Kasey, New to group- intro (9-10 y/o min poodle)

[Kasey's Mom]

I've spent the last few days reading through a couple threads..

My name is Tracey, owned by two poodles (Kasey the probable cush dog, Turner, 5yrs) in Central Ohio

Kasey- 9-10 yr old min poodle

History- He has been on thyroid meds since he was 4 or 5yrs old. He had some sort of episode right before, his eyes were tracking (jiggling), head tilting, had trouble keeping his balance, partial facial paralysis that has improved over the years. He has to blink with his inner eyelid. (The thyroid meds helped with the eye tracking, balance, head tilt)When I had a better job, I took him for acupuncture/chiropractic. It definitely helped the paralysis .

He has always had concentrated urine, rarely any infection. The vet recommended low protein diet but for both dogs wasn’t really feasible. When I got him from the rescue, they warned me that they had not been able to housetrain him. I of course that that I could.. ha ha.. There was no rhyme or reason to his accidents. The last couple years, I have just used belly bands on him. My mom comes over during the work week to let the boys out mid day.

Present day..
About 3-4 months ago, he was rather quiet, not wanting to eat (extremely unusual), so to the vet we went. The vet put him on two weeks of Simplicef, boiled chicken/rice. He improved. About a month later he was bloated/retaining water. Back to the vet.. He is now on Lasix. He said to let him know how he did. He improved greatly, surprisingly his accidents became less frequent (assuming the Lasix was forcing his bladder to empty?). Few weeks later (after being so paranoid).. he seemed that to be having labored breathing, back to the vet. He is now on Enalipril, another trip he is now on Vetmedin. My vet suspects congestive heart failure. If I had the money to spare, I would absolutely have it verified by a cardiologist.

Kasey’s thyroid med was increased so I had to get his levels checked. I asked about getting some other levels checked (bun, creatine etc), they were supposed to ask. The tech, popped her head out and asked if he was “ravenous”? I said all the time! They said with his thinning hair, pot belly….. they wanted to get a urine sample to send out for a cushings test. Few days later, I got the call and the indicators (not sure what they were) are there. Next step is the ACTH(?) where he will basically spend the day at the vet. If he thinks I am late with his food, he stomps his feet, snorts and will bark. I have a few choice names/descriptions of this. It makes it VERY hard to give meds an hour before a meal! Periodically, I give in, choose my battles. I read in one of the threads that you can’t give the Veteryl when they have CHF? Or is it just a specific med interaction? What about the lysodren?. I know the acth test is $100+? Does that price go down after diagnosis? At least two of his meds I can get at Walmart for the $4..

Tracey & Kasey

[Harley PoMMom]

Hi Tracey,

Welcome to you and Kasey! So sorry for the reasons that brought you here but glad you found us.

Cushing's is one the most difficult diseases to get a confirmed diagnosis for because not one test is 100% accurate at diagnosing it and nonadrenal illnesses can create false positive results on all tests for Cushing's.

How did the vet diagnose Kasey's CHF? Was an x-ray done? It is true that Trilostane/Vetoryl is contraindicated in dogs that have liver and/or kidney problems. Angiotensin-converting enzyme (ACE) inhibitors, such as enalapril, should be used with caution with Vetoryl since both drugs have aldosterone-lowering effects. More information about Vetoryl/Trilostane can be found here: http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

If you could get copies of all tests that were done on Kasey and post anything that is marked abnormal that would help us a lot....e.g. ALT 150 U/L (5-50)...Thanks!

The initial expense with Cushing's is during the diagnostic phase, once the dog is stablized with treatment the cost does go down. Both the medicines, Trilostane/Vetoryl and Mitotane/Lysodren, which are usually rx'd for Cushing's can be compounded, that saves money too.

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

Love and hugs, Lori

[Budsters Mom]

Hello and welcome from me too. :)
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. We will do all we can to help, but be ready for lots of questions! So again, welcome Tracey and Kasey.

