Sparky - Just diagnosed with Cushings & prescribed vetoryl

[Sparkys Mom]

Sparky is a soon to be 12 year old male mini schnauzer who's had more than his share of health related problems, but always pulls through the warrior. But he was just now diagnosed with Cushings Disease, which killed his sister/litter mate 4 years ago :( At the time his sister had to be put down due to complications from Cushings, Sparky was undergoing surgery for a pheo-chromo cytoma cyst on his adrenal gland. Chances for survival of surgery were less than 50% and he pulled through like a champ. He also had to be neutered at that time due to testicular issues and then had bladder stones removed. Obviously now he only has 1 adrenal gland so this is a tough diagnosis for him. The vet prescribed vetoryl 30mg yesterday, so today being day 2 I am already seeing a major change in him. He has not gotten sick as I have seen in the side effects, but he has NO energy, seems "drugged" and unsteady on his feet and just disoriented. Can anyone that has been giving this med to their dog please let me know if they have experienced this and does it go away after time when their body adjusts to the meds and starts making the changes in the body to decrease the cortisol? Because looking at him right now, if he has to be on this medicine for the rest of his life, this is not the life he had which was full of spunk, happiness and love. Sparky is my shadow and an amazing dog & friend, who I love with all my heart and soul so this is breaking my heart. I am not one to give up, but I also want him to have quality of life and do everything in my ability to help him. Can someone please guide me and help me find some peace and strength? The thought of losing him kills me, but watching him suffer is unbearable....

[frijole]

I am totally confused. If you had the adrenal gland removed due to the pheo then the cushing's is gone. Why are you starting treatment with vetoryl. The description you just made of your dog being unsteady on his feet and disoriented sounds like a dog that has gotten too much vetoryl... and if he no longer has cushings (since the adrenal gland was removed) he no longer needs to treat cushings.

I would stop the vetoryl and bet money that by tomorrow he is acting much more normal. I realize I don't have your whole story but am very very concerned. Please tell us if your vet explained why he/she is still treating the cushing's after removing the adrenal.

Note - I had one schnauzer with cushing's and the other had a pheochromocytoma so I can sure relate.

Cushing's does not have to be fatal - most dogs die from other diseases and not cushing's so don't be afraid of it. Pheos are much more horrific.

Sending healing hugs to your little guy, Kim

[frijole]

PS I forgot - do you have prednisone on hand to give in case of emergency? When a dog has diarrhea, vomits and cannot stand it is a sign that cortisol has gone too low. They need cortisol to LIVE so giving prednisone can offer relief in a few hours as it mimics cortisol.

[Roxee's Dad]

Hi Sparky's mom and welcome,

I am also a bit confused as to why the vet prescribed vetoryl, This med will inhibit the cortisol production by the adrenal glands and since Sparky already had 1 removed, it would seem prednisone would be more in order. I don't really know for sure, but if it were me and mine, I would hold off on the vetoryl based on your description of symptoms until I could speak with the vet and ask him why the vetoryl? Especially since Sparky already had 1 adrenal gland removed.

I would be so afraid he would be going so low on his cortisol production that he may be going addisons.

[Roxee's Dad]

Just my opinion but, If he continues to be lethargic and as Kim (Frijole) mentioned,I would run to a local veterinary ER for some Predisone.

I wouldn't wait too long. but definitely no more vetoryl.

[Squirt's Mom]

Hi Mom and welcome to you and Sparky! :)

My understanding is that a pheo does not mean Cushing's - it is a different type of adrenal tumor that can cause some of the same signs and elevated cortisol but is still not Cushing's. So I'm a bit confused on the Cushing's diagnosis that resulted in the surgical removal of a pheo. With an active pheo, it would be almost impossible to accurately diagnose Cushing's. When a pup has ADH, adrenal based Cushing's, typically the affected gland will be very large while the other gland is very small, even atrophied. It can take time for the remaining gland to get up to speed and take over for the one that was removed. So this is why we are concerned about Sparky being on Trilo now. We want to make sure his other adrenal gland has had time to work as it should. NO Cushing's medicine should be given until that gland is working and then ONLY if Cushing's is present - which would be very rare.

However, if it has been four years since the pheo was removed, it is entirely possible he could have developed Cushing's since. Is this what has happened that resulted in him being given the Trilo?

If so, do you know if it is adrenal or pituitary based? ie does he have another tumor on the remaining adrenal gland?

It would help us a great deal if you could post all the test results that led up to the use of the Trilo and if you could fill in as many details about the surgery and following time for us.

