Recently diagnosed with Cushings (10 y/o Spoo/Standard Poodle)

[Joyce]

Greetings~

My 10 year old 45 Lb. Spoo/Standard Poodle, named Brandy Cakes, was just diagnosed with Cushings disease three weeks ago. She had all of the classic signs such as excessive panting, drinking a lot of water, frequent urination, loss of hair on her back, chest, ears and tail and general malaise. The oncologist started her on 60 Mg Vetoryl Capsules to be taken daily. The first week I noticed her appetite had greatly diminished to the point where she flat out refused food of any kind, with the exception of her Blue Mountain Salmon treats. I also noticed a slight tremor of her head and sleeping a lot.
I called her oncologist to let him know and he recommended that I try giving her one capsule every other day to see how that works. So far, It's working a lot better. She's regained her appetite, but only eats smaller portions throughout the day, which is fine with me since I've always fed my dogs twice per day to lower the chance of getting bloat. The tremors have stopped and she seems to be feeling better. Her oncologist said that we will have to lower her dose so that it can be given to her every day. Still in the tweaking stage and trying to learn as much as I can about this condition. I want to be able to do everything possible for my baby~:)

[Spencersmom]

Welcome to the forum, Joyce! There will be plenty of help here and lots of questions, so be ready with test results!

[Joyce]

Thanks so much Terry and Spencer~ <3 I'm looking forward to sharing and learning from this forum!

[Harley PoMMom]

Hi Joyce,

Welcome to you and Brandy Cakes from me as well! I just love your girls name, Brandy Cakes, AWWW, so cute!!

Terry is right, we do ask a lot of questions! Also, what would be a great help to us if you could get copies of all tests that were done on Brandy Cakes and post all abnormal values here along with the reference ranges and units of measurement...e.g...ALT 150 U/L (5-50)..Thanks!! Does Brandy Cakes have adrenal or the pituitary type of Cushing's? Is she taking any other herbs/supplements/medications?

It sure does sound like Brandy Cakes was started at a Vetroyl dose that was too high for her. We see less adverse effects when a dog is started at a low dose, 1mg of Vetoryl/Trilostane per pound of a dog's weight is what we like to see, so for Brandy Cakes weight of 45 lbs a Vetoryl dosage of 40 mg would of probably been ideal.

Giving Brandy Cakes' Vetoryl every other day is generally not a recommended dosing protocol because Trilostane, the active ingredient in Vetoryl, only remains active in the body for approx. 12-18 hours. If a dose is too high, it's better to just decrease the daily dose rather than increasing the interval between dosing.

Dogs on treatment for Cushing's have to monitored with an ACTH stimulation test, has this test been scheduled? Also the ACTH stimulation test has to be done 4-6 hours after the Vetoryl was given. And has the oncologist told you that the Vetoryl has to be given with food to be properly absorbed?

Cushing's sure can be hard to wrap one's head around, but we are here to help in any way we can. Cushing's is a treatable disease but success in treatment does depend on a few things; a pet parent educating themselves about Cushing's, keen owner observation, and a vet/IMS that is experienced with treating Cushing's and knowledgeable about the proper protocols for Cushing's.

I'm providing you with some links from our Resource Forum that pertain to Vetoryl/Trilostane: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

Dechra's U.S. Product Insert (http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf)

If you have any questions please feel free to ask as many as you want. ;)

Hugs, Lori

[Joyce]

Lori~You are a jewel! Thanks so much for all of this invaluable information! I will call tomorrow and ask for the copies of her first ACTH stimulation test which was given on 8-14-2014. I'm scheduled to go back in after 30 days of being on the meds. Her oncologist did mention that it should be given with food.
I'll read all of the information in the links that you provided me with!

Again, Thanks from the bottom of my heart~

[Joyce]

These are the most recent results from August 15th.
Endocrinology
8/15/2014 (Order Received)
8/15/2014 @ 5:12 am (Last Updated)
Cortisol - Pre ACTH 7.5 ug/dL
Cortisol - Post ACTH a 40.8 ug/dL

[Harley PoMMom]

These are the most recent results from August 15th.
Endocrinology
8/15/2014 (Order Received)
8/15/2014 @ 5:12 am (Last Updated)
Cortisol - Pre ACTH 7.5 ug/dL
Cortisol - Post ACTH a 40.8 ug/dL

Those ACTH stim results do point to Cushing's, however, no single lab test is 100% accurate at diagnosing Cushing's so usually multiple tests are needed to validate a Cushing's diagnosis.

Besides the ACTH stimulation test the other tests generally performed to aid in the diangosis for Cushing's are: low dose dexamethasone suppression test (LDDS), Urine Cortisol/Creatinine Ratio (UC:CR), and/or ultrasound.

Was a chemistry/CBC blood panel done on Brandy Cakes? If so could you post any abnormalities that are listed along with the reference ranges and units of measurement. Sometimes this blood panel is called a senior and/or wellness test. Also, has another ACTH stimulation test been scheduled? How is Brandy Cakes feeling? Have her symptoms decreased?

Hugs, Lori

[Joyce]

Hi Lori~
I'll call her regular Vet tomorrow and get the lab work that was done a few weeks ago. It was a wellness/senior blood panel which did show abnormalities...
Her oncologist hasn't scheduled another ACTH as of yet, although I've been reading that she should be re-checked several weeks after starting Vetoryl to see if it's working and if the dosage needs to be adjusted.
Brandy Cakes is eating better! She does eat smaller portions throughout the day. The panting is better and she's not drinking as much water nor urinating as much. I will post her results from the blood panel as soon as they email them too me~

THANKS :)

[Joyce]

Is there a way to upload a pdf file of the Blood Panel?

Thanks,

Joyce

[labblab]

If you take a photo of the document, you can upload it as an image to your personal photo album. However, all we really need to see are any abnormal values posted along with the reference range. For greatest visibility, you can just type those abnormals within the body of a normal reply. That is easier for most people to view and comment upon.

Marianne