Need help - kidney failure

[cats8398]

My moms dog 11 year old Shitzu (Mimzy – 15lbs) was diagnosed and subsequently treated with Trilsolane (sp). After several months the dosage was upped to 20mg after bloodwork. Almost 2 months back, Mimzy ended up in kidney failure and what they think may have been a stroke due to high bp. She is now on high bp meds and iv fluids twice a wk. My question is is there anymore that can be done? She is having appetitie issues and will be going on some form of Pepcid and for some reason my Mom has cut back her Trilsolane dose to every other day (bad idea??) I think she thinks the med did something. Any input would be appreciated on what we can do.

[labblab]

Hello and welcome, although I am so sorry that little Mimzy is doing so poorly. There are lots of questions that I would like to ask you about her diagnosis and treatment, but probably the most important thing I can write at the moment is that if Mimzy is truly experiencing renal failure, she probably should not be taking trilostane at all in any dose. The manufacturers of brandname Vetoryl publish this specific warning about the use of trilostane:


Do not use VETORYL Capsules in animals with primary hepatic disease or renal insufficiency.

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

Are Mimzy's vets aware that your mom is still giving Mimzy trilostane? If Mimzy's renal function has deteriorated to the point that she is needing IV fluids twice weekly, taking care of her kidneys sounds like the most important consideration and Cushing's can be pushed to the back burner for the moment.

Do the vets think this was an acute kidney episode that will normalize over time, or will Mimzy have an ongoing need for the fluids and other support?

Marianne

[mytil]

I completely agree with Marianne, please do not give any more Trilostane.

Is she getting the IV fluids at the vets or at home? Is she vomiting?

I also wanted to add that her appetite issues are because of her kidney problems (and she is not feeling well at all).

Please follow up with you vet and see if this is an acute episode.

Terry

[molly muffin]

Kidney failure, always trumps cushings and the meds for cushings. So, I add my voice to those who have already advised stopping the trilostane.

Sharlene and molly muffin

[cats8398]

Thank you for your responses. I can't believe that both my Mom's local vet and the vets at Tufts put her back on this medicine if she has kidney failure which sounds like it could have been caused by the trisolane? My mom wants to stop the medicine after hearing all this but what do you do to control the cushings ie. cortisol etc? Also.. is Pepcid (or the generic alternitive ok?)

[addy]

Hi and Welcome,

Were you able to find out if this is acute kidney failure?

That would be important information as well as the fact your pup is being treated at Tufts.

[labblab]

If Mimzy's care is being overseen by the specialists at Tufts, then their medication recommendations have the top priority. Of great importance is that they have access to the entire treatment and medication history for Mimzy. So my best advice to your mom is to follow the medication dosing schedule that they are recommending.

And just to clarify what I had written above, trilostane does not cause damage to an otherwise normal kidney. But if a dog's kidneys become damaged due to other causes (like perhaps high blood pressure), then it may be dangerous to continue to give the drug because it cannot be properly eliminated from the body and may build up in the system. This is the type of issue that the vets at Tufts should be well aware of, however. So they will be the ones to know whether and at which dose Mimzy should be taking the drug.

Under these circumstances, it is really important that your Mom pays attention to the vets' instructions, OK?

Marianne

[cats8398]

I'll find out if it was acute failure and have my Mom talk to the vets at Tufts.

[addy]

I think that is a perfect plan!!!

Let us know what happens, ok?

[cats8398]

Still no answer from my Mom on what the vets say, however, what do people use if they can't use Trilostane?

[molly muffin]

Well if Tufts thinks it is okay to use the trilostane, and I would just confirm that it is, then they must think this isn't an acute kidney failure? Otherwise, I'm not sure what would be used.

Maybe one of the others knows.

Sharlene and molly muffin

[Harley PoMMom]

Hi and a belated welcome from me as well. Could you tell us how the kidney failure was diagnosed? Was an ultrasound performed? Could you get copies of all tests that were done on Mimzy and post the values that are maked abnormal (high/low)...thanks!

What blood pressure medication is Mimzy on? Giving Pepcid AC is recommeded when a dog has kidney issues but sometimes the Pepcid AC can cause inappetence, giving slippery elm bark (SLB) can be used for tummy problems, the one thing is that SEB needs to be given 2 hour before or after other medications.

Link to info about slippery elm bark: Slippery Elm
( http://www.littlebigcat.com/health/slippery-elm/)

Hugs, Lori

[cats8398]

My mom's dog was diagnosed with Cushings and then had subsequent kidney failure. We've had all kinds of issues but right now its not eating. Shes had her on all kinds of appetite stimulants, anti nausea etc etc. My mom stopped the Vetrol (sp) and her dog has been shaking/shivering off and on. Could her stopping the Vetrol cause the shaking due to the resurgence of the Cushings? I'm not sure if she stopped it because she thought that it caused the kidney failure or not.

Second question... The vet mentioned putting my mom's dog on steroids to get her to eat. How does that work with Cushings? This whole thing is overwhelming.

[doxiesrock912]

Stopping the meds when a dog is not acting right is always the right thing to do.
Steroids cause a whole other set of problems and I wouldn't advise it.

If there are any IMS specialists in the area, I would definitely get a second opinion and rule out other health issues. Dogs with Cushings are prone to infections when the disease is not adequately controlled. Getting an ultrasound done is a good idea to determine the health of organs.

[apollo6]

If your dog is sick stopping the vertroyl is a good idea. I would question the steroid use. It should not be used on a Cushings baby. You are getting good input from the forum. Don't hesitate to question your vet and run questions by us.
Hugs Sonja

[molly muffin]

Are you still having Minzy seen at Tufts? Are they the ones who want to put her in steroids? Stopping the vetroyl is the right thing to do if she isn't eating.
I think they should do an ACTH to see where the cortisol is at and if it has gone low for any reason, also check her kidney function. Have they already done those things? We've had some dogs given prednison for appetite before. It makes the cushing symptoms worse, but it it gets them to eat, then that is plus. How long has she not been eating?

Sharlene and molly muffin

[Robert]

Hi i had a dog who suffered from kidney cysts and he shook from that. Can't comment on steroids. Cheers

[labblab]

As Sharlene says, if Minzy's cortisol has dropped too low due to the Vetoryl, then you would indeed stop giving the medication at least temporarily and also perhaps give prednisone (a steroid) to make up for the low cortisol. Is this perhaps what the vet is telling your mom to do?

Marianne