jodie meds ...

[susanne davies]

Jodie meds......hi. I have a westie age 13...been told she got cushion.she on 60mg meds. Been on it a month......when i took her to vet first off she was drinking gallons of water..peeing a river..and looking for food..pot belly.......now aftrr a month the only thing she got is a pot belly and asth results that conflick.what she like. And they want to up her meds.....:confused:

[doxiesrock912]

Would you please post the test results here so that we may help you.
How much does your dog weigh?

[Roxee's Dad]

Hi Susanne and welcome to you and Jodi, I am so glad you found your way over here. :D

Jodi is 13 years old and weighs 11.25 Kg (24 pounds)

Jodi is on 60 mg of Vetoryl started approx Oct 5th

Oct 24th - ACTH results:
basal = 7.58 ug/dl
post = 43.49 ug/dl

Ravenous appetite is now normal
Thirst is now normal
Urinating normally
Pot Belly still exist

Vet wants to increase dosage. :eek:

Glynda had a few good questions which need replies..
1.Was that last ACTH test performed while Jodi was already on the 60 mg of Vetoryl? YES

2. Was that ACTH testing performed within 3 to 6 hours after taking the vetoryl? YES

3. Was the vetoryl given with a small meal? YES

Many more will stop by to welcome you and help you and Jodi through this.

[susanne davies]

Jodie wss put stright on 60mg.....yes she has a small meal after meds at 7 in morn..... She takes her meds at 7.small meal drop her off at vets at 8 and i pick her up at 3......

[susanne davies]

I put jodie results up on a phote page

[Roxee's Dad]

Moderators note: I posted the ACTH results here for ease of reference:

Calculated =
basal = 7.58 ug/dl
post = 43.49 ug/dl

[Roxee's Dad]

The very high dosage really has me concerned which is why I am glad you are here. Hang in there, many more will stop by to review once they get home and log in. Please check back often and please do not increase that dosage.

In the meantime here is a link to Dechra's (Vetoryl) "Treatment and Monitoring of Hyperadrenocorticism"

http://www.dechra-us.com/files//dechraUSA/downloads/Client%20Literature/47902_VETORYL_10mg_Treatment_and_Monitoring_Brochu re_Update_3_2_ps.pdf


It's an easy to read chart type presentation. Take a look at the cortisol levels and recommendations on page 2, 3 and 4.

[Squirt's Mom]

Hi Susanne!

Glad to see you and Jodi on the forum. :) I'm one of the folks that have been talking to you on Facebook, Leslie. Happy you made it over!

Hugs,
Leslie and the gang

[addy]

Something just seems off those results are what we would see prior to treatment. It is possible to have an adrenal tumor that makes it hard to control the cortisol but - it almost seems like a laboratory error. What were the test results to diagnose Jodie?

Any other concurrent illnesses going on?

I know members are not used to seeing pups on high doses of Vetoryl but both Glynda's and Marianne's pups were on pretty high doses and my Zoe is 17.5 pounds and on 50mgs.

Having said that- I still dont understand how 60mgs did not touch her cortisol unless it is a lab error or something else going on.

I am sure Glynda and Marianne will be stopping by soon.

[molly muffin]

Hi Susanne and Jodi, this is Sharlene from Facebook.

I think and I mentioned this on facebook that a couple things need to happen. One an ultrasound to see the internal organs, to include not only adrenal glands but liver, spleen, pancrease, gall bladder, kidney, etc.
Do not up the dosage as the vet wants to do at this time, but wait until after the ultrasound.

If this is at all feasible considering financial concerns for an ultrasound, then that is what I would do. If it is not feasible financially, and we do understand that this is a very expensive process, then I would still stay at 60mg and see what the next ACTH shows, which should be done in a couple weeks. (not next week, since you just had one).

Others will be by too and they might have some other thoughts.

hugs,
Sharlene and Molly Muffin

[susanne davies]

What jodie go next wed for bloods .i have ask about ultrasound it 47.00 pound im going to book her in .....

[susanne davies]

I have put jodie test results before meds up

Moderators note: I have inserted the test results into your thread.

[Squirt's Mom]

Oh, I'm glad you are able to get the ultrasound for Jodie! That test saved my Squirt's life!

[molly muffin]

I am glad that you are doing the ultrasound. Seems that something else might be going on, or very curious as to what is causing such high results, when on 60mg of med.

hugs,
Sharlene and molly muffin

[Roxee's Dad]

We are looking forward to the ultrasound results. Please post them as soon as you get the results.

Still wondering what is going on with that Vetoryl dosage and high ACTH stim results.

[Squirt's Mom]

And Susanne, you just tell that vet NO to an increase in the dose for right now. Let's get the ultrasound done first then we can look at the dose again. ;) I don't think I would even allow another ACTH until after the US results - might save Jodie some unnecessary stress and you some money!

