New to Cushing disease

[rebecca]

Hello, I am hoping to hear good results with dogs with Cushing disease as my dog Charlie who is 7 he is a cocker spaniel X king Charles has just been diagnosed with cushings he is getting started on trilostane, the only symptoms he has is panting drinking a lot, the pot belly and hungry all the time! I just really want to know good storys of dogs that have been on trilostane. Rebecca

[rebecca]

My dog Charlie who is 7 hes a cocker spaniel x king Charles has just been diagnosed with Cushings he symptoms so far is drinking a lot , panting the pot belly and always hungry. I have been advised to put him on trilostane and despite the cost I am going ahead, I just wanted to ask if any has any good experience with this, and I really want some good news of other people dogs on trilostane.

[Harley PoMMom]

Hi and welcome to you and Charlie,

I have manually approved your membership so now all your posts will be seen right away. Also please just disregard the validation email that was sent to you from k9cushings.

Could you yell us more about Charlie, such as his weight and the dosage of Trilostane he is prescribed? Also could you post the results of tests they did to diagnose his Cushing's?

We have many members here that are using Trilostane/Vetoryl as their treatment for their dogs Cushing's and with success. Cushing's is a treatable disease but 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.

Here's a link from our Resource thread with info regarding Trilostane/Vetoryl: 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, and remember we are here for you both and we will help in any way we can.

Hugs, Lori

[addy]

Hi and Welcome, Lori has asked our usual questions we always ask of new members so we can give more meaningful feedback.

We are all shell shocked when we first hear the diagnosis. We just need to educate ourselves and then things are not as scary.

Cushings is a very difficult disease to diagnose so we try to make sure all the pieces seem to fit.

I'm glad you found us and look forward to getting to know you and Charlie. I have always loved King Charles Cav. Spaniel. Such a beautiful breed.

[molly muffin]

Hello and welcome. We have had dogs on trilostane medication for cushings for years and doing well.

It's true we all come here a wreck and then we learn and the more we learn, the better things go.

The key with trilostane is getting the dosage right. 1mg/1lb is the starting dose, don't go over that.

Welcome to the forum!

[rebecca]

Hi thanks for quick reply Charlie weighs 31.3 pounds he is getting starting on 70mg for 14 days then it will be reduced to 30 mg there after, I am sorry buy I don't have his test results, I just wanted to hear some positive things to keep me going thanks for your support

[LauraA]

Hi Rebecca :) Vetoryl/trilostane really has given my girl her life back. The recommended starting dose is 1mg to 1 pound of dog weight. If it was me there is no way I would risk starting on 70mg. I would start at 30mg then retest at 14 days and tweak up as needed. An overdose of this drug can put your dog into an Addisons crises. I am certain others will post the same. You are in a great forum and will gets lots of help and advice along the way. Dogs with Cushings do live out their natural lives so don't think it is a death sentence as it isn't. It does make it a bit more of a challenge to deal with some of those old age issues they may have but Cushings parents do it successfully everyday.

Laura
Bulger (Cushings grump), Maggie (just crazy and thinks she is still a pup)

[labblab]

Welcome from me, too! I just want to agree with the comments already made: it is safer and more comfortable when dosage is started at a lower level and adjusted upward if necessary, rather than vice versa. I have to assume your vet is wanting to induce an early rapid decline in cortisol, but I'm wondering to what purpose? Rapid lowering of cortisol in a short time can really make dogs feel unwell, even if the cortisol has not fallen below the desired therapeutic range. And with larger doses, there is always the chance that the cortisol can drop lower than is even safe. Here's a quote from Dechra (maker of brandname Vetoryl) that addresses this issue:


A small percentage of dogs may develop corticosteroid withdrawal syndrome within 10 days of starting treatment. This phenomenon results from acute withdrawal of circulating glucocorticoids; clinical signs include weakness, lethargy, anorexia, and weight loss1. These clinical signs should be differentiated from an early hypoadrenocortical crisis by measurement of serum electrolyte concentrations and performance of an ACTH stimulation test. Corticosteroid withdrawal syndrome should respond to cessation of VETORYL Capsules (duration of discontinuation based on the severity of the clinical signs) and restarting at a lower dose.

