PDA

View Full Version : Hello from accross the pond (Chandler Pomerainian)



ChandlerBing
01-18-2015, 05:45 AM
Hi all,

Thought I'd read up on Cushings as my Pom was diagnosed in Sept 14. A year earlier he had been diagnosed with tracheal collapse for which he was prescribed small doses of prednisol steroid twice a day.

I only gave him small doses of the steroid when his 'goose honk' was particularly noticeable and he seemed happy with this. It cost a mere £5/$7.50 per month.

However in Aug 2014 I noticed a different type of lethargy and symmetrical hair loss across his rear section, only a week of excessive drinking. After 4 blood tests (the last one sent away) he was diagnosed with Cushing's and put on 10mg of Vet a month later due to his levels being 6 x the highest safe norm

In the Nov bloods levels of natural steroid in his system were 3 x the highest and in Dec it was increased to 20mg.

Weird that his initial condition required steroids and that his body seemed to be making it to compensate?. Downside of steroid levels coming down is that the goose honk is more noticeable. :(

However he now has developed a wheezing that makes his whole body convulse, these don't last too long with a cuddle usually helping clear these up.

He has rarely ever been physically sick in his 10.8yrs, I think maybe 2 or 3 times, his weight has come down from 7.2kg (16lbs) -to around 6.5 (14.5lbs)...his fighting weight is 5kg/11lbs, but as we know the Cushing's causes that loose skin and bloating. You've probs guessed he's not a teacup! Dad was an American show dog (5.2lbs) and Mum from the UK and a rather chunky 15lbs!:D

One thing I have noticed from this forum is that the prices of meds seem a lot higher stateside, for example I pay £60 for 60 x 10mg Vetoryl capsules which last a month. I think that works out to circa $90 of your USD. Mine would have been double but my vet agreed to match the lowest on-line price (so goes to show their mark-up!). Something that some of you may want to ask...after all you are paying your vet for everything else (tests etc)?

As he's a fussy/slow/unconcerned eater I can't mix with his food but open the capsule and tip it on his tongue, so to the questions:

1) Is it OK to give it to him neat like this,?I give him one in morn and one before bedtime, usually 12 hours apart, which I've read on here is OK

2) He is due to have bloods tested again (sent away) at the start of Feb which costs me about £80/$120. He was last tested in Nov when his dosage was upped from 10mg to 20mg. Vet said that every 3 months is fine and once settled it would only be required each year. Is that what you've been advised, is this normal?

He sleeps through the night without issues (snoring gently under my bed!) and luckily can get through a medium sized cat flap in our back door. He's never had an accident in the house as can take himself out! :)

Personal profile of Chand

He's a proud and rather weird canine in that he's never smelt another dogs butt (runs away if one tries to his...lol), also when he goes to the toilet he goes behind our conservatory so no one can see him. In all of his life he's never passed a stool anywhere but in his own back yard (or if we are away somewhere) I still carry bags though. Also I can probably count on two hands the number of times he's cocked his leg when on a walk. He's very gentle and I can take a treat/bone/biscuit away from his mouth with my mouth...he just says "well you probably need it more than me!" ;)

PS: He won't eat plain steamed chicken and plain wholegrain rice, he just sniffs it and walks off...if however it is seasoned with garlic, some black pepper and a little soy, he'll eat it...lol

His fave is marinated steak which I mince once cooked and THAT will disappear like most dogs eat dog food (20 seconds)

NB: I've noticed that stateside you all seem to have the print-outs of your animals tests, it's not the norm here in the UK, but will remember to ask my vet for a printed history.

More later!

ChandlerBing
01-18-2015, 05:46 AM
Oh, have noticed that many seem to lay out posts in rather large paragraphs, to me that is VERY hard to read, so forgive my excessive spacing :o

Squirt's Mom
01-18-2015, 09:38 AM
LOL Single sentence structure is very hard on my eyes. ;) I often don't read those posts if they are long because they give me a horrendous headache. My posts will at times contain 1 sentence paragraphs but only because that one sentence completed that thought process. Otherwise, all thoughts on one 'topic' go in a paragraph. I don't like reading posts that are all crammed together tho either. I like to read more normal writing - you know, whole words not text-speak, paragraphs, punctuation, and all that nonsense. :D

First, never ever open those capsules. That coating is there for a reason and to empty the content in the mouth prevents the pill from working as it should. In addition, Dechra cautions against this.

Adequan injections can help with collapsing trachea. One of the vets the rescue I work with uses it often and has had wonderful success treating this condition with Adequan. The pup will take 1 shot a week for something like 6 weeks then they are tapered down to less frequent intervals. The Adequan strengthens the cartilage in the trachea.

It would help a great deal if you would get copies of the actual test results and post them here. Both tests done to diagnose the Cushing's in Sept as well as all the ACTHs done since treatment started. He should have several by now. The testing schedule depends on how the dog is doing. If the med needs to be adjusted then the testing schedule starts all over at 2 weeks. Once the pup is settled on a dose and doing well, the ACTHs are given less frequently. You will find a great deal of info on Vetoryl (Trilostane) in our Helpful Resources section, including a flow chart on Vetoryl.

I'm glad you found us and look forward to learning more as time passes.
Hugs,
Leslie and the gang

ChandlerBing
01-18-2015, 09:57 AM
I did ask my vet as there is no way I can get him to eat a whole capsule. Tried with cream cheese a couple of times and he ate the cheese and spat out the (by now dissolving capsule). Can't imagine that it's THAT slow release if it dissolves in cream cheese so quickly?

I do know that stateside you can get trilostane in a suspension but not here, would defo make things easier for delivering in a syringe to the back of the throat.

