Cushing symptoms return after 9 months

[kwisnep]

Hi everyone! Just wanted to say a huge thank you to this entire community - my 10yr old mutt Gus was diagnosed with Cushings in May 2014 after we noticed he was starting to have accidents in the house (even if we just let him out), started whining constantly, was lethargic, was always dying of thirst, and was losing tons of hair. When we first received the Cushings diagnosis, I, like everyone else on here, was terrified....but reading everyones posts and thoughts on this forum made me feel confident. And I can report that for the past 9 months, my Gus has been back to his normal self after being on 32mg of Trilostane...playful, happy, controlled. Its been very, very easy!

However, over the past month and a half, I have noticed he was starting to get a little whiny again, has had a few accidents in the house after I come home from work, and is also losing a ton of hair again. But hes still very happy and playful, ther are no changes really to his mood. My question to anyone on here is, can Cushings symptoms return if a dose is too low? Or do you perhaps think his Cushings is getting worse? As I read about the disease, may people say to give dogs at least 1mg per lb of body weight - however, Gus is 65lbs, but only taking 32mg of trilostane. As before, the first thing that goes throuh my mind is that he has a tumor and its growing and Im going to lose him - but Im hoping it might just be that he needs a higher dose? I have a vet appointment for an analysis in a week, but ill worry myself sick before then! So if anyone has had a simialar experience, would definitely be great to hear about the steps you took and the outcomes. Thanks again to everyone in this forum for sharing and making us newbies feel better!

-Jen

[labblab]

Hi Jen, yes, the most likely explanation for the rebounding symptoms is simply that Gus needs an increase in his dosing. In conjunction with rebounding symptoms, the results of monitoring ACTH blood tests will tell you whether Gus' cortisol is no longer being controlled sufficiently. It is not at all unusual for trilostane doses to require tweaking during the course of treatment.

Has Gus had any monitoring ACTH tests performed since starting on the drug? They are recommended at the 14-day mark, 1 month mark, and then every 3 months thereafter. If tests have been performed, it will be a great help if you can post the numerical results. If you haven't had a test done recently, you really need to have one done now to assess his current cortisol control.

Marianne

[LauraA]

It is common to have to adjust the dosage over time, that is why it is so important to have regular ACTH stim tests. They recommend every 3 months but if your dog is doing fine often the vet will stetch it out to 4-6 monthly to save some money :) We had to increase Bulgers dose by about 5mg after having good numbers for around 7 months.