What next?!!! (9 y/o Rott)

[PjCarey]

Hi. I'm Pam and my dog is Tonka. He's a 9 yr old Rott that I adopted 5 years ago and was recently (end of July) diagnosed with Cushing's. He started Vetoryl 2 weeks ago and as of right now is clear of all Cushing's symptoms and as of his last UA he is normal. We still have to do a stim test but we are looking for good news there as well. He injured his knee this past weekend playing with his best friend (one of our cats) and I took him to the vet yesterday as he's been off his food since the injury. His vet gave us some food to stimulate his appetite and it gave him immediate diarrhea and I quit giving it to him as it hurts him to have to squat so frequently. I was walking him today and he still has diarrhea and now it's followed by a little squirt of red blood at the end. Has anyone ever had this happen? I'm so tapped out because of all the treatment for the cushing's and now this. I know he should go to the ER Vet but I don't know how to afford it. Please if anyone has any experience with this please contact me. Please!!!!

[Junior's Mom]

Hi Pam, welcome to the forum. How much does he weigh, and how much vetoryl is he getting? Anytime a dog is not eating, is vomiting, lethargic, or has diarehha, vetoryl should be withheld. It could be a sign of overdosing. A acth to check his levels should be done. A dog would then be restarted on vetoryl, at a lower dose, once symptoms return.

[Spencersmom]

The sudden change in food can cause the stomach upset too! Cook some chicken and rice, no seasonings and feed that to him until his tummy is better. No meds and withhold food for a time to let his stomach settle down, then introduce the chicken and rice! No dog food until symptoms have abated.

[Harley PoMMom]

Hi Pam,

Welcome to you and Tonka, sorry for the reasons that brought you here but glad you found us.

Diarrhea can be a sign that a dog's cortisol has dropped too low, so I agree with the others, no Vetoryl until Tonka is feeling more like himself. Can you tell us what color the blood is that Tonka is passing in his stool (tarry or bright red)?


If you could get your hands on copies of all tests that were done on Tonka and post any abnormal values listed that would be great. Also we are especially interested in the results of the test/s used to diagnose his Cushing's.

How much does Tonka weigh and what dose of Vetoryl is he on? When is Tonka's next ACTH stimulation test scheduled for? Dechra, the makers of Vetoryl, recommend that an ACTH stimulation test be done within 10 -14 days after treatment has started. Is Tonka getting his Vetoryl with food?

We certainly do understand the expense of treatment for Cushing's and do sympathize with you. I have a carecredit card which I use often for my furbabies, here is a link with info about carecredit: http://www.carecredit.com/vetmed/ Also in our Resource Forum we have a thread that has a list of other financial resources which may be able to help: Financial Resources to help with Vet bills (http://www.k9cushings.com/forum/showthread.php?t=212)

We are here to help in any way we can so do not hesitate to ask all the questions you want. ;)

Hugs, Lori

[PjCarey]

Hi and thank you!! I was so very happy to find this site!! Up until yesterday he was on 60mg of Vetoryl. He weighed 128 lbs at the start of treatment and when I had him at the Vet yesterday he weighed 120 lbs. Because he was off his food his Vet decided to stop the Vetoryl until possibly tomorrow - he was convinced the loss of appetite was due to the pain from the knee injury and honestly it all coincided.
He will not eat anything. I've tried hamburger, chicken and nothing...he just spits it out. This just started this evening as I gave him his Tramadol (25mg) for pain with some chicken early this afternoon. He is drinking water - normal amounts.
I am supposed to give him Prilosec but at this point I can't give him anything as he will not eat. I intend to take him to his Vet in the morning but I'm so very worried and scared. I really hate this disease!!!

[Harley PoMMom]

Tonka started at 60mg of Vetoryl? Glad to read that his symptoms are being controlled with treatment.

It is always worrisome when they don't want to eat. Do you think he would eat baby food? What about something stinky like tuna? If you do decide to make chicken for him save the broth and I bet Tonka will at least drink that up.

Let us know how it goes, ok?

