Newly diagnosed 10yr old boxer w/cushings...

[ddnene]

My 10 year old boxer was just diagnosed w/cushings disease last week. I found your FB page and did an introduction there a few days ago… I just received her meds today. They want her to take 2 60mg Vetoryl every morning. I'm a little concerned that this dosage is way high, I was curious to any advice on this. AND after reading the adverse reactions pamphlet inside the Vetoryl box I'm worried about the side effects :(

[Harley PoMMom]

Hi and welcome to you and your girl!

So glad you found us and we will help in any way we can. It would be a big help to us if you would tell us more about your furbaby, this is so that we can provide you with better feedback, ok? Some questions that I have are: How much does your girl weigh? Is your girl taking any other herbs/supplements/medications? Does she have any other health issues? Was an urinalysis done, and if so, could you post those findings too? Could you get your hands on copies of all tests that were done on your girl and post any abnormalities that are listed...e.g....ALT 150U/L (5-50) Also we are especially interested in the results from any tests that were used to diagnose Cushing's in your girl...Thanks!

As for that dose they want to start your girl on, it sounds awful high to me unless your girl weighs over 120 lbs. The usual starting dose for Trilostane, which is the active ingredient in Vetoryl, is 1mg per pound of a dog's weight, so if a dog weighs 30 lbs, then a starting dose of 30mg would be reasonable. On the forum we see less adverse effects when a dog is started out at the 1mg per lb dosage.

In our Resource Forum we have a wealth of information regarding canine Cushing's and treatment, here's a handy link for you: Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10[/url)

Link to info about Trilostane/Vetoryl: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185[/url)

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

Hugs, Lori

[lulusmom]

Hi Tracey and welcome to you and Roxie.

I saw your thread on FB and see that others there agree that a starting dose of 120mg once daily is too high. The outcome of a study involving dosing for bigger dogs indicates that big dogs may need smaller doses to effectively control cortisol. Roxie would definitely be considered a large dog at 70 pounds so that dose could be a double whammy for her. The good news is that your vet has directed you to give Roxie two 60mg capsules in the am which makes it really easy for you to cut that back to 60mg once daily. You should really talk to your vet about that. If you want some credible information to provide your vet, I would suggest that you share Dechra's recent change in dosing recommendations that can be found on their UK website. They have had an application in to the FDA for over two years but the FDA wheels grind very slowly. It's outrageous really that dogs continue to be placed at risk because Dechra's hands are tied. However, I believe Dechra has done too little to get the word out to the U.S. veterinary community. I've included a link to Dechra's (UK) announcement via vetsonline.com and I've also included a link to a summary of the big dog study that was published in a veterinary publication, Clinician's Brief. If I were you, I would print both out and give them to your vet so that he understands the risk to Roxie and will not make the same mistake with any other patients.

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

http://www.cliniciansbrief.com/sites/default/files/attachments/CAP_Larger%20Dogs,%20Lower%20Trilostane.pdf

As Lori already mentioned, it would great if you could round up all of the testing that was done to diagnose Roxie and post the results here. With respect to the blood chemistry and cbc, you need only post the highs and lows and please include, the normal reference ranges. I don't recall if Roxie had an acth stimulation test or a low dose dexamethasone suppression (LDDS) test and would appreciate your confirming, along with the results. Was an abdominal ultrasound done?

I'm so glad you decided to join us. We're here to help you in any way we can. I know you are probably a nervous wreck and that is a perfectly normal emotion at this point for folks who just got the diagnosis. It's a frustrating disease that becomes a lot less frustrating as you learn more about cushings and Vetoryl. Please check out our Helpful Resources sub-forum. There is plenty there to help you learn and we're always here to answer questions and help you learn what we've learned from our own research and experience.

Glynda

[ddnene]

Hi Lori, my Roxie weighs about 70lbs. She has low thyroid, arthritis in her hips, and is suffering from a neck spur. The vet took her off of Soloxine for her thyroid condition because she was having issues tolerating that and of course then she suspected cushings. She gets Adequan injections every 2 weeks for the arthritis, and Sentinel is what we use for heart worm/flea treatment. I give her NuVet and NuJoint supplements daily. I feed her Merrick dry kibble (Chicken & Sweet Potato) and give her coconut oil daily. Unfortunately I don't have the findings from her urinalysis or blood tests, and NO she didn't do an ultrasound on her. I will ask her for a copy of that information tomorrow...

