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View Full Version : Jasper - 11yr old papillon - on vetoryl



Madcatlady
01-01-2013, 04:12 PM
Hello! My 11 yr old pap Jasper has just been diagnosed with pituitary Cushings before Christmas.

He has had symptoms for a while that we thought were just aging, particularly since last summer, he started to have accidents in the house, weeing a lot more, drinking a lot, panting a lot. He also got a big pot belly, he developed eczema, his fur was thinning on his back, all random symptoms that we had looked at at the vets individually but the vet didn't connect the dots. He has also been a very nervous dog with bad skin since we got him (we have had him since he was 7, he was a rescue dog) so I don't know if perhaps this has been building for years.

About 3 months ago he had to have an operation to remove an ulcer on the back of his knee that just wouldn't heal (could this be a symptom?), we always get our dogs blood tested before a GA to make sure that they are fit for it and his blood tests then came back slightly elevated on some things but within a normal range for his age. Then a few weeks ago we spotted him limping on his front leg and took him to the vets, he had some muscle wastage in that leg and the vet found eczema and a corn in between his foot pads, so it was decided that he would have the corn removed again under GA, we thought that that had probably been causing his limp.

This time his blood showed lots of too high levels, some was tracked down to a mouth infection and he has had antibiotics to treat that and that got better, but finally his other symptoms have been looked at and the vet suspected Cushings so they did all the different blood tests to be as sure as possible and that's what they think it is.

They did have a weirdly anomalous result in his first test where the result was low where it should have been high before a medication was given, but this didn't happen again so they aren't sure what caused this.

Today would be day 4 of his Vetoryl 30mg regime however on the advice of the emergency vet last night we have discontinued the tablet after Day 3 because of some side effects.

Yesterday he was sick once a small amount in the morning and then after that we gave him his next dose at 4pm. Around 8pm he started to lose strength in his back legs and couldn't get up or down the steps into the house and was walking really stiffly. We were pretty panicked and spoke to the emergency vet who advised us to monitor him, thankfully this weakness seemed to pass by this morning but he was still not quite right at 3am when I checked on him again (the main problems seemed to start around 4 hours after which fits with what I've read here about when Vetoryl peaks in the blood).

We are going to speak to our own ordinary vet tomorrow and see if he needs to be tested again.
I feel so sorry for him, I want his symptoms to get better but not at the risk of such extreme side effects! I don't know if the side effects will pass after a time or what.

Jasper weighs about 4.6kg and we are based in the UK. Our vet has based his dosing on the literature by the manufacturer which states 3kg - 10kg of body weight is 30mg, but as Jasper is at the lower end of that perhaps he should be on less?

He isn't on any other medication and doesn't have any other health conditions that we are aware of but he did recently have suspected lungworm which has been treated.

Thanks for any advice you can give!! I'm trying to be positive, he's my little man!!

Marie

molly muffin
01-01-2013, 08:09 PM
Hello Marie and welcome to you and Jasper.

Do you have copies of the test results that you can post? Just the abnormal high/low and ranges, also the results of ACTH or/and LDDS that were done to diagnose the cushings? It's a bloody hard disease to get a correct diagnosis of, with diabetes and thyroid issues often showing the same sort of symptoms as cushings.

4.6kg would be about 10.14lbs. Right now, it is most often recommended that you start low and go up, with 1mg vetroyl to 1lb. At that basis, then I'd say that 30mg, is going to be too much to start with for Jasper and what you were seeing is the results of too high a dosage. In this case, the normal procedure would be to stop medication and get an ACTH test done pronto to make sure that he hasn't gone too low.

Hopefully stopping the medication if it hasn't gone too low, you'll see Jasper returning to more normal actions soon, but without knowing what the cortisol level dropped to you won't know for certain. Did the vet give you any prednisone to have on hand in case of a crash?

How is Jasper doing now? Can you get another ACTH done to check? It really does sound like a case of over dosing.

Unfortunately, just like with people, every pup is different and can have a different response to any medication, with some being more sensitive than others.

Others will be a long soon to comment also. We have members with a long history of dealing with cushings.

Sharlene and Molly Muffin

labblab
01-01-2013, 08:12 PM
Dear Marie,

Welcome to you and Jasper! I am sorry that your little boy is doing poorly, but very glad that the ER vet told you to withhold Jasper's Vetoryl. It is very frustrating to us that they have not updated their written publications, but Dechra (the manufacturer) is now verbally recommending that patients be started on an initial dose that follows a formula of 1 mg. per lb. (2.2 mg. per kg.). So in Jasper's case, it would seem that a starting dose of 10 mg. would have been a safer place to start. Please do update us as to how Jasper is rebounding, OK?

