yorkie unable to tolerate vetoryl

[zakismum]

Hi everyone! I am mum to Zaki, an 11 year old yorkie. He was diagnosed with Cushings in June 2014. He weighed 4.7 kg and was put on 30mg Vetoryl daily. Since then he has gone into Addisons four times at doses of 30mg, 20mg, 10mg and for the last two weeks at 10mg every other day. Each time he has been poorly, not wanting to eat or drink. It is so sad as he has started to grow his hair back and has been able to run and jump again. The vet says there is nothing that can be done, lysodren is not used here in the United Kingdom.
As a last resort I have ordered some Adrenal Harmony Gold from the USA. It is my last hope to try to do something for my boy. It breaks my heart to think that he will become a little, weak, ill boy again.
Can anyone who has had a similar experience advise me of anything that might be helpful to my little boy?
Best wishes, Anna, Zakis mum

[mytil]

Hi and welcome - I am sorry your boy has had these troubles.

Firstly, the dosage has been way too high for his weight of which caused his cortisol levels to fall dangerously low.

Did you have a recent ACTH test to give an accurate level of his cortisol? This is very important. If so, please post those numbers here.

I am not a vet but I do disagree there are some things that can be done. Firstly, in my opinion I would stop the Vetoryl all together as it sounds as though his cortisol levels are still too low and have an ACTH test performed.

Secondly, when you get the chance, post all the tests and results performed to come to the diagnosis of Cushing's. Also I would not introduce any new meds at this point (i.e. Adrenal Harmony Gold).

Terry

[labblab]

Welcome to you and Zaki! I have only a moment to post, but I do want you to know that if the size of the Vetoryl dose turns out to be the only issue for Zaki, there may be a solution. Although it is not available elsewhere in the world, Dechra does manufacture a 5 mg. capsule for use in the U.K. It is not available there for general purchase, but vets can make special request to Dechra on behalf of small dogs who are physically unable to tolerate a larger dose. So on Monday, I would contact your vet and ask him to make inquiry for you.

In the meantime, can you tell us more about the actual test results that were used to diagnose the Cushing's in the first place, and also the subsequent monitoring that has confirmed that Zaki's cortisol has dropped too low since beginning treatment?

Thanks so much!
Marianne

[zakismum]

Hi Terry and Marianne
Thank you for your replies. My vet does not supply test results, just tells us what they mean. We took Zaki to the vets in June because he was drinking huge amounts and having accidents in the house, he had lost most of his coat, he was panting, his hind leg muscles had wasted and he could not climb the stairs.
He had a baseline ACTH done, and then had ACTH after 10 days, then three weeks and several times, when he went into Addisons. Each time this happened he had to stop the vetoryl for one week and then start on a lower dose, then he had a stim test after two weeks on the reduced dosage. The vet also tested his potassium and sodium levels, and these tests were always wrong, with a high potassium and a low sodium. I know it would be easier if I could post the results but I can't get them, and our vet is the only one around here, so I am worried about upsetting him.
He has been completely off the vetoryl since last Wednesday, and the vet says he cannot have any more. We will ask about the 5mg pills, maybe they would be better than the 10mg every other day, which is what he has been on. After a few days on all the different dosages, he has become sick, listless, not drinking or eating, or going to empty his bladder. I really do not know what to do for the best. In the booklet that came with the pills it said that dogs over 4.5 kilograms should have 30mg daily, and Zaki was 4.7kgs. He is now 4.5kgs, as he has lost weight through not eating (he is about 9lbs, I think, in "proper" measurement!)
The vets use metric scales here, now.

[labblab]

It may be the case that Zaki simply cannot tolerate the Vetoryl at any dose, but more recent experience has rendered that older dosage chart contained in the booklet as no longer being appropriate -- in many cases, the initial doses are simply too high. We are annoyed that it has taken Dechra so long to formally update their protocol in written form, but they finally did so this summer. Here is their revised protocol released in July:

http://www.vetsonline.com/news/product-news/140722-new-lower-starting-dose-for-vetoryl.html

As you will see, per the revised protocol, Zaki would have been started off at no more than 10 mg. Right now, even given only every other day, that is proving to be too much for him. But it may be that a decrease to 5 mg. may suit him, since the roller-coaster of a too-high dose of 10 mg. one day and then a day of no dosing at all may be destabilizing his endocrinological system.

