View Full Version : Xanax for Panting
PetCrazed
07-19-2014, 10:15 PM
My Amanda is a 14 year old 21 lb. ShihTzu who was first diagnosed 3 years ago. After about 18 months of treatment with Lysodren she went into remission. About 4 months ago she had mild symptoms, and after testing it was determined the Cushings is back. Our vet insisted on switching to Trilostane, at first 20 mg once a day, and she overdosed in 5 days. The Trilostane was stopped for awhile and 6 weeks ago she started 10 mg once a day. After 2 weeks at that dose she started what we thought were anxiety attacks - heavy panting, restlessness... this coincided with a series of heavy thunderstorms. Our vet prescribed Xanax, which helped only with advance notice of an attack (it takes 2 hours to kick in). We weren't satisfied and took her in, the result being upping her Trilostane to 10 mg twice a day as of 3 days ago. She has a level 2 heart murmur and I'm concerned about the stress of an attack. I have conflicting advice-my vet says not to worry, while a vet help line felt sustained panting could trigger a heart attack. I hate to drug her with Xanax routinely but worry while we get the Trilostane dose figured out. The attacks are random now (but seems to happen most often in the evening about 4-5 hours after her evening Trilostane) so we'd have to give Xanax as part of her routine. Any thoughts? Thanks in advance.
LauraA
07-20-2014, 01:57 AM
I know with my girl she used to pant really bad in the evenings and even after we started the Vetoryl the panting got worse. She would roam around the house as she couldn't get settled. If we cooled her down with water/fan/air conditioning then she would be good in about 10-15 mins even though we were freezing lol. After about 2 months on the Vetoryl though these episodes substantially reduced. May be something totally different in your case but thought I would share :)
lulusmom
07-20-2014, 10:38 PM
Hi and a belated welcome to you and Amanda.
I am sorry for the reasons that brought you here but I'm glad you found us. When you say that Amanda was in remission after 18 months of Lysodren treatment, do you mean that at some point she was taken off the drug and her cortisol remained normal or within the therapeutic range? Or do you mean her symptoms were well controlled on a maintenance dose for 18 months and then she became symptomatic again? It is not uncommon for dogs on Lysodren to relapse, in which case, and depending on how high cortisol is, you would either increase the maintenance dose or reload.
How long after treating with Lysodren did your vet start Amanda on Vetoryl (Trilostane)? Was an acth stimulation test done to determine Amanda's cortisol level before starting Vetoryl. If so, can you get a copy of that test and post the results here? Due to high risk of adrenal toxicity when switching from Lysodren to Vetoryl, a dog should go through a 30 days washout period before starting the new treatment. The 20mg dose your vet prescribed is appropriate for a dog weighing 21 pounds; however, every dog is different so it is possible that a low dose could drop cortisol too low. If no washout was done between treatments, adrenal toxicity could have occurred as well.
How long after Amanda's crash on 20 mg did your vet wait to reinitiate treatment at a lower dose? Has an acth stimulation test been done since starting treatment on 10mg? Can you please get copies of that test and post the results here? Are you giving Vetoryl with meals and getting Amanda to the vet to be tested within 3 to 5 hours after her morning dose?
If you have read any of the studies on Vetoryl, you will find that restless, anxiety and pacing are side effects of the drug. This side effect was not short term in some dogs so if I were you, I'd have the vet contact Dechra and discuss this issue with them. I have included a link to contact info for Dechra U.S. below.
http://www.dechra-us.com/Default.aspx?ID=365
I'll be looking forward to seeing those test results.
Glynda
molly muffin
07-20-2014, 10:59 PM
Hello and welcome to the forum.
Glynda has vast experience with both lysodren and trilostane, so I hope you can go through and answer her questions and perhaps we can help to get your baby girl on the right dosage for her.
Have you looked into melatonin? I notice that it kicks in within about 30 minutes or so, at 3mg. (my shih tzu/llasho is about 19lbs) That might be an option, it seems to keep my molly pretty calm and sleepy for a bit too not long after giving it but then she perks right back up after having it.
Sharlene and molly muffin
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