Hugs, Lori

[molly muffin]

Never, say never, but at 128lb and 60mg of vetroyl, been on it for a week, should be a safe dose. That doesn't mean that the tramadol might not be upsetting his stomach, along with the injury, but never give vetroyl/trilostane to a dog that isn't well. You can always start back up later. Baby food that doesn't have any garlic, onion in it, might try. Chicken, mushy consistency rice, etc, you are looking for something that will be easy on the digestive system.

There were no issues at all prior to the injury and the pain med being given?

Sharlene and molly muffin

[PjCarey]

Success!! He finally ate. At about 8pm it's like a switch flipped and he was his old self. I was able to feed him a mixture of ground beef and rice. He ate every bit and tolerated it very well. He's not been out yet but I have my suspicions that it's the Tramadol that's causing the appetite issues. He was acting so blah and odd. Going so far as spitting out chicken and hamburger without even attempting to eat it and now approximately 7 hours after I gave him a 25mg dose of Tramadol he's back to his old self. Mind you he's still having knee issues and I still have to see about the diarrhea problem but I truly believe the culprit is the Tramadol. Thank you all so very much for being there. This is such a scary disease and there are so many variables once treatment is started and your dogs "new normal" begins to emerge that having the extra knowledge and support is a blessing.

Again. Thank you all!!!

[doxiesrock912]

Dogs can get upset stomachs fairly easily. Canned pumpkin from the baking aisle at the grocery store is a great way to help with diarrhea and most dogs LOVE it.

[PjCarey]

Canned pumpkin? I'm going to go to the store after work and give it a try. I am happy to report that we have not had any more bright red blood or any blood for that matter. His appetite seems to be returning a little. He showed some interest in the scrambled eggs I made him this morning...didn't eat them while I was home but my husband did call me and report that he eventually ate them so I have hope!!
Thank you!!!!!:D

[Squirt's Mom]

If you try the pumpkin, be sure to get plain canned pumpkin, NOT the pie type. It contains spices that could very well make things much worse. ;)

If blood is present, I would not use the pumpkin myself but would first have the vet make sure this isn't Colitis then put him on a very bland diet for a while. Chicken broth, over-cooked rice (til it's like wallpaper paste), or beef broth. Nothing more solid than the rice and only add it after 24 hours or so on the broth alone. If you have Flagyl (Metronizadole) try it.

[PjCarey]

Hi everyone. It's been quite some time since I posted here and it was a crazy time when I did. I do have a couple questions if someone would care to help out and maybe give me some advice. Tonka was only on Vetoryl for 2 weeks(started beginning of Aug 2014), he started having bloody diarrhea and refusing food and I had to take him off. I will say that in that 2 week time period his symptoms improved 110%!! They had completely disappeared. As of today the old symptoms still have not returned and I have not started him back on any treatment yet. I have noticed however that for about a week now he has been very itchy!!! I have been changing his diet trying to find something he'll eat and I thought that was the problem and ruled it out, I made sure he was flea treated and ruled that out, I haven't used any new products at home so I ruled that out as well. He has more energy then he's had in 3 years. His weight is normal, he's not drinking too much water, his appetite is normal but his skin is a bit dry and flakey...is this a Cushing's symptom? Can he just present with one symptom like this? I find it hard to believe that he had Cushing's and after 2 wks on Vetoryl he's cured...as a matter of fact I know that's not the case. His last lab work at the 2 wk mark the Vet said his steroid level was normal. Can anyone lend me a hand here and maybe give me some insight as to what might be going on? I am giving him Benedryl to ease the itching he's experiencing.
Thank you all so very much!!!

[labblab]

Welcome back! I have only a moment to post, but wanted you to know I've merged your new new post into your original thread so all the history and info about Tonka will be consolidated in one place.

Marianne

[Harley PoMMom]

It would help us if you would get copies of Tonka's ACTH stim tests and post those results here. During that short course of Vetoryl treatment was Tonka getting his Vetoryl with food? Also, was the monitoring ACTH stim tests being performed 4-6 hours after the Vetoryl was given? Another thing, how much does Tonka weigh and what was the dose of Vetoryl he was taking?