[ddnene]

Hi Glynda, I saw the articles that Dechra posted and I'm absolutely shocked that this information has NOT been shared in the US!!! I'm going to call my vet tomorrow and share this information w/her… I'm embarrassed to admit that I'm not positive what type of test that she had done I think it was the ACTH one. I'm going to check out your helpful resources, and I'm not going to give Roxie any meds until I talk to the vet about this medication. I can't THANK YOU guys enough for sharing this information… I feel completely overwhelmed :(

[camval1]

Hi Tracey,
My 58lb Airedale was just recently diagnosed with Cushing's and my vet wanted him to start with the 120mg capsules, once daily.
I had to insist that we start with the 60mg capsules once daily.

She wasn't happy with me, but I had to do what was right for my dog.

He's now on the 60mg capsules, started last Friday the 5th (today he got his 6th dose). I haven't noticed any adverse reactions at all,so I guess he's tolerating the meds OK.

See my thread here:
http://www.k9cushings.com/forum/showthread.php?t=6775

[molly muffin]

Hello and welcome to the forum. I'd definitely start with the 60mg since you have them in 60mg pills correct?
Double dose equals possibility of double trouble, where as starting low and slow, has less risk of problems.

[ddnene]

I just read your entire thread, seems like the same experience that I'm having. I just talked to my vet this morning, and she told me that she doesn't use manufacturers recommendations for medications. She consults her internists for her dosages, and what was recommended was 120mg. I insisted that we go SLOW and only give Roxie 60mg for the first 10 days. I don't think that she's happy about it, but she agreed that it would be fine for Roxie to have 60mg initially. She warned me that he dosage would more than likely have to be increased, and I told her that I was FINE w/that… I just want to take is SLOW.

I'm glad to hear that your baby is doing well so far… Keep your fingers crossed for me, starting the first dose in the morning…

[ddnene]

I DO have the 60mg tabs, and that is what I'm giving her in the morning. I insisted to my vet that I was going to be very conservative w/these meds...

[lulusmom]

Good for you, Tracey. You are a great advocate for Roxie. Apparently the specialist your vet is consulting with isn't up on the latest either, which is rather concerning. Hopefully your vet will accept your donation to her continuing education and will share it with her consulting specialists. No matter what, we'll be here with you every step of the way so please keep us posted. Also please let us know if you have any questions about anything you've found in our Helpful Resource sub-forum.

Glynda

P.S. I forgot to mention how glad I was to see that Mark shared Brick's experience with you. This happens more than you know so having Mark chime in was great. He's been there for other members as well. Thanks, Mark!

[ddnene]

I can't tell you how grateful I am to have found this forum… I'm going to take this literature to the vet. I'm glad to hear that I'm NOT the only dealing w/this issue, and hearing Mark's experience was an eye-opener. It's scary to think of how many dogs are getting TOO much of this medication… Thanks to you BOTH!!!

[ddnene]

Roxie had her first dose this morning, and I gave her the 60mg… she did have some bad gas later in the afternoon, which I fully expected. But she started shivering this evening… it wasn't bad, my daughter got her on the couch w/a blanket and she stopped. I honestly think that she was cold…

Is it normal for cushings dogs?!! I'm getting her blood work & urine test results tomorrow...

[Renee]

I think one isolated incident of shivering would not make me think she's overdosed... but, watch very, very closely for any other signs, or continued shivering. It could just be that she was cold.

Keep in mind, some dogs go through a type of 'withdrawal' when the cortisol is first being lowered. My own pug did this too, and we started low and slow at the beginning.

You are doing good!

[ddnene]

I think one isolated incident of shivering would not make me think she's overdosed... but, watch very, very closely for any other signs, or continued shivering. It could just be that she was cold.

Keep in mind, some dogs go through a type of 'withdrawal' when the cortisol is first being lowered. My own pug did this too, and we started low and slow at the beginning.

You are doing good!

Thank YOU!!! I'm keeping a close eye on her, and I'm so grateful that you guys are here to walk us thru this...

[ddnene]

Roxie has been on 60mg of Vetoryl for 4 days now… the only side effects that I had noticed was some mild shaking that only lasted about 30min or so. My vet has been in constant contact w/me these last 4 days… well the last 2 mornings Roxie has thrown up some of her breakfast before she got her meds. I had read that this was a common side effect of the Vetoryl. My question is this… I had JUST transitioned her to dry kibble about 2 weeks ago, but before that I was giving her raw patties. Should I just continue to feed her raw instead of the kibble? I would assume that the raw would be easier for her to digest, and I don't want to start another food trial w/everything else going on. I feel overwhelmed as it is… Thanks for any advice/input!!!

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about diet into Roxiw’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thanks!

[ddnene]

MODERATOR NOTE: I have merged your post about diet into Roxiw’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thanks!

