Help! - Seizures and Vetoryl

[laura&penny]

Hi everyone, I'm new here so sorry if i'm breaking any rules! My dog Penny was diagnosed with Cushings last week and has been on Vetoryl, 30mg for seven days. She is a nine year old Cavalier King Charles. I don't know very much about this disease yet so hopefully I can learn more here.

I really need some help as about ten minutes ago, while she was asleep on the couch, she seemed to have a seizure. Her body was shaking, head went way back and was crying/whimpering. It probably only lasted about ten seconds, but it felt like hours! Needless to say she scared me very badly and I am worried that it will happen again.

I'm going to ring the vet in the morning, but wanted to know if this is a symptom of the disease itself or the Vetoryl? I don't know if this is an emergency and she needs to go to the vet now or if she will be ok until the morning.

Thanks in advance :)

[Squirt's Mom]

If it were me I would be calling the vet asap. Do not give any more of the Vetoryl for right now.

[Squirt's Mom]

Me, again. I wanted you to see the first post asap.

How is your baby acting now? Any signs of confusion or being really tired acting? Is she moving normally? Drinking and eating ok?

Is there anything she might have gotten into either in the house or outside today? Exposed to anything new today?

Is your baby taking any other meds, supplements, herbs, etc?

How much does she weigh and what dose of Vetoryl was she taking?

We have several here who have dealt with seizure disorders and I'm sure they will be along soon to share with you. Most pups can live a fairly normal life in spite of seizures so don't lose hope. We will be here to help you anyway we can so don't hesitate to ask questions and talk to us at any time.

Let us know what the vet has to say and how your sweet girl is doing.
Hugs,
Leslie and the gang

[Budsters Mom]

PLEASE CONTACT YOUR VET NOW!!! YOU DEFINITELY HAVE MY ATTENTION!

I'll drop in later to welcome you properly:cool:

Kathy and Buddy:D

[lulusmom]

Hi Laura and welcome to you and Penny.

I have manually approved your user account so everyone can now see your posts, and there is no need to respond to our email asking you to validate your account.

I'm so sorry to hear that your precious girl has been diagnosed with cushing's and had a seizure last night. I do know how scarey they are to watch and how helpless one feels when it's happening. You just want to blink your eyes and wake up to the way things were before the diagnosis. Unfortunately, that can't happen so we do the only other thing we can and educate ourselves so we can make educated decisions for our dog. The good news is that you came to a great place to learn. We've got a great library which I heartily recommend you access in your spare time; however, we will be happy to answer any questions and share our own experience with cushing's.

It would help us greatly if you could tell us more about what took you to the vet to begin with. Did the vet suspect cushing's because of symptoms and/or abnormal blood values? Which symptoms does Penny have? Can you round up all of the testing that was done by your vet to diagnose and post the results here. With respect to the blood chemistry and cbc, you need only post the high and low values and please including the normal reference ranges. How much does Penny weigh?

My little cushdog had very infrequent seizures the last several years of her life. Her specialist didn't think they were related to cushing's nor were they frequent enough to treat with seizure meds. Aside from the seizure, is Penny experiencing any other problems. Is her appetite and activity level okay? Any diarrhea or vomiting? I don't want to frighten you but it is known that treatment can facilitate rapid growth of a pituitary macroadenoma. Most dogs have micro tumors that never grow but there is a still a fairly good number of dogs who have a macrotumor at the time of diagnosis. If a macrotumor grows, it can cause seizures and other neurological issues. I'm very glad you will be calling your vet for guidance. Has your vet had lots of experience with cushing's?

We'll be looking forward to hearing more about Penny.

Glynda

[Budsters Mom]

Hello and welcome from me too,

You have come to the right place! There is a huge arsenal of K9Cushing's angels to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. The more they know, the more they will be able help you and Penny. Please keep talking to us!

So again welcome to you and Penny,

Kathy and Buddy:cool:

[laura&penny]

Thank you so much everyone for responses and support. :) I really appreciate it and I fully intend on learning as much as possible about this disease.
Penny is acting fine now (she's asleep as usual!). Keeping a close eye on her so I will probably wait until morning to go to the vet.

The reason I brought her to the vet in the first place was because of excessive drinking and a dull coat that wasn't growing in places, and had long hairs along in others. She was also very depressed and lethargic. I figured it was Cushings initially only because I know of the symptoms in horses, but I didn't know much about the actual disease.

Vet thought it might be diabetes but was tested and she isn't diabetic. Did a urine test which had abnormal results, I can't remember what she said specifically but it was something about dilution..