Hugs, Lori

[PjCarey]

Thank you Marianne!! I couldn't find the original post. :o

Hi Lori and yes I was feeding Tonka his breakfast - 1 cup of dry mixed with 1/3 cup canned - and then giving him the Vetoryl. When Tonka started the Vetoryl he weighed 123lbs and was prescribed 60mgs of Vetoryl once a day. To answer your next question the monitoring test was not being done 4-6 hours after the meds were given. As a matter of fact it was done within 1-2 hours of the med being given. I'm going tomorrow to pick up his medical records from the Vet. I really hate to say this but I think I'm going to have to find another caregiver for Tonka as I just don't feel confident in the handling of his current situation with this Dr.
Again, thank you for responding. This is so confusing and crazy and it's good to know there are folks out there who are just as crazy and confused as I am!! :D

[Harley PoMMom]

I looked through your thread and saw that we do not have any results from any tests that were done on Tonka. Once you get Tonka's medical records could you please post all abnormal values along with the reference ranges and units of measurement...thanks.

Hugs, Lori

[PjCarey]

Hello kind folks. I was really hoping I wouldn't have to return to this site but I guess it was all a pipe dream. For a year now my boy Tonka has not had any Cushing's symptoms since I was here in 2014...NOTHING! No, I promise I'm not losing my mind...he's not had any symptoms at all. However, they're back and they're bad. It seems this time that they've come back with a vengeance. All of the symptoms are now more extreme than they were the first go 'round and he's not doing well at all. I never did start him back on Vetoryl as it was determined he could not tolerate the drug so he has been off treatment now for over a year. I don't know what to do as he's dying in front of me I can see it. He's in terrible shape and it's happened all very, very suddenly! Within a month his health has gone from good to very poor. His body condition has gotten horrid and he's just not doing well at all!!! How do you watch your best friend die? I don't know what to do!

[Harley PoMMom]

I've merged your new post into your original thread about Tonka. This way, Tonka's entire health and treatment history are all in one place.

Can you tell what symptoms Tonka is displaying? Have a chemistry/CBC blood panel been done recently?

[labblab]

And in addition to Lori's questions, can you tell us more about the decision that Tonka cannot tolerate trilostane? In reading back through your thread, it looks as though there were several issues going on during those two weeks in addition to starting trilostane: the painful leg injury, an abrupt change to new food, pain medication, etc. So I am wondering whether/how you established that trilostane was the culprit in terms of the GI issues. Maybe it was something else altogether, and trilostane isn't necessarily ruled out as a treatment option?

Marianne

[PjCarey]

The Vet I was using at the time is the one that told me Tonka's issue was the Trilostane. I believed him. Once Tonka was taken off the medication his problems stopped completely. No more bowel issues, he started eating again etc...
I can't post Tonka's original test values as that particular Vet won't give them to me. More than likely it's due to the fact that I complained fairly heavily that the Vet had no clue how to treat a Cushing's dog and was taking a stab in the dark and guessing and using my dog as a guinea pig and charging my bank account way too much money for it.
I have switched Tonka to a grain free dog food. He can't eat a raw diet so I figured this was the next best thing.
No...he hasn't been to a Vet recently. The last one broke me financially and I have no resources left and was laid off from my job this past July so it's me and Tonka against the world at this point.
I was just hoping someone could give me some insight or help or something...I don't know.
Thanks in advance for listening.

[Squirt's Mom]

Your vet is breaking the law by refusing to give you YOUR records. Here is what is law in OH -


Records shall be released upon request from a subsequent treating veterinarian and must be returned to the originating practice within a reasonable time. Copies of records must also be available upon request from the owner of an animal at a reasonable cost to the owner.

https://www.avma.org/Advocacy/StateAndLocal/Pages/sr-confidentiality-patient-records.aspx

I would make a phone call and ask for my baby's records - ALL of them, test results, notes, everything pertaining to your baby. If they refused, read them the law that says they HAVE to provide you with those records - they are YOURS, you PAID for them and they cannot keep you from having them. If they still won't comply, call the Veterinary board for OH and report them.

[Harley PoMMom]

Can you give us more details about Tonka's symptoms and behavior?