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

The safer alternative really would be to start off with the 30 mg. and then adjust upwards later on if monitoring ACTH results and clinical signs warrant an increase.

Marianne

[rebecca]

Hi all thanks for your comments, I suppose I was just trusting my vet I'm unsure if I should question it. It's good to hear other dogs live with this I have hope he will be okay

[labblab]

Me again! :)

I had forgotten earlier to give you the link to Dechra's most recent initial dosing recommendations. This recommendation revises the dosage amounts given in the chart contained in that Product Insert I had given you earlier. The older chart does give an initial dose of 60 mg. for a dog of Charlie's weight. But as you will see, Dechra's current formal recommendation now is to start at an amount no greater than 2 mg./kg., which translates into 1mg./lb.

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

Your vet may not even be aware of this new recommendation because we fear that Dechra has not done a great job of publicizing it. So even though I know it may feel really uncomfortable to question him/her, one approach would be to print out this information, tell him that you found it while educating yourself about the drug, and you are wanting to discuss dropping back to the new revised lower recommended dosing level for Charlie. ;)

Marianne

[Squirt's Mom]

Sweetheart, you should always question the vets, always.

[addy]

Well, it may feel uncomfortable at first but you are the only voice your dog has.

If you review the current dose recommendations with your vet, it should be easier.

[labblab]

Me again! :)

I had forgotten earlier to give you the link to Dechra's most recent initial dosing recommendations. This recommendation revises the dosage amounts given in the chart contained in that Product Insert I had given you earlier. The older chart does give an initial dose of 60 mg. for a dog of Charlie's weight. But as you will see, Dechra's current formal recommendation now is to start at an amount no greater than 2 mg./kg., which translates into 1mg./lb.

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

Your vet may not even be aware of this new recommendation because we fear that Dechra has not done a great job of publicizing it. So even though I know it may feel really uncomfortable to question him/her, one approach would be to print out this information, tell him that you found it while educating yourself about the drug, and you are wanting to discuss dropping back to the new revised lower recommended dosing level for Charlie. ;)

Marianne

Just wanted to make sure you see this link since it fell at the bottom of the preceding page.

[rebecca]

Hi all I am going to email my vet today I'll let you know how it goes

[rebecca]

Hello I'm still waiting nervously to hear back from my vet, im hoping that she understands and put Charlie on he lower dose. Laura you mentioned your dog is on trilstone does it work well for her, how long has she been on it may I ask? I am so nervous about Charlie going on this medication. Postiv stories would help me a lot so please share!

[LauraA]

Hi Rebecca. I was worried about changing to the trilostane from the Vetoryl as things were going so well. She has now been about 7 months on the Trilo and doing just as well fortunately. It has been just as effective as the Vetoryl but at a third of the price :)

We had no issues at all starting the meds, but like you I was a nervous wreck and worried constantly for the first two week. But we started the low and slow way and tweaked the dose up as needed. That is why it is important to start the dose low. You can always tweak the dose up but if you give them too much then then can be it for your dog, you don't always get another chance. That is why it is so important to do the 1mg to 1 pound of doggy weight. If your vet disagrees I would seriously look at going to another vet. It may be that you will eventually have to go up to 70mg in the end, but the safe way to do it is in small increases. Used properly this drug is a life saver.

[Harley PoMMom]

Hello I'm still waiting nervously to hear back from my vet, im hoping that she understands and put Charlie on he lower dose.

Ultimately YOU are the one that decides what dose Charlie is on, the vet recommends what they think the dosage should be. Sometimes we have to put our foot down and get aggressive with our vets because we are the only voice and advocate for our furbaby. I know it can be scary challenging the vet's decision but sometimes it has to be done. We're here for you and Charlie, ok ;)

Hugs, Lori

[Shelby01]

Hi Rebecca, welcome to you and Charlie!