[Kasey's Mom]

Thanks! He was diagnosed primarily from xrays, his hack/cough that i forgot to mention in his history. He has no problems inhaling, but exhales in puffs or panting. My vet did recommend a visit to the cardiologist, but the $6-800 is my 20% of a much needed sleep study. I can't get a part time job if i'm not sleeping :(

Do they have to fast for the acth test? hope not.. my vet doesn't open until 9am, and during the work week they are used to eating 4-5am!

I tried to call my vet for info but they closed early for family emergency (which worries me to death, the family member is a dear friend ) :(

Tracey

[Harley PoMMom]

Fasting is usually not required for an ACTH stimulation test, and if a dog is being treated with Trilostane/Vetoryl then it is vital that they NOT be fasted.

[Simba's Mom]

Hello and welcome, so glad you found us, this is a great site, settle in and ask questions, knowledge is power...read posts, theres tons of info in them and get ready for encouragement along the way, one day at a time!!

[molly muffin]

Hi. :) I just want to welcome you to the forum. It is so hard to diagnose cushings, one of the hardest and if anything else serious is going on, then it makes testing very difficult to get an exact reading on what is up.

We know that you have to sometimes just take things day by day and do the best you can with what you have. Not always easy, when trying to figure out your own medical problems too, which it sounds like you are. Those sleep studies can give you some good feedback, so I hope you get that figured out too.

If you are feeding at 4 - 5am then you are going to want to get the ACTH done at 9am sharp. You need to test within 4 - 6 hours of giving the medicine with a bit of food.

Did you figure out how to get replies, and see them? If not let us know and someone will help you with that.

Welcome again,
Sharlene and Molly Muffin

[Kasey's Mom]

Kasey goes in Monday for his first ACTH test.. praying there is no complications. i did forget to ask if he should still take his morning dose of meds.

Tracey

[addy]

Hi,

He needs to take his dose with food and the test needs to start 4-6 hours after giving the pill. I usually try for 4 hours and keep that time as consistent as I can for each ACTH test. Sometimes that means being forceful when scheduling the test;);)

We'll be waiting for the results:):):):)

[Harley PoMMom]

With Trilostane/Vetoryl it is vital that it is given with food and the ACTH stimulation test be performed within 4-6 hours after the morning dose of Trilostane/Vetoryl was given.

Here is a link with info regarding Trilostane/Vetoryl: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

When the ACTH is done please do get a copy of those ACTH results and post them here...Thanks!

Love and hugs, Lori

[Kasey's Mom]

He isn't on any cushings meds, just thyroid, vetmedin, lasix, enalipril. Is the ACTH the test that also helps diagnose the cushings?

He is starting to get uncomfortable in bed, not sure if it is because i have a memory foam topper and that puts heat back to you, or it might be too soft. He still wants to start out in bed

Tracey

[Harley PoMMom]

He isn't on any cushings meds, just thyroid, vetmedin, lasix, enalipril.

Gosh, so sorry about that, I just assumed that Kasey was taking Trilostane :confused::eek:

I still would give him his medications, also, did the vet ask you to fast Kasey for the ACTH test?


He is starting to get uncomfortable in bed, not sure if it is because i have a memory foam topper and that puts heat back to you, or it might be too soft. He still wants to start out in bed

Tracey

I, also, have a memory topper on my bed and both my boys (non-cush) do not like it and want down when it is time for sleep.

[frijole]

The acth test measures cortisol. Cushings is a disease caused by overproduction of cortisol. So if the cortisol is HIGH it COULD be cushings. Typically additional testing and/or an abdominal ultrasound are done to confirm the diagnosis.

You mentioned your dog wasn't eating - is this still a problem? Gaining or losing weight? What is the daily water consumption and how much does your dog weigh?

Thanks, Kim

[addy]

My bad too, I thought your pup was already on Trilostane thus I posted the same as Lori. Sorry about that:o:o

[Kasey's Mom]

No problem..

