My Cooper (6) was diagnosed today, please help

[Lauren]

My 6 year old Maltese, Cooper was diagnosed today after the initial urinalysis, ACTH, and the 8 hour test. Recently, he has been having accidents in the house, sleeping a lot more, drinking excessively, and urinating uncontrollably. When he had an accident right in front of me, I knew he needed help. Took him to the vet, and after a week of tests, he was diagnosed today. He is scheduled for a soon on weds and is starting Vetoryl in the morning. Please tell me what to expect, as far as side effects and quality of life. Been crying most of the day and just am so confused about the process.

[frijole]

First off Cooper can live a normal life and don't believe anything anyone tells you to the contrary. It takes a while to get up to speed but you will and your dog will not be in pain. It is not an immediate life threatening situation. The more you know the better off Cooper will be. Tell us as much as you can and ask questions! You will be just fine so please don't cry any more ok?

How much does Cooper weigh and what dose are you giving and how often?

DO you have copies of test results?

Thanks
Kim

PS I have approved this post but please activate membership by returning our email when you get it. Thanks!

[frijole]

http://www.dechra-us.com/files//dechraUSA/downloads/Client%20Literature/48685_VETORYL_10mg_PatientBro_COVER_FLDOUT_2_0_dis .pdf

This is a link to dechra's brochure. Look for vomit and diarrhea or lethargy.. if you see it call your vet and cease giving the drug.

When are you supposed to go back for an acth test?

Kim

[SoggyDoggy]

Hi Lauren, being completely new to this myself, I can understand your response and confusion. Read this forum frequently, other peoples links and the information given here, it is completely invaluable. My boy Fraser was diagnosed three weeks ago and we started him on triolstane. I read pretty widely and the dose he was started on seemed high to what I had read. The wonderful people here gave me the confidence to question and challenge my vet, but more importantly to ask for copies of the test results. As a result of this, I was able to pick my vet up on a mistake and seek a specialist's advice which has to my mind worked wonderfully.

I guess my advice is, don't be afraid to question and challenge your vet. Essentially they are animal GP's and shouldn't be expected to know everything, but you can certainly ask them to read and expand their knowledge of a condition and the current treatments. As I've said, read widely, get used to the terminology and numbers and don't worry too much, it is certainly manageable.

Good luck and keep us posted!

Naomi.

[Lauren]

Thanks Naomi. Through my tears, I'm trying to get a handle on what this diagnosis means for my little guy. I can tell you the initial cortisol/creatine results gave him a number of 16 and it needed to be 20 to be conclusive. I insisted that more test needed to be done and that's when the low dose 8 hour test was given. Starting the veteroyl tomorrow morning and quite apprehensive about giving him something tha may make him even sicker. Just scared and worried. thanks for your quick response, it helps to have someone hear me out.

[Lauren]

Cooper weighs 16lbs and was given 30 mg. Of veteroyl once a day. Going to get copies of tests results on Wednesday, he's having a soon then. I have activated my account through email. Thank you so much!!!

[Squirt's Mom]

Hi Lauren and welcome to you and Cooper! :)

Before you actually start giving him the Vetoryl, please share some information with us. We are going to bombard you with questions at first but that is so we have as much info as possible in order to give you the most meaningful feedback. So, you ready? :D

What signs is Cooper displaying beside the accident, sleeping, excess drinking and urination?

Has his appetite increased or decreased?

Is he losing any hair? If so, on what part of the body?

Has he gained or lost weight recently?

Does he have any other health issues you are aware of?

Is he on any other meds, supplements, herbs, etc? If so, what, how much, and what for?

Was he tested for a urinary infection?

Is he neutered?

Were hypothyroidism and diabetes ruled out?

Ok, that will get us started. I'm sure others will be along with questions of their own to add. We simply cannot have you wandering around the house at loose ends, nothing to do, wasting time so we will give you "homework" like this for a few days to keep you busy. :p So these questions are the first part of your assignment. The second part is to get copies of all the actual test results for the testing Cooper has had so far and post those results here in his thread. Be sure to include the normal ranges for each value that is too high or too low (no need to type out the normal values), include the units of measurement for each value which will be letters like ug/dl, mnol/L, etc, and any comments the lab has written on the report sheets.

Some other things that will help as time passes. Make it a habit to get all test results and keep a file at home for Cooper. This way you have all his info in hand should he ever need to see a different vet, like on vacation. Also, start keeping a daily journal or diary for Cooper noting things like water intake, pee and poop history, moods, sleep patterns, anything new you see in him. This will be invaluable over the years to come to both you and his vets.

Tell us anything and every thing you think is important about Cooper's health history and life to date. We LOVE details so don't worry about a long post. ;)

Now, for the most important part of this note. You and Cooper will not be alone on this journey. You are both now part of our family here at K9C, and it is an formidable family full of knowledge, experience, and support freely given. We will walk every step right beside you - all you ever need to do is holler. Never hesitate to ask questions and we will do our best to help you understand. If we dont' know, we will all learn together.

I'm glad you found us and look forward to learning more as time passes.
Hugs,
Leslie and the gang

[Lauren]

Leslie, thank you so much! It means so much to me to have people like you in my corner. "non" dog owners have no idea how painful it is to have a pet be diagnosed with a disease like this. I sort of feel stupid when telling someone and breaking down who doesn't own a dog.