Will ask about Adequan, the only option they gave me was stents in his throat, but with a heart murmur there's a high chance he'd not come back from anaesthetic.uan But possibly the Adequan may be a drug that's not available here.

Thanks again

labblab
01-18-2015, 10:55 AM
I can change your username for you if you'd like. Just tell me what you want it to be and I will make it happen. Just remember that you will need to shift to the new username when you next log in after you see that I've made the change. ;)

Marianne

P.S. 'Tis done! The username change is complete. :)

Harley PoMMom
01-18-2015, 12:22 PM
Hi and welcome to you and your sweet boy,

AWW, he sure is a cutie pie!! I've had 2 Poms myself and both boys were the larger type, Harley weighed 22 lbs and my Bear came in at 15 lbs, neither one was overweight just big boys! My Bear also had a collapsed trachea, the medications that were given to him were Terbutaline and Hydrocodone which really did control his cough.

The one thing that jumps out to me is that your boy was on a steroid. When a dog is given a steroid over a period of time they can get what's known as Iatrogenic Cushing's. Dogs with this type of Cushing's do have the same symptoms as the natural occurring type of Cushing's but the only treatment required for Iatrogenic is to slowly taper the steroid use.

Was your boy on the steroids when the test/s for Cushing's were performed? If so, steroids will register the same way that cortisol does on the diagnostic tests for Cushing's, so they will skew the results toward giving "false positives."

There are certain protocols that need to be followed when using Vetoryl: Vetoryl has to be given with food, and according to Dechra, the makers of Vetoryl, opening up the capsules is not advised; the ACTH stimulation tests have to be done 4-6 hours after the Vetoryl is given; after a dosage adjustment an ACTH stimulation test needs to be performed within 10-14 days. Are these protocols being followed?

Here's a handy link where you will find this information and more: 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 will help in any way we can.

Hugs, Lori

ChandlerBing
01-18-2015, 12:52 PM
I've in fact had 8 Poms...at the same time!!:D

Both parents, 5 puppies and a crazy teacup auntie (who's Dad won Crufts BoB in 2000).

He was prescribed a small dosage of steroid twice a day (half a tablet). I probably only gave it to him 3 times a week, so don't think it's linked.

Appreciate I cannot guarantee when he'll eat (unless it's steak) as he has always simply left food untouched...and then eaten it the next day. So given that he has to have his Vetoryl twice a day it is given to him on an empty stomach sometimes.

Yes Vet advised 5hours before tests he needs to be dosed

Oh, as they were born 24th April 2004 during the first two episodes of the last series of a rather well known American sit-com was aired in the UK...guess what the other puppies were called?? :D

Squirt's Mom
01-18-2015, 02:58 PM
3 times a week for how long? How long had he been off the pred when he was tested for Cushing's? It can matter; dogs who come in contact with humans who have used creams that contain steroids can develop Iatrogenic even tho the pup has not had steroids, only the human did. ;)

http://archderm.jamanetwork.com/article.aspx?articleid=554848


Topical corticosteroids are known to produce unwanted local side effects in humans and other animals. This is especially true of the more potent fluorinated corticosteroids. Systemic side effects in humans from these topical steroids are uncommon despite some laboratory evidence of pituitary-adrenal axis suppression.1,2 However, smaller animals, such as dogs, appear more susceptible to adrenocortical suppression from topically applied corticosteroids.3We describe a dog with iatrogenic Cushing's syndrome that resulted from the dog's systemic and/or percutaneous absorption of a topical glucocorticoid prescribed to treat the owner's psoriasis. The owner reported the previous death of two other dogs over the preceding 4 years. Both had diabetus mellitus and, anecdotally, had clinical signs suggestive of Cushing's syndrome, canine hyperadrenocorticism.

ChandlerBing
01-18-2015, 03:44 PM
Weirdly I have psoriatic arthritis, but no outward psoriasis, I do have a steroidal ointment but do not use it and it's locked safely away.

The prednisol Chand was prescribed was a total of 14 treatments per week, he got as a max 3 of the 14 per week, sometimes he didn't got any in a fortnight if he seemed happy. I did say in my initial post that he was diagnosed a year earlier with the tracheal collapse.

Dixie'sMom
01-18-2015, 03:49 PM
Hi and welcome to you and Chandler. He is gorgeous!

I know that all Cushing's pups don't all have the same symptoms but it's odd to me that he is so very picky about his eating. Most of them are ravenous eaters. It will be hard for Chandler to absorb the Vetoryl correctly without having a meal in his belly and a little fat with it. Will he eat peanut butter? What other things does he like that you could hide the pill in? I'm concerned that over time with the powder from the pill being put directly onto his tongue that he will start to experience some soreness or even ulcers in his mouth which will contribute to his not wanting to eat. Vetoryl is very strong medicine. If you absolutely cannot find anything to hide the pill in, it may be better to just "pill him" and push the capsule down his throat.

I look forward to getting to know your boy. I love the name! :D

ChandlerBing
01-18-2015, 05:07 PM
Of all of my 8 poms only two were ravenous eaters, Chandlers eating has been no different in his life, sometimes he'll not eat for a couple of days, I've gotten used to it.

Either he's bored with the food or just isn't feeling the need, he will however eat a maximum of 5 small biscuits and drink the normal amount of water.

This evening I put his tablet at the back of his throat and gave him a teaspoon of water immediately after and know he did swallow it (as opposed to it hidden in his voluminous fur!).

He'd had 3oz of chicken breast and cheese about 90 minutes earlier.

Harley PoMMom
01-20-2015, 09:50 PM
Oh, as they were born 24th April 2004 during the first two episodes of the last series of a rather well known American sit-com was aired in the UK...guess what the other puppies were called?? :D

This TV show is "Friends" right? So the other names would be Monica, Rachel, Joey, Ross, and Phoebe, yes?!!