She had other tests done, I have no idea what they were called but I will find out! I do know she was at the vets all day and had two samples taken at specific times. I have her results written down somewhere but I don't know how to interpret them. Liver function and kidney function were normal. The vet said it looks like she has the non tumor version, or the most common type of Cushings.

She weighs 9kg and is on 30mg of the Vetoryl a day. I thought this seemed a bit high for her weight but the nurse said it's the starting dose and then they tailor it after the results of next blood test.

I don't know how much experience the vets there have with Cushings, they seem very good and explain everything in detail, and one of them did say that they were treating other dogs who had responded well to the medication (One 16 year old dog with and i quote "the worst heart I have ever seen!").

Penny has no other symptoms other than the excessive drinking and general malaise. Definitely not off her food. She was previously on steroid medication for very bad allergies, but has been off it for about a year. Her allergies have since cleared up completely. The vet seemed to be interested in this, is there a link or something?

I Cushings hereditary? I have her son who is about 5 and I'm terrified he will inherit it.

[molly muffin]

Hello and welcome to the forum.

Well, that was scary.
Can you tell us if She was lethargic today? Did she eat?
I wouldn't give her any more vetoryl though until a vet has seen her and possible follow up testing has been done to see if the cortisol has dropped to much and what might have caused the seizure.
9KG would be 19.8lbs, University of Davis recommends a starting dosage of 1lb/1mg I believe. So, 20mg is probably where I'd want to start at.

It sounds like you had an LDDS test done. With a base draw, a 4 hour and then an 8 hr draw. What you are looking for on this test is full suppression for a negative diagnosis, and then to see how much they are slipping if the cortisol isn't low enough at 4 and 8 hours.

Every dog is different and Can have different reactions to medications.

As far as being hereditary, what I've read is that it can be yes. I know they located a gene in humans related to hereditary cushings and some dog breeds are more predisposed to getting cushings than others. There is not a definitive answer though on what causes the tumors. Usually you will have either an adrenal or pituitary tumor, with pituitary being the most common. In the case of heredittary cushings, you have a gene that causes endiocrin tumors to grow. (this is a human study)

I wouldn't say that it necessarily means that her son Will have it though.

hang in there and again welcome to the forum.
Sharlene and Molly Muffin

[Simba's Mom]

Welcome to you and Penny, so glad you found this site, it's awesome for info and encouragement....sending hugs as you start on this journey!!

[SoggyDoggy]

Hi Laura and Penny! A huge welcome from me, but sorry that you had the need to find us.

If you are intent on learning what you can about this disease, this is by far, hands down, the best site around. Not only is it full of information and links, but the folks here have an amazing wealth of knowledge amongst them and willingly share it. There is also such a comfort factor in being able to talk to others who have been through and are going through exactly the same things you are. At any one time here, there is always someone in the same boat as you, so there is always someone who understands the emotional connection you have too.

Anyway, you've been pointed to a great start with the other's posts here. One thing I will say though is to ask your vet for copies of all of the tests done so far. It is a great idea to have all of the information stored in a file at home, so if the need does ever arise when you have to seek an emergency vet, you have all of the information at your fingertips to take with you and show the ER. Vet's will understand this and will be happy to hand the results over, and most tend to agree that it is a good idea, especially if they don't run their own ER too.

I'm also wondering where you are from? I ask as it is unusual for a post to pop up with a weight in Kilograms, I am so used to seeing pounds it caught my eye :D

At this point, I will wish you luck, take care and I hope things are settling down a bit from a few hours ago. At any time you have questions or need help, be sure to post them up. As I said, there is always someone here willing to do whatever they can for you.

[laura&penny]

Thank you guys for all the info! Penny is much better today thankfully. She's eating normally, although is still pretty tired. Was at the vet this morning and had her vitals checked, everything is good. She has the beginning of cataracts though. :(
She said the seizure could possibly be due to a tumour, but that it may have been a once off thing, or related to the drug. We're keeping a close eye on her, and if it happens again it will be investigated further. I'm praying that it's not a tumour!

Do the seizures cause pain? She seemed to be really confused after it and was panting heavily. Also is there any specific foods or diets she should be on with the disease? Her coat is very poor at the moment.

And the metric system gave me away did it :D I'm from the Republic of Ireland. Are there not many Europeans on here?

[doxiesrock912]

Hi Laura,

great news that Penney has improved! Daisy's coat is not so nice either. Cushdogs are prone to skin infections, UTIs among other things. If her coat smells or is falling out, ask the vet about a bacterial infection which is easily treated with antibiotics and special shampoo.

