Newly diagnosed, about to start trilostane

[RunnerGirl]

So my poor old dog (12 years old mixed breed, 53lbs) has been suffering for almost 4 weeks with on and off diarrhea. I took him to the vet had general blood work done. Apparently his liver enzyme levels are "through the roof" so I was given a few options for next steps to confirm cushings, which was suspected awhile ago but wasn't confirmed because I couldn't afford any additional tests.

This time around they put him on Tylosin and some special canned food for a few days to help his tummy but he didn't seem to really like it. The diarrhea didn't really improve and when the canned food was finished, he wouldn't touch his kibble. I tried chicken/rice a few times a day but he hates the rice. I know he needs more than this to eat but I don't know where to go from here. He's been on chicken/rice for a week now, 3-4 small meals a day.

Yesterday, he had the ATCH stimulation test done and today the vet said that the results are favourable for cushings. I don't have the results in front of me but from what I recall her telling me over the phone, one of the levels after two hours was close to 1000 (almost double of "normal"), if that makes any sense to anyone.

I'm still not really in a financial position to do additional testing but will be starting on trilostane later this week, once it arrives at the vet office. The cost per month is very high and he will require additional blood testing in a few weeks after starting the meds.

I'm wondering if diarhea is a symptom of cushings and what, if anything can be done to "clear it up" so I can accurately say whether or not he suffers from side effects from the drug, once he starts it.

The vet is also putting him on sulcrate and pepcid to see if that helps his tummy.

To sum up:

* what is the best food for me to be feeding my pup (and how much/how often)?

* will he need constant supervision after starting on trilostane? i have vacation coming up and he will be staying with a friend...

* how often do negative side effects occur on trilostane?

[Budsters Mom]

Hello and welcome:)
You have come to the right place! There are many K9Cushing's angels standing by 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. Others will be popping in shortly to welcome you also. So again welcome to you and precious fur baby.

Hugs,
Kathy

[Roxee's Dad]

Hi and welcome to you and your pup :)

Diarrhea is not normally a symptom of cushing's. Can you tell us more about his symptoms, Excessive thirst, excessive urination, ravenous appetite? loss or thinning fur, pot belly ? Please ask your vet's office for a copy of the cushings test and post the results and normal ranges.

Just my opinion, but I wouldn't start cushings treatment until the diarrhea is cleared up as diarrhea is a symptom we watch for after treatment is started which could be a sign that his Trilostane dose is too high.

There will be many who will stop by to welcome you and help you through this. We are looking forward to hearing more about your pup :)

Moderator’s note: In order to complete your registration, please check your e-mailbox (or spam folder) for a communication from us. Once you respond to that email, your membership will be finalized, and anything that you post will become visible on the forum immediately. Until that time, your replies must be manually "approved" by a staff member before they are visible to the public -- so there may be a bit of delay between the time that you write your replies and the time that you actually see them.

If you have already received and responded to the confirmatory email, please be patient. Your registration will be finalized shortly…Thanks!

[RunnerGirl]

Thanks for the welcomes!

Symptoms are excessive thirst leading to excessive urination (very long pees), heavy panting, small pot-belly, no loss in fur other than typical shedding.

When I spoke to the vet today she said she'd like to try him on sulcrate (sp?) and pepcid to see if that helps his tummy issues.

I'm hesitant to start a new drug like trilostane while the "tummy issues" are still present. I'll see about getting copies of test results and report back.

[Trixie]

Oh..so sorry to hear about your dog. Welcome to this helpful board. There are many knowledgeable people here to advise you and give support. I'm still a little new but it sounds like the symptoms you describe point towards Cushings though there are other conditions which have similar symptoms. It sounds like the tummy upset and diarrhea may be unrelated.
I would certainly wait until it clears up before doing anything else in regards to Cushings. Pepcid works great for my dog. I would try some sticky rice and maybe a little plain boiled chicken until the gastro problem is cleared up.
I hope your pup feels better soon and then you can try and get some answers about Cushings.
Barbara

[mytil]

Hi and welcome from me too.

I have just a sec, but I agree with the others. I would wait to start giving any Trilo until the tummy issues are cleared up. Really do not know what is going on, but there is a possibility what is causing this may influence any testing; even though the symptoms you mentioned do point towards Cushings there are other conditions that mimic these as well - diabetes, liver problems, pancreatic problems and even thyroid issues. I would see if these have been ruled out.