My Shelby has been recently diagnosed with pituitary cushings. The folks on this forum have been SO helpful and supportive. My Shelby is 69 pounds on a dosage of 60mg trilostane for 14 days and then a recheck. We go in this Saturday to be checked. The 1mg per pound is the recommendation - like others have said, you can always work your way up as needed. It's always good to ask for a copy of the blood work so you can research and track progress yourself. Again, the wealth of information here is amazing!

Hillary ~ Shelby & Wrangell's mom

[Dixie'sMom]

Somehow I have missed welcoming you and Charlie to our family! :) A cocker and king Charles cross - Oh My. I bet he is the cutest pup ever! Please post pictures when you get time. One of my favorite parts of this forum is seeing all the sweet pup's faces.

I'm here to offer you more assurance that when the meds are used safely, our pups do well. The very worst of the Cushing's horror stores seem to be coming from the folks that their pups were overdosed early in the course of treatment. I had 2 vets try to start my doxie at 30 mg of Vetoryl per day and I had to just refuse this dosage. I told them I was uncomfortable with that dosage and that since she weighed 19 lbs, I felt better about starting at 20mg/day. My vet agreed and I was very thankful because I had no intention of starting at higher than 1 mg/lb. Dixie has done very well at that dosage and is thriving with good test results at the 14 and 30 day testing mark. And my vet has also been pleasantly surprised and pleased. If your vet is resistant to the 1mg/lb starting dose, I would change vets. No question about it. You have to be very firm about this for Charlie's sake. Too little Vetoryl is so much safer than too much. Starting at 30 and increasing slowly if his tests show he needs more, is the way to go.

Once Dixie's dosage was established I started getting her trilostane from a compounding pharmacy and the cost was soooooo much easier on the pocketbook!

So.... you can do this. And we will hold your hand every step of the way, but you have to trust us. The folks on this forum have real life experience with parenting Cush pups. Unfortunately, most of the vets in practice have never parented a cush pup. Charlie is your baby. Take every precaution as you would if he were a human baby. Best of luck to you and I hope your vet will agree to your request. It's so much better working as a team to get Charlie under control than feeling helpless and at the mercy of your vet. I'll be waiting to see your vet's reply. Hugs!

[rebecca]

Hi thanks for all your support I have spoken to my vet who has said he research shows 5mg per kg for the first 14 days, I have got a second opinion who also said the same. I am completely unsure about what to do, it so hard to make this decision as I have disputed this but she keeps reassuring me that her dosage is the correct dosage.

[Dixie'sMom]

Oh Geez... Ok. can you email them or fax or take by there the new recommendations from Dechra who is the manufacturer of Vetoryl? I'm reposting the link that Marianne provided for you.

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

(I tested this link in my preview and it timed out. You may have to copy and paste the link above into a new browser window to get it to come up.)

I know this puts you in a awkward position since 2 vets are telling you that their starting dose is correct. They are looking at outdated information. The link above provides information dated July 2014... the most current information. Dechra also has not updated their product inserts or their website with this information so its understandable that the Vet's office is resistant. Show him the new information and tell him you wish to start at the 1mg/lb dosage. Ask them if they will call Dechra and get the new dosing information if they are still resistant.

Maybe the others will chime in with some other ideas to get your vets onboard. Hugs and don't give up!

[rebecca]

Hi suzie thanks for your reply, I did actually email that to my vet and she stills says its 5mg per kg for the first 14 days.

[LauraA]

Rebecca my girl had an ACTH Stim test today so I asked my vet about the 5mg per kg for the first 14 days when I just rang her. She said she would never start a dog on that high a dose and she said she had never heard of that approach. I would ring Dechra myself and see what they have to say about that approach. I am sure they will say under no circumstances start at this dose.

[rebecca]

Hi Laura thanks so much for asking your vet, im unsure why I have been advised by two vets that the dosage should be 5mg per kg. I have emailed dechra as I couldn't get in contact with them over the phone, I am hoping I get a quick response as I just want this sorted! I have printed off the recommended dosage I was kindly sent by Marianne and im planning to take it into my vet tomorrow along with a trilostane management tree I have found http://www.cliniciansbrief.com/sites/default/files/2011JuneCBManagementTreeEndocrinology.pdf. I don't know what else I could possibly do, especially if the vet is advising the 5mg per kg even after me emailing her the links!

