treatment questions

[ngeipel]

Hi Everyone,

I found this place after finding out my dog has cushings today. It seems like a great place with a ton of experience and knowledge.

So I have noticed that for the past few months that my dog has thinning hair. So I decided to look up why last week and came across Cushings. He has the pot bellied look and seems to have a few skin issues here and there so i got him checked.

My vet is out of town until thursday but had another vet call to tell me. They will do further testing.

So my questions are about the Vetoryl. It seems like it works well in most cases. My worries are about the side effects. What is your experience with them? Does the dog take it every day for the rest of their life or do you do maintenance?

[molly muffin]

So, the thinning hair and pot belly look is the only symptoms? Have you had regular blood work done? If so could you post the abnormal results, high/low?
Also has a urinalysis been done, as normally cushings dogs have very dilute urine specific gravity.

As far as vetroyl, as long as you do proper dosing, start at 1mg/1lb once cushings is confirmed, and follow testing protocols, then there are little to no side effects. Side effects are most often seen when giving too much vetroyl.

I do want to caution though that you do not want to start medication unless you know absolutely that it is cushings, and not diabetes, or thyroid, for example. Those all have to be ruled out first.

Sharlene and molly muffin

[Harley PoMMom]

Hi and welcome to you and your boy, sorry for the reasons that brought you here but so glad you found us.

Cushing's is one of the most difficult diseases to get a confirmed diagnosis for, and unfortunately, it is often misdiagnosed. Its symptoms are shared with other nonadrenal illnesses, such as diabetes and thyroid problems, and they should be ruled out.

Dogs with Cushing's will usually have a ravenous appetite, drink copious amounts of water and pee lakes, is your boy displaying any of those? Strong obvious symptoms do play a huge part in the diagnosis of Cushing's, thinning hair and skin issues sound more like hypothyroidism to me than Cushing's.

If you could get copies of all tests that were done or that are going to be done and post those results here that would help us a lot.

Cushing's is when a dog's body produces excessive amounts of cortisol, over time this elevated cortisol will cause a host of health problems, especially harming the internal organs. Treatment for Cushing's is lifelong.

Trilostane/Vetoryl is one of two medicines most prescribed for treatment of Cushing's. Trilostane/Vetoryl is not a cure for Cushing's but is used to abate symptoms associated with Cushing's. Trilostane/Vetoryl is a strong drug, adverse effects are usually caused when the proper protocols are not followed. Cushing's is a treatable disease, however, success in treatment does depend on a few things; keen owner observation, a pet parent willing to educate themselves about Cushing's, and a vet/IMS that has experience treating Cushing's and is knowledgeable about the protocols for Cushing's.

I am providing links from our Resource thread that have a wealth of information regarding Cushing's and the medications:

Links to Cushings Websites (especially helpful for new members!) (http://www.k9cushings.com/forum/showthread.php?t=180)

Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

If you have any questions at all please do not hesitate to ask them ;)

Hugs, Lori

[ngeipel]

I have had blood work done for hypothyroidism and that was negative. I then had blood tests for cushings and was told it was positive.

The vet that worked me up is on vacation until tomorrow, but another vet called and told me the results. They are going to discuss it tomorrow. I imagine I will have the full results then.

I wouldn't say he eats more than usual. He does drink and pee a lot, but he has always drank a lot of water.

I will post tomorrow when i speak with the vet again. Thanks for the help.

Nathan

[molly muffin]

Did you speak to the vet today?

Sharlene and molly muffin

[ngeipel]

I spoke with the vet today. I had gotten the scan. I also have his results.

I am not sure what results to post here. Here is the Dex results:

Pre - 3.1 ug/dl
Post - 1.6
Post 2 - 3.5

What the vet has said to me is that the scan showed no growths. He says that because he doesn't show all the symptoms that the treatment will be up to me.

Let me know what you think. I have other results too. I didn't know what to post.

Thanks,
Nathan

[molly muffin]

Hi Nathan,

You would post anything that is abnormal High or Low with the range. For instance:

Alkp 890ug (5- 100)

Also what did the scan show? did you get the report? That is good no growth. So, along with the LDDS results, it looks like pituitary. Not all dogs have all the symptoms.

You didn't mention what breed of dog and how much does he weigh?

If you decide to go with vetroyl, yes it is for life and since there aren't alot of symptoms at this time, other than, thinning hair, drinking, peeing, etc, I would go with a very low dose of vetroyl. I have previously said, to start at no more than 1mg/1lb but seeing how small the symptoms are, an even lower dose might work.

If he had no symptoms at all I'd say hold of, but mild symptoms might be easily helped and the main thing is to do what helps him the most, and makes him feel better.

But first can you post those abnormal results from the test?

Sharlene and molly muffin

[ngeipel]

Barry is currently an 8 year old American Pitbull Terrier who weighs 103 lbs. He has always been very large dog hovering around 95 lbs for most of his adult life.

I didn't ask for the scan results. I will do that Monday.

Sorry if the spelling is off, this copy they gave me is tough to read. Here are his blood test results that show HIGH:

ALT (SGOT) - 128 u/l - normal - 12-118
alk phoschatass - 350 u/l normal - 5-131
cholesterol - 467 mg/dl, normal - 92-324

microalbuminuria >30 mg/dl, normal <2.5

[molly muffin]

Those results can certainly be consistent with cushings.
As I said, I would go with a lower dose of vetroyl to start out under 100mg.

I want to see what others think too, but if you want to start vetroyl I'd go with a dose as low as 60mg even. Normally you'd start at around 100mg (which means you'd need to have vetroyl plus compounded) I'd rather be under the 100mg than over at 120mg which is where some vets would start. But with not too many symptoms I wouldn't start that high.

Yes, the pitbull terriers are very muscular so tend to weigh in at some hefty weights. It makes for a lap full that's for sure. :)

Sharlene and molly muffin

[ngeipel]

Thank you for the advice.

[ngeipel]

Hi all,

Sorry to start my thread again, but I figured this is good in case anything needs to be referenced.

It has been two months since Barry's diagnosis. The Vet recommended testing again in 6 months to see how things have progressed. I think because I know he has Cushing's that I am seeing more symptoms.

Initially i was saying that he has always drank a lot, but the more I pay attention his drinking is up. His skin is grayish and seems thin. He also develops spots here and there on his skin.

He gets solid exercise every day, and his energy level seems consistent with an 8 year old dog.

I am debating on whether I should wait this 6 months or go get another opinion or possibly go to a specialist and get some advice.

[Squirt's Mom]

Simply because you mentioned skin changes, I would RUN for another opinion today. There is a rare and serious complication with Cushing's called Calcinosis Cutis that is a booger to get under control once it starts IF it can be controlled. I would want a derm vet to see those spots today if at all possible. ;) A derm vet can give you a diagnosis of Cushing's probably as fast or faster than any other vet if CC is present.

[molly muffin]

I always opt for the specialist when things get too complicated for regular vets, even if they don't realize it, you know that things have changed.

[ngeipel]

I would compare the skin bumps to pimples. They do however go away. I will probably get scheduled for an appointment soon

[ngeipel]

Squirt's Mom,

He was also already diagnosed two months ago. We haven't started any type of treatment yet. I believe I found it extremely early where he wasn't showing many signs. My paranoia is just kicking in and I don't want to start too late. But I realize that there are side effects to consider as well.

[molly muffin]

Pimples is often how beginning of cc is described. Ask for a skin scraping to determine for sure. You do not want it to get worse which it does or ateqst can. So find out. C is little calcium deposits under the skin that end up breaking through and. Amusing weeping sores. So you want to find out for sure