The loss of appetite only lasted a couple of days about 3 months ago. Absolutely no problem now! I would say he could easily lose 3-4lbs. He is about 12inches tall, either 18.9 or 19.8. He does drink quite a bit but not "buckets"

Tracey

[Kasey's Mom]

Question about the acth test. Is it just to measure the cortisol? should I make sure they do any other tests? Just in case they are worrying about cost, I would like to get it out of the way.

Only thing new about Kasey, he seemed to be panting a lot yesterday.. but it was more humid etc. Today doesn't seem that bad. I guess there are two things. He hasn't been as ravenous. He is still eating.. It is usually my first sign of something is wrong with him

These are the belly bands that I use. No messy pad to toss, you just toss the band in the washer. He tolerates them
http://www.kvsupply.com/search/&do=s&type=P&terms=pooch+pants

Tracey

[lulusmom]

Hi Tracey,

I am just now reading your thread and unfortunately, I can't answer too many questions or tell you which questions to ask when my head is full of unanswered questions about Kasey. I will echo others who have already mentioned that it would be really helpful if you would please post test results. I would be most interested in knowing when the last blood chemistry and cbc was done and what were the results that were high or low. I would also be interested to know when the last two thyroid checks were done. I know that you increased the thyroid meds at some point and had to go in for a recheck at which time I believe additional tests were done but I'm not sure. What were the levels prior to increasing the meds and after and were the tests done 4 to 6 hours after dosing?

You mentioned that the next test would be the acth stim test that Kasey would be at the vet's office all day. The acth stim test normally takes no more than one to two hours; however, the other diagnostic test, the low dose dex suppression test is an 8 hour test so dogs do have to say with the vet the entire day. Are you sure Kasey is having an acth stim test? If it is the acth stim test, the results are usually not immediate and must be sent out to a lab for interpretation. Therefore, I wouldn't recommend doing any further testing until those results come back and are consistent with cushing's. i don't have time at the moment, but I will be happy to try to explain what the acth stimulation test does a little bit later.

Glynda

[Kasey's Mom]

It must be the suppression test. His last thyroid test was 2 months ago, i will hopefully remember to get the results when i pick him up on Monday. He hasn't had any cbc's in years. He has just had thyroid, heartworm testing. I will have to check the last time he had his dental to see if he had a panel done then. He might have been old enough for a senior panel

New to this, trying to learn the terminology, now it makes sense why others thought he was already on the trilostane

Tracey

[lulusmom]

Hi again,

There are certain blood and urine abnormalities that are common in cushing's and blood chemistry, cbc and urinalysis are routinely done as screening tests before doing the diagnostic tests like the acth stimulation test, ldds and abdominal ultrasoiund. I have to believe that your vet is knowledgable enough to know this and has done some of those tests already. If you will ask your vet for copies of all testing done so far and post the results here, we can better understand Kasey's history, follow your vet's rationale going forward and provide you with much more meaningful feedback. At 9 or 10 years old, Kasey would have been considered a senior a year or two ago so I have to believe that your vet has already done these. If not, I'd question whether s/he has enough experience with cushing's to correctly diagnose and treat. Have you asked him/her how many cushdogs s/he has treated and with what kind of success?

So right now, if it were me, I'd absolutely make sure that a blood chemistry and urinalysis were done at the very least before proceeding with the ldds test. Without those, how do you know if there isn't something else going on that could be causing some Kasey's problems and if there is a non adrenal illness, like a urinary tract infection, the stress of that condition can yield a false positive result on the LDDS. Please talk to your vet and find out what tests have been done thus far and what abnormalities s/he is seeing.

