Please help me with my Lucy

[Valerie]

Lucy is a 12 year old 6 lb Chi, diagnosed with Cushings 2011 via ACTH stim test. An ultrasound of her adrenals looked normal, so the vet concluded it was probably pituitary dependent Cushings. Vetoryl was gradually raised to 20mg per day, when the cortisol levels finally looked "normal". However, even after 3 years, her symptoms (extreme hunger, thirst) NEVER improved. They've only gradually worsened. (I tried the holistic route but the supplements/herbs made no difference in symptoms). I lowered the Vetoryl to 10mg/day and saw NO change in symptoms--but the cortisol levels went sky high. So she's back to 15mg/day. Six months ago, she gradually started knuckling on front paws and panting during slow walks and it's getting worse. The vet thinks it's neurological--that the pituitary tumor might be growing. My dilemma is: Am I killing her with the Vetoryl--which seems like such a high dose for such a small dog?? Or, if I take her off Vetoryl and her cortisol levels skyrocket, will THAT be killing her? Is it dangerous to suddenly stop the Vetoryl if she's been on it for 3 years? I just want to do what's best for her and feel such awful guilt not knowing if I'm hurting her!

[mytil]

I am sorry you and your Lucy are going through this.

Firstly her symptoms never resolving after 3 years of medicating is something your vet should have addressed much earlier as it could not be Cushing's at all. Were other conditions ruled out? (thyroid issues, liver problems, even diabetes).

Was she on any medication at all when she was tested for Cushing's for any other conditions?

Was the dosage ever split (half in the morning, half in the evening) to maintain a steady dose in her?

What was the cortisol levels on her last ACTH test? And yes, 20 mgs is high for her weight.

Sorry for all the questions, but the more we know, the more we can help.

Terry

[lulusmom]

Hi Valerie and welcome to you and Lucy.

Terry has already gotten us off to a good start so my questions will be few. I am very anxious to see the results of Lucy's last acth stimulation test and it will help members understand the numbers better if we know that proper protocol was followed. Have you been giving Lucy her Vetoryl with food? Were all acth stimulation tests done within 3 to 6 hours after Lucy's morning dose?

It is not dangerous to stop Vetoryl treatment suddenly. If either one of my dogs were not eating right or acting ill in any way, I took them off of the drug for two to three days at a stretch. My cushdogs were quite small too. Lulu weighed 4.5 lbs and stabilized on 30mg once a day. Jojo weighed 6.5 lbs and stabilized on 15mg twice a day. All dogs respond differently so you never know what dose it's going to take.

With respect to Lucy's knuckling, it is possible that she could have an expanding pituitary tumor but you would need to have a very expensive MRI to determine that. Are you seeing any other neurological signs such as head pressing, circling, staring at the walls, etc. Has your vet manipulated the spine or done any imaging of the spine to rule out disc problems?

We're here to help you and Lucy in any way we can. The more information you can provide, the better.

Glynda

[Valerie]

Thank you, LULU's MOM and MYTIL for taking the time to ask for details. Lucy takes Vetoryl with food, the doses are split AM/PM, the stim tests are always done 4-6 hours after morning dose/meal. The only other "neuro" sign she has is occasional "teeth chattering" for a few seconds that looks involuntary. Her original stim test 3 years ago was pre 4.0 and post 29.9). It stays around 3.3/5.3 when she's on 15-20 mg but goes back up to pre 10/post 16 when I lower it to 10 mg. A low thyroid was found at the same time as the Cushings so she is on .1mg/day thyrozine. All her other blood work looks normal and done every 3-6 months. The vet has manipulated her spine and I don't see any evidence of pain. I've not had an MRI or imaging of her spine. She's had about a dozen stim tests and the costs for those, and the meds (as you know) are huge. But I will find a way to do the MRI if it will help her.

[molly muffin]

Hello and welcome from me too

With an MRI you would looking at seeing the size of pituitary tumor and to see if it is growing and causing neurological problems.

Sharlene and molly muffin