Charlie diagnosed with cushings disease 2 weeks ago

[Charlie's Mum]

Hi All,
I stumbled across this forum while doing some research on Trilostane.
My little Charlie, a maltese cross shitzu who is turning 12 this year was diagnosed with cushings 2 weeks ago and has been on Trilostane for 2 days. Just a quick couple of questions. We were given an info sheet with the meds including a "emergency" bottle of prednisone in case of a bad reaction to Trilostane. Have many of your pooches had a bad reaction to the medication? My vet gave me the impression that if it was going to happen it would be after he was on it for a few days. Also, how long did it take for your pooches to start to see an improvement in their symptoms?
A little bit of history on Charlie. He has a fair list of medical conditions. He was found to be allergic to preservatives as a puppy. Then he needed an operation on his front leg where one of his bones stopped growing. He has since had his anal glands removed due to constant blocking and infection. And in the past couple of years he has needed cruciate ligament surgery to both his back legs.
It was at a check up on one of his knees that I also asked vet about Charlie's recent weight loss and excessive drinking. With more examination and chatting about his behaviour we found him to have a pot belly (which we use to joke about calling him a little fatty) plus he has started to inhale his food, but this seemed to start the same time we got our Lab pup (who is now 1 yr old). I put this down to competition for food but in hind sight this could also be a symptom. He has also slowed right down, sleeping lots and I put this down to him becoming a little old grandpa. The vet also found a lot of muscle wastage.
Charlie was tested for diabetes and kidney problems but the only abnormal bloods result was a high alp (very high first result and still high after dilution). He has since had a dexa test which came back showing pituitary gland related cushings. He is booked to have a ACTH test on Friday. He is currently on 0.3 mls (3mg) Trilostane twice a day. I think that's all the info I have.
Cheers Charlie's Mum.

[labblab]

Hello and welcome to you and little Charlie! We are really glad you've joined us, and I know that others will also be by to welcome you as well.

In answer to your question re: issues with the medication, I think we've seen it all around here -- some dogs have not had any problems at all, some have had minor side effects, some have needed to reduce dosage fairly early on due to more worrisome side effects. There is just no way to predict in advance. But since you already have your first monitoring ACTH test scheduled and it is clear that you will be watching Charlie ever so closely yourself, we will count on nipping any problems in the bud. It is not at all uncommon for trilostane dosing to require tweaking either up or down, but hopefully it won't take Charlie long to stabilize on a consistent dose.

As far as how long it takes to see symptom resolution, it depends largely on getting that dose of trilostane stabilized such that the cortisol level is brought down into a properly therapeutic range. Once that happens, excessive thirst/urination/hunger are the symptoms that improve most quickly -- often within the first couple of weeks. Other issues such as pot belly and skin/coat problems can take a longer time, even months. But once you see your dog moving in a healthier direction, it's easier to have patience even with some of those longer term problems.

Please do let us know how Charlie's ACTH turns out next week. We'd like to know the exact numbers if you can please get those for us. And in the meantime, once again, welcome!

Marianne

[Harley PoMMom]

Hi and welcome to you and Charlie from me as well!

Marianne, as usual, has done a wonderful job at answering your questions, so I have a few questions of my own. ;) Could you tell us how much your boy weighs? Was an ultasound done? How about an urinalysis, and if so, could you tell us those results?

I am a bit concerned that the LDDS was the only test used for diagnosing Cushing's in Charlie because other non-adrenal issues can cause the LDDS test to have false positive results.

I am glad to see that your vet did rx prednisone for Charlie to keep on hand in case of an emergency. When a dog's cortisol goes too low the prednisone is given to help the dog feel better, the prednisone mimics cortisol.

Here's a handy link about Trilostane from our Resource Thread: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185) Please feel free to print anything out. Any questions you have do not hesitate to ask them, ok? We are here to help in any way we can.

Hugs, Lori

[Charlie's Mum]

Hi Marianne and Lori,
Charlie dog at present weighs 7kgs. He was at 9kgs at the start of last year which was a tad heavy for his little legs so we changed his biscuits to diet biscuits and cut down his meal sizes and with exercise we had him down to 8kgs which we were happy with. He then lost the other kg with no dieting in a matter of a couple of months.
My vet was going to test his urine but decided to do a full blood panel instead. And he has not had an ultrasound.
I will ask for all his results after he has had his ACTH test done.
Thanks for the info so far. No doubt I will have more questions later. Cheers Charlie's Mum.

[Meg_Elizabeth]

Please keep us all posted. I don't know as much about
Cushings and bloodwork as these wonderful ladies, but I am here to chat whenever you need too. I have insomnia and rarely sleep due to the stress my beloved dog puts on me. I'm here to talk or vent whenever you need it.