to the forum.

Dogs with cushing's pant because 1) high cortisol (a steroid) messes with just about every metabolic function and redistributes fat to the thoracic area, putting pressure on the diaphram. That coupled with muscle wasting, due to the catabolic effects of high cortisol makes is more difficult for a cushingoid dog to breath. One would surmise that if the disease has progressed enough to make a dog pant, you would surely see the hallmark symptoms of cushing's, like a voracious appetite and excessive drinking and peeing. Have you noticed a different in Abbey's eating and drinking habits.

Vomiting and crying in pain are absolutely not symptoms of the disease and red skin may happen over time but if this came on suddenly, I certainly wouldn't suspect cushing's. I would agree with Leslie that if testing was done during this time of illness, the diagnostic tests cannot be trusted. I'll go a step further and tell you that if your vet ran these tests while your dog was sick, s/he wasted your hard earned money.

Sometimes we're so overwhelmed with what is going on and trying comprehend what our vet is telling us, we omit some vital information when trying to draw the picture for members. Have you noticed any change in appearance of coat, any change in skin pigmentation, any weakness, especially in the hindquarters? Was she once able to jump on furniture but no longer able, any intolerance to exercise?

Based on the information you have provided so far, I personally would not have started my dog on treatment. It would be very helpful if you can round up all of the testing that was done to 1) determine the cause of Abbey's stomach upset and sudden skin problem and 2) determine if Abbey has cushing's What was the amount of time between the two rounds of testing?

Glynda

[molly muffin]

Hi and welcome.

Cushings is very hard to diagnose because so many other things mimic the same symptoms. My vet, absolutely diagnosed cushings and gave me 30mg pills of vetoryl to give her once a day. I didn't. Instead I insisted on a referral to an IMS and an ultrasound. The IMS made me feel much better about the possibility that is Is cushings, but ordered an LDDS test to confirm, and the LDDS test came back as normal. So, you can see that it can be very frustrating trying to nail this down.

However, based upon the apparent pain and skin reding, which is not a symptom of cushings, and nothing about cushings is sudden thank goodness, I'd say the ultrasound and full blood work is the next step to make sure of what is going on. Thyroid, Pancreitis, Kidney, allergy all need to be ruled out. Cortisol is going to rise in response to any illness or even nervous fear, or a UTI, that can completely skewer any cushing testing results, so just some things to think about and consider.

In the end you will decide what is best for your baby and you are her advocate so go in armed with all the knowledge possible. We have people on this forum whose dogs have lived with cushings for a very long time. Some of our members have been here for over 7 years and are quite knowledgeable about cushings. It is one disease that when you live with it, you learn it, rather intimately I'd say.

I guess what I mean to say is no, absolutely we do not want to scare you and that of course is where you are already at with this diagnosis. What we do want to do, is share experiences and knowledge that has been gained through years of going down these roads.

We are very happy that you have joined and believe me when something seems wacky or off, there is no better place to come to find out what others think than this forum.

Hang in there,
Hugs,
Sharlene

[abbey]

She has been excessively panting for about 6 or more months. I did notice that a little of her hair does come out when you pet her. She is drinking alot and just lays around all the time. But she does run to the door when anyone comes in to greet them. I'm so confused now. She is on 20 milligrams a day. Are we doing the right thing? The vet seems to think it is cushing and wanted an ultrasound to see if the tumor is on her adrenal gland. Either way, pituitary or adrenal they treat it the same. We didn't do the ultrasound due to the cost.
($400) Does anyone recommend that we do it anyway. I want to do whats best for Abbey and if she is on the meds unnecessarily this can't be good for her. They will check her cortisol level after two weeks on the meds. So far so good. No adverse reactions. She's been on the meds. for 3 and a half days. Any suggestions are greatly appreciated!

[frijole]

The ultrasound I had done showed that there was an adrenal tumor and that it was NOT cushings. (there are more than one type of tumor) My dog had false positives on the tests. She panted alot due to high blood pressure and her skin would turn red during episodes.

But before you do any more tests - could you please list out every test that was done to diagnose cushings as well as the results? Reading back it looks like several of us are wondering if your dog even has cushings. That is why we need the testing information.

Don't feel bad - we see this alot and owners are confused because after all - you didn't go to vet med school! :p We can help you, we just need a bit more info.

Glad you found us, Kim

[abbey]

So should we get the ultrasound and did you have the tumor removed? The vet who did the test last Friday suggested we do an ultrasound. The test she had last week was the day long blood test where they draw blood three times in an eight hour period. Thanks for your help.

[frijole]

Sorry I wasn't clear - I would go get the test results and post them here and let us look at them because we aren't convinced your dog has cushings. I'd hold off on the ultrasound until we can take a look.

That test is the low dose dex suppression test (LDDS). It can yield false positives if something else is going on. Is that the only test done to come up with the diagnosis?

Posting all test results including the blood panel abnormal values will give us a good start.

I had a bad vet (inexperienced) and I did boatloads of tests (for cushings) that were all false positives so I started treating for cushings when it wasn't. By the time I canned that vet and drove 5 hrs to the closest specialist (a teaching hospital) - they figured it out but it was a year later and she wasn't as good of a candidate for surgery. Her tumor was very very rare. She ended up living with it another two years so I was a very lucky mom.

I share the story not because I'm convinced your dog has the same tumor but just to prove how easy it is to get caught up into a treatment and how important it is to do multiple tests. An ultrasound might be a valuable tool. But let's look at where we are first. My two cents. Hang in there and don't be afraid... we have all been there so we understand. Kim

[abbey]

She did have the LDDS test. The first blood taken showed a level of 9.The second time 5.3 and the third that day 5.3. They told me 1 was normal. What do you suggest? Thanks!

[lulusmom]

I think you must have missed my prior post which is perfectly understandable. When our heads hurt from too much information, we sometimes miss stuff. I'll therefore repeat myself. Your vet should have done bloodwork and a urinalysis before doing the LDDS. Can you get copies of those and post the abnormal values, including the normal reference range. On the bloodwork, we need only see the values that are high and low.

If the abnormalities you eventually post are the usual patterns we see with cushing's, I might feel a tad bit more comfortable with the diagnosis; however, I am very leary of the LDDS results given there was something else going on with your dog at the time that test was done as false positives are not uncommon. Secondly, there appears to be a real lack of common symptoms associated with cushing's which casts a huge shadow on your vet's diagnosis. I haven't changed my mind and would still not treat my dog if circumstances were identical.

Glynda

[molly muffin]

Hi Abbey, where you able to get copies of the blood work? Hope everything is okay

Hugs,
Sharlene