As for details,
Cooper has gained 2 lbs in less than 4 months.
He is extremely lethargic
Over the last 6 months he is not able to keep up on our usual walks and cannot go on a walk consecutively the next day. I have to wait a day or two before walking him again.
No hair loss, but lack of hair growth. Thinning in the joint areas.
He gets allergy shots every 21 days, but he is being desensitized, not on any form of steroids, and has been getting shots for just under 6 months.
He is neutered
He was tested for a urinary tract infection and results were negative.
His fecal matter was also tested and that was normal as well.
He was also tested for diabetes and his numbers were in range.
Not sure about hypothyroidism, I will check on that when I get copies of his lab work.
He is going for a sonogram tomorrow morning. I want to know where he is being affected. There has been such a rapid decline in his overall life, so much so, I believe it's onset was approx. The end of July. We went to Disney in June and he was completely fine.
He has always been a "nervous" dog around 4th of July, or any firework night, but recently I've noticed extreme panting while he's at rest and snoring while he is asleep. It has also been much harder to wake him from sleep.
I hope some of these details help you in helping me. The journal is an excellent idea and I will start one today. Any questions to ask before or after the sono and will they show me the "actual" films from it or should I ask for them?
Thanks so much,
Lauren

[Boriss McCall]

HI Lauren,
I am glad you found this forum. You will find so much comfort from your fears here. I was just as sad & scared as you when I got here.

My boy started the meds this summer & he is doing great. :D
Just know it may take awhile to find just the right dose. I am still working on that with Boriss. But, there are lots of dogs who get the right dose right off the bat & never look back.

Good luck with sonogram today.

We are all here for you & Cooper.

[Lauren]

Thanks Amy,
Did Boriss side effects from the Vetoryl? Cooper has only had one dose, but has been sleeping most of the day. Gave it to him at 8am. What side effects should I be looking for? Good or bad. Sono is tomorrow @ 9. Did you have Boriss have a sonogram?
Thanks so much, helps to hear from everyone, being that this has hit me like a ton of bricks
Lauren

[Boriss McCall]

Yes Boriss had his sonogram right before he started on Trilo. Since Cushing's is SO hard to diagnose I wanted to make double sure he had it before we started him on the meds.
It is really good to know what all is going on inside.

Boriss has not had any bad reactions. The good signs you will see is the appetite will go back to normal. Boriss was so hungry all the time. He would search around the floor for crumbs NON-STOP. He also drank a larger amount of water & peed all the time. So, most of those symptoms are under control for him & pretty much have been from the first month we started the meds. He is much happier & has more energy. He started playing with toys again & could handle longer walks.

The bad reactions you want to watch out for are vomiting, extreme lethargy & diarrhea. All of these things can be signs of overdosing.
Did your vet give you some prednisone to have at home just in case?
If not I would ask for it. It is always good to have on hand if your Cooper gets in a crisis. From what I have read on this forum it can be a lifesaver.

You will have to keep us posted on the sonogram.

[Squirt's Mom]

Hi Lauren,

Thanks for the extra info! Good job! :)

I am replying to in the body of your post with my comments in blue. Otherwise, I tend to get lost and forget stuff! :rolleyes::D


Leslie, thank you so much! It means so much to me to have people like you in my corner. "non" dog owners have no idea how painful it is to have a pet be diagnosed with a disease like this. I sort of feel stupid when telling someone and breaking down who doesn't own a dog.

How well many of us here understand that! I think I came really close to completely losing my mind when Squirt was first diagnosed and no one around me could understand the depth of my anguish except her vet. When I found this group, my sanity was saved. Well, ok, before the hoard calls my hand on this - there wasn't a lot left to lose so there wasn't a lot left to save! :p But they took this bug-eyed, slobbering, blubbering, batty old broad and started to teach me what I needed to learn in order to help my Sweet Bebe. That was nearly five years ago and she is ticking along just fine...she will be 15 in Feb, too! And you will find many stories like ours here. So yes, we understand and welcome you both with open arms.

As for details,
Cooper has gained 2 lbs in less than 4 months.
He is extremely lethargic
Over the last 6 months he is not able to keep up on our usual walks and cannot go on a walk consecutively the next day. I have to wait a day or two before walking him again.
No hair loss, but lack of hair growth. Thinning in the joint areas.

These are all certainly indicative of Cushing's. Typically the hair loss is on the tail and back end area but slow or no regrowth is part of the picture.

He gets allergy shots every 21 days, but he is being desensitized, not on any form of steroids, and has been getting shots for just under 6 months.

What med does he get for this?

He is neutered
He was tested for a urinary tract infection and results were negative.
His fecal matter was also tested and that was normal as well.
He was also tested for diabetes and his numbers were in range.

Good - these conditions can all mimic Cushing's, as can many others which is why the testing is so important.

Not sure about hypothyroidism, I will check on that when I get copies of his lab work.

It will probably be listed on the report that shows things like BUN, ALKP, CHOL, etc and will say something about T4.

He is going for a sonogram tomorrow morning. I want to know where he is being affected.

