Introducing myself and my doggie

[walkingrock]

My mini doxie, Maya, was just diagnosed with Cushing's last week. I just started her on Vetoryl 30 mg capsules yesterday. She is a cream piebald, 12 lbs. 7-1/2 years old. She has a lot of allergies (blood tested), and is also on Atopica. Feeling sad as I had a terrible experience 10 years with my lab who also had cushings. My vet's office tells me that this med works much better than what was previously available when I had my other dog. Still, I am expecting a limited life expectancy due to her medical issues and medications. She is a wonderful little clown. Glad to find this group.

[jxeno13]

My mini doxie, Maya, was just diagnosed with Cushing's last week. I just started her on Vetoryl 30 mg capsules yesterday. She is a cream piebald, 12 lbs. 7-1/2 years old. She has a lot of allergies (blood tested), and is also on Atopica. Feeling sad as I had a terrible experience 10 years with my lab who also had cushings. My vet's office tells me that this med works much better than what was previously available when I had my other dog. Still, I am expecting a limited life expectancy due to her medical issues and medications. She is a wonderful little clown. Glad to find this group.

STOP THAT VETORYL NOW!!

Hi and welcome! Sorry for that warning...but that is WAY too much Vetoryl for your little Doxy! She shouldn't be on more than 10mg. 1mg per pound!! Your Vet should have known that. The senior members will follow me.......and be able to tell you all you need to know about Cushing's disease and Vetoryl.

I'm so glad that you found us...but sorry for the circumstances. What other medical problems does your baby have?? Can you post tests?

Please, please....DO NOT give your Maya anymore Vetoryl until the rest of the senior member posts.

[jxeno13]

Hello and welcome! I'm sorry for the reason that you are here...but I am so happy that you found us in time!!! That Vet will kill you dog, Maya! She is overdosing your dog on Vetoryl! If you don't want another bad experience with this dog....you'll STOP it now! 30 mg on a 12-13 pound dog is outrageous! You'll have a dead dog in a matter of days! Your Maya....should prbably have only been started imo on 5 mg.....10 mg tops! We have another dog....who weights about as much as yours now starting on 5mg and is doing just fine.

What lead you to believe your dog has Cushing's? What tests did your vet do? Can you post the results?

I am so sorry. I don't mean to scare you! But when I read your post I just help but warn you! PLEASE STOP the Vetoryl now! Learn a little more about Cushing's and the drug Vetoryl....and the maker Dechra. Please!

It's best to go low and slow with this drug.

[goldengirl88]

Welcome to the forum. I am sorry your little doxie is having problems, but as JoAnn warned you that is too much Vetoryl to start with for a 12 lb dog. When you start this high you run the risk of the dogs cortisol dropping to low to Addisons conditions. JoAnn is advising you well as she just went thru a terrible time with her Eli being over dosed. Dechra says 1mg per pound. I f it were my dog I would have never started on more than 10mgs. Please do not give any more of that dose and call Dechra they will help you with this 866-933-2472. Do you have a rescue dose of prednisone on hand? Do you know the signs? Lethargy, diarrhea, vomiting, won't eat, can't stand or walk. Please I urge you to get a lower dose for the sake of your dog. Blessings
Patti

[jxeno13]

This is from Dechra the maker of Vetoryl....it says to start at the low end of the range and work your way up.

You can call Dechra and talk directly to them.....and they will start a file on your dog.....and they'll tell you what they suggest.

"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."

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

[walkingrock]

I was expecting a response like I got above. The package insert says: starting dose: weight range (pounds) >/= 10-<22 is 30 mg, once daily. She fits that criteria. She had a Dex suppression test, I do not have a copy of the results. This was in response to high liver enzymes x 2 a month apart. She goes back for testing in 2 weeks for dose evaluation. I welcome more information and feedback. I know my vets very well, they have been taking care of Maya since I got her @ 8 weeks of age. I am an RN, so not unfamiliar with diseases and meds. However, I am not a specialist in animals or Cushings, so bring it on!! I am here to learn and get support, so, please, I want to know more!

[labblab]

Hello and welcome from me, too!

As the others have said, it will be great if you can supply us with some added info re: Maya's health history, the symptoms that prompted Cushing's testing, and the actual numerical diagnostic test results. This added info will help us give you even better feedback.

