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[Jan Porten]

I am so glad to have found this site. We have a 8 year old Shih Tzu/poodle, Bear, who was diagnosed with Cushings last October. His symptoms were weight gain, pot belly appearance, excessive panting and drinking water. We immediately put him on Vetoryl (30mg) and we had him on it for 4 months. He became lethargic, would not eat, and "depressed". He usually loved going for walks and we had to spell the word out if we were not actually going for one, but we could now call him for a walk and he would not come. The meds did do their job, his blood levels were spot on as normal. Despite that, we decided as a family to stop treatment. He is back to his old self, (very sociable and loving), loves his walks, and eats (sometimes too much!). His panting and water intake has increased and his fur is thinning, but he is playful, and energetic. I guess we have decided quality of life is more important than quantity with our best friend. I would like to know if anyone else has had trouble with meds for their furry friend? Thanks in advance.

[labblab]

Hello Jan, and welcome!!

I have only a moment to post right now, but the first and most important question I have to ask is: Can you obtain and post the actual numerical results for your boy's monitoring ACTH tests while taking the Vetoryl? We are wary when test results are described as "normal," because desired therapeutic results for dogs taking medication for Cushing's do not fall within the same normal ranges as those for dogs without the disease.

The negative changes you are describing while he was taking the medication do sound consistent with low cortisol, however, and that should have shown up as abnormal no matter what range you were looking at. So it may be the case that his cortisol level and blood chemistries were indeed within the desired ranges, but he just reacted poorly to the medication. In that event, there is an alternative to Vetoryl -- it is Lysodren, and we have many dogs here are being treated successfully with it. So that may be a viable option even if he did not tolerate the Vetoryl.

But first things first...if you can tell us those monitoring test results, that will be really helpful as we try to sort things out.

Marianne

[Jan Porten]

Thanks so much for responding. I will find his results right away and post them.

[Harley PoMMom]

Hi Jan,

Welcome to you and Bear from me as well! As Marianne has mentioned getting copies of those ACTH stimulation results and posting them here will able us to provide you with more meaningful feedback.

Another thought I have is this; two dogs can be on the same dose of Vetoryl and their ACTH stim tests show good control but they have totally different reactions. My meaning is that what one post cortisol works well for one dog may not suit another, and then an dose adjustment upward or downward may be needed.

Also, some dogs being treated with the same dose of Vetoryl over a period of time may have their cortisol drift downward too much and then a dose decrease is warranted.

Here are a couple questions that I have, how much does Bear weigh and what dose of Vetoryl was he started at? Is he taking any other herbs/supplements/medications?

When treating with Vetoryl, since it is a fat-soluble drug, it has to be given with food to be properly absorbed. Also, those ACTH stimulation tests should be performed 4-6 hours after the dose of Vetoryl is given. Were those protocols being followed when Bear was on the Vetoryl?

So glad you found us and we will help in any way we can.

Hugs, Lori

[Jan Porten]

Hi Lori

Thanks for your message. They did keep him for the day so they could administer drug and take levels certain times after the drug was given-I do believe they mentioned the 4-6 hour period. Bear has always been about 18pounds (sometimes down to 15 when he wasn't feeling good). He is now 25+ pounds and was started and kept on 30mg of Vetoryl.
His original lab results showed MO at 6% when norm is 2-4 and MCHC was 36 when normal was 31-34 and the rest seemed normal. I don't even know what this really means but to the vet they were able to diagnose cushings and he definitely looks like a cushings dog. I am just getting the vet to send over the lab results from his 2 month check after being on the Vetoryl as we have moved and are a bit chaotic and I can't find his results. I will post them when I have them but they said they were normal. Thanks for such kindness on this site. My Bear is my baby and I don't know what is best for him at this point. Thanks again :)

[labblab]

His original lab results showed MO at 6% when norm is 2-4 and MCHC was 36 when normal was 31-34 and the rest seemed normal.

Hi again, Jan. Those two results have to do with blood cell counts, and are not the results of either of the two diagnostic blood tests for Cushing's (either the ACTH stimulation test or LDDS test). So your vet really could not have based a diagnosis on those two values that you have given. So hopefully you will be able to track down the results of all the diagnostic testing that led the vet to believe that Bear has Cushing's.

Also, I am a bit concerned because it sounds as though only one monitoring test was done at the two-month mark, and yet Bear continued on the Vetoryl for two months after that? Even if that test was a monitoring ACTH test and the results were OK at the two-month mark, it is entirely possible that Bear's cortisol subsequently dropped too low. Was another monitoring test performed when he started to feel poorly? If not, the issue may simply be that he was overdosed on the Vetoryl, and would do just fine on a lower dose.

Actually, the recommended protocol is for ACTH monitoring testing to be performed two weeks after beginning treatment, then at the one-month mark, and then every three months thereafter as long as the symptoms are controlled and the dog is behaving normally. So just as soon as Bear started acting unwell, his cortisol level and blood chemistries needed to be rechecked to see whether his dose needed to be lowered. So as soon you can fill us in a bit more specifically as to the chain of events related to his dosing and monitoring testing, it will really help.

Is Bear being followed by a new vet now that you have moved?

Marianne

[Jan Porten]

Hello again,
I have actually booked an appointment with the vet next Tuesday again. When we lived in another province I continually took him to the vet as he was listless, had suffered small seizures, seemed to have abdominal pain (I as guessing as it was distended and he didn't like me touching him) and they did "tests" to see if they could find out what was wrong, but everything seemed to turn up normal. They did ultrasound of the abdomen as it was distended, they did blood and urine and all came back normal. That was in 2013 (the fall/winter). We moved provinces January 2014 and he was fine until the summer when he suffered another seizure, he was panting and thirsty, large belly and weight gain and we took him to the vet here. They did testing and the results I was given that I showed on my message is what I believe they told me was the reason they were able to diagnose cushings. Now I am second guessing myself so I will go in and get them to give me the results that led them to diagnose and then the results that showed "normal" during his time on the medication. His appearance is definitely a "cushing" dog but he seems happy and not in pain. He has excessive panting, and thirst and hair is thinning and big belly. I will follow up when I have more information from the vet. They seem to be very busy and want you in and out as quickly as possible and no time for explanations for us dog owners who don't know much medically about our pups sadly.
I will get information and would love your thoughts when I do.
Thanks again :)