Excellent! I credit this test with saving my Squirt's life when it found a tumor on her spleen during her testing phase! It will let the docs and you know so much beyond Cushing's but it can also be a big help in diagnosing and determining which form of Cushing's is in play.

There has been such a rapid decline in his overall life, so much so, I believe it's onset was approx. The end of July. We went to Disney in June and he was completely fine.

Cushing's doesn't typically come on that rapidly. In fact, most people think their dog is simply aging. Cushing's progresses at a snail's pace, taking years to start showing noticeable changes and doing real damage. Have you noticed any changes with his vision since June?

He has always been a "nervous" dog around 4th of July, or any firework night, but recently I've noticed extreme panting while he's at rest and snoring while he is asleep.

This is also in keeping with Cushing's but again not conclusively. The excess cortisol both stimulates, making them nervous, and tires them because of the stimulation. The panting is usually caused by the redistribution of fats in the abdominal cavity causing pressure on the lungs.

It has also been much harder to wake him from sleep.
I hope some of these details help you in helping me. The journal is an excellent idea and I will start one today. Any questions to ask before or after the sono and will they show me the "actual" films from it or should I ask for them?

He may be sedated depending on how still he can be on the table. This is a non-invasive test but his belly will be shaved in a large area. I have always been shown the films and the vet discussed the findings with me that day. It doesn't take long to do it or to get the results so you should know something that day. I have also been asked every time what I wanted them to do if they saw something urgent so don't be shocked if they ask - they are simply trying to prepare for anything, not expecting something. ;) You want to be sure they are using a high resolution machine for the test and that the person running the machine is the one who will be reading the results. Ask them to do all they can to see both adrenal glands as they will tell us a great deal about the possibility of Cushing's.

Thanks so much,
Lauren

Hope this helps a little bit!

Hugs,
Leslie and the gang

[molly muffin]

Welcome Lauren and Cooper!

There is not a one of us that didn't arrive here with tears running down our faces. It is very scary and if you just read randomly on the internet it can be even more scary. That is how I was anyway.

Now the good news is that this forum was created by people who are doing through the same thing, and wanted a place to gather information and share knowledge with others going through the same thing. That has been quite a few years ago and more than one vet now directs their cushing patients this way.
So, what I'm trying to say is that you'll have the opinions and knowledge of people who have been dealing with this disease, one way or another for many years.

Dogs diagnosed with cushings can indeed lead a normal life span and there may not be any scary reactions to the medicine and if there are, you have those who have been through it right here with you.

Don't be afraid to ask any questions you might have either.

Sharlene and Molly Muffin

[Lauren]

Leslie,
OMG thank you so much! I can't express how much it means to me for you to take the time to answer my questions and give me so much info. I needed to know more about the soon and you have been a huge help for tomorrow.
Day one- no reaction except for the fact that he has seemed to sleep most of the day. He has eaten and is still drinking excessively. I'm not sure when I will see changes, I've read from some posts that people saw a change after the first dose. I can't say that that happened today, but he hasn't reacted adversely, except for the sleepiness. Fingers crossed for the soon tomorrow.
One question, is the level of severity dependent on where Cooper is affected? Adrenal or pituitary?
Again, thank you.

[Lauren]

Thanks so much Sharlene. These past few days have been a blur and some people in my life have surprised me with their compassion and others have surprised me even more with their lack of concern. It has been an eye opening experience. This forum was a blessing to stumble upon.
Lauren

[molly muffin]

Lauren, there is no way to know for sure how each pup will react to the medication. Some will never have a reaction and other can have it in the early days or even around day 10. You really just have to keep an eye on them the whole time right up till the ACTH test to see where the cortisol is at and then you'll know how their body is reacting. That is as long as you don't see anything before. Then hopefully you are in a good control place and nothing needs to be adjusted, that doesn't often happen with vetroyl, but can. If it isn't you adjust and start all over again. This keeps going till you find that sweet spot, that the cortisol will ride at and keep his little body in balance. Then you can usually have a break and only will need to check every so many months to make sure that the stabilization continues.

I don't know if there is a difference in severity based upon where the cushings comes from. One thing is that if it is adrenal there is a chance of doing surgery. If it is pituitary, then it is a life long treatment. We do have those who have been on treatment for years. So, that is doable too.

The main thing is not to despair. That is an easy place to fall into and a harder place to crawl out of.
I probably cried for weeks before I found this forum. That was from a range of emotions, fear, anger, hopelessness, it's just not a good place to go to. The forum helped me immensely not only with facts but with an understanding from each of "been there, done that, wrote the book" to just understanding, letting me know what I could do to be proactive and not feel like I was drowning in a sea of "what do we do now, how do I save her" scenarios.

