vetoryl not working.....ideas....suggestions

[jessiejames]

Good morning.
Jessie is my 11 yr old mini schnauzer.
She has the following symptoms: excessive drinking of water, excessive urinating of a clear nature...ie not yellow, not smelly ,just like water and easy to clean up as it doesn't stain, hard swollen belly, doesn't want to go on walks, lethargic, emits low little groans, eating lots more food than normal. She has no hair loss.
Figuring this was Cushings, vet put her on Vetoryl 30 mg 1 x day with food. Did this for 24 days. No change.
So had to take her off Vetoryl for 10 days and then confirmed it was Cushings doing the std test. Vet emailing me results.
So now she has talked to drug manufacturer who says try Vetroryl again for 2 wks and then test to see if levels are correct. Also said that the dosage was correct for her weight (22 lbs before all this) and thought there might be something else going on.
She has been tested and has not got diabetes or liver disease.
So....I am wondering if I should just go ahead and put her back on Vetoryl or should I have an x-ray. My vet says there may be a tumor which she cannot feel due to hard enlarged tummy.
Any comments?
X-ray or new regime of Vetoryl??
Also....any ideas as to how to give the Vetoryl pills. Jessie easily separates them from any food and spits them out. I have to shove them right down her throat and watch her gag to ensure that they are swallowed.
I have another dog so difficult to monitor water intake but it is substantial and this needs fixing before winter when she would have to go out every 2 hrs.
Thanks for any help.

[jessiejames]

Hi,

Please add these results to my new thread....didn't know how to do this as thread not yet posted. Thx


Tube Labeled Pre

Tube Labeled 4Hr Post

Tube Labeled 8Hr Post

Cortisol Sample 1 Dex 100 nmol/L

Result verified.

Cortisol Sample 2 Dex 153 nmol/L

Result verified.

Cortisol Sample 3 Dex 90 nmol/L

Result verified.

************************************************** ********************

[Roxee's Dad]

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[Squirt's Mom]

Hi and welcome to you and Jessie! :)


Figuring this was Cushings, vet put her on Vetoryl 30 mg 1 x day with food. :eek::eek::eek::eek::eek::eek::eek::eek::eek:

I sure hope I am misreading your post. Did your vet actually put Jessie on Trilostane PRIOR to testing for Cushing's, PRIOR to an LDDS or ACTH or ultrasound?

When was the ACTH given that you have posted the results for?

It would help us a great deal if you could tell us exactly how the cushing's diagnosis came about. What tests were given and when? Please try to get copies of the actual test results, like you did for the ACTH posted, and post all the abnormal lab results here along with everything from any cushing's testing that has been done.

Based on my understanding so far, there is no way in Hades I would put my dog back on any cushing's treatment right now because it does NOT sound like any diagnosis has been made - only guessed at. :eek: So please fill us in with more details and we can go from there. ;) One thing I do strongly recommend is the ultrasound. That test saved my Squirt's life by finding a tumor on her spleen which was causing elevated cortisol, not Cushing's. Testing is CRUCIAL and the more extensive testing you can afford, the better in many cases. ;)

Looking forward to learning more very soon!
Hugs,
Leslie and the gang

[goldengirl88]

I think you are getting ahead of yourself. Until Cushings is confirmed I would not use the Vetoryl. If it were my dog I would be concerned about the hard abdomen. I think you may need an ultra sound or scan. I would determine if there is some type of tumor in the abdomen first. You need to know what you are treating. It is important to get this checked out first while waiting for the Cushings results. My dogs abdominal are is large but not hard. I am worried about what else may be going on with your dog, it could be a large adrenal mass so you need to get your dog seen. Then I would concentrate on the Vetoryl if your dog has Cushings. Good Luck and keep us informed. Blessings
Patti

[frijole]

I can't stay any longer as I have to go back to work but please read her 2nd post - they did the LDDS test for cushings. Kim

[jessiejames]

Yes....the test results show Jessie has Cushings... my vet has not suggested an ultrasound but has mentioned the xray as a possibility. I will ask her about the ultrasound. I do not think she knows what to do since the first regiment of Vetoryl did not work and now she is relying on the vet assoc. with the Vetoryl manufacturer and now wants to see if the dosage is correct even tho it did not cause any of the symptoms to subside.