I don't know anything about seizures. Others in the forum definitely will and I'm sure that they'll answer shortly.

Irelend! I've always wanted to go there!!!!!

[Budsters Mom]

Hi Laura,
Ireland, that is way cool!!!

What did your vet say about resuming the Vetoryl? ,if I understood your post, the vet told you the seizure could have been caused by the drug? Did he say anything about reducing Penny's dosage in light of the Seizure? Current recommendations are 1mg. Per pound.
30 mg. is a pretty high starting dose for Penny if she weighs 9K., or 19.8 lbs.

Please ask for copies of any of Penny's tests and post them here so our angels came better understand what is going on with Penny. We would love to help in any way we can.

Kathy and Buddy:cool:

[Mel-Tia]

They probably didn't know you could get 10mg pills. I remember I had to tell my vet 3 years ago!

Hoping you you are both doing ok?

Mel
Xxxx

[molly muffin]

Checking in to see how you and Penny are doing today.

hugs,
Sharlene and Molly Muffin

[goldengirl88]

Laura:
Hi and welcome to the forum. I had a quick question for you. Are you sure what Penny had was a siezure? My Tipper shakes at night while sleeping her legs jump, her one eyebrow twitches, and the muscle contractions she gets could look like a siezure to someone. Tipper's is a side effect of the Vetoryl. Just asking to maybe save you some grief. God Bless You and Penny
Patti

[apollo6]

Dear Laura and Penny
Below are some sites to give you knowledge and tests for Cushing's.
Also the website for Trilostane/ manufacturer Dechra.
http://www.peteducation.com/article.cfm?c=2+1597&aid=416
http://www.kateconnick.com/library/cushingsdisease.html
http://www.dechra-us.com/Cushings-Syndrome/Veterinarians/What-is-Cushings-Syndrome-1.aspx
http://www.dechra-us.com/US-Products/Products.aspx?pcatid=PROPFIELD465&catid=PROPGRP67&fid=&ProductID=PROD247
http://www.vet.utk.edu/diagnostic/endocrinology/treatment.php
Hope this helps. Penny's weight is important as to dosage, and what type of Cushing she has, if she has it at all. There are three types, pituitary ,adrenal and atypical( relating to the sex hormones. knowledge is the best weapon. Ask questions . Get a copy of all lab work and ask what it means.
Hugs Sonja and Angel Apollo

[laura&penny]

Update on Penny! Sorry it's been so long, I've been so busy with exams and work, this is my first day off!

Penny is getting along fairly well, she has had a few more seizures, but not for a while now. She was retested last week and one vet reccommended putting her dose up to 40mg as the levels of cortisol are still high. Another vet said to keep her at 30 and see how she goes. We have decided to keep her on the thirty for another month, as the side effects are pretty substantial (she is finding it hard to eat and is still lethargic in the evenings, although she is very hyper in the mornings now!).
I have all of her results, which I can make neither head nor tail of! I'll post them soon, but there's so much :D is there anything in particular you guys need to see?

[laura&penny]

Laura:
Hi and welcome to the forum. I had a quick question for you. Are you sure what Penny had was a siezure? My Tipper shakes at night while sleeping her legs jump, her one eyebrow twitches, and the muscle contractions she gets could look like a siezure to someone. Tipper's is a side effect of the Vetoryl. Just asking to maybe save you some grief. God Bless You and Penny
Patti

I think so unfortunately, she does the twitches when she's asleep, the seizures were definitely different, although not full blown seizures according to the vet (vet said she is having mild ones). Hopefully Penny's have passed now as she hasn't had one *touch wood* for over a week.

[Squirt's Mom]

You say Penny is more active in the mornings but has issues at night - is she getting the Vetoryl in the mornings or nights or both?

[laura&penny]

You say Penny is more active in the mornings but has issues at night - is she getting the Vetoryl in the mornings or nights or both?

She gets the vetoryl in the morning only, she is also waking up earlier. She gets progressively more lethargic as the day goes on. Also can be hard to wake up.

[Trixie]

HI Laura,
I hope Penny is feeling good. My dog Trixie gets her med 2x a day. Morning and night..seems to be a good way to avoid side effects. Of course all dogs are different. Perhaps you can ask your vet about this. Maybe it would help the seizures to not have a large dose at one time.
Barbara

[Harley PoMMom]

I have all of her results, which I can make neither head nor tail of! I'll post them soon, but there's so much :D is there anything in particular you guys need to see?