Knowledge is strength. The more you learn, the better advocate for Cooper you will be. :)

Sharlene and Molly Muffin

[Lauren]

Hey All,
It's been a long week. Cooper started on 30 mg of Vetoryl and as of Friday, it will be 10 days. Reaction to it has been mild(thank God), but his body seems to be going through some changes. Before diagnosis, I didn't really notice much hair loss or thinning, but now, it seems as though his skin is experiencing Calicunosis cutis and the lesions have increased 10x since last week. Is this common? Also, with the discovery of the increased lesions, I've noticed his hair getting significantly thin. Seems like the symptoms are going through his body like wildfire. I didn't realize this disease could hit them so hard so quickly. Has anyone else seen symptoms rapidly come on? Seeing the vet on Friday for a follow up ACTH test. Had the sono, and thankfully it showed that the adrenal gland was slightly larger than normal, no tumors to speak of yet. I've also read here, that Lysotrine may be a better alternative to combat his skin issues. Any thoughts on that? Hard day, brushing him and noticing the lessening hair.

[milosmom]

hi lauren!!! patty here,just reading up on you story,i too have recently come to this forum and it is a tremendous help.so many knowledgable,loving,caring,sweet people.they have been my go to place for the last wk or so.by the time we are done here we can sit for the vet tech test at least ! :). you can find my story under milo my 6 yr doxie.these are frustrating scary times,hopefully we will find our peace here...patty and milo

[molly muffin]

It almost sounds as if the cortisol was keeping the calicunosis cutis minimized doesn't it. I wonder if that is a possibility. Definitely talk to your vet about the change since starting treatment you go back on Friday.

Do you mean Lysoderm might be the better treatment over Trilostane/vetroyl? I don't know myself. Maybe one of the gang who has used that or both would have an opinion.

I do hope that Cooper continues with lessening cushings symptoms. I just wanted to pop in and say hello before I head to bed. You survived almost 10 days!! yay :)

Sharlene and Molly Muffin

[Trese]

Hi Lauren,
Glad you found this forum. I know how you feel as my little doxie has just gone on the Trilo on Oct. 31st. So far, it is doing really good. He has alot more pep and he is eating well and sleeping all night. His water intake is down which is good. Hang in there. I give Bondo his pill with his morning meal.

[addy]

Lysodren is sometimes a better choice for dogs with Calcinosis Cutis, however, we have seen dogs on Trilostane and their Calcinosis Cutis improved, usually on twice day dosing.

What is interesting to me is that you are saying Cooper had no skin problems before treatment and now he is rapidly experiencing skin problems. It is commom for a dogs skin/coat to get worse before getting better on Trilostane but why he would suddenly go from no skin issues to major ones is a stumper. I have read that some dogs experience skin/coat issues as a side effect of Trilostane but I did not equate that to Calcinosis Cutis.

Hopefully someone will have some input.

Hang in there

[Mel-Tia]

Hi Lauren

My Tia was diagnosed nearly three years ago as she had Calcinosis cutis all down her back panel, it cleared up after about 9 mths of vetoryl but we did have to change the dose a few times and she is now on 30 mg morning and night.

Please note there is a 10mg tablet available as most vets don't know this so I wanted to tell you just in case yours didn't

We also used cortavance spray to help manage the itching for her

Hope that helps, good luck

Mel and Tia x

[Lauren]

Thanks all, turns out his allergies are also acting up and needed to be put on benadryl in addition to his routine allergy meds. Good news after 10 days of Vetoryl treatment, his repeat ACTH test came back with a level of 7.2. Prior to the Vetoryl, he was at 16.8, so we seem to be on the right track. vet wanted to increase his dose from 30mg to 40, but I asked to hold off until his skin infection(from itching, and is on clavamax) clears up. She agreed that we could hold off and retest after the holidays or if other symptoms occur. Just happy to breathe a little with him more calm. Keeping fingers crossed that our path will be steady at least for a while.

[Harley PoMMom]

Wow that is a significant drop in the cortisol in just 10 days, good for you for choosing not to increase his dose!!

All fingers, toes, and paws crossed here!! :)

[Lauren]

It is? Oh, I'm so happy! I know the drop was significant, but wasn't sure if it was enough and if I should have let the vet increase his Vetoryl another 10 mg. . A friend was in the room when I got the call and listened to the conversation and thought I made the right decision to hold off on the increase. Just sooo new to this. Thanks to you guys, I learned about the dangers of increasing too much so that's why I asked to hold off. I'm so glad you agree with me. Lauren

[molly muffin]

It certainly sounds like you are on the right track. I too wouldn't increase with that sort of drop already, no need for one thing to increase right now and who knows, Cooper might end up being fine at 30mgs. See where he is in when you do your next test.
Hopefully you'll have a nice worry free holiday season! :)

Sharlene and Molly Muffin

[frijole]

I agree - great decision mom! I never used trilostane but we have seen that cortisol can go down to lower levels with time without making dosing changes so stay the course and see what happens. Kim

[Lauren]

Thanks Kim. We have had two really good days and nights. To date, no accidents and the itching has subsided. I'm really glad I had you guys to back me up on the decision to hold off with an increase in Vetoryl. Cooper didn't really eat much today, which bothers me a little, but I'll wait another day to see if it's just a fluke, or something to worry about. Thanks guys, talk soon, Lauren

[frijole]

Awesome. Yes, keep an eye on the food consumption because if it continues you'll need to have it checked out. Good job! Kim

[molly muffin]

Hi Laurne, Merry Christmas to you and Cooper.
Hope things are going well.