Getting your head and arms around cushing's is a long process so not knowing terminology is to be expected. I don't know many members who knew what cushing's was before their vet turned their world upside down with his/her suspicions or a confirmed diagnosis. I couldn't spell cushing's, much less tell you what it is, what testing should be done and why or what treatments are effective, how they work and what side effects have been reported. I've spent the last 8 years immersing myself in any scientific research I can find and following the many threads here which represent individual case studies....more case studies than most vets will ever see in a lifetime. We have a lot of very knowledgable members and we're here to help you become an excellent advocate for Kasey by encouraging you to learn by sharing our own experience and pointing you to legitimate reference material than can help you understand. There's scads of that in our Helpful Resource section. I've included a link below to a great thread for members who are new to the disease.

http://www.k9cushings.com/forum/showthread.php?t=180

[Kasey's Mom]

Kasey is back home. I did make a request for copies of the results. They were jam packed full of people and dogs tonight. I have a few days off this week, hope to get everything then. Today's results/test are being sent out. I did spring for a cbc.

Now the waiting game..

Tracey

[Kasey's Mom]

not sure how the formatting will turn out

Test Range Out of Range Flag Ref range
Cortisol (PRE) 9.1 H 1.0-6.5
Cortisol (4hr) 10.0
Corisol (8hr) 16.0

I don't believe they printed his thyroid results for me. I will add the cbc in a few

[Kasey's Mom]

1/21/2011 6:26 PM
TEST RESULTS REFERENCE
WBC = 11.7 10^3/UL 6-17
LYM =3.12 10^3/UL 1-4.8
MON =0.46 10^3/UL 0.2-1.5
GRA =8.13 10^3/UL 3-12
LY% =26.7% 12-30
MO% =4.0% 2-4
GR% =69.4% 62-87
RBC =6.50 10^6/UL 5.5-8.5
HGB =17.8 G/DL 12-18
HCT =42.1% 37-55
MCV =65FL 60-77
MCH =27.4PG 19.5-24.5
MCHC =42.3 G/DL 31-34
RDWc =14.8% 0-0
PLT =198 10^3/UL 200-500
PCT =0.22% 0-0
MPV =10.9FL 3.9-11.1
PDWc =40.9% 0-0
ALB =4.5 G/DL 2.5-4.4
ALP =11 U/L 20-150
ALT =45 U/L 10-118
AMY =319 U/L 200-1200
TBIL =0.3MG/DL 0.1—0.6
BUN =11MG/DL 7-25
CA =1038 MG/DL 8.6-11.8
PHOS =3.4MG/DL 2.9-6.6
CRE =0.8MG/DL 0.3-1.4
GLU =100MG/DL 60-110
NA+ =145MMOL/L 138-160
K+ =4.5 MMOL/L 3.7-5.8
TP =6.4 G/DL 5.4-8.2
GLOB =2.0 G/DL 2.3-5.2

TEST DATE 3/10/12 TIME 2.08PM
TEST RESULTS REFERENCE
T4 =LIPUG/DL 1.1-4.0
CHOL =455MG/DL 128-270

Test date 6.23.12
T4
=2.1ug/dl
ref
1.1-4.0
CHOL
=338MG/DL
REF 125-270

TEST DATE 7/8/13
TT4
=1.9ug/dl

Med change .3 soloxine 1/2 bid to .2 1 bid

test date
8/10/13
2.5 ug/dl



TEST DATE 8/12/13
Latest to follow. Is there a trick to formatting the post? looks all pretty before i hit the post button!

Tracey

[Squirt's Mom]

ALP =11 U/L 20-150

CA =1038 MG/DL 8.6-11.8

Hi Tracey,

Could you verify these figures for us? As for the formatting, I wish I knew! It has a mind of its own here! :p But we can read it just fine. ;)

[Kasey's Mom]

on that date
alp 11
ca 10.8

i'm typing up the one from 8/27/13. I had it part of the way done, couple keystrokes and it was gone... control z (undo..) did not work. So, i'm typing in word first!