[Harley PoMMom]

Tube Labeled Pre

Tube Labeled 4Hr Post

Tube Labeled 8Hr Post

Cortisol Sample 1 Dex 100 nmol/L

Result verified.

Cortisol Sample 2 Dex 153 nmol/L

Result verified.

Cortisol Sample 3 Dex 90 nmol/L

Result verified.

************************************************** ********************
Hi and welcome to you and Jessie,

Those LDDS test results are indicative for Cushing's but do not differentiate between ADH or PDH. I have converted the results to the units we are used to seeing:

Cortisol Sample 1 Dex 100 nmol/L = 3.62 ug/dl
Cortisol Sample 2 Dex 153 nmol/L = 5.55 ug/dl
Cortisol Sample 3 Dex 90 nmol/L = 3.26 ug/dl

One thing does bother me though, I am just wondering if the Vetoryl could of had any affect on the LDDS results even though Jessie was off the Vetoryl for 10 days.

I believe an ultrasound would be of better use than an X-ray right now because the ultrasound can show any abnormalities with the internal organs and hopefully the adrenal glands are visualized and a diagnosis of either ADH or PDH can be validated. Has an ACTH stimulation test been done? If so, could you post those results here...Thanks!

Regarding the pill dosing; Trilostane, which is the active ingredient in Vetoryl, can be compounded in a liquid suspension form.

Please know we will help in any way we can so do not hesitate to ask any and all questions.

Love and hugs, Lori

[Trixie]

Sounds like you did one Cushing's test so far? Are those the results on your second post? It was a low dose dex test? I'm not versed in the test numbers but maybe someone can post their opinion on your dog's LDDS test numbers.

I have a mini schnauzer too. Her symptoms were excessive drinking, dilute urine, panting and hunger. The Vetoryl is now helping more but it's been 3 months of tweaking, increasing, watching and testing. We started on a very low dose...my dog weighs about 14 pounds. There was no change for the first 3 weeks or so...actually her drinking got worse. Now symptoms are better but waiting for the latest results of a stim test to see her level. I feel like it's taken awhile for my dog to have a decrease in symptoms. I also do a split dose of 28mg...14mg in the morning and 14mg at night.
Sometimes my dogs belly is a bit bloated...it's not exactly a pot belly but when she's bloated by drinking so much her belly feels a little hard too. It is not always like that though.


If/when you start up again on the medication again can you try wrapping it in whatever your dog loves to eat? My dog just gulps cheese so I mold some around the capsule and it just goes straight down. I also use her canned food to do the same on the evening dose. After I hand feed her the pill I put her food plate down as you must give it with a meal. I don't put it on the plate where she would be able to nose the capsule out of the food. I find whatever she takes out of my hand she thinks is a treat and just grabs and gulps. They also sell pill pockets at the pet stores if you think your dog might like them...cheese works best for us.
Hope you can get a plan worked out with your vet? Does your vet have experience with Cushings?

Barbara

[jessiejames]

Jess' belly is hard hard hard. All the time. This is concerning me. Seems to me the suggestions about the ultrasound are worth persuing.

I don't know if the Vetoryl in her system after the 10 days would affect her test results. My vet says after 1 day, 1/2 is left in her system and then each day the drug is reduced by half so felt that by 10 days drug presence would be very minimal.

Thanks for suggestions about feeding her the pills...have tried every one of them....she just eats the treats, even cheese or hot dog piece and spits out the pill. Same with the pill pocket. Little monkey!!

Thanks to all of you for taking time to answer me.!!!

[goldengirl88]

Ok so it is Cushings for sure? Then I would check with Dechra on the dosing being given. I would pursue the abdomen problem now. I give Tipper her Vetoryl in a piece of chicken. I poke a whole in one end of a piece and shove the pill in. I approach Tipper very quickly show her the chicken in my hand and when she starts to open her mouth I push the chicken in towards the back and gently hold my hand under her chin so she has to chew it and not spit it out. I wait until I hear no sounds from the chewing and presto it is gone. Hope it works for you. Blessings
Patti

[spdd]

I had a bad time with starting my dog on Trilostane. 18 days went by with no improvement, took him off it, restarted again with an upped dose by 10 mgs and within 2 days it took affect. We have since lowered it again and he will be going for another ACTH test to see if we have it right. Hang in there, there is a lot of tweaking to do, but the ultrasound will definitely help in the diagnosis.