Have a safe and wonderful holiday.

hugs,
Sharlene and Molly Muffin

[Lauren]

Hey all, such a hectic holiday. I have a few questions. Cooper has been pretty stable the last 2 weeks, but just in the last day or so, he seems restless. I also noticed a slight increase in water consumption again. Should I rush to have levels checked again or should I wait it out? I'm journaling on a daily basis and it seems that he has an occasional set back every 2 wks or so, common? He's currently on 30 mg of Vetoryl and in spite of the little set backs, he seems to be doing fine on it. I'd hate to rock the boat. Also, I've noticed a decrease in the appearance of the " potbelly" look too. Today was just a little strange. Other than seemingly restless, he didn't eat his dinner until much later tonight, but then he finished his plate. Love to hear from you guys, thanks so much, Lauren

[Harley PoMMom]

Dechra, which is the manufacturer of Vetoryl, recommends that a dog be tested between 10-14 days after starting Vetoryl, also an ACTH test should be performed at 30 days, 90 days, and every 3 months thereafter.

Cooper's 10 day post ACTH results on 12/8/12 were 7.2 ug/dl, right? So if my calculations are correct then his 30 day ACTH test is due. Since he is acting restless and his drinking has increased I am thinking that Cooper's cortisol has risen and that is why the symptoms have rebounded. The only way to really know is to have an ACTH test done and if this were me, I would schedule one soon.

[Lauren]

Yup, I think you're right. I'm either gonna have him retest tomorrow or weds depending on when the vet can do the test. Just not himself and before he gets worse, I want to see what's going on. This might be a silly question, but after bloodwork done after 30 and 90 days, do most seem to be regulated on a 3 month schedule? He's still so young, hate that he's going through this. Thanks again.

[lulusmom]

Hi Lauren,

Once Cooper's acth stim tests show him stabilized within the therapeutic range and symptoms have resolved, you can usually go to every 90 day stim tests. It's been a number of years but I believe that both of my dogs had stim tests at 10 to 14 days, then 30 days, and another 30 days before their specialist deemed them well controlled. It was then that we were allowed to go a full 90 days for the next stim test. They stayed at every 90 days for at least a year before the vet finally allowed us to stim every six months, unless symptoms dictated otherwise.

Glynda

[molly muffin]

Happy New Year Lauren and Cooper.

Best wishes for a healthy new year.

cheers,
Sharlene and Molly Muffin

[Lauren]

Okay guys, got Cooper's results. His ACTH levels were slightly elevated from 7.2 to 8.3. Vet suggested adding 10mg to his current dose of 30mg. So he now takes a total of 40mg of Vetoryl once daily. Here's a question, what is the max. dose given to a Maltese approx. 14 lbs? Is there a cap on how much a dog weighing that much can handle. I'm concerned that he won't get stabilized and he'll reach a cap on how much medication he can take to keep him at normal levels. Thankfully, no il side effects yet (this is the third day). Any thoughts please let me know. Hope all are well, thanks, Lauren

[addy]

Hi,

There is no maximum dose with Vetoryl. I went through this with my Zoe in September. We checked with our IMS who also checked with Dechra. Most dogs are controlled at 1-3 mgs per pound but some dogs may need a higher per pound dose. My Zoe is 17 pound and is on 50mgs, 30am, 20pm and will most likely go to 30/30 next week after her stim.
Twice day dosing is thought to minimize side effects and you may sometimes need a lower dose when administering the drug twice a day.
IMO, when I started using the higher doses, I am going by symptoms more than numbers as my Zoe has multiple issues which can increase her cortisol on any given day. Dechra does state if symptoms are controlled the cortisol can be as high as 9ug/dl.

[Concernedmom]

Hi Lauren I've been reading your posts and just wanted to mention that you can call Dechra directly and they will answer any questions you have and will also speak to your vet. They are wonderful. I had no idea Dechra would do that until the great people on this forum mentioned it to me. Everyone is correct when they say you are in good hands here as I am new and have learned so much. I believe they saved my pup from going on a larger dose than he needed that could have caused some big problems for him if I had listened to my vet. I have a 16# Maltese male 12 yrs who was diagnosed and started vetoryl Dec 5 on 30 mg. on Dec 17 on his 12 day checkup his ACTH was pre 9.4 from 16.9 and post 10.8 from 23.0
The doctor immediately wanted him increased to 60 mg. So I increased him. A day later he became lethargic and he would shiver during the day and even though my dog is a stressful dog that shivers sometimes i knew something was wrong so i asked the vet this question "don't the levels continue to decrease after the 14 day mark" I was told "no, it is what it is". That seemed strange to me so I posed the same question on this forum and sure enough these knowledgable people said no way that's not true. The levels continue to drop. Please put him back down to 30 mg right away 60 mg is too much for him. They told me to call Dechra and I did. My pup went back to normal. Dechra confirmed the levels can decrease from 1-6 months after starting it. They said he was on the correct dose of 30 mg. they asked for his numbers and his clinical signs and said if the clinical signs are good and the numbers are a little high then they would keep him on the same dose. They said a lot of doctors only look at the numbers. They also said that my doctor was probably thinking of the other drug lysodren when she said the level doesn't decrease after the 14 day. They said retest on the 30 day mark which I did and guess what. Pre is 1.2. Post is 5.7 great numbers. Less panting less urination less drinking. That ravenous appetite is even decreasing. The hair on the back is still thin but looks a little better I think that and the pot belly might take more time. I know every dog is different and I am very blessed so far especially because of his age. I was so worried of the side effects. But everyone on this forum was so much help and it's unbelievable how much they know about cushings. This forum is the best place to be. I wish you and everyone all the best with their babies. It is a frustrating and scary road to travel but there is help here.