As has already been said, I would not give any more Trilo right now. The things you have mentioned could easily mean his cortisol has gone too low. Do you have prednisone on hand? Were you told how and when to use it in case of a crisis? Keep a very close eye on Sparky and if he starts to vomit or becomes worse in any way, get him to an ER asap.

I'm glad you found us and look forward to hearing back from you very soon.
Hugs,
Leslie and the gang

[Sparkys Mom]

Thank you all so much for the kind words of support and I agree with you to stop the meds...although he only takes 1 day and I gave him that this morning. I have been and will continue to watch him like a hawk tonight and if he gets any worse will take him to emergency e.r. I do not have an predinsone to help him with.
First and foremost, the pheo removal was 4 years ago and that was not associated with a cushings diagnosis. This diagnosis was just done yesterday as a new illness. The adrenal was removed 4 years ago because of the active cancerous tumor which was so close to the heart valve and would have ruptured if not removed. The vet yesterday said that the vetoryl will help reduce the high level (1100) of atch in his system and that we would start on a low dose to see how he does. If I were to see the vomiting or other sick side effects to stop and call the office and we would take him off it for 24 hours and retry. He has not thrown up or had the runs at all. He ate this morning, at which time gave his med to him, and I've had him out walking around the yard and getting fresh air...but he's just extremely lethargic and dazed. I did ask the vet about doing an ultrasound to see if it was an adrenal or pituitary and she said because he has only 1 adrenal that it wouldn't make that much of a difference on the treatment. That confused me, and still does, but I think I was in such shock yesterday and so emotionally overwhelmed that I didn't think to continue to question that response. Looking at the other meds out there one is for pituitary and one is for adrenal and I did see that one of the side effects of vetoryl (worst case scenario) is that it can cause necrosis of the adrenal. When the vet told me that I asked her what would happen if I did not do a med plan for him and she said he would get worse and his system would shut down in a matter of months.

[Squirt's Mom]

Thank you all so much for the kind words of support and I agree with you to stop the meds...although he only takes 1 day and I gave him that this morning. I have been and will continue to watch him like a hawk tonight and if he gets any worse will take him to emergency e.r. I do not have an predinsone to help him with.

If you continue with the Trilo, demand some pred to keep at home.

First and foremost, the pheo removal was 4 years ago and that was not associated with a cushings diagnosis. This diagnosis was just done yesterday as a new illness.

~~whew~~ That is a big relief!

The adrenal was removed 4 years ago because of the active cancerous tumor which was so close to the heart valve and would have ruptured if not removed. The vet yesterday said that the vetoryl will help reduce the high level (1100) of atch in his system and that we would start on a low dose to see how he does.

The purpose of the Trilo is to lower the cortisol.

If I were to see the vomiting or other sick side effects to stop and call the office and we would take him off it for 24 hours and retry.

When a pup gets sick on treatment, you stop them med, have an ACTH to check the cortisol level and do NOT restart until the cortisol is on the rise again and signs are stronger again. That could take 24 hours or months.

He has not thrown up or had the runs at all. He ate this morning, at which time gave his med to him, and I've had him out walking around the yard and getting fresh air...but he's just extremely lethargic and dazed.

These signs could also be indicative of a crash - the cortisol going too low.

I did ask the vet about doing an ultrasound to see if it was an adrenal or pituitary and she said because he has only 1 adrenal that it wouldn't make that much of a difference on the treatment.

While it is very rare to have either two adrenal tumors that cause Cushing's, or both ADH and PDH, it can happen. If it were another tumor on the remaining adrenal gland, it is possible to remove the remaining gland and the pup do fine with supplemental meds to replace the cortisol the glands can no longer release.

That confused me, and still does, but I think I was in such shock yesterday and so emotionally overwhelmed that I didn't think to continue to question that response. Looking at the other meds out there one is for pituitary and one is for adrenal and I did see that one of the side effects of vetoryl (worst case scenario) is that it can cause necrosis of the adrenal.

Both Trilostane (Vetoryl) and Lysodren (Mitotane) can be used to treat either form of Cushing's. Whether the tumor is on the adrenals or the pituitary makes no difference.

When the vet told me that I asked her what would happen if I did not do a med plan for him and she said he would get worse and his system would shut down in a matter of months.

