12yo Dachshund with Cushing's? (Red is at the Bridge)

[nbell001]

We are trying to figure out what is going on with our spoiled pooch. :)

Took him in on Nov 11 for routine exam, vet suggested we do CDC panel with his age (12). We agreed & it came back with highly elevated liver enzymes (7000 is what I was told - not sure if that is accurate). They had us bring him in for an x-ray (nothing appeared) & they did some additional bloodwork. Results came back that it was cushing's & possible uti. His red & white blood cells are at normal levels.

They gave us Baytril & Trilostane (30 mg daily). He didn't do well with the Baytril,stopped Trilostane for a day then switched to Amoxcilian. Antiobiotics are done & he is just on Trilostane but he is refusing to eat. No eggs, roasted turkey, dog food, peanut butter...nothing. We did get him to eat some turkey yesterday morning (maybe 2/3 cup). Today, so far, no eating.

He is up & around, alert & acting okay but is way more lethargic than normal & is sleeping a lot.

When he does eat, he looks really good, more active, bright eyes, but getting him to eat is highly difficult.

Any ideas? Any thing we are missing? I am wondering if he's over medicated.

TIA

[Squirt's Mom]

STOP the Trilostane immediately. What you are describing could mean his cortisol is too low. Can you tell us more about your baby? How much does he weigh? What dose of Trilo is he on? Once or twice a day? Was he tested for Cushing's while the UTI was present? If so, the UTI could skew the test results making the diagnosis suspect. Can you please get copies of all the testing done to diagnose the Cushing's and post the results here? That would help us tremendously.

For now, do not give any more Trilo, tho. Did the vet give you any prednisone just in case? Any loose stools? Nausea (a sign of nausea is air licking)? Vomiting?

[nbell001]

Red is at 20 lbs. Tril once daily at 30 mg. Last dosage was last night & no pred given for emergencies.

He was tested for cushings with uti & they want to do another urine test since he is done with meds.

No loose stools, he vomited a small amount of gas last night & licks his lips frequently. He is lying on the floor at my feet & has slight tremors that come & go. I feel like I should call the vet on call??

[Squirt's Mom]

If he has had the morning dose, then yes I would call the ER and let them know what is going on. I would also demand some prednisone. Do not continue the Trilo for now, 'k? He will probably be alright but he may need to be seen. Keep a very close eye on him and get him in if he seems to be getting worse. Let us know how he is as the day progresses and if you take him to the vet, ok? We are here with you....you are not alone.

Hugs,
Leslie and the gang

[nbell001]

No trilo today & I will be in touch with the vet. Thank you for you help. We will keep you posted.

[molly muffin]

Hello and welcome from me too. You said he is getting 30mg once a day and weighs about 22lbs. You mentioned you gave him his trilostane in the evening? The ACTH follow up test to make sure the cortisol levels are okay, has to be done within 4 - 6 hours of the medication being given. Because of that it is usually better to give in the morning with food as not many vets can do the ACTH test that takes a couple hours in the evening or night.

Any time they are not well, with hold the trilostane, but yes, this could be a sign of the cortisol going low. Did they check the gall bladder and do a liver test also? With ALKP in 7000 I would want verification of live and gall bladder too, as they can make the ALKP go up also.

Welcome to the forum.

[nbell001]

Yes, Red is at 20 lbs. We gave the 30 mg trilostane in the pm because he wasn't eating in the am.

Out running a couple errands and we ran into our vet. Trilo is stopped indefinitely until Red is stabilized again. The tremors are gone, he's still not eating but he looks better & was a bit more active this evening so I am hoping the eating will not be far behind.

[Squirt's Mom]

How is Red this morning?

[molly muffin]

Checking in to see how you and Red are doing.

hugs

[nbell001]

We are doing okay. He has meds to help with the dry heaves & an appetite stimulant. Problem is getting them down. We're trying different things but with him not eating well on his own, it can be challenging. And to make it more troublesome, he doesn't like his mouth messsed with. So we are real popular pet parents. :D

He is eating via syringe. Seems to be doing better but is still very tired. He seems to stand & stare into the distance at times. Not sure what that is about but will continue close monitoring.

I will be happy when he is back to his old self. We are not going to try the trilostane again - he has not handled it well at all.

[Squirt's Mom]

Did you get some pred and try that? What has the vet said about his state? Did they do an ACTH?

[nbell001]

At this time we haven't done any testing - the vet was more concerned with getting nutrition in him. He was hydrated but had nothing of substance in him.

He has a visit at the vet this pm

[Squirt's Mom]

Do you and your vet understand that loss of appetite could mean the cortisol is too low and that too low cortisol can be life threatening? I would INSIST on an ACTH today and DEMAND prednisone before I left today. But then I can be downright bullish when it come to my babies health. ;)

[doxiesrock912]

As others have mentioned, all infections must be cured before an ACTH is performed or the results will not be accurate BEFORE giving Trilostane. Dex needs prednisone asap to get his Cortisol back into normal range. This can easily become a life threatening situation.

For future reference, Dechra recommends starting at 1mg of Vetotyl (Trilostane) per 1 pound of dog weight.

Once he is stabilized and no infections are present, I would test again before resumming the medication.

Some people have had success treating atypical Cushings with lignans and melatonin.
Please explore this option. Others here have done so.

[nbell001]

Early this morning Big Red crossed to the bridge.

After 4 hours at MedVet it was determined that he had some signs of Cushings but of more concern was his kidneys - so he should not have received Trilo at all.

He had lost 3 pounds in the last 2 weeks. He was a fighter anf was brave to the end when he passed cuddled between me & my husband. The pain of loss right now is incredible & I know it will ease in time but I would give anything to have my little monkey beside me. My heart is broken right now.

Thank you all for your help & feedback.

[Trish]

I am so sorry Big Red has passed, my condolences and sending big hugs to you all xx

[labblab]

Oh my goodness, I am so terribly sorry! I can imagine you are still in shock right now, so thank you so much for gathering yourself to tell us what has happened. Such a sad day for you. I know it doesn't help to say that your boy is free from all suffering now, especially since your pain is just beginning. But please know that we are here for you at any time that you might wish to return and talk. We are very good listeners, I promise.

Sending huge consoling hugs to you and your husband, and wishing your precious boy "fare the well" as he joins our multitude of loved ones at The Bridge. He will never be alone.

Marianne

[Squirt's Mom]

Oh my word, I am so so sorry to hear of this! Please know we are here anytime you need to talk.

Our deepest sympathies,
Leslie and the gang

[molly muffin]

Oh now I am so so sorry to hear this. I am sure you are heart broken and devastated.
My sincerest condolences
Hugs

[doxiesrock912]

Oh honey I am fighting back the tears as I read your post!
I understand completely as I recently lost my sweet Daisy Mae due to a kidney issue being missed.

HUGS!!!!!

[Dixie'sMom]

I am so sorry for your loss. I had been following Red's story but hadn't posted to your thread. I know you are devastated. I will be keeping you in my prayers and close to my heart in the coming days. My deepest condolences to you and your husband.