Reaction to Vetoryl, advice needed please.

[MicheleR]

Hi,
My Scottie Baloo has been diagnosed earlier this year with Cushings and has been taking Vetoryl, she has been stable on them for a few months.
This morning I think she had a reaction to the tablets and I gave her a steroid that the vet had given us for 'emergencies' and rushed her to the vets, she has been admitted this morning.
The question is how do I know if she was having a reaction? She couldn't stand and when she was trying to walk she was bumping into the furniture, this was about 1/2 an hour after taking her tablets with her breakfast.
This is the first time she has done this so any help or advice would be great.
Thank you.

[mytil]

Hi and welcome to our site. How is your girl now?

Firstly, can you give a bit more information about how much Vetoryl are you giving and what is her weight and age?

When at the vets, did they check her electrolytes? When was the last ACTH test performed and what were the results?

Sorry for all the questions, but the more we know the better we can help you and your girl.

Terry

[MicheleR]

Hi Terry,
Baloo is still at the vets, I have to ring at 3pm to find out how she is.
She takes 2x10mg of Vetoryl in capsule form a day, both with her breakfast, her last ACTh test was on 30th June and as she was within the correct range they have now put us to 3monthly tests rather than monthly.
She has not reacted to the tablets before but we had to double the dose after one test as the results weren't good. She has had some fur regrow on her nose and back and is fine in herself.
Do you know what would have caused the reaction as she had been fine on them for approx 5 months.
Baloo is 7 years old (her birthday was yesterday).
Thanks

[labblab]

Hi Michele,

I am so sorry that Baloo is having these problems, and especially on her birthday! Poor little girl, and poor you! :( :(

When you have a chance, it will be great if you can get us the actual numbers for those monitoring ACTH tests. In the meantime, can you tell us a bit more about her overall health history and the symptoms/testing that led to the Cushing's diagnosis?

Even though the timing makes us wonder, the episode she experienced yesterday may not actually be related to her medication. Since it seemed to come on so suddenly and so acutely, I would tend to think that there may have been something else going on, like perhaps a seizure or a little stroke. How is she doing at the vet's today -- has she recovered at all or is she still having problems standing up? How about any lab results? Lab results will be the determining clue as to whether it is related to low cortisol and/or chemical imbalances resulting from the medication.

Marianne

[MicheleR]

Hi Marianne,
It was actually this morning that it happened so have very little information as yet, I am to ring the vets in about an hour.
Baloo hair had not grown much on her back and her fur on her muzzle had got quite thin, we noticed this as we clip her ourselves (we actually have 2 Scotties and also a tiny Yorkie) mostly we noticed that she was sitting by herself when normally there would be a scramble for sitting on our laps!
I don't know much about the tests that she had to begin with but we also took her to an animal clinic near where we live called the Animal Health Trust and they diagnosed Cushings, our vet then started treatment with a low dose of Vetoryl a and 4 weekly blood tests.
Baloo has not had any health issues apart from this, she is spayed and has her vaccinations but has not had a real health issues, we have had her since 10 weeks old. We have had several Scotties previously and they passed away from cancer at 12 years old.
Would a seizure be related to Cushings? We have not had any experience with Cushings before.
The episode she had this morning was like she was drunk and couldn't walk properly, I gave her a 'Prednisalone' tablet which I believe is a steroid when it happened- our vet gave us these with directions to give her one if she reacts so I did.
Perhaps I can give you more information when we speak to the vet in an hour?
Michele

[jxeno13]

Hi Michele! I'm so sorry to hear about your baby, Baloo being sick. Your baby is probably having a crash when her Cortisol dropped too low....after today's dose. My Eli reacted the same way. I thought he'd had a stroke. ...You did right by giving her the Predisone to bring her cortisol level back up and taking her to the Vet immediately, but we need to know her weight and other numbers....before the really greats....Marianne, Terry, Glynda, Leslie, Sharlene, Lori, and many others are able to tell you anything more.

I know this is a horrifying ordeal right now that you are going through with your baby....I pray she'll be OK. My Eli almost died from an overdose. (not to scare you)....but for hope...she can be OK...You did the right thing! My Eli is doing great now (thanks to the ladies on this forum who saved his life), what I've learned here since then....and, I keep a VERY close eye on him. :) He's a Cairn Terrier mix. Cairn's are related to the Scottie breeds. Eli is only on 10mg of Vetoryl now..and weights 33.5 pounds.

Please let us know how your baby, Baloo is doing when you can.

[MicheleR]

Hi,
Thank you so much for your reply, I have got Baloo home now and she has made a good recovery and was immediately camped out in the kitchen for her tea!
Your explanation was very clear and easy for me to understand and I get what happened now, the vet has told us not to give her any more and we have an appointment with our regular vet on Monday morning to discuss our options.
We don't generally make notes about the actual test results but I will get a print out on Monday, this is all a bit new to us and we are trying to do the best for her, she has no symptoms apart from the hair loss.
I'm glad your little Eli is feeling better, Cairns are very closely related to Scotties.
Michele

[jxeno13]

Hi,
Thank you so much for your reply, I have got Baloo home now and she has made a good recovery and was immediately camped out in the kitchen for her tea!
Your explanation was very clear and easy for me to understand and I get what happened now, the vet has told us not to give her any more and we have an appointment with our regular vet on Monday morning to discuss our options.
We don't generally make notes about the actual test results but I will get a print out on Monday, this is all a bit new to us and we are trying to do the best for her, she has no symptoms apart from the hair loss.
I'm glad your little Eli is feeling better, Cairns are very closely related to Scotties.
Michele

Hi Michele!