Here is a link to other links that may assist in some of the financial issues of testing etc....we all know that any diagnosis can be expensive. http://www.k9cushings.com/forum/showthread.php?t=212

Keep us posted
Terry

[addy]

Hi,

Every dog is different and the details of their specific case different as well. When my pup was diagnosed she was in the middle of a colitis flare up. I had been to many vets, had many tests and nothing was ever resolved regarding her colitis. Because of the advice I received here on the forum and because my dog did not have many worrisome symptoms, mostly coat and skin with a bit of weakness in the hind legs, her blood work was not like an usual Cush pup either I waited to start treatment. We did a full adrenal panel at the University of Tenn. Her cortisol was marked elevated and "significant" adrenal elevations. It was sky high so I did not doubt the diagnosis.

At the time, her bad poos bothered me more than her Cushings symptoms and then her colitis got even worse. I worked on getting her colitis better which was subsequently diagnosed through biopsies as Inflammatory Bowel Disease. It took me a year to finally get consistent good poos. We started on only 10 mgs of Vetoryl, she weighed then about 18 pounds I think. Her colitis flared for 3 weeks on that low dose. In the beginning she flared every time we changed her Vetoryl dose and we did so by small amounts.

Sometimes the specialists will tell you that their Cushings is causing frequent infections and that is why their stool is bad.

I don't know all the details of your pup's history but you might want to ask the vet for a plan B. The one good thing about Vetoryl is you can start and stop the drug without much drama.

I don't blame you for not wanting to start until the tummy issues are better controlled.

Glad you found us.

[molly muffin]

Hello and welcome from me too. Is it possible to get copies of the testing, blood, urinalysis and the cushing tests and post the results here? That would help us to know what is going on. No, Diarrhea and not eating are NOT symptoms of cushings. They need to be cleared up before you even think of starting any drugs. You wouldn't know what was causing what otherwise. Usually after you have them settled on cushings meds and stable for a couple weeks, then you can have someone else watching him. They would need to know though what to watch for just in case.
I don't know that I'd put that money out yet for the drugs until this other is figured out. Lets see what the blood test show and go from there.

Sharlene and Molly Muffin

[RunnerGirl]

I'm happy to report that my pup's tummy issues are back to normal and have been for 48 hours. I know that isn't a long time but I'm still overjoyed!

I have test results from his recent general blood test done on June 4 and ACTH test done on June 11. I'm not sure what numbers you'd like me to post.

General blood test
ALT(SGPT) 279 (12-118 U/L)
Alk Phosphatase 1988 (5-131 U/L)

ACTH test
First sample: 91 (28-124 nmol/L)
Second sample: 582
Third sample: 966

Do these numbers mean anything to anyone? :)

[Budsters Mom]

We celebrate even the tiniest improvement. 48 hours with a calm tummy is huge!:D What is your baby's name? Addressing them by name is much more personal. It helps us to get to know them and you much better.
Hugs,
Kathy

[RunnerGirl]

:) My fur baby's name is Jerry :)

[Budsters Mom]

Welcome Jerry and Mom:) Now, isn't that better?:D
Hugs,
Kathy

[molly muffin]

Glad to hear that the tummy troubles are clearing up. How is the appetite? Is Jerry eating any better?

Were the ALT and the Alk Phos the only thing abnormal on the blood work?
The ALT isn't that high. They usually get worried at 3 times the normal range. At least that is what my vet told me. The ALKP going up does show that something is going on, but not what exactly. My Molly's first started to go up when she had crystals in her urine. They've bounced up and down since that time. Which is about 5 years now.

I'm going to convert the ACTH to what most on here are use to seeing which is results in ug. To get ug from nmol, you divide by 27.59.

ACTH
base - 91 (28 - 124 nmol/L) - 10.11
1st draw - 582nmol - 21.09ug
2nd draw - 966nmol - 35.01

Was there anything written on the ACTH results from the lab. Something like consistent with if < xxx

I'm still a bit iffy as to whether or not this is cushings or not. A UTI was ruled out? what about any kind of gastro intestinal bacteria? (that can get out of whack pretty easily).

Sharlene and Molly Muffin