[LauraA]

I understand how hard it is to question the vet when it is all so new. We have all been through it :) There is so much information overload going on and stress at the same time. But there is a reason why the manufactures have reduced the recommended dosage to 1mg/1 pound, or approx 2kg per 1mg. And that is because of the incidences of dogs going into an addison crises and in quite a few cases the dogs have not made it (there a few threads here on this happening and it is heartbreaking). I know when we increased my girls dose about 6 months ago the vet wanted to go up 10mg but I refused and said 5mg was all I was willing to go up. Fortunately I did question her as my girl was on the lower side when we did the next test, luckily not in addisons. You vet should really do as you want as you are the one spending the money on the necessary ACTH stim tests that will be required. I also know that I am lucky to have a great vet that has had a lot of experience with Cushings and is willing to work with me, it really has made all the difference. I do understand that not everyone is able to be as fortunate as me. We all just want what is best for Charlie and I really hope your vet reconsiders starting at a more conservative dose.

[rebecca]

I would ring Dechra myself and see what they have to say about that approach.. you wouldn't happen to have there number I have googled it and found 01606814730. But will calling from Australia id need an area code

[LauraA]

Rebecca I am from Australia as well!! In Western Australia :)

[rebecca]

Rebecca I am from Australia as well!! In Western Australia :)

Oh really I'm from nsw!

[LauraA]

Just saw the pictures of your boy. He is just gorgeous!!

[rebecca]

Thank you, your dog is very cute. Fingers crossed I get this sorted with my vet will let you all know how I go, I am also going to try and get in contact with dechra 🐶

[rebecca]

Hi Laura me again! I have just called dechra who told me that my vet would have to call them, they couldn't give me any info unfortunately. I hope you don't mind me asking this but could I possibly have your vets number, so at least I have some backup! Thanks

[Squirt's Mom]

Sweetheart, those vets work for you, not the other way around - unless they are paying you to come to their clinic? ;) To start a dog on a dose that high would likely kill them, plain and simple. Those vets are wrong, plain and simple. I would request documentation FROM THE MANUFACTURER showing their 5mg/kg dose is correct. I dare them to produce it!

I know you are in Australia and things aren't the same over there as they are here in the US but you still have the right to protect your property, right? Then protect your baby from these vets who are simply wrong and will take your babies life if you listen to them. RUN! Find another vet today. Cushing's can wait but finding a vet who will talk with you and work with you as a team cannot. ;)

[labblab]

I think the ongoing problem is that the manufacturer's printed literature that accompanies the Vetoryl boxes still retains this dosing information:


The starting dose for the treatment of hyperadrenocorticism in dogs is 1.0-3.0 mg/lb (2.2-6.7 mg/kg) once a day based on body weight and capsule size (see Table 1). VETORYL Capsules should be administered with food.

So your vet's 5 mg/kg is actually right in the middle of that range, and unfortunately it is formally published in black-and-white. The problem is that the information is outdated and has been revised, as you now know.

I have no idea why your vet is being so obstinate in ignoring Dechra's newest directive. I would not call the 70 mg. a lethal dose, since historically there have been many dogs that have indeed been started out at that level. But just as Dechra says in their newest bulletin, the risk of unwanted side effects and the potential for problems increases when dosing is started at higher rather than lower levels.

If you have shown this new directive to your vet and your vet still chooses to ignore it and refuses to contact Dechra directly for confirmation, if you remain with this vet I think you have little choice but to simply refuse to dose your dog at a level higher than 2 mg/kg. As all have said already, you are the one paying the bills for the med and the testing. When starting at a lower dose, you are the one who actually stands to lose if you end up needing to increase the dose and test more frequently -- not the vet.

I have to say, though, I would like to be a fly on the wall in order to hear how your vet rationalizes ignoring Dechra's written directive that you have in hand. You know, you might ask him for an actual copy of whatever it is that he is going by, with the accompanying date!