I'm being lazy here :eek: can you tell me what Tonka's Trilostane dose was and how much he weighs?

[PjCarey]

Tonka's original dose was 60mgs of Vetoryl once a day. At the time I believe he weighed right around 128lbs. He now weighs about 120lbs. His symptoms are severe thirst, increased hunger, pot belly, scaly skin, I didn't think he had any real hair loss until the other day and yes well...he does. On his underside (chest, belly etc...) his hair is very thin. He pretty much is incontinent. I've taken as of last night to crating him of the nighttime for which I feel insanely guilty about. I now sleep beside his crate so he's not alone. No, I'm not crazy. He saved me 6 years ago and by golly I won't leave his side when he doesn't understand what and why all this is going on.
His vision is starting to decline a little and he seems to have a lot of problems with constipation.
I'm taking him to a new Vet tomorrow. I'm taking him to Banfield. I don't know if any of you have experience with them but they're close to me (easier for Tonka) and I can make payment arrangements if necessary through the ridiculous pet insurance they have. It's not cheap or necessarily good but right now it's better than watching him die and doing nothing.
Yes I know I don't sound very positive but I'm not sure there's a whole lot to be positive about when your best friend is fading in front of your eyes. Believe me...I would gladly trade places with him just to keep him alive, well and happy!!
Forgive me for rambling please.
Thank you again for listening!

[CocoPuff]

I use the local Banfield as well! I don't know if you are familiar with them but the plan they have covers preventive care only and gives you a discount on anything not covered. I had to pay for Coco's LDDS and with the discount it was around $130. Also, if they have the prescription there you will get a discount but if not, it will not be covered under the plan. My girl will be starting Lysodren in a few weeks and I am having to use an outside pharmacy. My Banfield vet is extremely experienced with Cushing's and I am located in Tennessee. I have run into some not so good vets at Banfield, in fact there is one there now that I refuse to see as after Coco was test for both diabetes and hypothyroidism, the vet just said put her on a diet. She didn't address the other issues, water intake, incontinence and excessive hunger. I even explained that I didn't feed Coco anymore than the others yet she continued to gain weight. I ended up talking to one of the other vets and she suggested the LDDS. The vet that did the test is Coco's primary, and the chief-of-staff, and has told me not to let the other vets see her due to the nature of Cushing's. I'm telling you this because you want to make sure that you are seeing a good vet that is experienced at Banfield, they are out there but there are some not so great ones either. If you haven't used them before and have questions about their plan, my pups have been on the plan for about 4 years now :)

[Harley PoMMom]

Nausea, vomiting, inappetence, these are all common ill effects from tramadol, so I would be inclined to believe that the tramadol was causing those issues and not the Vetoryl.

If this were me, I would have an ACTH stim test performed along with a chemistry/CBC panel and see what those results are. If the ACTH post number is elevated, than I would restart the Vetoryl. It could be that Tonka is more sensitive to the Vetoryl that other dogs and may need to be given a lower dose than that 60 mg.

Also, it is very important that the monitoring ACTH stimulation tests are performed correctly...the morning Vetoryl capsule with food, than that post draw should be done 4-6 hours after the dose of Vetoryl.

For the incontinence, there are belly bands and diapers that are made for male dogs.

Hugs, Lori

[PjCarey]

Hi Lori and thank you for responding!! I originally thought it was the Tramadol that was causing the problems with him but the Vet said it was the Vetoryl. Either way, he's going today and I'm finding something out one way or another.
I do have one question that has really been bothering me. If he does go back on the meds and the Cortisol levels are decreased in his system, will he start to feel the aches and pains of possible arthritis, the old knee injury and other ailments that may be being masked by the over production of the Cortisol in his body?
Now my next question. When it comes to quality of life...is it fair to make our babies all of a sudden feel all this new pain just to combat the symptoms that for the most part from what I can tell are mainly bothersome to the pet parents?
Oh and thank you for the belly band/diaper suggestion. I had no idea they made those. Any idea where to pick them up?
And thanks also "CocoPuff" for the info on Banfield. I'm going to call before I go over to make sure a Dr. with experience with Cushing's is going to be there.
Thanks again folks!!! Don't know what I would have done if I hadn't found this site!! You're the best!!!

