recently diagnosed with cushings

[mia]

Hello my 11 year old boxer was recently diagnosed with cushings. We had the 8 hour test completed this past monday and the vet recommended we start her on vetoryl. My research has mixed reviews about this drug, one in particular referenced this site as saying they wished they had paid more attention to the information on this site regarding the proper dosage. The author stated that her dog as put on vetoryl and crashed and wish she had started at a lower dosage. So my Mia is a bit on the heavy side, she had steroids given to her for too long of a time due to two broken legs. I suspect this might have caused her condition. Wonder if anyone can suggest if i should start her at a lower dosage than what is recommend. She weighs 68 pounds and was started on 120 mg. Should i start lower at 60 mg and depending on her follow up test increase the amount?

The decision to treat has been been a challenging one due to the conflicting research. Any guidance anyone can give would be greatly appreciated. Mia is also on Thyrozine 2 tabs of .8mg twice a day. She also has pretty bad arthritis so she is on Rimadyl 100 mg 1/2 a pill twice a day.

Thanks all in advance for your help and guidance.
sd

[Roxee's Dad]

Hi and welcome to you and Mia,

Based on studies by UC Davis and world renown Endocrinology vets, it is highly recommended to start at the lower end and work up as their will be much less risk of any emergency.

http://www.dechra-us.com/Cushings-Syndrome/Veterinarians/Prescribing-VETORYL-1.aspx

Please tell us more about the events that led to the testing and diagnosis of cushings. Was an ACTH performed to baseline Mia's cortisol levels? Please do get copies of the test that were performed and post the results here, so we may have a better idea.

How long has Mia been off the steroids?

Many will stop by to say Hi :) and to help you through this, weekends are kind of slow, so hang in there. :)


Ideally, the starting dose to aim for is 1.0 to 3.0 mg/lb (2.2 to 6.7 mg/kg) once a day based on body weight and capsule size. When calculating dosage, it is suggested to round down. Start at the low end of this range. If you have any questions on dosing, contact Dechra Technical Support at 866-933-2472 or support@dechra.com.



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[Harley PoMMom]

Hi and welcome to you and Mia!

So glad you have joined our family and we will help in any way we can.

Looks like John has gotten you off to a good start. I, also, am concerned with Mia's treatment with steroids. A type of Cushing's known as Iatrogenic is caused by the extended use of steroids and the treatment for this is to gradually taper the dose of the steroid.

Steroid use can skew the results of all tests for Cushing's so if Mia was tested for Cushing's while on steroids her tests will be invalid.

Regarding the Trilostane/Vetoryl dosing, we have seen that adverse signs are minimal when a dog is started at the low end of the dosage scale.

I'm providing a link from our Resource Thread that has a wealth of info regarding Trilostane/Vetoryl: Trilostane/Vetoryl Information and Resources. (http://www.k9cushings.com/forum/showthread.php?t=185
)

Please feel free to print anything out and do ask any questions you may have.

Hugs, Lori

[LtlBtyRam]

I hope you have found some answers. I'm late in doing so, but welcome to the boards and PAWSOME folks around here.
Angela

[Trixie]

I'm not a big expert on the other drugs your dog is on and how that could effect the treatment for Cushings...or the steroids that most likely caused the issue to begin with.
I will be able to advise you on the Vetoryl dosing though as my dog is now 6 months into treatment. I would not give the 120mg dose if it were my dog.
We started my dog very low and gradually increased her dose along the way. We never had any side effects at all over these 6 months. If you stick with 1mg per pound-the current recommendation of the drug manufacturer Dechra you would want to start with the 60mg a day for your Mia and see how it goes. It's a starting place...you may or may not see any immediate change in her symptoms on this dose, but you will hopefully not see any adverse reactions either. Then you will need to test her levels and see how her numbers change (or don't change) on this dose and adjust (or not) from there.

Low and slow may take a little longer for improvement with Cushing's symptoms but you will avoid the bad side effects which could be what you get starting at the higher dose.
If you go with a higher dose and have bad reactions it will also slow down the course of treatment. You would then have to wait and start over at a lower dose, and you will probably be fearful to use the drug if anything bad happens. This drug can help your dog feel better and control the cortisol level in her system, it is working for my dog we just had to do a lot of dose tweaking.

I think it's better to start low and build up if needed, it takes some of the fear out of treating, knowing you are starting at a safe strength for your dogs' weight.
Others will chime in with their advice...it would be great if you could post a little more about Mia-what symptoms does she exhibit, and how long she was on steroids. Also-if you could post your dogs test results--the ldds test and any bloodwork that was done. Then the real experts will be able to advise you. :)

Barbara

[goldengirl88]

SD:
No matter what anyone tells you start low. You have less of a chance of your dog having an adverse reaction, or crashing. It gives you dogs body time to adjust to the drug. My vet wanted to start my dog high to and I told him no way. I started off at the lowest dose and worked my way up, my dog has never had any adverse effects so far. The vets all want to start these dogs off high, and if they read Dechra's material they might be enlightened. If you want to call Dechra they have vets there that will help you. 866-933-2472. With a powerful drug like Vetoryl you always want to err on the side of caution. Would you be able to post the abnormal results from your dogs testing that confirmed this diagnosis? That way everyone can help you. Start a doggie diary and write what your dog does daily. You will need it to refer to. You can purchase your Vetoryl cheaper than at the vets online. Were you given prednisone to keep on hand? If not please get some before starting treatment. Is your vet experienced with treating Cushings? If not you may have to find another one. Many vets are clueless when it comes to this disease, and the dog suffers because of it. Just be vigilant and your dog will do fine as long as you keep watch. Blessings
Patti