I'm so happy that Baloo is doing OK now! :D It took little Eli forever to get back into "shape" again....after his crash. He almost died from his. I couldn't tell you all that yesterday. ;) But, thankfully, he's doing OK now..but I do watch him VERY closely. It was awhile again before he got on the Vetoryl again......not until his symptoms came back...and his Cortisol level was back up. ....But, I have to ask if your Baloo was only showing signs of some hair loss....what is the world led the Vet to believe she has Cushing's disease?? Did I miss something? :confused: Where do you live? But, I am so happy that Baloo is back home ......doing OK again, I was worried about her. :D

[lulusmom]

Hi Michele and welcome to you and Baloo.

Whenever I see a new member with a Scottie, my heart sinks because they are a breed that is at high risk of being misdiagnosed with cushing's. The reason for this is that the Scottish Terrier is on the list of breeds known to have breed specific hepatopathies. Scotties have a genetic defect that messes with the synthesis of steroids the cause most of the liver abnormalities we see in dogs with cushing's. Vets that aren't familiar with the breed nor experienced with cushing's are likely to see very high elevations in ALP and immediately want to test for cushing's, despite the absence of the usual symptoms commonly associated with cushing's. The most common symptoms of cushing's are voracious appetite and excessive drinking and peeing. Based on what you have posted so far, Baloo's only symptom is thinning of hair on the back and muzzle. I question whether that symptom should even be included in the diagnostic picture as cushing's does not cause loss of hair on the muzzle. The only time you would usually see any skin or coat issue on the face of a dog with cushing's is if the've had the disease for so long that it has seriously compromised the immune system causing demodectic mites to overpopulate. A skin scraping examined under a microscope can immediately diagnose this.

Here is a quote from an article entitled "Scottish Terrier Degenerative Vacuolar Hepatopathy". I've included the url to the article below:


The elevations in ALP and degenerative VH in Scotties is likely due to a genetic defect in steroidogenesis. It may also explain the prostatomegaly common in this breed. Hepatocellular carcinoma may also be associated with chronically increased androgens. Treatment with Lysodren, Trilostane and ketoconazole is ineffective and may lead to illness, hypoadrenocorticism or death.

http://www.pacificveterinaryspecialists.com/newsletters/Pacific%20Tide%20July%202012-%20Scottish-Terrier-DVH%20.pdf

Can you confirm that thinning of coat was Baloo's only symptom when she was diagnosed? It would be very helpful if you could please obtain copies of all testing that was done to diagnose Baloo. Initial tests would include blood chemistry, complete blood count and urinalysis. You need only post the highs and lows on the blood labs and please include the normal reference ranges. The diagnostic tests would have been either the low dose dexamethasone suppression test (LDDS) or the acth stimulation tests. Can you please post the results of those tests as well? We recommend all members consider keeping a folder with all of their pup's medical records, including the actual test results. This comes in very handy if you have an after hours emergency just like the one you had with Baloo. ER vets love to have a dog's complete medical history at their finger tips. Can you get copies of the tests that were done by the ER vet as well?

I apologize for all the questions and requests but I am very concerned about Baloo's diagnosis. We can't help you be the best advocate for Baloo without a full understanding of her medical history. The one thing you learn quickly when dealing with cushing's is that no vet, no matter how trusted, is worthy of your blind faith. My dog suffered the consequences of my placing blind faith in our trusted vet who had taken care of my dogs for years. It was an internal medicine specialist who finally diagnosed her and got her stabilized. Sadly, my story is not that unusual which is why it's so important to be a proactive participant in our dogs' care. I learned that lesson many years ago when I showed up as a new member here with my second cushdog.

I'll be looking forward to your updates.

Glynda

[Alison]

Sorry to hear about Baloo. Is she still on steroids?

Cairo, our staffordshire bull terrier had a bad crash back in April. Here in the UK, there was no synacthen to do the stim test - manufacturing problem and the vet said that baseline cortisol would suffice - it obviously didn't as he crashed. He'd had an ear infection and we told the vet that he wasn't right and she said it was probably the ear infection and to see how he was after treatment. He got worse and worse until over the week - he was sitting trembling like a leaf, couldn't walk, very wobbly,wasn't eating so I made an appointment at the vet and said I wanted a stim test done - by this time stocks of synacthen were back. His cortisol levels weren't even registering they were so low.

He had two emergency injections and was on 10mg prednisolone a day for about 5 days, then weaned off it. He's never been put back on the vetoryl - so we're back to monitoring him for a return of symptoms. :(