Desperate for help Meds for 90lb pit bull

[Cozmo the Pit]

I posted this on nov 5 but I've search and it is not here! I am posting it again, I'm desperate for help
Côzmo

Hi, my name bobby I am co-owner of côzmo,man 11 year old 90 lb pit bull. We were just diagnosed with Cushings in June. The vet wanted to put him on Miotane but I can not afford 600$ a month so she said to try

Hi, my name bobby I am co-owner of Cozmo an 11 year old 90 lb pit bull. We were diagnosed with Cushings this June. The vet wanted to put him on Miotane but I can not afford 600$ a month. she said try Ketoxonazole 600mg a day, Which only cost $40 month. He was on it on it as directed for a couple months (if that) but then the people I relied on to give it to him cut it in half. So I thought it wasn't doing any good and took him to vet again. 1 week ago I started him back on it as directed but will have to buy more today if I want to keep trying this med but right now and when we started him on it there was no changes. Has anyone with a large dog had luck on this med?

Now she wants to try Trilostane for 200$ month. I can not afford that either Has anyone else ever tried this medicine, if so any luck on it? It didn't appear to be getting a handle on his symptoms. Her prefeferred drug is the miotane, because it works on either adrenal or pituitary.??? Anyone know that if that's true?

The test they did back in June was inconclusive if its adrenal or petuitory so they want to do another test That's $300. I love Coz so much as I'm sure you all understand and I really wish I could afford the best care but I live on SSDI! I barely make it now so putting this kind of money out is not doable!!!

I am so happy I found this forum! Please I'd love advice on how to move forward! My dog is miserable!!! Oh one more question, what is the cheapest online place for meds or local stores?

[doxiesrock912]

Welcome :)

I am unemployed so I completely understand.

Please see if you qualify for Care Credit. It's easy to apply online. It's a credit for vet bills and they often have a zero interest period. Once the right med and dosage is found, costs are spread out considerably.

An ultrasound could possibly narrow down whether or not it's pituitary or adrenal based.

I used Diamondback Pharmacy (online) for Daisy's Trilostane and it costs less than $50 a month for 12mg capsules.

Please obtain a copy of Coz's tests results and post them here so that we can see them please.

[Cozmo the Pit]

Your dog must be small huh? If I went to that med I think she said it will be 200mg. I do have copy of his test but all it says is inconclusive as far as which kind. I will put the whole thing up after I scan it if I can. Do you have good luck with that med? How long has your dog been on it?

[molly muffin]

Hello and welcome. For trilostane you usually start at say around 1mg/1lb, so you'd start out at 90mg. It is cheaper to get the prescription or have your vet fax it to the pharmacy of your choice than to buy the prescription vetroyl.

You can just type out any results on the test that are high/low. For instance

date
ALKP 1500ug range 50 - 120ug

As an example only. For an ACTH or LDDS test result, we need the base and then the follow up, which for ACTH 1 hour post xxx or LDDS 4 hr xxx 8 hr xxx

and of course what any urinalysis said.

This will help us to give you better feed back.

Sharlene and Molly Muffin

[StarDeb55]

Welcome to you & Cozmo! I have successfully treated 2 pups for Cushing's with lysodren (mitotane). Cushing's is expensive in the beginning to get a diagnosis pinned down & get the pup stabilized on meds. I don't have direct experience with trilostane, but it seems that trilostane takes a bit more tweeking with the dose than lysodren does, initially.

I will talk to you about lysodren in detail. First of all, the dosage is calculated by weight of the pup, usually 25-50 mg. /kg. Cozmo's weight in kilos is 41kg. There is a loading or induction phase with lysodren where you are giving the loading dose which for Cozmo would be 2050 mg, split into 2 doses during the day. The pills are 500 mg. tabs, so Coz would be getting 2 pills twice per day. You will need to be monitoring Coz closely during loading, watching for any changes in behavior, no matter how minor. This means that the dog who literally vacuums his food from his dish without stopping, now, will look up at you if you call his name when he's eating. It could be something as simple as leaving a few bits of kibble in the dish. All of these things sound very minor, but during loading they could easily indicate that your pup is loaded. You would want to schedule an ACTH about 48 hrs. after the last dose of lysodren was given. Lyso is a long acting drug, reaching its peak in the body at about 48 hours. Being optimistic, if this ACTH shows that the cortisol is between 1-5 mg, Coz would now be loaded. You, now, go to maintenance where the loading dose is split into several doses over the week. For example, with the 2000 mg, Cox might get 1 pill 4x per week, or 2 pills twice per week. A lot of vets do not like giving maintenance doses only twice per week because each dog is different & the adrenal glands may regenerate very quickly. You would need another ACTH at the 1 month mark to confirm that the maintenance is correct. If it is, then you would only need an ACTH done as little as twice per year or possibly quarterly, it really depends on the vet. My last boy was a small Shih Tzu, about 13 lbs, he was 13 when he was diagnosed. My vet was very cautious with him, so he wanted an ACTH done quarterly. My first boy was treated successfully with lysodren for nearly 8 years, crossing the bridge at 15 due to causes unrelated to his Cushing's.

