Worried sick about treatment

[Deezle's Mom]

My almost 9 year old chia-poo has been diagnosed with Cushings Disease. We are in the process of finding out what the dosage is for him. He is only 5.14LBs so I am concerned that he may be reacting to too much medication. He has been on 10mg Vetotyl now for about a month. As of today he goes into a deep sleep when he naps and we have to touch him to wake him. His excessive thirst has decreased but he still seems hungry all the time and the test last week showed that his count ( not sure of the name) was down from 31 to 9. The vet said 5 was ideal. Today, for no apparent reason, he started yelping as if he were hurt. I had to scoop him up and cuddle to make him stop. This lasted seconds but was unnerving. He also now prefers to sleep on the tile floor spread out instead of the bed or in our lap. Is all of this normal for Cushings? Can I expect him to get better with time? Is this medication cumulative?

[doxiesrock912]

Hello to you and Deezle,
For 5.1lbs, 10mg is on the high side. The rule of thumb from Dechra is to start low and work up as needed. 1mg per pound is a good starting dose.

I'm concerned about the deep sleep and crying out. Is he lethargic? This is a sign that the dosage is too high. Also, his numbers lowered considerably in such a short time.

Under the helpful resources section of this forum, please familiarize yourself with the symptoms of Addison's as this occurs when Cortisol goes to low. Time is of the essence with this as it can be life threatening.

Lethargy is one of the symptoms of Addison's and if Deezle exhibits others, stop the Vetoryl immediately and go to your vet asap or an emergency animal hospital.

Every dog responds differently to treatment so one scenario doesn't work for all.
Cushdogs tend to run a higher body temperature and have a difficult time regulating their body temperature

Please contact your vet since you are concerned.

[labblab]

Hello and welcome from me, too. I am sorry, though, that Deezle is not showing more improvement and I agree with Valerie that you need to tell your vet about these new problems. It is common for cortisol levels to continue to drop throughout the first month or so of treatment, so as Valerie suggests, it is possible that Deezle's cortisol level is now too low. The only way to know for certain is to perform another monitoring test, which is recommended anyway for all dogs at the 30-day mark.

Even if Deezle's numbers have not technically dropped too low for concern, dogs can still suffer from a condition known as "cortisol withdrawal," which basically just means that they feel yuckky from the sudden drop in the steroid level in their body. Either way, the remedy may be to decrease the trilostane dose, at least temporarily. Since Deezle is still exhibiting some symptoms of high cortisol such as the hearty appetite and seeking out cool places, though, it sounds as though a cortisol level that is genuinely too low is unlikely. So there may be something else going on with him right now besides the Cushing's. Again, the only way to know for sure is to talk with your vet and likely perform those monitoring tests. We are worried about Deezle, too, so please let us know what you find out.

Here's a link that will explain a whole lot more about those test numbers, drug side effects, and also the recommended treatment and monitoring guidelines:

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

Marianne

[molly muffin]

Hello and welcome from me too.

I think that in addition to the information shared by Valerie and Marianne, I would take him in and have his electrolytes tested, specifically sodium and potassium.

We had one of the dogs on the forum recently being treated, that yelped and turns out the potassium was off. I'm not saying this is the same thing that is going on with your pup, but it certainly wouldn't hurt to have the levels checked .

Thyroid, Diabetes and gall bladder issues were all ruled out prior to starting vetroyl?

So glad you found us and welcome to the forum.
Sharlene and molly muffin

[goldengirl88]

Hello sorry your baby is having troubles. The medicine is not cumulative, it does leave the body. You baby is sleeping on the tile floor because it is cool. The cush dogs are very heat sensitive, so remember this for summer time they cannot take the heat. I am so glad to hear you started on 10mg. After they are on it the drinking , and peeing will decrease, but each one does it on their own time. Just be very vigilant and watch your baby and you will get it worked out. Blessings
Patti

[Deezle's Mom]

Hi,
I am dealing with the same thing with our chihuahua poodle. He is 8 1/2 years old. He developed what they told us was Cushings and last night he started seizing. He's been on Vetroyl for a month. He had seizures until we got him to the hospital an hour later. They now say he has Addison's. I am waiting for a call from the vet. The emergency vet told me that treating Addison's is easier than Cushings so all is not bad. I feel like I have been run over by a truck. I know this isn't much help for you because I am new but want you to know that this is probably "normal" for Addison's.

[labblab]

Hi again! As you'll see, I have "copied" your above reply from another member's thread to whom you had posted earlier today. I wanted us all to be aware of this turn of events for Deezle, and also this way it will be easier for folks to talk to you directly about what's going on.

I am so sorry to hear about the seizures! You must have been so worried and scared for him :(. It sounds as though the ER vets performed the initial testing to determine that Deezle's cortisol and/or aldosterone has dropped too low. We'll all be very anxious to hear what the gameplan will be going forward. I do want you to know, though, that is very possible (even likely) that Deezle will not remain permanently Addisonian from an overdose of trilostane. It can happen, and has happened to dogs we've seen on the forum. But more commonly, the oversuppression is a temporary state and the adrenal glands end up rebounding such that trilostane is again restarted at some point (although at a lower dose). When and if that is necessary will be determined by Deezle's behavior and oingoing monitoring tests.

I'm sure your vet will explain all this in more detail, but I just didn't want you to automatically assume that Deezle is now permenantly Addisonian. Definitely keep us updated, OK?

Marianne

[goldengirl88]

Oh my goodness I am so sorry about your other baby going to the hospital. Everyone does say Addisons is easier to treat, but gladly have no experience with it. Hoping all is better and your babies are alright. Blessings
Patti