[Lauren]

Thank you sooo much! Cooper is experiencing more than usual diarrhea and his need to go out is more often as well. This is after 3 days of the increase from 30 to 40 mg. I am concerned that it may be too much. Also, his hair seems to thinning more and more everyday. I don't really see any, but he use to have such a thick coat that I could run my fingers through like a rug and now you can see his skin . That really worries me! He is only six and he's just soo young. I too has witnessed some shivering ( didn't know it could be a symptom. Thanks for the advice on contacting Dechra, will do in the morning. Another symptom is his lethargy, seems to want to sleeps ALOT. Shou
D I contact the vet ASAP or wait through the week to discuss newer symptoms? He was doing well with 30mg but he needed the wee wee pad nightly. I just don't know the right plan.

[addy]

Lauren, I would contact your vet or Dechra if you cant trust your vet to be knowledgeable and tell them about the loose stools. Sometimes it is a side effect of the trilostane, sometimes it can be a sign Cooper's cortisol may be going to low. We have seen dogs get loose stools with a dose increase and it turned out it was a side effect or another issue but you never know. Happens to my Zoe because she has IBD. Remind me if Cooper has any colitis type issues.

When in doubt withhold the pill. Is Cooper eating? Any vomiting? Any activity from him at all? Does he seem alert?

Let us know.

[lulusmom]

Hi Lauren,

I have just reread your thread and see that I missed some vital facts when I first posted to your thread. I now see that the UC:CR was normal, the post stimulated acth stim test prior to treatment was also normal and I don't see where you posted the results of the LDDS. Can you please posts those results now?

Based on the information you have posted so far, I don't see any supporting evidence that Cooper's cortisol is elevated so I am hoping that the results of the LDDS were consistent with cushing's; otherwise, I have serious concerns about starting treatment in the first place, much less increasing the dose. Which form of cushing's did your vet has diagnosed? Adrenal or pituitary?

Glynda

[Lauren]

Glynda, thanks so much for getting back to me. The vet diagnosed him as having the adrenal form. I will be picking up copies of all test results tomorrow and will get back to you. Question, his hair is not necessarily falling out as much as it is getting thinner, to me, almost daily. Is this a symptom that I can expect to get worse? Again thanks so much and I'll reply with the results tomorrow. Lauren

[molly muffin]

You know, we have seen some dogs that their coats recover and others that never do. If they do it usually take awhile, others like Addy's Zoe, are just stuck with the thinner coat it seems. Hopefully, Coopers will come back.

hugs,
Sharlene and Molly muffin

[lulusmom]

If your vet diagnosed an adrenal tumor, it would have been necessary for him to do more than a low dose dex suppression test. An abdominal ultrasound, endogenous acth or a high dose dex suppression test are the tests that differentiate between an adrenal tumor and pituitary dependent disease. 85% of dogs have pituitary cushing's so Cooper is in the minority with an adrenal tumor. Surgery is an option for adrenal tumors so I'm wondering if your vet discussed this with you??? Looking forward to seeing the results of all the tests your vet did.

Glynda

[Lauren]

Glynda, I have all the test results in front of me. Which numbers would you like me to post? Sorry for the silly question, but I don't know how to read them quite well. The vet did do an ultrasound and found the adrenal gland to be enlarged, not showing any tumors yet. And the increase for the meds was due to his increased cortisol levels. Just tell me what I should be looking at and I'll post them, thanks so much, Lauren

[molly muffin]

Hi Lauren,

On test results for blood work you are looking for any abnormal numbers, High or Low and the range. (anything that isn't high or low don't worry about posting)
For ACTH, LDDS you are looking for pre and post numbers with ranges ACTH usually has a Pre and a Post, LDDS has a base, 4 hr, 8 hr
Ultrasound you are looking for the notes on what was found. For example, left adrenal englarged slightly, right normal, or both enlarged, any comments on other organs.
Oh and the dates that the tests took place if you have say comparison of test in August and another in October (as an example only)
hugs,
Sharlene

[Lauren]

On his sono this is what it says:
Spleen:homogeneous, no distinct masses or nodules
Kidneys: normal size and shape, good cortico medullary definition
Adrenals: upper limit of normal size/ no masses
Gi tract/ pancreas: normal wall thickness and layering. Pancreas-no visible lesions
Lymph nodes: no gross lymphadenopathy
Urinary bladder: no calculator masses, normal wall thickness
Additional comments: no free abdominal fluid
Assessment: hepatic variations, cholestasis, r/o vacuolar hepatopathy, borderline adrenomegaly
Recommendations: ldds test-no suppression, trilostanetherapy-conservative dose

Initial testing 11/21/2012:
Cortisol: 19.1
Creatine: 193.1
Cortisol/creatine ratio: 31 (high)