[Harley PoMMom]

Arthritis is often unmasked, especially in older dogs, once treatment reduces cortisol to an acceptable level.

My biggest concern for a senior dog is immediate quality of life. Since the damage from elevated cortisol usually occurs over time, my own opinion is that I don't worry so much about the "silent" damage in a dog who is already elderly. Now, if the overt symptoms are making the senior dog uncomfortable, I would treat. Otherwise, I might not.

They make those diapers in disposable form and machine washable. Here is a link for the washable ones: http://www.inthecompanyofdogs.com/itemdy00.aspx?T1=D154021+DN+XS&srccode=NXCDC6&utm_source=google&utm_medium=comparison&utm_campaign=datafeed&source=origin&gdftrk=gdfV210680_a_7c3426_a_7c12944_a_7cD154021&gclid=CNTekpXxlcgCFZM7gQodS-oEZw

Washable male wrap: http://www.inthecompanyofdogs.com/itemdy00.aspx?T1=D12447+BK+S&source=igodigital

Disposable diaper: http://www.chewy.com/dog/simple-solution-12-disposable/dp/56055?utm_source=google-product&utm_medium=cpc&utm_campaign=hg&utm_content=Simple%20Solution&utm_term=&gclid=CNvgxuXxlcgCFdQvgQodzXsNXQ

Disposable wrap: http://www.petguys.com/vets-best-comfort-fit-disposable-male-dog-wraps-small-12pk.html?productid=vets-best-comfort-fit-disposable-male-dog-wraps-small-12pk&channelid=FROOG&utm_source=CSEs&utm_medium=GoogleShopping&utm_campaign=PetGuys&gclid=CLKCkvjxlcgCFVc6gQod13YMaQ

I just used google, searched for "male dog diapers" and many of them came up.

Hugs, Lori

[PjCarey]

Thanks for all the info Lori...you're amazing!! He does have arthritis, I do know that for sure. The other Vet did diagnose him with it in his back, hips and knees.
It seems that since I made the switch to the grain free dog food he's doing a little better. I guess I might be wishing wellness on him but I swear he's drinking a little less, peeing a little less and he seems to be more comfortable.
I ended up not taking him to Banfield. I called over to make sure the Dr. he was going to see had at least some knowledge of Cushing's and found out they refer all their Cushing's cases out to Ohio State University. So much for that! You think they would have told me that when I called and expressly told them "he has Cushing's" when they asked why he was being seen. It's fine though because this weekend I've been able to make some decisions regarding him that may not be the "popular" decision but I know in my heart it's what's right for him.
Oh and Lori...I don't think they make XL OR XXL belly bands for male dogs...lol!!! He's a pretty big boy and the biggest I've been able to find is for dogs 90lbs. I've looked every where so I'm going to use my crafting skills and make him one. Designer belly bands for the stylish big dog :D

[CocoPuff]

I lucked out with my Banfield having a vet experienced with Cushing's. There is also a specialist clinic an hour away in Nashville that they have partnered with so she also has a direct line with them as well. She was able to call them after Coco's LDDS and talk with a pathologist about the results, just to double check the findings. I'm glad you didn't go in, have to pay the fee only to be told they were referring you elsewhere.

[molly muffin]

Good thing you called first as you would just be referred somewhere else.

I'm guessing that with the arthritis that you have decided not to pursue the cushings and treatment for that.
It really is a balancing act and sometimes when you have an older dog, you just have to make these decisions based on what you feel is best for the dog and their comfort. "quality of life" It is what it is and we all just do the best we can.

hmm, so you are going to take pictures of this Designer Belly Band you are making right :)

[PjCarey]

Hi Sharlene,
My husband and I have talked this through at great length and for Tonka's benefit we've decided not to treat. It just seems cruel to unmask aches and pains that our old man just doesn't feel now. Like I had said earlier we changed his diet to a grain free diet and the difference in him is honestly remarkable! It's been a little over a week now on the grain free and he seems to be doing a little better...at least we see a change in him and anything's a blessing!!!
As far as those designer belly bands??!! You betcha!! Big dogs need love too and by golly our bigger boys need discreet protection :)
I'm going to work on the design this week (while my boss isn't looking at work) and get it worked up this weekend...I'll post a pic when I do :D

[molly muffin]

It is all about quality of life when dogs get older and you are right, there is a very good chance that the arthritis would cause him more pain if the cortisol came down too much.