Marianne

[rebecca]

I am so very greatful to you all for all your posts I have finally talked this through with my vet who has finally agreed to start at 30mg, and then tweak it up or down with his blood results.I am incredibly greatful because if it wasn't for all your support Charlie wouldn't of had the best treatment and with all your help, and your knowledge it helped me push this issue with my vet. They are now ordering in the 30mg so I will keep you posted when he finally starts. Thank you all so much I so appreciate all your help.

[Squirt's Mom]

Oh you done good, Mom! So proud of you! Now you will have a new relationship with your vet based on mutual respect hopefully. You have been a great advocate for Charlie!

[LauraA]

Sorry took so long to get back to you Rebecca, had a long day in hospital today in prep for an upcoming op. But I am so happy your vet has agreed to start more conservatively, you must be so relieved! And Charlie will have less side effects from his cortisone dropping too quickly. You have done so well and should give yourself a pat on the back (and a big cuddle for Charlie).

[rebecca]

Hello, My vet has called up and said Charlies pills are in there giving him the 30mg for 30 days its costing me $125:eek: Hopefully it will be worth every penny.
I know I have asked previously but some more positive stories about people dogs with Cushing would help me a lot! As I just want reassurance that dogs can live a long life with Cushings.

Thanks for all your support :D

[addy]

http://www.k9cushings.com/forum/showthread.php?t=5155

Trixie is approaching the two year mark for treatment. Barbara just posted an update, Trixie is doing well.

Bumps in the road are going to occur with a Cush pup, it is just the nature of the disease. Treatment does not cure the dog.

[Dixie'sMom]

YAY! I'm so proud of you! That is great news. I'm so glad you stuck to your guns and stood up for Charlie. OUCH on the cost of that Vetoryl. Hopefully you can get Charlie in range soon and you can switch to compounding if you want which is much cheaper. Let us know what day you plan to start him on Vetoryl and we'll hold your hand. (Be sure to give it with a meal) :) Great job Mom!

[LauraA]

So happy Charlie is starting treatment!! You must feel such a relief. Once you settle on the correct dose you can get them compounded from a reputable compounding pharmacy and it is much cheaper. Used to cost me $110 for 30mg Vetorly for 30 days, the trilostane costs me $170 for 100 tablets (so just over 3 months).

[rebecca]

Me again! Charlie starts on his 30mg of trilostane tomorrow (Friday) fingers crossed he'll be okay. :)

[addy]

We will be here for you:)

[Harley PoMMom]

All fingers and toes crossed that everything goes smoothly, which I bet it will, keep us updated. ;)

[tryan8]

Hello Rebecca & Welcome,
I am fairly new to the community here - only started in Dec. 2014, but I can tell you there is a wealth of information here and lots of support. My dog, Ginger, is a 60 lb. lab mix and she is on Vetoryl for 2 weeks. As a matter of fact she is at the vet today for her 14 day followup ACTH Stim test. Ginger has been on 60mg of Vetoryl for 2 weeks and I have already seen a major change in her water consumption and food. Please keep us posted on how things are going for you and Charlie.
Hugs,
Terry

[rebecca]

Hello, I've called my vet to book Charlie's blood test and unfortuently apparently in Australia they don't have the drug that tests the acth. So I'm really unsure now of what to do. Also I'm paying $125 for 30 trilostane 30mg and as he cant have his blood test they said they can't order it in bulk, so I feel like it's a lot of money I have noticed that you can buy it cheaper online myself, (noted from some of you)

http://compoundinglab.com.au/trilostane-30mg-caps-30.html?desktop=

It's actually a big difference in price, being $55 which is a massive save! I just don't know if it's possible for me to buy it myself. And I really don't feel like I could ask my vet.

[molly muffin]

Synacthen unfortunately doesn't appear to be available any longer or not for much longer and most countries are joining the US in switching over to Cortrosyn as the stimulating agent that will be used for ACTH testing.
Mention that to your vet.

In the mean time, get a baseline ACTH test and electroyltes test. You'll at least know if things are going too low.

I'd tell your vet you want a script for the medication and that you can get it much cheaper by ordering yourself and that you are going to have to do this as it is cost prohibitive to keep paying their prices when you can order it so much cheaper yourself. Unfortunately you do need a prescription to order the meds, so you'll have to get one from your vet.