ACTH 1 hour test 11/21/2012:
Total protein: 7.9
Albumin: 4.8
Alk phosphatase: 1927
Calcium: 11.8
Triglycerides: 389

Cortisol series 2 (ACTH):
cortisol sample 1: 4.6
Cortisol sample 2: 16.2

Cortisol serial 3 (DEX):
cortisol sample 1: 8.4
Cortisol sample 2 DEX: 0.8
Cortisol sample 3 DEX: 4.8

Cortisol serial 2 (ACTH):
cortisol sample 1: 8.2 (high)
Cortisol sample 2: 8.2

I wrote all the numbers that were bold and pertinent. I hope you can dicipher the findings and help me to understand their meanings. Thanks again sooo much, Lauren

[Lauren]

Cortisol serial 2 was completed on 1/5/2013 that's when the vet raised the dose from 30mg to 40

[Lauren]

I've been reading all the posts in regards to more elderly pups contracting Cushings. My Maltese Cooper is only 6 and am wondering what this diagnosis means for my little guy at such a young age. He currently is on 40mg of Vetoryl. I've done a lot of reading in regard to life expectency and have not found much info. I know one can never pinpoint an age to when life will end, but is there/ will there be a time when I will be able to see Cooper at his "best" again ( going for long walks, playing in the yard for long periods of time, etc..) or should I expect to keep him "comfortable" ? He's just so young and if he's having such troubles now, how bad can/ will it get? Love to hear from you guys who have had a pup diagnosed early on and what it meant for you and how your pup is currently doing.

thanks so much,
Lauren and Cooper

You can also read my posts in regard to Cooper @ the thread "My Cooper (6)... Just go to search box.

[addy]

Hi Lauren,

Glynda's pom was 3 when diagnosed, Zoe was appx 8 but probably had it longer than that. While we do sometimes think of it as an older dog disease, sometimes younger pups will be diagnosed.

It really all depends if the dog has any other health issues, how they respond to treatment, etc. Does Cooper have alot of muscle wasting? That takes a long time to overcome. Also keep in mind that sometimes the drugs have side effects so there might be times he feels a bit unwell from the drugs.

We had a member whos dog continued in agility while on Trilostane.
Also keep in mind, some of the members who's pups are doing really well, just dont come back and tell us about it.

With proper treatment a dog should be able to live out his typical life expectancy.

I will say that Zoe will never be the dog she was 3 years ago when we started this journey. But we all get older and we age differently so I will not be the same as I was 3 years ago either. Also, Zoe has multiple health issues. She still hauls toys out of the toy box, still tries to play with Koko but racing around the house she can no longer do, still cant jump on furniture but that is do to her arthritis not just muscle wastng.

Keep the faith, Lauren.

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about Cooper's age into his original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed.

Thanks!

[SoggyDoggy]

We had a member whos dog continued in agility while on Trilostane.
Also keep in mind, some of the members who's pups are doing really well, just dont come back and tell us about it.

With proper treatment a dog should be able to live out his typical life expectancy.


I saw your post and immediately thought of Penny (the agility champ), then saw Addy had mentioned her as well. For a confidence boost, have a watch of this youtube clip. It really reassured me in the early days, even though my boy is 13.

http://www.youtube.com/watch?v=ijO1Ocj5vTo

This is Penny, she is a 10yo Daschund, and a member here. the link to her full thread if you want to have a quick look is http://www.k9cushings.com/forum/showthread.php?t=4250 The youtube clip is linked from this thread as well, so I hope Lisa wont mind me posting it here as well.

Yes, she is older than Cooper (Penny that is), but if the old gals can do this, then the skies the limit!

[molly muffin]

Hi Lauren,

Haven't forgotten about your test results, I'm just hoping that one of the members who are better with the numbers will come by and give their input.

Based on the last ACTH 2 of 8.2 pre and 8.2 post, it would seem that the post is coming down some which you want but I'm not sure why the Pre would have gone up if comparing it to the other ACTH 2 pre 4.6 and post 16.2, that seems strange to me and is why I'd like others to take a look at the results you posted.
The ultrasound actually seems pretty good, as in no adrenal masses present. Kidneys fine, pancreas fine, bladder fine, etc.

I think that there are plenty who have had their dogs live out a normal life span once everything is controlled and there are no other health issues. So, lets not worry about that one just yet. :)

Sharlene and Molly Muffin

[Lauren]

Thanks guys, I'm so new at this and when the vet printed out all the results, they were so overwhelming. Happy to say Cooper has adjusted to the increase pretty well and seems quite comfortable. Weather here has been terrible and rainy the last few days, but if Wednesday is nice, I plan to try to go for a walk with him and see how it goes. Walks are always a good indication for me of how he's feeling, because he either wants to keep going or he'll give up midway our normal route. So I'll keep you posted on how it goes. I also wanted to note that now going into 2nd month on Vetoryl, some positive things have happened as well. His potbelly appearance is almost completely gone, his allergies and itchiness has subsided, and he seems less restless, and to date, no more accidents in the house( that was horrible, because he cow
Dnt even control it, it seemed). Just hoping we stay at this level for awhile. Anyway, thanks for the help and the place to vent my concerns. Hoping to stay in touch with you all for a very long time, Lauren xoxo

[frijole]

Great update Lauren. Please do hang out with us. We are more fun once your dog is stable :) We like positive updates too!!! Kim

[Lauren]

Update on Cooper since his increase from 30 to 40mg of Vetoryl. His symptoms have improved, primarily, he is not having accidents around the house any longer, he has a little more pep in his step, and his pot belly has lessened substantially. But over the last two-three days, he has been experiencing diarrhea. Other than that, he has improved overall. Should I be concerned enough to contact vet or is diarrhea a general side effect of an increase? He's eating and drinking well. Hmmm, what do you guys think?