At any rate, it will be good for your vet to contact Dechra, both for confirmation of the new dosing guidelines and also to inquire about the 5 mg. capsules given Zaki's response.

Marianne

[zakismum]

Hi Marianne
Thank you so much for the information about the dose changes. It could have saved Zachi a lot of sickness and fear of going to the vets, if my vet had checked with Dechra. We are going to ask about the 5mg tablets, if the vet will contact Dechra about them. You have given us something else we may try, thank you!
Do you know of anything we can do if Zaki is (as we fear) unable to tolerate vetoryl at all?
thank you, Anna, Zaki's mum

[Squirt's Mom]

There is a drug called Anipryl (Selegiline) that can help some pups for a short while. There is another drug called Ketoconazole that is used rarely because of the harsh effect on the liver...nor does it help much. The other alternative that MIGHT offer some relief would be an alternative approach incorporating herbs, supplements, diet. It is not cheap to do, nor is it as efficient with controlling the cortisol, which is the enemy in Cushing's. I would look for a Holistic vet and talk to them if your traditional GP and specialists have nothing else to offer.

[jas77450]

Anna,
hi and welcome. I'm so sad about Zakis trouble. I'm very concerned about him not eating or drinking. I'm new here too so won't offer advice but there are lots on here who are well experienced that can help. Just know you are not alone. Hope your little one turns around soon.

[zakismum]

Hi Squirt's mom
Thank you for your advice. Our vet won't use anything but vetoryl, unfortunately.
We live in rural Wales, and I have not actually been able to find an holistic vet anywhere in the country. It is several hundred miles to the nearest one. I am very disabled and can't travel. Do you have any idea of what to give for an holistic diet for Zaki? At the moment he will only each a small portion of minced beef, and we more or less have to hand feed him.
My husband thinks it may be better to wait afew weeks until Zaki has got all the vetoryl out of his system, before trying anything else. I think a holistic way sounds good, I am willing to give anything a go to help our boy!
thank you, Anna

[zakismum]

Thanks for your post, Cosmo's mum! I am really pleased to find this marvellous forum, with so many knowledgeable people. Our babies just need us to do the right thing for them. Today Zaki ate a little more mince and drank a little water. He has been so poorly on the vetoryl, I hope we can find some way to help him.
thankyou, Anna Zaki's mum

[molly muffin]

Hello and welcome.

I wouldn't actually start Zaki on any vetroyl until symptoms of cushings have come back and his electroyltes are in a good place. Some dogs do not end up needing vetroyl for a long time after Addison's crisis.

If your vet will Not give you copies of the test results even when you ask for them, then at least have them tell you the numbers Pre and Post 1 hr and 2 hour if they do three draws and then let us know what they are.
As Zaki's mum, just tell them you need to know as much as possible about what is going on with your baby and you want numbers with ranges. Most vets will cave and just print out results at that point, but if they won't, make them go through everything verbally so you can write it down. result, ranges, etc :)
Lets get Zaki back on track and see what needs to be done. :)

Welcome
Sharlene and molly muffin

[jrepac]

Why some vets fixate on one and only one treatment is beyond me... anipryl might help w/symptoms if vetoryl is not tolerated. However, it probably just addresses the symptoms, not the underlying causes....but that can be a big help in many cases.

Other vets may recommend lysodren. But, if he's having trouble w/Vetoryl, not sure I'd go w/lyso.

Herbal remedies/helpers include lignans and melatonin...you can search this board to find out more...U of Tennessee (?) prescribes a regimen of meds + these things.

Is the vet/are you 100pct sure he has Cushings? And not diabetes?

[mytil]

What alternatives did your vet discuss with you on helping your boy?

Terry

PS - let us know what your vet mentions tomorrow.