However, in the meantime, just to elaborate a bit more on the dosing info... I am guessing that your vets may be relying on the dosing chart that is included with Dechra's U.S. Product Insert for brandname Vetoryl. For a dog weighing 10-22 pounds, the chart does indeed list an initial starting dose of 30 mg. Your vet would rightfully think that the chart could be relied upon as the best dosage indicator. But as it turns out, the chart is based on initial clinical trials performed a decade ago. More recent experience has led most specialists and even Dechra themselves to encourage vets to start dogs off at the lowest end of a dosing range of 1-3 mg. per pound. So in your dog's case, that would be 10 mg. rather than 30 mg. That is not to say that it is impossible nor even unlikely for Maya to ultimately end up needing a larger dose, but there is less danger of side effects and cortisol dropping too low when beginning with a smaller dose and working up, rather than vice versa.

I would not expect 30 mg. to be a lethal dose since it remains within Dechra's initial dosing range. But it is the very highest end, and if it were my dog, I would strongly prefer to start at the lower end as is now much more commonly recommended. As Jo Ann and Patti have mentioned, this info can be easily clarified by contacting Dechra directly. If you do, I suspect they will say what I've written above: 30 mg. is within the published range, but there are several reasons why starting lower may be preferable for the majority of dogs.

Vetoryl comes in 10 mg. capsules, too, so you can easily shift to that lower dosing level while you are starting out. You can tell your vet that you understand that a higher dose may end up being needed, but you'd rather start slowly and work up so as to lessen the risks of side effects, especially in relation to high cortisol levels being rapidly lowered ("corticosteroid withdrawal syndrome").

Marianne

[walkingrock]

That totally makes sense. I agree that I am starting at the high end instead of the low end; I am going to call my vet and ask about why and if I can start at the lower dose. I want to also get a copy of the lab test results.

[jxeno13]

Hi, I know my Vet very well also. He is also treating other dogs with Cushing's. I also realize the ranges on the inserts that you have with the Vetoryl. Those were my thoughts as well. They were also changed by Dechra in 11, 2012. Dechra just never changed their inserts. It wasn't cost effective. Imagine that. :(

My story in short....Eli, my 30 lb., Cairn Terrier mix, 10 yrs old, was given 60mg of Vetoryl, 2X his weight. ..2mg per lb....right smack in the middle of that same scale you are reading. .....(Your dog was given 3X her weight in Vetoryl, rounded off) ....within 10 days....he was doing great. I thought Wow...my Eli is back!! I couldn't have been happier!! On the 11th day.....he started vomiting.....and vomiting....and vomiting. Non-stop. He didn't eat....he couldn't even hold down water...my Vet was out....I was still at the Vet's daily and still gave him 3 more pills...his couldn't walk....he was falling all over, running into walls.....he was finally hospitalized for 2 days and 2 nights. He didn't eat for over a week. He was dying slowly.

In short....If I had not come on the forum and talked to people who actually knew something about Cushing's, Vetoryl, and how to bring him back......Eli would be dead today! He's not though! He was in an Addison's crisis........his cortisol level had dropped too low, too fast. In other words......he was overdosed on Vetoryl! An Addison's crisis can cause instant death.

Please call Dechra and talk to them.

I also took him after that to an IMS..A Vet who specialized in Internal Medicine. ......I now work with both of them. Eli is now back on Vetoryl....10mg to start.....at 30pounds. ...He's doing fine now. I'd rather start him at low and slow and have to maybe work up from there....than bury him.

[labblab]

I see we were posting at the same time earlier, so I have a quick P.S. to add. You mention elevated liver enzymes of two months' duration. Does Maya exhibit any other symptoms consistent with Cushing's? If not, then even more questions marks arise for me. :o

The consensus among most specialists is that, due to the imperfect nature of the diagnostic blood tests such as the LDDS and ACTH, Cushing's treatment should be reserved for dogs who exhibit consistent overt symptoms in addition to bloodwork abnormalities. There can be a number of reasons for elevated liver enzymes, and any underlying nonadrenal illness can skew the LDDS into providing a false positive. So now I'm doubly anxious to find out more about Maya's overall health history and any other symptoms that point to Cushing's other than the labwork alone.

Marianne

[walkingrock]

I am going to go to my vet's and pick up some 10 mg capsules and get her lab results; and also talk to the vet. Happy to get any info anyone can share with me, before I go over there. They close at 4pm (noon here now). So, fire away!

[Harley PoMMom]

Hi and welcome to you and Maya,

I'm so glad you found us and we will help in any way we can. None of us our veterinarians but we do have a wealth of cumalitive knowledge here among the members and we can guide you thru the process.