If there are only certain values needed, let me know

[Squirt's Mom]

~~whew~~ glad to see that was a typo on the CA (calcium)! :)

[knitbunnie]

Hi, and welcome to our little corner of the world. My little Maggie takes Vetmedin, too, and it has made her so much more comfortable. She used to wake up at night with raspy breathing, completely uncomfortable, almost gasping for air. I get mine through California Pet Pharmacy, and their prices are much better than getting them at my vet's office. Maggie gets 2.5 mg morning and night. I order the 5 mg chewables, and they're $53.99 for 50. I get two bottles at a time because shipping is free for $100 or more. If you have a source for a better price, let me know!!! The people at California Pet Pharmacy are super nice, and they'll contact your vet for all the information needed for the prescription. My vet's medication prices are much higher. They ship fast, too.


http://www.californiapetpharmacy.com/

[Kasey's Mom]

Hi, and welcome to our little corner of the world. My little Maggie takes Vetmedin, too, and it has made her so much more comfortable. She used to wake up at night with raspy breathing, completely uncomfortable, almost gasping for air. I get mine through California Pet Pharmacy, and their prices are much better than getting them at my vet's office. Maggie gets 2.5 mg morning and night. I order the 5 mg chewables, and they're $53.99 for 50. I get two bottles at a time because shipping is free for $100 or more. If you have a source for a better price, let me know!!! The people at California Pet Pharmacy are super nice, and they'll contact your vet for all the information needed for the prescription. My vet's medication prices are much higher. They ship fast, too.


http://www.californiapetpharmacy.com/

Thanks! I will have to look into it. Honestly, i forget how much i pay at the vet. My vet may actually match the price.

Tracey

[Kasey's Mom]

this was done the same day as the suppression results. Of course the lay out was not the same and i couldn't just type over... nothing is simple anymore! One thing that i have thought was strange... Kasey has not had his normal ravenous appetite. It has been leaning more towards normal. His personality hasn't changed.

TEST RESULTS REFERENCE
WBC = 20.63 5.05-16.76
LYM =1.82 1-4.8
MONO =1.93 0.16-1.12
NEU =16.54 K/UL 2.95-11.64
EOS 0.25 0.06-1.23
BASO =0.09% 0-0.1
%LYM =8.8%
%MONO =9.4%
%NEU =80.2%
%EOS =1.2%
%BASO =0.4%
HCT =46.5% 37.3-61.7
RBC =6.88 M/ul 5.65-8.87
HGB =16.7G/DL 13.1-20.5
RETIC =23.4 K/UL 10-110
%RETIC =0.3%
MCV =67.6FL 61.6-73.5
RDW =18.8% 13.6-21.7
MCHC =35.9 G/DL 32-37.9
MCH =24.3 PG 21.2-25.9
PLT =405 K/UL 148-484
MPV =12.1 FL 8.7-13.2
PCT =0.49% 0.14-0.46
PDW =16.3 FL 9.1-19.4
ALB =2.9G/DL 2.2-3.9
ALKP =192U/L 23-212
ALT =142 U/L 10-100
AMYL =582 U/L 500-1500
BUN =32 MG/DL 7-27
CA =10.6 MG/DL 7.9-12
CHOL =266 MG/DL 110-320
CREA =1 MG/DL 0.5-1.8
GGT =15 U/L 0-7
GLOB =3.9 G/DL 2.5-4.5
GLU =116 MG/DL 70-143
LIPA =721 U/L 200-1800
PHOS =6.1 MG/DL 2.5-6.8
TBIL =0.8 MG/DL 0-0.9
TP =6.8 G/DL 5.2-8.2
NA =154 144-160
K =5 MMO/L 3.5-5.8
CI =117 MMO/L 109-122
ALB/GL =0.7
BUN/CR =32
NA/K =31
OSM/CA =314 MMO/KG

[Harley PoMMom]

Hi Tracey,

From looking over Kasey's blood work the levels that stick out to me are the increases in the ALT (alanine aminotransferase), GGT (gamma-glutamyltransferase), TBIL (total bilirubin) and the decrease in the ALB (Albumin). These are enzymes associated with the liver so for right now, I believe, I would put the Cushing's diagnosis on the back burner and have a bile acid test preformed to check the function of the liver.