In regard to getting the pill down, no one has a dog as finicky as mine I'm sure, partly cause he's completely spoiled, and it's all about texture with him if you can believe it, but the trick I did after the dog could find that pill in anything I gave him- chew around it and spit it out, I wrap the pill in meat, but have the next piece of meat right in front of his nose almost in his mouth. He is so eager to get that second piece he gulps the 1st one with the pill. Works with cheese too or sometimes a hot dog. Now this is a dog that literally chews his food all the time, but so far since having to dose him... it's worked for me. Not sure how long it will last before he catches on, but it's working.

[frijole]

OK could you help us please.. I just read first and second posts again and it does look like your vet started you on trilostane prior to testing for cushings which is ridiculous and scary. Then you did the LDDS test which is known to give false positives if something else is wrong.

Can you please tell us your story from the beginning? Start with what led you to the doc to begin with (symptoms) and then tell us in chronological order what tests were done (we'll need results of the tests) and what drugs have been given (your dog's weight and dosage of each drug)

I think we are missing some pieces and want to make sure we have it all so that we can help you. Thanks. Kim

[knitbunnie]

My little Pia, a French Bulldog, has been on Vetoryl since mid-June. She continues to drink and pee and pee and drink, but I was told by Dechra that it can take a few months for that to resolve. And that sometimes it never completely goes back to "normal".

Has Jessie been checked for pancreatitis? They can run a spec CLP at the vet's office to check for it. Pancreatitis can be pretty darned painful, and the main thing they do for it is a super lowfat diet. Some vets do pain medication, too. A lot of dogs with Cushings, especially before it's well controlled, get pancreatitis.

Pia had a terribly hard abdomen, the worst bloating every, and her abdomen was so noisy I could hear it across the room. I started giving her Prozyme (an over-the-counter enzyme for gas), Gas-X (which is simethicone, another OTC drug that is so safe that I've given it to babies as a neonatal ICU nurse), and something else that I got from Amazon - Himalayan Gasex - that has really worked for Pia. I've tried not giving the Himalayan Gasex to her, and as soon as I try to go without, she bloats up hard as a rock and looks like someone put a football in her sideways. You could play the drums on poor Pia's belly. I also gave my dog Pepcid, which the vet recommended. I've tried various combinations of all of the above, and the other stuff helped her a whole lot more than the Pepcid. Not everyone has the same results, so they're all worth a try. I check with my vet on everything that I give to her.

The Prozyme (also on Amazon) is a powder and the simethicone tablets (I used 1/4 tab twice a day) are super easy to crush up and mix with food. The Himalayan Gasex is a pill that's coated like an M & M. Pia has a "super tongue" and she can find pills no matter how hard I disguise them. It's a struggle, but I finally figured out that if I smear them in some pasty dog food onto the roof of her mouth and then hold her lips shut (not the whole snout, just the flews) she usually can't maneuver her tongue enough to get the pills out. I check the sides of her gums on the outside of her teeth in the side pockets, too, because she occasionally does get that tongue magic working and I have to shove the pills into her again.

Unlike most Cush-dogs, Pia is not a ravenous eater. Her Cushings roared into life after a case of pancreatitis, and she has had eating issues ever since then, so for us, getting anything into her can be a struggle, but it's getting better. I think she's had pain with swallowing, and I've started giving her slippery elm tea. It has seemed to help, too.

Despite her continued drinking and peeing and peeing and drinking, and looking like the saddest dog in the world, Pia's bloating is getting better and she doesn't look nearly as pot-bellied as she did a month ago, so I feel like the Vetoryl is working. She pants a lot, but not as much as she did a few weeks ago, and she's more interested in playing with the tennis ball, always a good thing. She does seem to be drinking a bit less as the weeks go by. I have another dog, too, so it's hard to quantify how much she drinks, but she's not going outside as often, so I do see some improvement.

I sure hope Jess starts to feel better soon. I'm pretty new to this whole Cushings thing, and I have to say, this forum has been a complete sanity-saver for me. The knowledge and the support here are amazing. Without this group, things would have been so much harder.