[Harley PoMMom]

Diarrhea can definitely be a sign of cortisol going too low. I would make a call and let your vet know about this.

[Lauren]

Thanks I will call tomorrow

[addy]

Loose stools can be a side effect of the drug or going to low. So definitely call the vet. Did you start any new food, treats or supplements? Does Cooper have a history of colitis type problems?

[NoonelovesmelikeNorman]

Hi Lauren,
Welcome to the group. Sorry we have to meet this way and that your little Cooper is so young with this disease.
This site is a complete blessing. The wealth of knowledge, encouragement and suggestions have been a tremendous help.
Wishing Cooper the very best and a quick maintained healthy cortisol level.
Peace, Sharon, Norman and Millie

[Squirt's Mom]

Hi Lauren,

What did the vet have to say? I hope Cooper is feeling better!
Hugs,
Leslie and the gang

[Lauren]

I actually took a sample in to have tested. Will get results tomorrow. The diarrhea has subsided and he has slept well the last 2 nights. She thought it could be because of the increase. She's skeptical about lower his dose again because all other symptoms have improved. Suggested another ACTH test, but I asked if we could wait and see. Thought it would be ok as long as results were ok.

[Harley PoMMom]

I actually took a sample in to have tested... Will get results tomorrow.

What "sample" did you take in to get tested?

[Lauren]

Stool. Wanted to rule out anything else.

[Harley PoMMom]

Hi Lauren,

I just read your visitor message about Cooper's allergy issue. Some members have had success with cyclosporine (Atopica) so maybe ask your vet about this medicine.

Sending soothing and loving hugs, Lori

[Lauren]

Lori, just got home from emergency room with Cooper. Thought he may have contracted ringworm. Thankfully, it wasn't ringworm, but his skin is getting worse as the hours tick by. The vet has suggested Atopica. He's already doing the shots and adding ANOTHER med is seeming like just too much. I just want him to have some peace. I am thinking that it may help. We are going to try Hydroxide( I think spelling is correct) waiting for it in the mail, should be here in the morning. Exhausted and no end in sight...just too much. Thanks for hearing me out, Lauren

[Budsters Mom]

I am so sorry that Cooper has been having such a tough time of it.:( Those ER runs are stressful and scary.:eek: I hope you both able to get some relief soon. sending hugs, strength and healing energy your way.
Kathy

[molly muffin]

Hi Laurne, sorry to hear Cooper is having so many difficulties. Have you tried the chamomile tea? Course his white fur would probably turn brown, but it's a thought.
Another one I just read recently is apple cider vinegar, mix with water and use it to soak his paws in. It should give instant relief of itching.

Just some things I thought of and wanted to mention.

Also, what was Coopers last ACTH numbers? As his cortisol had come down, it is entirely possible that the allergies are now showing up more.

hugs,
Sharlene and Molly Muffin

[Lauren]

Hey girls, sorry for the delayed response, but got the new med in the mail and we are on the 3rd day, and still no improvement. We had no other choice but to put a collar on him to stop him from licking his skin raw. His ACTH levels are in normal range and I am confused on what to do next for him. He CANNOT continue to suffer this much. It saddens me to think that since his diagnosis, his quality of life has diminished by 50%. We can no longer go on long walks, we can no longer play in the yard for more than a few minutes, and he has to wear a collar around his neck to keep him from injuring himself. I'm in tears about it most days and just want some relief for my boy. Sharlene, I did try the apple cider vinegar method, as well as oatmeal baths, and witch hazel to no avail. This is truly a tough setback :(

[molly muffin]

What did the vet think?

In January the itichness had gotten better. His post numbers were still a bit high. So, I am wondering if they have come down any further. If so maybe they need to go back up a bit for him to be at an optimal for the allergies and the cushings.

I am thinking tweaking might help. What dosage is he on right now?

hugs,
Sharlene and Molly muffin

[Squirt's Mom]

Have there been any changes in his environment recently? Like a different laundry detergent, or different scent; new air / carpet freshener; new perfumes / colognes; new curtains / carpets / bedding; etc. Is there something outside that is pollinating now? Try to think of anything at all that could be different that he is exposed to and if you can change it back to what you were using before, or if you can prevent him from being exposed.

It may be like Sharlene said - his cortisol may need to run a bit higher than optimal to help with the allergies. This is one of the good things about Trilostane (Vetoryl) - it is easy to adjust the dosage. So you may need to find that happy range where the signs are acceptable to you both and the allergies are under better control.

Let us know how things go....and keep your chin up! You are doing a great job!
Hugs,
Leslie and the gang