While we don't know the full extent of Sparky's health status, this sounds a bit alarmist to me...and I should know, I are one myself. ;) Cushing's is a VERY slowly progressing condition taking years to damage organs so if you choose not to treat, yes, his life will probably be shortened and he will face other obstacles, but I wouldn't take that "months" to heart. UNLESS there are other things that could impact his lifespan within that time frame.


Thank you so much for clarifying! The panic party behind scenes will be less hectic now. :p At first read, it sounded almost like they took the Pheo out and put him right on Trilo and we were FREAKIN' OUT! :D:p:D

Let us know how he is doing tonite and certainly in the morning. If it is the Trilo making him off, you should see a difference by morning. You are are an amazing mom for Sparky to have on his side! Lucky boy!

Hugs,
Leslie and the gang

[Simba's Mom]

Hi and welcome to you and Sparky, on this forum you will get lots of info and tlc, we all understand this confusing cushings world. Sendings hugs from me and Simba!

[Sparkys Mom]

Thank you Leslie for that quick reply.
I too started freaking out when I realized the panic I set off and then reading all the dangers of too low cortisol levels my blood pressure hit the roof! No worries, I am very healthy just stressed! ;)
I just took him out again into the yard to get him up and moving and he's still lethargic and moving slowly, but he's at least responsive. I gave him a little dry food with water and he ate it up and drank the water. He's still doing good with NO vomiting or diahrria. I just sent off an email to his vet, who told me she checks her emails regularly even on the weekends when she is off and she made it clear she would be checking in to monitor Sparky during this process. Hopefully I will hear back from her and if not, I will be at the office at 0730 Monday morning! I do want an ultrasound done to know which one we are dealing with as you stated. I will talk with her about the predinsone to keep on hand as well.
Thank you for letting me know a dog can live without either adrenal, as I wasn't aware of that. I thought if it hit the other one he was doomed. But you have given me some hope with that, and also to let me know that cushings can truly be managed and not a death sentence.
I know he's going to be 12 in May, but despite all the prior health issues he's had, he's been happy, healthy, strong and full of life so I pray to have a few more years with him if we can get this Cushings figured out (how it's affecting him) and how best to manage it so he can carry on.
Again, THANK YOU all for your support. I don't feel so alone and helpless as I did when I typed my first entry crying! I will keep you posted and if there are any other questions you have or any other suggestions, please fire away!
Happy Easter!

Michelle & Sparky

[Sparkys Mom]

I did take Sparky into emergency e.r. vet tonight at 5pm. After many tests and checks, he is overall ok and it's the vetoryl to thank for his behavior. I will be following up with his primary vet tomorrow a.m. and seeking the ultrasound to know where we go from here and get the proper diagnosis for treatment...as agreed upon by the e.r. doc/vet. Sparky is doing much better this evening as it seems the med is leaving his system and he's a bit more responsive and moving w/o the lethargy. I'll post tomorrow once I meet with his vet and the ultrasound results.
Thank you again for your thoughts and prayers.
Michelle & Sparky

[frijole]

Michelle, I'm glad you clarified that the pheo was removed 4 yrs ago. Just so you know cushing's is often misdiagnosed. It mimics other diseases and there is absolutely NO rush to treat it.

I am curious what test or tests were done to diagnose it and if you have the numbers from those tests. I am also curious what dose of vetoryl/trilostane you were giving and your dog's weight... just want to check. It could be the dose was too high or that he doesn't even have cushings. To crash like that after one day makes me a bit concerned about the diagnosis and I just want to make sure we have all the info before offering other advice.

Glad he's ok and that you took him to ER. Kim

[molly muffin]

Hello and welcome from me too. Oh my you did have a bad day yesterday. How very scary and confusing.
I'm with Kim. It would be good to know and see what tests were done to determine that Sparky has cushings now and also any other abnormal High/lows on any blood and urine work. This might give us an idea of 1) what is going on with Sparky now and 2) why the vet determined cushings.
What were his cortisol results from the previous ACTH tests? Was an LDDS test done?

I know, so many questions. I'm very glad to hear that Sparky is doing better with the vetoryl leaving his system. whew.

Again welcome to the forum
Sharlene and Molly Muffin

[Squirt's Mom]

Mornin' Michelle,

I'm so glad to know that Sparky was checked out and is home again where he belongs. Please let us know how he is feeling this morning.

Looking forward to seeing the test results!
Hugs,
Leslie and the gang

[molly muffin]

Hi Michelle,

I wanted to check in and see how you and Sparky are doing.
Hope all is well.
Let us know when you get a chance.

hugs,
Sharlene and Molly Muffin