I am not saying that Kasey does not have Cushing's because some of these anomalies can be associated with an increased production of cortisol and although her LDDS test does point to a diagnosis of Cushing's other non-adrenal illnesses can create a false positive result from the LDDS test, so I think ruling out any other health issue is important.

Love and hugs, Lori

[labblab]

If there are only certain values needed, let me know
Omigosh, I am so sorry you went through the torture of typing out every single lab result! In the future, all you need to give us are the results that are specific to Cushing's diagnostics (like ACTH or LDDS), specifically requested (like thyroid), and any other test results that are out of normal range (either high or low). That should save you some time and effort with the typing. :o

Marianne

[Kasey's Mom]

Omigosh, I am so sorry you went through the torture of typing out every single lab result! In the future, all you need to give us are the results that are specific to Cushing's diagnostics (like ACTH or LDDS), specifically requested (like thyroid), and any other test results that are out of normal range (either high or low). That should save you some time and effort with the typing. :o

Marianne
I wondered, but I wanted to get it done. I have it in word now too..lol. One thing i noticed is his cholesterol has been high for years.

Tracey

[Kasey's Mom]

Hi Tracey,

From looking over Kasey's blood work the levels that stick out to me are the increases in the ALT (alanine aminotransferase), GGT (gamma-glutamyltransferase), TBIL (total bilirubin) and the decrease in the ALB (Albumin). These are enzymes associated with the liver so for right now, I believe, I would put the Cushing's diagnosis on the back burner and have a bile acid test preformed to check the function of the liver.

Love and hugs, Lori

Is the bile acid test something that a general vet can do? or do i need a specialist?

Thanks!
Tracey

[Harley PoMMom]

Is the bile acid test something that a general vet can do? or do i need a specialist?

Thanks!
Tracey

Yes, I believe this test can be done by a GP. Performing the bile acid test requires 2 blood draws; one fasting and the other 2 hours after a meal that contains some fat.

Here is a link to an article that explains the test: http://ahdc.vet.cornell.edu/clinpath/modules/chem/bileacid.htm

Love and hugs, Lori

[Kasey's Mom]

Thanks. I stopped by the vet today to get his heart med and apparently there was also an antibiotic! He probably hasn't been feeling well.. the reason his ravenous appetite has been absent the last 7-10 days. He has it now!

I have to coordinate with my mom on getting him there for the bile acid test

Tracey

[Kasey's Mom]

Been nearly a year, wasn't sure if i should post on my intro thread or not. http://www.k9cushings.com/forum/showthread.php?t=5601&page=4

Kasey's symptoms seemed to stabilize, so i didn't treat him for the cushings until now. Now i'm wondering if i waited too long. He has actually lost a couple pounds, has some hind leg weakness. I thought he had a uti but he didn't (last two times clear). The vet said the only thing left to do was to start the med for cushings.

It is day two on the vetoryl, he is much quieter, no interest in dinner. just looks pitiful. What are the usual side effects when starting the vetoryl? I just wasn't sure if there was an adjustment period or if i need to skip tomorrow's dose

He is still on thyroid med, enalipril, lasix, vetmedin twice a day

thanks

Tracey

[Trixie]

Hi Tracey,
I'm sorry that Kasey isn't doing too well. By what you describe it sounds like maybe Kasey is getting too much Vetoryl. What is his dose? The safest starting dose is 1mg per pound of the dog. My dog was 16 pounds and we were even more conservative starting with 12mg.
It seems that many vets start dogs too high. It is much better to begin low and raise the dose if needed very gradually. My dog ended up taking 24 mg a day, the current dose she is on, but we got to that dose very slowly. We never had any adverse effects and the medication is working great to control all the Cushings symptoms.
Poor appetite, extreme lethargy, soft poops/diarrhea and vomiting are all signs of too much medication. I would withhold giving anymore until you can speak to the vet.
Even if it is not too much med you shouldn't give Vetoryl if the dog seems unwell. I don't think you waited too long to treat but it is key to get the dose just right. It takes some time, the symptoms will not disappear overnight.
Hope Kasey is doing okay, if he seems to feel better without the Vetoryl then maybe the dose was too high.
Barbara

[doxiesrock912]

This is important, the symptoms you describe sound like he's definitely getting too high of a dose. It takes longer, but it is vital to start at a low dose and work up as needed. This can be life threatening if it isn't resolved quickly.