Oh okay… Sorry!!! Lol

[Squirt's Mom]

No problem! :) Coming to a set up like this from Facebook is a bit different but I like this much better - it's SO much easier to keep up with each pup and it's journey here than on FB. ;) OH! I'm Leslie on the FB group. :D

[ddnene]

No problem! :) Coming to a set up like this from Facebook is a bit different but I like this much better - it's SO much easier to keep up with each pup and it's journey here than on FB. ;) OH! I'm Leslie on the FB group. :D

Oh HEY!!! Nice to meet you… AGAIN!!! Lol I guess I will just stick to questions on here… I can't THANK YOU enough for all of your advice :)

[lulusmom]

Hi Tracey,

Vomiting is not really a common side effect of Vetoryl, it is a sign that cortisol could be too low. It does drop cortisol rather quickly so some dogs will feel rather crappy due to cortisol withdrawal Vomiting at any time while on Vetoryl is not a good thing so always stop dosing until Roxie's appetite is completely normal again. When you add a new medication to a new diet it is always difficult to determine which one is causing the problem. Either way, it's a good idea to stop the meds until she's her cute normal self again.

I fed my own cushdogs a commercially prepared raw diet which they thrived on. All of my senior and medically challenged foster dogs also do extremely well on raw food. so kibble will never be a mainstay in my home. Diet is a really a personal decision based on our own research and experience. Sadly, there is little research to be found on canine diet and in my experience, kibble is strictly a convenience and not the healthiest choice for any of my dogs. I much prefer raw or home cooked. Can I ask why you decided to go from raw to kibble and what kibble you are feeding?

Glynda

[ddnene]

Hi Tracey,

Vomiting is not really a common side effect of Vetoryl, it is a sign that cortisol could be too low. It does drop cortisol rather quickly so some dogs will feel rather crappy due to cortisol withdrawal Vomiting at any time while on Vetoryl is not a good thing so always stop dosing until Roxie's appetite is completely normal again. When you add a new medication to a new diet it is always difficult to determine which one is causing the problem. Either way, it's a good idea to stop the meds until she's her cute normal self again.

I fed my own cushdogs a commercially prepared raw diet which they thrived on. All of my senior and medically challenged foster dogs also do extremely well on raw food. so kibble will never be a mainstay in my home. Diet is a really a personal decision based on our own research and experience. Sadly, there is little research to be found on canine diet and in my experience, kibble is strictly a convenience and not the healthiest choice for any of my dogs. I much prefer raw or home cooked. Can I ask why you decided to go from raw to kibble and what kibble you are feeding?

Glynda

Roxie's appetite has been fine… she is always hungry, I just noticed the last 2 mornings she has run outside to throw some of it up. She has actually done this before… that is the reason I took her off kibble in the first place. I thought initially it was that a certain brand of kibble, but now I'm thinking it's just kibble in general. I was feeding her Nature's Variety Raw Instinct Patty (Chicken) and she was doing great on it. The reason that I changed was 2 reason's actually… I have a bulldog on Fromm's (and he was VERY interested in his sisters food… Lol) and the expense. Her kibble is Merrick Grain-Free Chicken, and before that I had her on Earthborn Holisitic Meadow Feast. I believe that you are right… raw kibble is the best for dogs anyway you look at it. It's the most natural form of protein for them, and I want to make sure she is getting the best nutrition that she can.

[flynnandian]

my dogs are on a raw diet too! they thrive on it too.
i do feed them BARF too, so not only some minced raw food in rolls, but also meaty bones, fish, and e.g. whole baby rabbits etc.
snacks are dried raw meet too, no commercial ones.
if roxie is doing well on a raw diet and not so well on kibble, i know which choice i would make for her..................[and for your bulldog too]

[ddnene]

my dogs are on a raw diet too! they thrive on it too.
i do feed them BARF too, so not only some minced raw food in rolls, but also meaty bones, fish, and e.g. whole baby rabbits etc.
snacks are dried raw meet too, no commercial ones.
if roxie is doing well on a raw diet and not so well on kibble, i know which choice i would make for her..................[and for your bulldog too]

I went ahead and bought her some more raw patties, and I'm thinking of transitioning the bulldog as well. It just makes more sense to me in the long run...

[flynnandian]

i hope they will both enjoy it!
you can try some fish too, alaska pollack is pretty cheap, and some salmon for the omega 3.
drying your own snacks is fun too. natural and cheap.
meat, fish, fruits etc.
you can buy little electric ovens for +- 40$ made to dry food/snacks for humans and pets.
hope roxie is feeling better soon.