Of course big boys need love too. :) and discreet protection! Rofl.

[Squirt's Mom]

We are here for you and Tonka all the way no matter what. So just because you have chosen not to treat that doesn't mean you get to disappear. Nope, ya'll are family now and we want to be kept abreast of what is going on with you all. Looking forward to those pics you mentioned and future updates on our boy, Tonka.

I have a Chiweenie who is quite hunched in his back. He needs a belly band so badly but none will stay on him due to his shape. His little weenie touches his ribs so he needs one that covers from the shoulders to his hips. :p I have given up trying to get one to stay on - even the ones with the straps that go over the shoulders like the Pee Keeper didn't work. I now have peepee pads taped and hung all over my house with multiple pee stations made up of totes covered in peepee pads set up throughout. This along with the bubble wrap for one of my blind babies who is a pin ball will surely keep me out of Good Housekeeping this year. :p:D:p

[mytil]

I have been following your thread and it is about quality of life for our pups. You and your husband know your Tonka best. Please continue to keep us posted on how things are going.

Terry

[My sweet Ginger]

http://www.k9cushings.com/forum/picture.php?albumid=780&pictureid=7921\uc0\u8236 }

Oh Leslie dear, I didn't know you were having a hard time with it.
I know you say his back is hunched but if you take a close look at Ginger's pic above it (the pad) covers from her ribs all the way back to her tail almost. Anyway that pic was from way before when I was still experimenting the best possible way.
You just have to use long pads, extra long if needed. I use either Tena or Berkeley Jensen women's long pads and then cut them in half by taping the cut sides but you may have to use a whole for him. I checked back on their website looking for boy's but their design is for both boys and girls. He probably needs the smallest size they have and still needs a little modification to make them fit to his body shape. I can't imagine my life without peekeepers with Ginger. They are godsend. Just so you know they only take care of #1. ;)
I hope you give peekeepers another try and hope it works out. Hugs.

[Squirt's Mom]

Thanks, Song! Redd is a Houdini when it comes to wraps. :D I have found one way to keep something on him but that involves an ACE bandage that wraps around his neck, between his legs, and around his belly...but that makes his peepee mash up next to his body which is not good. AND I have to wrap it just so or he will rub until the velcro lets go. :p So any time he has to leave the house, vet or groomer, he is held the whole time or he WILL pee all over the place. LOL And I wash his bedding at least once a day. ;)

[My sweet Ginger]

Oh Geez! That's too bad. I guess Ginger is an angel compare to your Houdini. Never really messes with it. You gotta do whatever works for you.

[PjCarey]

Sorry I haven't been around. Unfortunately I ended up with a horrid case of pneumonia and have been a bit on the blah side.
Well...my belly band idea didn't work so well. My big boy is not very well endowed and I just can't seem to place anything so it will cover him. And diapers? Nahhhh...I simply refuse to attempt to wrestle with a dog that's as big as I am to get a diaper on him.
As far as Tonka's health it has stabilized I believe. He is loving the grain free diet and it has truly done wonders for him! The "free range" peeing has stopped and is now the occasional dribble, his water intake seems to have decreased slightly and in general he seems to be much more comfortable.
I don't know that the food switch is completely responsible but I do know that 4-6 wks ago I knew I was going to be saying goodbye to my boy very soon and now I'm not so sure. He's definitely doing better than he was and I'm grateful! He's back playing with his best friend (a 12lb cat named Bogey) and his eyes are bright again.
Yes I know our time is limited and he's not going to be around as long as I'd hoped but at the moment his quality of life is pretty darn good and he's feeling better! Thanks so much for caring! I wish you all so much love and luck with your own situations! This is a horrid disease and our pups just shouldn't have to go through this!
I'll be sticking around now that my own health has gotten better. Talk to you soon folks!!!