Marianne

Tina
01-01-2013, 09:04 PM
Hi Marie,

I would like to welcome you and Jasper as well. I have a Jasper also! He is an 8 yr old miniature schnauzer, diagnosed with Cushings last June.

I am not an expert, but have learned that cortisol levels can be abnormally elevated if there is any other illness or stress going on. I see that you mentioned that Jasper had a mouth infection around the time he had his bloodwork done, which could certainly affect the cortisol level. It sounds like he had some sort of lung infection also? Was that around the same time? I will be interested to see the results of the tests that were done to diagnose Cushings. You have hit the jackpot with this site. It is the most kind and caring group, and the knowledge available is second to none.

Tina and Jasper

Madcatlady
01-02-2013, 09:57 AM
Hi, thanks for all your replies! I will try to get copies of the results to post up, I will ask the vet. He bounced back fairly quickly, yesterday he was still a little bit stiff in the legs but he seemed much better, I haven't dosed him since obviously.

Just spoken to our vet and the vet was suggesting stopping treatment as he was concerned that it was doing more harm than good due to his anomalous test results and he is concerned that we don't push him into Addison's Disease. Luckily thanks to some info I have read on this site I mentioned lowering the dose and he thinks this is a good idea, he hadn't realised that the medication was available any lower than 30mg as he has only been treating bigger dogs with 60mg and had to order even the 30mg in specially.

He hadn't given me any of the prednisone before but he has just suggested it before I could mention it, he will give me some of that along with the lower dose tablets when they arrive. He is going to order in the 10mg and he said perhaps we could even consider alternate day dosings?

Thanks for all the info on here! I really felt like I knew a bit more what I was talking about when I was speaking to the vet!

Should I call the vet and ask him if we can get his cortisol retested then before the next treatment?

Does anyone have any advice on the best time to dose him? As in, if I'm looking out for a crisis would it be better to dose him when I get home from work so I can observe him all night? I don't know when a crisis is more likely to kick in.

Thanks so much!

lulusmom
01-02-2013, 10:25 AM
You need to dose in the morning as the acth stimulation tests must be done 4 to 6 hours after dosing. I am a little concerned about "anomalous" test results. I'm not sure what that means as a diagnostic test for cushing's is either consistent with cushing's, normal or borderline. Once you post the results of the tests your vet did to diagnose Jasper, we'll be in a much better place to understand.

I am also concerned about your vet's lack of experience with Vetoryl so I'm really glad you found us. We have lots of reading material and I highly recommend that you take advantage of it so that you have a much better understanding of how Vetoryl works, what adverse reactions to look for should cortisol drop too low and the monitoring testing that is required. It is not a benign drug and your vet should have taken the time to educate himself before prescribing it. If your vet understood how Vetoryl works, he would know that every other day dosing is not recommended due to Vetoryl's short half life. I've included a link to info in our Helpful Resources section. Please feel free to share the links with your vet or print out pages for him.

http://www.k9cushings.com/forum/showthread.php?t=185

We'll be looking forward to seeing those test results?

Glynda

P.S. I also have a Jasper. He's one my precious Maltese boys.

Madcatlady
01-02-2013, 10:53 AM
Thanks! I will bear in mind what you've said, I think I'm going to call the vets and ask for the test results and then a new blood test.

The result he was taking about was one where they took an initial blood sample and they expected it to be high but it was low (in cortisol?) but when they did the test again to confirm the result, it was high.

He had two different tests because the results were not clear, I think we need to be a bit more sure of what is going on. His symptoms do seem to match cushings but the effects of the test being wrong would be very bad.

Thanks!

Madcatlady
01-03-2013, 12:33 PM
I have booked him in for further bloods on Monday and asked for the text results but they haven't been sent yet.

His legs seem to be ok now thank goodness, so it does sound like it was an O/D :(

molly muffin
01-03-2013, 06:24 PM
Also let us know exactly what test have been done, like ACTH or LDDS to confirm the cushings diagnose.

Glad that that leg is better.

Sharlene

Madcatlady
01-08-2013, 07:32 PM
Hello, I have his test results now! How do I put them up??

molly muffin
01-08-2013, 09:03 PM
I typed mine out on notepad and then copy/pasted them into the text box here.
What you are looking for is, only abnormal results high or low on blood or urine and also the range from the lab. If urine and a gravity test was done, post that.
If an ACTH or LDDS, post which test, the pre and post numbers.

If you get something up, then we can adjust as needed to clarify.

Sharlene