I know, even using the compounding pharmacies here in Canada the cost is ridiculous expensive for trilostane. That is because everything Still has to be ordered by our vets.

[LauraA]

Hi Rebecca. I hear you about the Stim agent. Took my vet 6 months to be able to get any more, but they finally did receive the Synacthen mid January (I am in Western Australia). My mums dog just had to have the ACTH test last week as well and they were able to get some more in so it sounds like it is becoming available again. Maybe you could ring a few vets in your area and see if they have any in stock.

As for getting the compounded version, in my case my vet just faxes through the prescription to the compounding agency and I can have it delivered or go and pick it up.

[rebecca]

Hi called my vet to ask about the prescription they are willing to give me it with a $15 charge, so I'm pretty happy. Just now looking into what site is the cheapest can anyone recommend a site in particular? Charlie is doing really well he's been on trilostane for 2 weeks now and has no side effects😃

[LauraA]

Your Vet may have a recommendation of a reputable one that they use. That is what we did :)

[Squirt's Mom]

In the US, lots of folks use Diamondback Drugs. Not sure that can help you in Australia but it's a good reputable company. If nothing else, they may can recommend a good pharmacy there for you. ;)

[LauraA]

The one I use here in Western Australia is Maylands Compounding pharmacy, but I am on the other side of the Country and I am sure there would be one in your state. Are you on the Cushings group on facebook as there are a few Eastern Staters that may have some better suggestions closer to you.

[Squirt's Mom]

Good idea, Laura! I do remember folk on FB finding some compounding pharmacies there they were please with.

[rebecca]

Hello, The vet was able to do Charlies blood test on Tuesday I received back his results yesterday she was very pleased with his results and said Charlie could stay on the lower dose (30mg). I don't have his actual results to post sorry!

I am so happy with how he is going he isn't showing any side affects and I am starting to notice a change in his drinking habits, he also seems to have much more energy.

Thanks for all your comments regarding his trilostane I didn't even think of taking his script to the chemist! There is one 5 minutes from my vet that compounds, I am very happy with the price 100 capsules for $129.00 way better than the vet that was charging $256.00!

Rebecca+Charlie :)

[Harley PoMMom]

Glad Charlie is doing so well on treatment!! We sure would love to see those ACTH stimulation results, could you post them for us?

Hugs, Lori

[rebecca]

Hi everyone, hope you are all well and all your beautiful dogs are doing great! I can't believe it's been 10 months since Charlie was first diagnosed with Cushing diesase he is doing so well to which I am so great full he has had about three blood tests now, and is still in his 30mg trilostane with no side effects!! :D it has been a big year for Charlie he tore his crucial ligament in May and with the 6 weeks recovery it was not fun, he had to wear a cone on his head to prevent pulling his stitches and then we had to start him walking again. His leg healed up fantastically and he had a clean bill of health till just two days ago his mouth was really bleeding when he was eating took him to the vet turns out he had gingivitis. He also had three lumps on him which were worrying me thankfully they turned out to be just fatty lumps, but the vet did a lumpectomy when he was getting his teeth fixed just yesterday so now it's back to the cone on his head, and he's all stitched up hopefully he will make a speedy recovery:) would love to hear how your dogs are all doing

[molly muffin]

Awww, hope Charlie recovers soon and is back to his usual self. He has done just wonderfully on cushings treatment. So good to hear that!

[rebecca]

Hi all hope your all doing well! Just took Charlie in for his blood test which is normally $286 and was charged $445 as apparently the drug has gone up. Just wanted to know if any one else had experienced this? As it was quite a shock

[molly muffin]

If your vet is not yet using the freezing method for the ACTH test. Print out the protocols for,splitting and freezing and take in. I tip will help them to,keep,the cost down. If you have to buy the whole vial for the test it is way too much.

http://ctvrc.ca/internal-medicine-product-watch-cortrosyn-for-acth-stimulation/

[LauraA]

Rebecca mine is still the same price as it has always been and her test was done just a couple of weeks ago and included a kidney panel. Was around $260.