The Dechra product insert does state that 30mg of Vetoryl is an appropriate starting dose for a dog that weighs between 10 lbs - 22 lbs, however; we have seen less adverse side effects when a dog's initial dose is at the lower end of the dosage scale, so if this were me, I would feel more comfortable with beginning at a dosage of 10 mg.

If you could get your hands on copies of all tests that were doen on Maya and post any abnormal values that are listed, that would be great. Also could you include the reference ranges and units of measurement for those values, that would help us alot. We are especially interested in the results from any diagnostic or monitoring tests for Cushing's.

Was an ultrasound performed on Maya, and if so, could you post those findings? Does Maya have pituitary or adrenal form of Cushing's? Besides the Atopica is she taking any other herbs/supplements/medications? Was the low-dose dexamethasone suppression (LDDS) test performed when Maya's allergies were active? Was an urinalysis done on Maya, and if so, could post those findings too?

I am sorry for all these questions but the more we know about sweet Maya the better our feedback can be, ok? Please know we are here for you both, and do ask all the questions you want.

Hugs, Lori

[labblab]

I see we were posting at the same time earlier, so I have a quick P.S. to add. You mention elevated liver enzymes of two months' duration. Does Maya exhibit any other symptoms consistent with Cushing's? If not, then even more questions marks arise for me. :o

The consensus among most specialists is that, due to the imperfect nature of the diagnostic blood tests such as the LDDS and ACTH, Cushing's treatment should be reserved for dogs who exhibit consistent overt symptoms in addition to bloodwork abnormalities. There can be a number of reasons for elevated liver enzymes, and any underlying nonadrenal illness can skew the LDDS into providing a false positive. So now I'm doubly anxious to find out more about Maya's overall health history and any other symptoms that point to Cushing's other than the labwork alone.

Marianne
I am going to quickly repost this reply, not because I think it is brilliant enough to warrant it! -- but just to make sure you see it since it fell at the bottom of the previous page right before you posted your newest reply. ;)

Marianne

[jxeno13]

I hope you read on page 1, in short, what can happen to a dog when overdosed on Vetoryl. I didn't mean to scare you. But, I do get frightened every time I read where a dog is starting at such a large dose now for it's weight. I know from experience what can happen. :(

[walkingrock]

Yes, she has had skin symptoms for several years, and has been drinking and urinating much more than usual in the last several months. She has a normal urinalysis. She was on Fluconazole (40 mg/day) as well as the Atopica for her allergies; the liver tests were to follow due to the Fluconazole. She has been taken off Fluconazole about 5 weeks ago. She is being seen by a dog dermatologist as well as my regular vets (2 in the regular vets office, one specializes in skin conditions). She already has issues with some vomiting and diarrhea at occasional intervals due to the Atopica (25 mg, once/day). I also have her on: Trifexis (once a month), Denamarin (13-34 lb dog size, once daily), Fortiflora (1 pkt/day), Freeform Sniptips (1/day), and hydroxizine 12.5 mg/day. She is an excessive licker, and has some sneezing, coughing, wheezing, bronchospasms. She is allergic to dirt, grass, some specific plants and molds. She was on allergy shots (I gave her at home) that were custom for her allergies for years, then it got harder and harder to give her the injections, so I switched to Atopica and Fluconazole. Both her dermatologist and the vets at my regular place have suspected she has cushings for the last couple months.

[walkingrock]

and yes, some panting, although nothing like my former cushing's dog had. She has had lab chemistry panels annually and more frequent lately. She has had UTI's several times and bacterial skin infections in the past.
I think it is terrible the manufacturer didn't update their drug insert, I see it is from 2011. Why don't they say anything about this on their website? I couldn't find any reference to starting at the low dosage and working up.

[walkingrock]

The vet that did her dex test, said that her results show it is a pituitary tumor; but the other vet, that regularly sees her, discussed her getting an abdominal US to rule out adrenal tumor; which I will ask her about again when I talk to her today, just to be sure we are all on the same page. I realize that there are various conditions that can have similar presentations, and that not just one test is fool-proof diagnostically.

[labblab]

OK, gotcha! We are finding more and more dogs being referred for Cushing's testing due to skin abnormalities. Sounds like poor Maya has had multiple reasons for feeling poorly! Since she has already had some medication-related GI issues, it will make it even more challenging for you to identify whether additional episodes are signaling a trilostane overdose. So I would think this would be added reason for starting off with a lower rather than higher dose of the drug.