[Kasey's Mom]

Why didn't i post earlier? (I wasn't thinking and gave it to him before reading responses) He is definitely getting too much med then The vet started him on 30mg! He isn't eating his food but will eat some cheese. Guess i should look to see if dairy is contraindicated.

I will call the vet

Thanks

[Kasey's Mom]

is there anything to get it out of his system more quickly? I really do not want to make him sick. I'll keep trying to get him to eat some treats. I'll try some chicken

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about the Vetoryl question into Kasey’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thanks!


I have also taken the liberty to add Kasey's name to the title of the thread so it might be easier to find. ;)

[Squirt's Mom]

Has there been any loose stools or diarrhea? Nausea or vomiting? If so, get him to the vet asap for an ACTH and to have the electrolytes checked. Do not delay if those signs have been or are present. Did the vet give you any prednisone? If so, give him the dose your vet recommended now. If the cortisol is too low he should bounce back within an hour. If you do not have pred, call the vet and demand he give you some - unless the vet will be available 24/7 year round.

[Kasey's Mom]

hopefully the pill came up. The water that he drank and the cheese came up. The vet opens in a bit, i will call. Sad part is they do not keep vetoryl in stock. Now i have all this 30mg that he can't take. I just took all of the vetoryl out of his pill box, to make sure there was not another 4am blunder when i'm not awake. I need to take him in again to verify his weight.

hate it when they do not feel well. Turner just does not understand why his brother is getting the extra attention!

[addy]

If the higher dose is the problem, you would want to discontinue for a few days and restart at a lower dose so you have time to reorder and start over.

Sometimes Vetoryl drops their cortisol really fast and the dogs feel yucky from cortisol withdrawal. Lowering the dose helps that problem as well.

Keep the 30mgs, you might end up needing them anyway somewhere down the road.

[Kasey's Mom]

Vet appt at 2pm. He is alert, just the pitiful pup look

Tracey

[Harley PoMMom]

He is still on thyroid med, enalipril, lasix, vetmedin twice a day

Tracey

An area of concern with me is that the manufacturers of Vetoryl do issue cautions about combining the medication with ACE inhibitors such as Enalapril and some diuretics.

I'm glad that Kasey will be seeing the vet today, do let us know how it goes.

[Kasey's Mom]

Back from the vet, forgot to get a copy of the bloodwork. I had one of the office girls read it to me. His electrolytes were normal, his potassium was slightly elevated but in normal range (3.5-5.8) and his was 5.3. He told me to not give the vetoryl the next few days to see how he does and also gave a low dose of prednisone for the next few days. I will go back for a recheck this saturday or monday. I told him i wanted the 10mg Vetoryl and to build from there. He seemed to think every other day would work. I said i'd rather spend the money and do it slow/gradual. I work about 45 mins from home with my mom coming at lunchtime to let the dogs out.

I just wish his heart med didn't start with a V also. He asked me what strength he was on, told him and he said that is a really low dose. Then i realized he was talking about the Vetoryl, not vetmedin.

He is acting better since he got sick. I do need to take some soap/water to his mouth. Stinky bile smell :eek:

Tracey & Kasey (always happy to get a car ride w/out brother)

[addy]

Why did he tell you to give prednisone? Was an acth test preformed?