[rebecca]

Hello, I just got Charlie's results and he needs to come down to 20mg which is fanstatic news, only thing is I need to wait for the new tablets to be compounded so in the mean time he'll be off his meds until I get them, which I'm a bit concerned about but my vet said he could go for 7 days with out medication. Fingers crossed!

[lulusmom]

Thanks for the update, Rebecca. Can you please post the results of the acth stimulation test? You never know how quickly symptoms will return after withholding treatment so it is possible to see some symptoms return in seven days. However, I agree with your vet that one week off isn't going to be problematic for Charlie, especially if his acth stimulation test results were low enough to justify a decrease in dose.

Glynda

[rebecca]

Hi everyone, hope you had a lovely Christmas. Just a quick question in regard to dog food Charlie has to be on biscuits as he has a sensitive stomach at the moment I feed him super coat but have found he farts and poops a lot, I'm looking into the premium dog biscuits now $$ ha ha, and just wanted to know everyone thoughts on the best ones I'm looking at advance, hills science and Royal canin. I would love to hear your thoughts. :D

[molly muffin]

My dog is on Medi Cal low protein, but I like a Fromms for treats, and either a Fromms or Royal Canine age related to add into the LP. Just giving the LP (vet diet for protein loss kidney disease) gives her diarrhea, so she needs that bit extra.

Whatever you decide to go with, just make sure it is good quality and introduce it slowly into the diet, doing a transition.

[rebecca]

Hi oh I feel its been such a long time since I was on this writing to you all, I hope all your fur babies are doing really well. Charlie has had numerous lumpectomy surgery's he has just recently recovered from his latest one he is doing really well on his medication and doesn't have any symptoms I am so unbelievably happy. I have recently just had his blood tested long story short I normally dealt with a vet I was really happy with this time it was someone else who done it normally as well I would of gotten scripts to get his medication compounded after just paying for his blood test ive just been informed today that he no longer does scripts his medication was six times the amount I pay which has now totally stressed me out.

I wanted just to see if anyone can check his latest results, just to double check there still doing the right thing by me : Request Details: Lab Ref: 18-13543436 Your Ref: V189850 Collection: 04/05/18 00:00 Ref. by DR.PAUL ROBIN
Tests requested: Final report. Thank you for your referral.
Clin notes: Species: Canine,spaniel x,10y,mn.
Report: ACTH STIMULATION TEST TIME (Hours) CORTISOL (nmol/L) 0 54 (30-100) 1 85

I know this is a lot to ask but I know feel like my vet has really lost my trust..
Thank you all so much for reading this

Rebecca & Charlie

[Harley PoMMom]

Sorry to hear that Charlie has had several lumpectomies but glad that he is doing so well!! His recent ACTH stim test results look great ~ "CORTISOL (nmol/L) 0 54 (30-100) 1 85" and converted to ug/dl = pre - 1.95 ug/dl ~ post - 3.08 ug/dl. What dose of Trilostane is he on and has he been on this dose for a while? Also, was his ACTH stimulation test performed 4-6 hours after his Trilostane was given with a meal?

That's just so not right that the vet will not give scripts for his Trilostane, is it because of compounding? Brand-name Vetoryl usually can be found cheaper online, so if the vet just has a issue with compounding maybe he'd be okay with you purchasing the Vetoryl online.

Lori

[rebecca]

Hey thanks so much for replying, Charlie currently take 10mg of trilostane twice a day, 10 hours apart, Yes he was tested 4-6 hours after taking his medication. Oh i know it so bad that now i cant get scripts from my vet he was wanting to do the medication in house now probably a money making thing he was wanting to charge me $350 for 50 pills, which was a total rip off i was currently paying $120 for 200, as that did us for just over three months with taking the two a day. So now i have to look into something else as i know cant get the medication without a script so ill probably have to go to another vet. As i will not be back there after what hes just done.

[rebecca]

Also would anyone have any recommendations on when i should get his blood tested again how long can i wait?

[Harley PoMMom]

Since his recent ACTH stimulation test was in May, another one should be performed in August along with a Chemistry/CBC blood panel, unless of course, he seems to be doing unwell or symptoms worsen.