[labblab]

I think it is terrible the manufacturer didn't update their drug insert, I see it is from 2011. Why don't they say anything about this on their website? I couldn't find any reference to starting at the low dosage and working up.
I'm gonna repost the link from Dechra's website that Jo Ann found earlier:

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

My understanding from talking to them about the chart on the insert is that, from a regulatory standpoint, there are issues with changing the wording because this was the documentation that was submitted and formally approved when initial application was made to the FDA. They would now have to jump through a bunch of hoops to alter the wording of the insert. I am definitely not saying this shouldn't be done, but just that apparently it is more complicated than just rewriting and running off some new inserts/charts.

[walkingrock]

I see the reference on that link, printing it out now, to take to my vet's office today. I understand about the FDA, etc. Things can get very complicated. I will update you all later, gonna go get ready to go run errands and go to the vet's.

[goldengirl88]

So glad you are getting the 10mg. I just don't want you to have problems, and I want your baby to be safe. Blessings
Patti

[jxeno13]

and yes, some panting, although nothing like my former cushing's dog had. She has had lab chemistry panels annually and more frequent lately. She has had UTI's several times and bacterial skin infections in the past.
I think it is terrible the manufacturer didn't update their drug insert, I see it is from 2011. Why don't they say anything about this on their website? I couldn't find any reference to starting at the low dosage and working up.



"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."

http://www.dechra-us.com/Cushings-Sy...VETORYL-1.aspx
__________________

[jxeno13]

Great that you're getting the 10mg Vetoryl! Be sure and ask for some rescue Predisone just in case of a crash. We all keep some just in case...not saying that it will happen, but it pays to be safe. :D

[goldengirl88]

Kudos for starting low!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[walkingrock]

I got the 10 mg to start tomorrow. I didn't read about getting a prednisone dose before I went to the vets. I can try to get that on Monday. I got a chance to speak with Maya's regular vet, she specializes in internal medicine, and takes all the skin problem dogs also; the other vet specializes in surgery. Maya has seen both. The surgeon had thoroughly updated and reviewed Maya's test results with the internist on Friday (which I didn't know until I talked to her today). She was totally ok with going down to 10 mg. she agreed with the other vet, that Maya's test was definite for a pituitary tumor. I did get copies of her lab results, which I haven't looked at yet, but will and post here. Fortunately, I am very close to a 24 hour emergency vet hospital if she should have any problems before Monday.

[jxeno13]

Hi! Great news then! I work with an IMS and my reg GP Vet. Our IMS is about a 2 hour drive from where I live and my regular Vet is about 5 mins from my house. So, they work together. When I took Eli to the IMS in Louisville, I also had an ultrasound done there, since my Vet doesn't have the more sensitive equipment here for that. The testing is also much cheaper here than in Louisville....which for me is a plus. :) Eli is also a pituitary dependent type.

Here's one link that is good to start. I have another I'll post as soon as I can find it again.

http://www.kateconnick.com/library/cushingsdisease.html

I hope Maya is feeling better soon.

[walkingrock]

lab results:

baseline cortisol: 6 mcg/dL
4 hr post low dose dex: 4.2 mcg/dL
8 hr post low dose dex: 2.7 mcg/dL

The interpretive guidelines are if both 4 & 8 hr > 1.5 mcg/dL and < 50% of baseline=consistent with PDH.

ALT: 4/11/14=95 U/L, 5/13/14=280 U/L, 6/9/14=201 (reference range=10-100)
ALKP:4/11/14=446 U/L, 5/13/14=739 U/L, 6/9/14=411 (refere range=23-212)

She is on Denamarin

[Trish]

HI and welcome to the forum! You must have got quite a fright reading some of the replies on the forum earlier today, hope your heart rate has settled back down :). It sounds like you have a good vet that you can talk these decisions through with. Pleased you got a better starting dose.

I am no expert on interpreting the LDDS test so I will leave that for the others. But those liver tests appear they had a little blip in the middle then trending back down. Was she sick at all with any other problem that might have caused that?

