GSD mix with cushings

[passon13]

Hello, I have a German Shepherd mix who was diagnosed with cushings around April. He has been on trilostane. I do not have the ACTH stim test with me ATM. He was diagnosed and then got retested in July and all his levels were normal. Now he is starting to shake and has a loss of thirst and appetite. He has begun chewing at his hips and eats about a half a cup a day. This has been going on for about a week or so. He is also on 60mg 2x/day. He was about 60lbs and probably lighter now as he has lost some weight. Any suggestions on what can be going on?
Thanks

[labblab]

Even though his ACTH level was OK in July, it is entirely possible that his cortisol level has now dropped too low. Tremoring and loss of appetite can be common symptoms of low cortisol and/or an imbalance in his blood chemistries caused by too high a dose of the trilostane. He is due for another ACTH anyway (testing is recommended at 90 day intervals), and under these circumstances I would take him in immediately. You will want the monitoring ACTH and also a test of basic blood chemistries that includes sodium and potassium levels.

Marianne

[passon13]

Ok thank you. I will make and appointment for tomorrow. Should I still give him his normal dose of trilostane?

[labblab]

That really is a judgement call because you don't want the cortisol to be driven even lower if that is the problem. But on the other side of the coin, you will get the most accurate measure of the true effect of this dose of Vetoryl if he gets his medication as he normally would and is tested thereafter. Just to confirm, he should be given his Vetoryl with a meal and then tested 4-6 hours later.

I am not a vet, but I guess if he were my dog and as long as he is not vomiting or having diarrhea or seeming lethargic, I would go ahead and dose as you normally would for one more day until the test is completed tomorrow. But at that point and with your vet's knowledge, you may wish to stop the Vetoryl until the test results are known and you can confirm whether or not low cortisol is the problem.

Marianne

[passon13]

I just dropped him off at the vet. The nurse said the doc. is going to look at him and see if we should do another acth test or lower the dose. I'll keep everyone updated. Thank you!

[labblab]

We'll be anxious to hear how things go. But I really, really hope your vet will proceed with the testing, no matter what. Even when a dog outwardly appears stable, monitoring testing is recommended at 90-day intervals by the manufacturer of brandname Vetoryl and also by most specialists with whom we are familiar. In this way, worrisome trends of cortisol either trending too high or dropping too low can be rectified before they translate into abnormal behavior. And in this case when your dog is behaving abnormally, I don't know how your vet can identify the genuine cause just by outwardly eyeballing him :o. Even if he suspects low cortisol just by your dog's appearance, he needs the ACTH results to know by how much to appropriately lower the dose. I really hope the testing will be done.

Marianne

[molly muffin]

Hello and welcome to the forum. I always like to error on the side of caution, so I'd probably get the ACTH test if it is possible and practical to do so. Otherwise, I'd stop the vetroyl until things appear to return to normal with him.

Sharlene and molly muffin

[passon13]

Ok so we are doing half the normal dose per day until we get the ACTH test results. I found a food that he will actually eat so thats good!! And the blood work came up good. Anything that was high last time has now stabalized.

[Squirt's Mom]

Good news on the food and blood work! Oh! and welcome to you and your baby! :)

[Junior's Mom]

Welcome to the forum. I'm curious as to how you are cutting the dose in half. Did you get 30mg vetoryl, or will you only be giving it once a day instead of twice. You cannot open the capsules.

[passon13]

Well he's on a synthetic trilostane made here in the USA. It's a liquid and given in a syringe. I was doing .5ml 2x daily. Now its .25ml 2xdaily.

[Harley PoMMom]

I didn't know that your boy was on a liquid form of Trilostane, could you post how many mg are in 1 ml, it should state this on the label...thanks!

Hugs, Lori

[passon13]

it says "trilostane 60mg/ml Suspension, Give .5ml by mouth twice daily." so I guess 60mg/ml.