[jessiejames]

I just was referred to a site called petwellbeing.ca which is a natural products site for dogs etc.
They sell a product for Cushings and the reviews are quite positive.
I might try their product.
The ultrasound, stim tests, Vetoryl pills etc are adding up to a very large amt of $$...and if a natural cure will work it is worth a try.
Vetoryl manufacturer indicated that the liquid form of the drug is not very stable and does not give good results.
Jess actually seems better and held her pee for 7 1/2 hrs when I had an emergency yesterday....very nice but how do you explain that??

[goldengirl88]

I have not heard of any natural product that works on Cushings, and have never used one either. I am sorry about the expense, but you may be sacrificing your dogs well being doing this, just so you know there a products out on the market that say they will manage Cushings, they do not . There are many that I see come on here and say they saw a natural product that works on Cushings only to find out that it does not. If it were that easy and cheap everyone on here would be using it.I wish you luck in what you do and will pray for you and your Jesse, but just know the consequences. Blessings
Patti

[Squirt's Mom]

Honey, if Adrenal Gold, Cushex and the like truly worked, forums like this would not exist, the fear of Cushing's would not exist because we would all have our babies on these sort of products and they would be just fine and dandy. The fact that our forum and others like it do exist and are flourishing, and the fact that folks who truly KNOW this disease do not have their own babies on such products, should let you know just how effective they are. They are highly effective at making the folks at PetWellbeing and other sites wealthy but that's about it. Some of the ingredients in these products won't hurt and may help with some of the signs in a small way, but some ingredients are harmful and should not be given to a cush pup - like licorice. Dandelion can confuse the picture because one of its actions is as a diuretic - it causing increased urination, one of the signs of Cushing's. None of the ingredients will effect the enemy in Cushing's - cortisol. ;)

I, for one, have always found it extremely odd that many of these products claim to be effective on both Cushing's and Addison's - polar opposite conditions. :confused:

[Trixie]

You have to give it more time. It takes awhile to get the right dose and then it takes more time for the symptoms to decrease, and even then things may not be exactly what they were before your dog was diagnosed. Wish the "natural" products could do something...but I agree, if it were that simple none of us would be here looking for help.

Barbara

[doxiesrock912]

Give it time and realize that every dog responds differently.

Daisy began at 20mg once a day, then went to 10mg twice a day, now she's at 10mg in the morning and 7.5mg at night.

The key is to watch your dog. Determining the proper dose is in part done by the testing, but you also have to be aware that some may not tolerate the ideal dose well. This is the case with Daisy, despite what the numbers said.

I make sure that she is willing to eat her food before I give her the meds, and once I know that she is going to eat. I give them to her.

Watch for lethergy and not eating or being unusually picky about eating.

You'll get there. It takes time :)

[Squirt's Mom]

Hi,

I wanted to make sure you read Kim's (frijole) post above. If you could please provide this info it would help a great deal -


Can you please tell us your story from the beginning? Start with what led you to the doc to begin with (symptoms) and then tell us in chronological order what tests were done (we'll need results of the tests) and what drugs have been given (your dog's weight and dosage of each drug)

Thanks!
Hugs,
Leslie and the gang

[Junior's Mom]

Hi. I wanted to let you know that I felt the same as you in the beginning. I was worried about the drugs, and wanting to try something natural. I was told by many on here that adrenal gold, cushex etc. wouldn't work. I tried adrenal gold anyways.
Within the first couple of days of giving it to my dog, he stopped peeing in the house. His water intake also decreased some. I was impressed. This was the only affect it had though. I had Junior on this from January 2013 till the end of July. Through that time, his urine remained dilute, he still had to pee massive amounts, his hair got thinner and his appetite increased steadily.
In July I decided it was too hard on his bladder to have to hold in that much urine, and he was miserable and annoying, feeling like he was starving all the time. I had more blood work done, and his liver values had got somewhat worse.
I decided it was time to try trilostane. I went with a low dose .4mg per lb, twice a day. He has been on it 4 days now, and I have seen improvements since the first day.
I thought I should share my story with you. I hope things work out well for your pup.

[Junior's Mom]

I would also say, as others have that while an ultrasound is very expensive, it is definitely worth getting to rule out anything else.
It seems very few vets know what they are doing, so it is up to you to educate yourself about this disease, and the protocols that need to be followed in order to manage it. This forum has more info on it than just about any vet you will talk to. Just my opinion, but I think it is best to start with a very low dose, and work up if need be.