I did just want to point you in the direction of our forum section for resources which is excellent in helping those newly diagnosed or just seeking information. http://www.k9cushings.com/forum/forumdisplay.php?f=10

With all due respect to the Kate Connick site mentioned above, we have had that pop up on here before. It does have a few bits that are OK but it is not a website we recommend. Mainly because the treatment options are really out of date, like MANY years!! Vetoryl only gets a sentence or two as it was so new back then. The site is dated 2002 and lots has happened since then to progress our knowledge of Cushings. But do pop into the "Helpful Resources" forum. Hope all goes smoothly for you :)

[walkingrock]

She wasn't sick, nothing out of the ordinary. However, as I posted previously, she had been on Fluconazole, that had been discontinued after we got the 2nd result in May, due to the high level. Plus, she was started on the Denamarin. However, my vet thinks probably the Fluconazole isn't a factor, and when we get her stabilized with her Cushing's we will be able to restart it; as, it is likely that her allergies will get worse as she decreases her cortisol output. Thanks for the tip about the website, I had just read it. Yeah, My last dog, a chocolate lab, had Cushings, and I had to put her down in 2005, and nobody seemed to know what to do for her, she was a mess. I had put her on a human prescription, but it didn't help. She had lost weight, lost hair on the last 3 inches of her tail and it bled all the time, kept whacking it against the wall and left blood splats all over the place; plus she was vomiting, peeing, and pooping in the house, and a little demented; but HAPPY, and I couldn't get a vet to put her down. I finally had to take her to the humane society to have her put down, they were extremely nice about it, but I couldn't be with her when she was given her injection. I had to pay to have the whole house's carpet replaced, as I was renting. I was living by myself with the dog, and gone to work for about 14 hours at a time. It was a horrible time for me, and I loved that dog. I had rescued her from the humane society in 1999, when she was 5-6 years old, and I recognize now that she had Cushing's when I got her. She was grossly overweight, her hair was poor quality, she panted constantly, and she just left puddles of urine when she was sitting or lying down. I got her weight down from 120 to about 90, put her on a med for the peeing and got her coat conditioned; but she always panted. She was a great dog. She was 11 or 12 years old when I put her down. Oh, yeah, she also had bad hip displasia, but it never seemed to slow her down!!

[molly muffin]

Hello and welcome from me too.

Here is a good website where you can do some research about current recommendations involving cushings. Dr. Peterson is a leading expert in cushings and a contributor to Dechra continuing education on cushings.

http://endocrinevet.blogspot.ca/search/label/Hyperadrenocorticism%20%28Cushing%27s%20syndrome%2 9

I think it is an excellent choice to go to the 10mg. You know, it's just hard on them to drop real quick like that and normally having that chance for them to adjust just makes sense.

Things have come very far in regards to cushings over the last 10 years or more. My golden retriever too had cushings, from prednisone, which she had been on since she was 2 years. By the time she was 10 she was in the same shape as your lab. It was horrible, I'd had her since she was 6 weeks old. Not once, in all the vets we saw, did anyone tell me anything about cushings, that it can be caused by prednisone, steroids that act like cortisol, or anything about her adrenal glands at all. At least now vets are more inclined to diagnose cushings than they were and to have options for treatment. If anything, now we have to keep an eye out as it is too easy to say it something is cushings, without ruling out the other options first, which has to be done.

It sounds like your vets are pretty sure of the diagnosis and the symptoms are matching up. The hope is of course that with the cushings controlled that they will be able to treat the other problem areas with more success, which does make sense.

Welcome again
Sharlene and molly muffin

[walkingrock]

Thanks to all of you who have responded with your stories and experiences and encouragement. I really appreciate it.

[Trish]

Hi, did she start the denamarin after the 2nd liver test?

Did she have fungal infections? Just wondering why the fluconazole for allergies? I thought that med was used for fungal problems?

[goldengirl88]

Just wondering how things are going? I am hoping that you are able to get a rescue dose of Prednisone Monday and keep it handy. I think your baby is going to do a lot better on this dose. Blessings
Patti

[walkingrock]

Yes, she has a chronic fungal skin condition as part of her allergy profile. She started the Denamarin after the 2nd liver test (I think!?!). We both stopped the fluconazole and started the Denamarin at some point due to her liver tests. I can't remember if we did it at the same time or if we started the denamarin for a month, then stopped the fluconazole.

[walkingrock]

She had a short episode of being very trembly, for 5-10 minutes this morning. She however, has had some trembly stuff since she was a baby. the first time I saw her and held her at 6 weeks of age, she was trembly, as though very excited. What she had this morning was much more pronounced than her usual. She also has been the hardest dog I have ever had in the potty training area. She still occasionally has accidents. She also has the overexcited peeing. We routinely try to greet her or have visitors greet her in the back yard, then move back into the house.