Could you post any thing that is marked abnormal along with the reference ranges and units of measurement...ALT 150 U/L (5-50)....Thanks!! Also if you have copies of the ACTH stimulation tests we would be especially interested in those results.

[laura&penny]

I wish we could give the meds twice a day, but they are in capsule form so not possible to split, I asked the vet about it. :(
Here are the results:-

11/4/13
bast and low dose dex
Biochemistry -
Bile acids 22 umol/L High ( ref range not given )
Dynamic bile acids 24 umol/L High (0.1 - 10.0)

Basal Cortisol 98.5 nmol/L (<125)
Cortisol Dex Suppression 63.7 nmol/L High (<40)
Cortisol post dex (3) 81.9 nmol/L High (<40)

(Pathologist spoke to vet and advised has cushings disease, starts 30mg Vetoryl capsules and rv in 2 weeks for bloods)

25/4/13
check up post seizure
petit mal seizure
HR;110
good mm colour
good crt
good pulses
nad on auscultation
still pu/pd
hair re growing
owner warned likelihood of brain masses secondary to pituitary based tumour, to investigate further will need abdo us scan to differentiate pituitary vs adrenal hyper-adrenocorticism.

2/5/13
acth stim and lytes
E/lytes aok

Basal Cortisol - 106
Cortisol Post ACTH - 284
(Vet says this should be under 200)

I'll post any high or low results next. 4/4/13
Test
RBC - 5.27 (5.50 - 8.50) Low
WBC -17.9 (5.50 - 16.90) High
NEU - 13.54 (2.00 - 12.00) High
MONO - 2.23 (.30 - 2.00) High
PLT - 689 (175 - 500) High
WBC Abnormal Distribution (WD)

CREA - 38 (44 - 159) Low
ALKP - 783 (23 - 212) High
GGT - 14 (0-7) High
CHOL - >13.42 (2.84 - 8.26) High (off the chart)
Na - 143 (144 - 160) Low

[Bernies4u]

All of this is scary for any one, I have a dachshund that has Cushing's as of two years ago Shelby. She has been doing good till this month and started with seizures. Hope to get reply on my question posted yesterday.

You are in a good place the people here have a lot of good information and will be of help to you Good Luck

Bernie with shelby

[Squirt's Mom]

BUMP for lab results

[Harley PoMMom]

Although her recent ACTH stimulation test shows that her cortisol is not within the therapeutic ranges, I agree with the vet's decision not to increase her dose as of yet.

One of levels that is concerning to me is the cholesterol, has the vet mentioned any thing about this being so elevated?

[molly muffin]

I agree with Lori, if the cortisol is coming down then no point in changing the dosage unless it stops and the symptoms aren't controlled. Yea, that cholesterol is pretty high, did the vet say what he thought was causing that?
The bile acid tests look like the liver bile acid and both are high, I'm wondering if the vet wanted to do an ultrasound to look at the liver and surrounding organs including adrenals. I think I would probably have this done if it is possible.

You're doing great. This is an awful lot to try and learn all at once.
Sharlene and Molly Muffin

[laura&penny]

Thanks guys for all the help I really appreciate it!
The vet said her kidneys and liver were fine, although she did say an ultrasound would give us a clearer picture of what type of Cushings we're dealing with. That's definitely next on the cards after her next blood test. Just need to find somewhere that will do it; the joys of living on a small island. :D

Does anyone here get Vetoryl online? The tablets here are extremely expensive, for one month it's over 120 euro..

I'm also concerned about her high Cholesterol, the vet said it goes with the disease, and to try and get her walking as much as she is able, which isn't much coz she's super lazy.

Also, recently Penny has been losing weight due to her reduced appetite, now that's no bad thing because she was a bit porky, but I'm worried she'll lose too much. Right now she will only eat chicken, will not eat ANY dog food (only licks it). Anyone else have this problem, is it a side effect of the treatment? Any ideas on how to get her eating?

[frijole]

You need to let the vet know about the eating issues as it is a sign that the cortisol is too low. Your dog should be eating like a normal dog - so less than when the cushings was out of control but certainly like a normal dog.

When exactly was the recent acth test done? Keep a close eye out for diarrhea or vomit as that would be a real warning that its the cortisol.

Kim

[Mel-Tia]

Hi

I can help with the vetoryl

http://www.vet-medic.com/dogs-c348/prescription-only-medicine-c351/dechra-vetoryl-hard-capsules-for-dogs-p7684

Need a prescription. Should work out cheaper for you

Big hug

Mel
Xxxxx