[zakismum]

Hi everyone
Zaki is now drinking as normal and eating minced beef, although he won't eat kibble. I don't mind, I'm glad to get some food in him! My husband went to the vet's this morning. The vet recommended we keep Zaki off all medication for three weeks. In the meantime he will contact Dechra and ask their advice. My husband told him that we have found out from the good folks here that they make a 5mg tablet, and he will look into Zaki trying that. Thank you for all your support here, we may be able to do something for Zaki yet!
Worries come along from a different matter, though. At the weekend we noticed that Sula, our Jack Russell/chihuahua girl has a swelling on her top lip. The vet diagnosed this as a histiocytoma tumour. She has been given a dexamethazone antibiotic cream to see if it helps, but realistically we are looking at surgery. This is a nasty shock, now we are dealing with two sick pups! I will post when I know something further about Zaki.
thanks for your support
Anna

[zakismum]

Hi
the vet and my husband and I are 100% sure Zaki has cushings as all his symtoms disppeared when he started on the vetoryl. He was tested for diabetes before the cushings and he is definitely not diabetic. Th only treatment available for cushings in the United Kingdom is vetoryl, so if he is not able to take the 5mg*tablets, it will have to be a holistic approach, which I am trying to research if we need it
thak you for all the help and suggestions
Anna.

[Dixie'sMom]

Anna, I am a new Cushing's pup mom myself so I don't have any advice to offer, but I did want to welcome you. I'm very glad to hear that Zaki is drinking and eating some. Thats a good sign, right? I hope that your vet will arrange for you to get the 5 mg Vetoryl because it sounds like that may be your solution to this problem. Hopefully Zaki won't start showing any Cushing's symptoms any time soon so you may not have to restart treatment for awhile. I'm sorry to hear about Sula. Hopefully the medicine will help her lesion. Do they think that it is cancerous?

I'll be praying for your babies healing, and again, welcome to our family.

[molly muffin]

Oh my you do have your hands full right now. Hope Sula is going to be okay too and that your vet can get the 5mg.

[zakismum]

Hi Suzie and Sharlene (and fur babies)
Thank you for your welcome! I am really hoping that our vet will get the 5mg vetoryl from Dechra and that Zaki will be able to take it without going into Addisons again. That would be the ideal solution. We won't know whether Sula's tumours are cancerous for certain until she has had a biopsy, though the vet said that normally they would be surgically removed he wants to see how they respond to the cream he has prescribed first. The cream is only usually used by human patients, so my husband had to sign a form that he agreed to Sula use the drug. I've looked it up online and for the type of tumour a hystiocytoma, it seems as though the only cure is surgery, and that means Sula will lose most of her upper lip. I feel awful that I had not noticed it sooner, but all our attention has been on Zaki. I know that is not a good reason though.
I do appreciate the support from all the folk on this forum - thankyou!
Anna r a

[jas77450]

Anna,
So glad to hear Zakis is eating and drinking. Yeah!!!
hope all turns out well with Sula.
Don't beat yourself up...you have your hands full...you are taking care of things as needed.
I inherited my dad's dog after he passed recently. Took him to vet re growth on gums. Surgery and biopsy recommended with teeth cleaning. This was put on back burner while I was dealing with my very sick Cosmo as that was priority and Buster, my dad's dog was doing fine. I will take care of this soon. Sometimes we have to deal with the most serious problems first. You are doing great esp considering all things going on. Hang in there, one day at a time.
Jenny

[zakismum]

Thanks Jenny
your post cheered me up. It is very easy to be hard on oneself when it concerns your pets' health. We all do as much as we can, but it always feels we should do more. Zaki managed to eat a full portion of minced beef for his lunch today:) I hope your pets are now on the road to recovery.
thanks Anna

[jas77450]

Good to hear Zakis is eating a little, hope he continues to get better.

[molly muffin]

Whoo hooo, glad to hear that Zaki ate his full meal for lunch today. That is a good sign!

hugs

[jas77450]

Anna, Just checking in on you and Zaki, hope all is well.

[doxiesrock912]

Anna,
If Zaki needs an even lower dose, there is a compounding pharmacy that numerous people use online called Diamondback.

Please let us know what Dechra advises
I'm glad he's feeling better!

[jas77450]

Anna, I will be taking Buster in soon but I lost my little Cosmo 3 1/2 weeks ago. Thank you for best wishes. I feel better knowing Zakis is eating, it always scares me when they don't. I thought I read that trilostane could be made in liquid form which would make giving smaller doses possible. Not for sure, maybe someone with more knowledge can advise on this. Keep us posted on Sula.

[molly muffin]

Is Zaki still eating? How are things going?

hugs