[goldengirl88]

Many of the dogs on here tremble when using Vetoryl it is one of the side effects. Then I have heard others say that their dog trembled until starting Vetoryl and then it stopped. My dog had terrible tremors on the Vetoryl at nite. Could it be a pain issue? Blessings
Patti

[jxeno13]

Hi! Eli started having a tremor before we even knew that he had Cushing's. So, in our case, the tremor was caused as a side effect (along with a bunch of other side effects) caused by Cushing's) ...when he was on the Vetoryl before his crash....after 10 days his tremor was gone.

That was just in our case. Other dog in here, Flynn (who has now passed) also had a tremor caused by the Cushing's...but disappeared when he took Vetoryl.

Each case seems to be different. :(

I hope your, Maya is doing better now on the Vetoryl. Although, I know she has other medical problems. I am one of the lucky ones (crossing paws) that Cushing's is the only medical problem that Eli has......for now anyway.

[Chloe's Mom]

Hello and welcome from me as well. I think my dog may be the one referenced earlier with regards to a similar weight and a VERY low dose of vetoryl. My Chloe weighs 14.5 lbs (gained from 12.5) and my vet started her on 5 mg. I agree with the others that starting low is the safest course to take. You can always go up, but JoAnn's precious Eli nearly died from being on too high a dose. My vet recommends starting at 1 mg./KG, not LB. Using that formula, Chloe could have started at 6 or 7 mg, but elected to start at 5 mg. I'm so glad you got the 10 mg. for your precious pup.

I don't think Chloe's 5 mg. is going to be her optimal dose long term, but we started very low to see how she would do. I'll probably get my vet to do the ACTH test when she's been on this dose for 30 days, and we'll see how she's doing.

[walkingrock]

Doing well so far, no unusual tremors since the third day of med, she got 30 mg the first 2 days, then down to 10 mg on the third day, that's the only day I noticed abnormal trembling intermittently for very short periods. I take her back in for retesting and dose eval on the 28th.

[goldengirl88]

What a cute baby poking out of that blanket. I hope things go well for you both. Just take a day at a time, sometimes I have to take an hour at a time! Blessings
Patti

[molly muffin]

Maybe the 30mg gave her a bit of a sudden drop and now the 10mg is leveling her out more.

Hopefully tremors, other than her normal ones that you said she had, won't be an issue. Glad to hear that all is going well.

I agree, so cute peeking out of the blanket.

Sharlene and molly muffin

[walkingrock]

Yeah, I love that picture! She loves to burrow in blankets. Yes, she seems fine now, so I think she may have had a big drop with 2 days on 10 mg. It will be interesting to see how her next testing is on 10 mg. I would love to keep her on a lower dose if it is effective; we will see. At least I feel much better starting low and going up more gradually even if she eventually needs the 30 mg dose; it seems that would be less stressful on the system.

[walkingrock]

Thank you all for your caring responses, and words of wisdom and experience. I really appreciate it.

[jxeno13]

Hi! So happy to hear that Maya is doing OK still. And, yes, that was Chloe, I was talking about, being about the same weight and on 5 mg. :D

Eli is now on 10mg and is doing well. I'm sure he'll probably have to go up some as well.....but we're taking our time. That overdose he had was a horror! The wonderful ladies on this forum saved his life! Literally! I had no clue what to do....let alone know what was happening to him. I'll know if there's a next time! :D

[goldengirl88]

My Tipper's maximum dosage was 30mg after quite a while we graduated to that. After being on that dosage and doing well for a long time her pre number started to go low. I then had to back down on the dosage as Dechra told me once a dog is on a mg for a certain amount of time they take less of the drug. Tipper is now on 25mg. I keep 2,5, and 7mgs compounded trilostane so I have it on hand if there is a drop in her number I can switch her around on doses she has already had and is safe with. My feeling about this drug is that is saved my dogs life she had such bad symptoms. It is not a perfect drug none are, but I use a little as possible to control her. I do not give her one mg more than she needs. It will be ok and you are smart to keep your dog safe. You are doing a good job. Blessings
Patti

[goldengirl88]

Just wanting to know how everything is going? Are you noticing the symptoms slowing down yet? Every dog is different and some take longer. My Tipper showed improvement within hours. She had really bad symptoms though. Hope you are both well. Blessings
Patti