Last thing, you may be able to save a substantial amount of $$$ by using a compounding pharmacy for the lysodren. I, also, know that a lot of people have used the pharmacy at Costco to save money. You don't have to have a membership to use the pharmacy.

I don't want to bore you with too many more details, but would like to recommend that you take a look at our helpful resources section as their is a link for lysodren loading instructions that will give you in great detail what happens with lysodren during loading.

Again, welcome to you & Cozmo. We are here to help in any way we can.

Debbie

[lulusmom]

:mad:Hi and welcome to you and Cosmo.

I had a novel typed out for you but my computer sucked it down a black hole. :mad::mad: I'm glad that Debbie covered most of the stuff I had about Lysodren but I would also like to say that $600 a month is ridiculous. Perhaps your vet was including the cost of acth stimulation tests too? If so, that would not be a monthly recurring cost. Once stabilized, you would want to do stim tests quarterly for the first year. Using pricing from Costco at $5.56 a pill, and assuming that Cosmo loaded in eight days, the cost for loading would be $177.00. The cost of weekly maintenance would be $22.24 so your first months expense would be approximately a bit over $200.00. Once stabilized, monthly maintenance would cost the high end of the high end of the average days of loading, and I figured the first month would be your biggest expense at about $200. If Cosmo were to stabilize on the dosing Debbie mentioned, maintenance would cost under $100.00

Ketoconozale is rarely used in the states anymore because a good number of dogs don't absorb it into the GI tract. I think I read something like 35% of dogs. This could be why you were not seeing any improvements in Cosmo. Ketoconozale is also very tough on the liver, which is why it is mandatory to check liver values routinely. It's really not a good choice.

The other effective choice would be Vetoryl (Trilostane). At 90 lbs, you would want to start Cosmo on the lower end of the dosing range recommended by the manufacturer, which is 1mg per pound of body weight. That would be 90mg once daily. You can save money by having the dose compounded; however, it has to be in a dose that is not available from the manufacture. It is known that larger dogs may require lower doses than small dogs so you may want to drop that dose down to 85mg and have it compounded by a compounding pharmacy. Many of us use Diamondback Drugs in Scottsdale, AZ. I've been getting all my vet meds from them for years....they are very reputable. I called and got a quote of $53.55 for 30count 85mg capsules. So you are looking at a fraction of the cost of Lysodren.

The other big ticket item is the acth stimulation test which is mandatory in order to monitor treatment and determine when you've got the right dose. The first few months are the worst but once stabilized, you move to quarterly testing and down the road a little further you may be able to stretch it out a bit further.

I hope that helps.

Glynda

[StarDeb55]

Her prefeferred drug is the miotane, because it works on either adrenal or pituitary.?

I did want to comment on the above statement. Yes, your vet is correct, lysodren will work in treating an adrenal tumor. Since you say the testing, which I assume was a low dose dex test, was inconclusive in determining what type of Cushing's, you would have to have an abdominal ultrasound done. If Cosmo would have an adrenal tumor, surgical removal of the tumor would offer a permanent cure for his Cushing's. This assumes that Cozmo would be a good surgical candidate. Adrenal tumor surgery can be quite "dicey'. You would want a board certified vet surgeon who had had plenty of experience with adrenalectomies. I will be honest that this surgery is not cheap. The main reason for the ultrasound is to confirm the positive the Cosmo had on his other testing as Cushing's can be very difficult to diagnose as it symptoms mimic several other diseases including diabetes, & thyroid.

If you want to share with us, could you tell us what symptoms Cosmo has had that led you to go to the vet. Does he have any other medical problems? Is he taking any medication or supplements? Giving us some more history on Cozmo will help us to give you more specific feedback.

Debbie

[doxiesrock912]

Daisy is doing very well on Trilostane. We also use Diamondback Pharmacy.

[goldengirl88]

Welcome to the forum. Sorry you are having so many problems. I just wanted to say my part after reading the postings. Please whatever you do, so not start your dog off on 200mg of Vetoryl. That is twice the dosage recommended. I have found from personal experience that you need to start low and tweak it from there. Giving you dog 200mg you are asking for trouble in my opinion. A dogs cortisol can plummet real fast in some dogs. If you want to be safe please listen to the low and slow. Your dog will be better off, and you will minimize risks. There are plenty online reliable sources to get this Vetoryl cheaper. As Valerie suggested apply for Care Credit. Most vets take it and it will allow you to pay small payments over a long period of time. It is better to apply and keep it handy even if you do not use it. I have never used mine, and keep it for emergencies. Blessings
Patti