[goldengirl88]

Susanne:
just started reading your thread and I am wishing you and your baby good results on the Ultra Sound. I would not up the dose either under these conditions like Leslie said. Blessings
Patti

[susanne davies]

Just had phone call off vet he does.nt think scan is needed he going to give her another month meds at 60MG. BUT IF. ANOTHER. TEST COME BACK THE SAME.HE WANT TO DOUBLE THE DOSE...VERY FRIGHTEN

[Squirt's Mom]

Aw, sweetie, you do NOT have to do as the vet wants. THEY have to do as YOU want. ;) This is your baby, not theirs. YOU will suffer along with your baby if something goes wrong, NOT the vet. YOU pay THEM, so THEY work for YOU. YOU are the boss over Jodie, not the vet. ;)

You simply call that vet back and tell him you want an ultrasound anyway and that you are NOT going to increase the dose right now. Tell them you will not pay for any meds if they order a higher dose for Jodie. If this vet will not work WITH you, find another vet asap. Get Jodie's records from this vet and RUN out the door. :)

I know how difficult it is to do this for the first time - stand up to your vet. We are led to believe they are the superior ones, the ones we must listen to, the ones who always know the right thing to do. But that is not the reality. Yes, they have more knowledge than we due to their education BUT they do not know our babies best - we do. Medical professionals made mistakes every second of every day - they are not infallible. I grew up in a medical family - my dad was a Dentist, my mom a Pharmacist and Med Tech - so I was taught to have great respect for the medical profession, and I do. But I also saw the underside of this profession when my dad worked on a disciplinary board. In every case, the cause of the problem was the doctor's arrogance. They sometimes think they truly are gods and do no wrong. BUT sometimes they do make mistakes, they do do things wrong, they do cause more problems than they help. Vets fall prey to this thinking as well - that they know all, that they always know best - but that is simply not true.

So now is the time to dig deep inside yourself and find the courage to tell you vet you are NOT going to increase this drug, that he WILL do the ultrasound or you WILL find another vet. ;) We are right by your side the whole time, Susanne, even tho you won't be able to see us. We will be hovering all around you, lending you our courage and strength. You can do this, Mom, I know you can. For Jodie, you can do anything. ;)

Hugs,
Leslie and the gang

[goldengirl88]

Jodie:
Please for the sake of your baby, do what you think is right and do not trust the vet, please. So many vets, have very little knowledge of this disease, but big egos. They think they know what is right and in reality can end up costing you your dogs life. Please I urge you not to listen to this Dr. Blessings
Patti

[lulusmom]

Hi Susanne,

So sorry to just now seeing your thread here. I see that you posted the results of complete blood count done before Jodie started treatment. Can you possibly post the blood chemistry or alternatively, post the highs and lows, with normal reference ranges?

I think most of us are stumped as to how a dog Jodie's size, prescribed a 60mg dose, shows some improvements in symptoms but results of stim test tells me that you shouldn't have seen any improvements in symptoms as post stimulated cortisol is sky high. In all the years I've been here, I don't recall seeing anything like Jodie's case. So here's my two likely scenarios. Either the acth stimulation test was flawed or Jodie is one of the very few dogs who simply do not respond to Vetoryl. Dechra does state, "A small percentage of animals may require doses significantly in excess of 10 mg/kg/day. In these situations appropriate additional monitoring for adverse events should be implemented as the safety of doses > 10 mg/kg/day has not been fully evaluated. A small number of dogs do not respond to VETORYL Capsules and alternate therapy should be considered. If your vet were to double the dose if there is no change on the next stim test, Jodie will be receiving more than 10mg/kg a day and that would be of great concern to me.

Members here in the states are fortunate to be able to contact Dechra directly and talk to them about their dog's case. Unfortunately, Dechra doesn't extend that same courtesy to pet owners in the UK, and it makes me angry that they have ignored my emails asking them why they don't offer the same help in the UK. I am hoping that they do extend that courtesy to veterinary professionals and if I were you, I would encourage your vet to contact them to get their feedback and recommendations.

I'm glad you joined us.

Glynda

[susanne davies]

Has i write this .i.m crying jody in bed beside me.......she not well tonight..off her food ......im yhink about the vet i said to the vet about scan..he said if it in the head or the stomach.the meds are the same........so y scan......he said he do another....acth test....and if it the same he double the dose.i said but she on high dose now...he disagreed....he keep her on 60mg till then........i ask what food do i give her. Non fat or fat foods He said i.ll look that up. Just normal food...........my gut telling me.something not right

[Mel-Tia]

Hi there,

so sorry your baby girl isn't doing so well. Dechra will talk to vets and mine would consult with them so I would see if that's something your vet would do.

The scan looks at all the organs so I would ask for that regardless of what your vets says

Hoping she perks up soon

Big hug

Mel
Xxxxx

[lulusmom]

You are correct, something is not right and I think it's your vet. I'm not convinced he has much experience with cushing's. This is all the more reason he should call Dechra to discuss Jodie's unusual case and get guidance from a vet on staff. A cushdog who is not eating is a considered a sick dog and Vetoryl should be withheld until appetite returns to normal. If Jodie's appetite does not improve shortly, she should be seen by your vet or another vet to determine the cause.