Sorry,I think I am confused.:confused::confused:

[Kasey's Mom]

thought it was something to do with the potassium and electrolytes? I'll get a copy of the bloodwork

tracey

[Kasey's Mom]

Kasey was really wanting his meds (peanutbutter involved), but is not interested in his food. I think he is waiting to see what else I will offer.

Have a good day!

[addy]

Hi,

What is the prednisone dose you are giving? I still am unclear as to why he is getting prednisone unless your vet is assuming his cortisol went to low. Vetoryl leaves the body fairly quickly. I guess I would have thought since the electrolytes were normal and the potassium a scant above normal, the vet would have just stopped the Vetoryl for a period of time and restarted on a lower dose unless an acth test was done or your pup exhibited low cortisol symptoms when examined. Did he comment on the heart issue?

I think that is why I feel some info is missing. I know it is hard to remember and write it all down when we are worried.

[Kasey's Mom]

he did mention that his cortisol may have dropped too quickly. My mom came over twice today, the 2nd time she stayed long enough for the boys to eat. For some reason, she comes over, it is time to eat!

I'm going to call the vet tomorrow to make sure they order the 10 mg

We ended up only getting up once last night, hope there is a repeat of that :)

Tracey

[molly muffin]

Glad to hear that things are better now. Hopefully this will be a good night too.

Sharlene and molly muffin

[Kasey's Mom]

Back to the vet today. He still wasn't himself so back we went. I saw the other vet, thinking another perspective could help. He has still had some vomiting/diarrhea. He is still drinking.

I'll type out the ones in red. Some of his kidney/liver values were elevated

WBC 17.08 k/ul 5.05-16.76
NEU 13.08 k/ul 2.95-11.64
MONO 1.42 k/ul 0.16-1.12
GLU 156 mg/dl 70-143
BUN 84 MG/DL 7-27
PHOS 7.9 MG/DL 2.5-6.8
ALT 165 U/L 10-100
GGT 30 U/L 0-7
K 6.1 mmol/L 3.5-5.8

He was given some sub Q fluids, some powder for the high phos, probiotic something for the diarrhea. Back tomorrow for more fluids

glad i had some vacation time today!
Tracey

[addy]

Hi,

Can you please tell us the dose of prednisone you are giving or gave and if an acth test has been done?

When did the vomiting and lose stool start? I don't remember that being mentioned earlier.

[Kasey's Mom]

ACTH has not been redone. The diarrhea started earlier in the week when the Vetoryl was started (last dose was Monday). It was periodic. When he didn't have much of an appetite Wednesday I believe, i tried to entice him with some chicken, which he happily ate, then in 5 minutes it came back up. My mom came over and stayed long enough to see if he would eat (usually when she gets there, both dogs eat).

I called the vet yesterday, made the appt for today. He did start to eat last night and this morning. The vet had prescribed 2.5mg of pred to be given daily for 10 days. I only gave him 1/2 a dose a couple of days.

I could just tell he didn't feel good. We'll see how he is tomorrow after another round of fluids. I knew going in today i wanted to at least have a senior profile, but ended up with a full panel. He has eaten a bit more since we got home, definitely still begging for people food.

update- stool now solid ;D

[molly muffin]

Glad to hear the stool is now solid. How is he doing otherwise?

hugs
Sharlene and molly muffin

[Kasey's Mom]

He is doing better. Still has some ups and downs. His appetite is almost back to normal, his attitude as to what he wants and when he wants it is back!

Went back to the vet yesterday for more sub q fluids and potassium/electrolyte recheck. His potassium went from 6.1 to 5.4 overnight.

The vet also took him off the enalapril for now. He is now on Epakitin for the high phos. For the diarrhea he gave fortiflora packets. He said they have had good results with it. Kasey seems to like it

Tracey & Kasey

[molly muffin]

Molly has been on the flortifora many times and I now just keep it in the house for when the poops start getting off a bit. I'll give it to her for 3 days and see how she is doing usually. We've had good luck with it.

hugs
Sharlene and molly muffin