There really isn't a lot of information on proper diet for a cushdog but because of the effects of excess steroid on protein and fat metabolism, a good quality, moderate to high protein, low fat diet is recommended. Of course, this does not include any dogs with advanced stage renal failure or liver disease as protein is usually restricted.

[frijole]

I agree with Glynda. Is there another vet that you could go to? I'm afraid for you and don't want you to double that dose as it is already high. Kim

[molly muffin]

I'm going to be straight with you. There is always the possibility that it is not cushings causing the high cortisol. The scan is the best way to eliminate that there is something else going on, and in light of the test results, that should be the first thing that a vet considers. A scan at this point, I think is a must. Gall bladder blockage, spleen, anything could be going on and you need to eliminate those possibilities.

If Jodi is one of the dogs with cushings, that doesn't respond to vetroyl, then alternatives need to be explored and frankly, I'd be asking for a consult to an Internal Medicine Specialist to get to the bottom of this. If Jodi continues to be off her food and not right, I also would withhold the vetroyl until you get to the bottom of the issues causing this.

We have other members in the UK and they have been able to go to a specialist. Maybe there is one near you that they would even know of or we can help look for online for you.

We worry about you and Jodi, so much and want this to be resolved so that you and Jodi can go on with happy, healthy lives. This is just no good as it is and could be dangerous even. We are all worried and concerned too.

Hang in there. Do you have an emergency vet you could take Jodi to if needed?

hugs,
Sharlene and Molly Muffin

[Roxee's Dad]

Hi Susanne,
Rule of thumb is to stop giving Vetoryl when the pup is not feeling well, or has loss of appetite or diarrhea.

It's morning now in the UK, please do not give Jodi any Vetoryl today. You should actually withhold it until she gets her appetite back.

The High Definition Ultrasound is not only to investigate if her "cushings tumor" is on her adrenal or pituitary glands. it is to get a good look at the other organs that may be causing the symptoms of cushings. We have a few members here that found other causes for cushings symptoms.

It really sounds like your vet has a one track mind and is not interested in investigating further. He is gambling with Jodi's life. It's not a gamble I would allow.

No Cushings meds until Jodi is up and around and feeling better. If she continues to decline, you need to find a better vet. and soon.

[doxiesrock912]

PLEASE find another vet. Yours does not know enough about Cushings, that is obvious by what you're telling us.

We tried 3 vets before finding one who knew enough. Giving Jodie the Vetoryl while she is not eating should not be done as others have said. When they lose their appetite. it often means that the dose is already too high so increasing it again will likely kill her.

I am not trying to scare you dear, but your vet does not know what he is doing. Many of us have encountered vets who do not know enough about Cushings so it is not unusual. Stop the Vetoryl and find one who does, please.
Also ask the new vet about a scan, this is really important.

[Squirt's Mom]

Mornin', Susanne,

How is Jodie doing today? How are you doing today? Thinking of you today as I know this is going to be a stressful day for you.

Hugs,
Leslie and the gang

[goldengirl88]

I know you are traveling a rocky road right now, please know where are there with you. I too would hold off on the Vetoryl until the dog was better. I think you need to start calling around and try to find another vet. I am afraid with this vet not knowing what they are doing it could harm your dog. Please think it thru, as I know you love your baby. Blessings
Patti

[Mel-Tia]

Hi Susanne

Just checking in. Hope you are both ok and that we hear from you soon.

Bug hug, kisses to your girlie

Mel
Xxxx

[goldengirl88]

Just checking in to see how you and your baby are. I hope you are trying to find another vet. I think this will put your mind at ease if you get someone that knows what they are doing.Blessings
Patti

[susanne davies]

Hi all..jody eating and has pick up....i.m keeping a close eye on her i won.t let him higher dose think back when i pick jody up last. Asth....yhey said she been barking all aftrrnoon .... Could that higher the test.results..has she a mammys girl and my shadow......

[Squirt's Mom]

I'm so glad she is eating better and acting better! I was soooo worried about her! The barking could be any number of things including just wanting all your attention. :D Unless she starts drinking and peeing buckets, or her appetite gets very strong, I wouldn't worry over much about the cortisol being too high right now. Just keep watching her like you have been and keep in touch. We worry when we don't hear from folks. ;)

[goldengirl88]

Hoping all is ok with your baby. Just keep watching like a hawk. Blessings
Patti

[Squirt's Mom]

I want you to know how proud I am of you for not letting the vet force you to raise the dose. You done GOOD, Mom! :cool::):cool:

[goldengirl88]

I second that thought!

[Roxee's Dad]

Just checking on you and Jodi.... How are you 2 doing?

[doxiesrock912]

Being stressed can certainly affect the test results. Some people bring them in and have the test done but take them out of there in between so that they are not sitting in a strange place for the whole day.

[Squirt's Mom]

Hi Susanne,

Haven't heard anything in a few days on Jodie and am wondering how she's doing? Is she eating better?

Hugs,
Leslie and the gang