Chaka's servant

[Chaka's servant]

Hello, My darling little pom Chaka has just been diagnosed with Cushing's. I have just picked up Trilostane from his vet to commence treating him. Chaka has just had his 5th birthday. He has suffered from skin diseases since puppyhood and
he has lost most of his hair. He has been treated regularly with antibiotics for his chronic skin disease and recently with Prednil as a last resort to clear up his skin infection. We have had him on every conceivable diet and he has had numerous pathology tests. He has been on Thyroxine for last 3 months and as the results of his ACTH stimulation test he has been prescribed Trilostane. He is to have a further ACTH stimulation test in 2 weeks. He Does not have other sysptoms, such as drinking abnormal amounts of water or frequent urinating, although he appears to b:confused:e developing problems with his ligaments. We have 5 dogs, he is the father of 3 and other baby is their mother (not a planned family), all now desexed.

[mytil]

Welcome to our site - sorry you and your family are having to deal with the possibility of Cushing's.

I do have a few questions.

Was your Chaka on Prednil when the ACTH test was performed? (can you post the actual numbers here too).

One test does not properly diagnose Cushing's and there can be false positives. Was a LDDS test performed, an ultrasound?

How much Trilostane was prescribed? How much does Chaka weigh?

Sorry for all the questions, but the absence of symptoms do play a big part in the presence of and diagnosing Cushing's AND that means whether to start giving the medication or not.

Terry

[Squirt's Mom]

Just wanted to welcome you and Chaka...and say I love the handle - "Chaka's servant". All her life, my Squirt was the Queen of all she surveyed and I her humble servant. I had to smile when I saw your name as I knew just what it meant and how blessed you are.

[labblab]

Welcome from me, too! I have only a moment to post right now, but wanted to give you the link to another member's thread in which one of our staffers, Glynda ("lulusmom"), discusses a disorder called Alopecia X. As you will read, this disorder most commonly affects dogs of Nordic breeding such as your Pom, and the primary symptoms are skin abnormalities and loss of coat. An elevated adrenal hormone is often found in the profiles of these dogs, though not cortisol. Trilostane has been prescribed to treat this condition even in the absence of elevated cortisol, apparently with variable results. Has your vet ever mentioned the possibility of Alopecia X, especially since Chaka does not suffer from any other symptoms of typical Cushing's? Again, it will help us to find out the results of Chaka's ACTH testing so we can confirm that his cortisol is truly diagnostically elevated.

http://www.k9cushings.com/forum/showthread.php?t=4381

Marianne

[Chaka's servant]

Thank you so very much for your replies. It is such a relief to have you there to share this worry ordeal. We love all 5 of our dogs dearly and Chaka is a really gorgeous little personality. He is the head of his little family even though he is so much smaller than mum or their off springs. I work from home and I am with all day on most days. They make me laugh when I am feeling stressed and give me comfort when I feel down. Chaka is always the initiator of mischief and you know when he is about the set the family going. He just gets a naughty look about him and then he taunts the others until he get them all up and going.

Until recently Alopecia X has been considered to be the most likely culprit. Chaka has been seeing a vet who specializes in skin diseases for years. He has had numerous skin scrapings and biopsies done but Alopecia X is also difficult to diagnose and treat.

He has also had numerous blood tests conducted by his regular vet and about a month and a half ago his thyroxine count was low. He was put on thyroxine and then had a further blood test a month his count was high so his dose of thyroxine was halved. He was to have a further blood test to establish whether he is now on the correct dose of thyroxine which is now a little up in the air because apparently the Trilostane will also impact on his thyroxine count.

At the time he had the last blood test for the thyroid his vet suggested the he be tested for Cushing's. His knee joint had dislocated and the vet said that Cushing's can cause weakened ligaments, thinning of the skin making is susceptible to bacterial and fungal infections and loss of hair.

The tests were done by a specialist in Cushing's and he has had a number of tests done, including using two different processes.
unfortunately that specialist is in Western Australia which is on the other side of Australia from where I live in Sydney but she is recognized as the best in Australia.

Chaka's vet is unfortunately a very poor communicator. She does not explain anything and I get most of my information from the internet. She had not provided me any of the test results however, I will now be asking for them and get back to you.

Thank you again so much more than I can say.:)

[Chaka's servant]

Thank you Squirt's mom. Our furbabies just don't live long enough do they? The last thing we want for them is for their short lives to be marred by health problems or cruelty. We kept Chaka and Ellie's puppies because we just could not bring ourselves to trust anyone else to give them the life they deserve. I am so sorry that Squirt is no longer with you. The only comfort we can have though is to know that they have had the best life we can provide for them. Thanks again.

[Chaka's servant]

Thank you so much for replying Mytil. No Chaka was not on Prednil when he has his blood test. He has not been on Prednil for nearly 12 months. He was only put on it to clear up skin infections that were not responding to anything, including many different antibiotics administered topically as well has orally.

[Chaka's servant]

Hi Labblab, Thank you, I have read the thread to which you provided the link and the links referred to in the posts. I will certainly keep the information it provided me in mind. I suspect that the first step for me is to now get the test results of what has been done.

I have administered the first dose of Trilostane about ten minutes ago and I have Chaka with me so that I can observe any side effects.

Thanks again.

[Dixie'sMom]

I wanted to say hello and welcome. I have just read Chaka's story and am sorry you both are going through this. He sounds like a wonderful little guy. :)

I will be interested to see how he responds to the trilostane. Please keep us posted on how things are going.

Again, welcome. :)

[Chaka's servant]

Thank you for your welcome. He is just a delight, as we all think our animals are. Actually, I think all animals are delightful, but sometimes they don't get the parents they deserve.

This is Chaka's third day on Trilostane and so far he is OK. After searching the internet and reading solidly about Cushing's and the various treatments, including Trilostane since he was diagnosed I am so full of concern about possible side effects that I am not letting him out of my sight.

Tomorrow I must go out to work but I have arranged for a sitter that looks after the dogs when we are away to sit with him. She is very trustworthy and I will leave my mobile phone on while I am away, but I will be glad to get tomorrow over and done with. As I read it, the main period to be extra vigilant is during the period of establishing the correct dose of Trilostane and in particular this first two weeks.

I must admit that after reading the research on Trilostane I have taken it on myself to introduce the treatment at a lower dose than his vet prescribed. A paper that I read said that by doing so and increasingly the dose gradually appears to reduce the risk of serious side effects. I have asked for his test results and I will let his vet know what I have done when I pick up the results of his tests.

Again thank you for your welcome. I am asking tentatively how Dixie is, because I realize that a number of members have lost their furbabies but so kindly continue to support those of us who are commencing the journey.

[Dixie'sMom]

Thank you for asking about Dixie. She is fat and sassy and doing very well on 20 mg of trilostane per day. We were lucky in that she weighs 20 lb and the 20mg worked well for her. She has never displayed any adverse symptoms to the medicine and her symptoms (except appetite) have all improved. I had 2 vets want to start her at 30 mg per day and I told them I was uncomfortable with that dosage and lucky it wasn't too hard to get them to agree with starting at 20. Its good we did that or she could have gotten very ill. So yes, you are correct in your reading that "low and slow is the way to go." Just be sure to tell the vet what you have done. :) We will be there for you every step of the way.

Dixie is also a young pup like Chaka to have developed Cushing's so early. She just turned 7 the end of December.

How much does Chaka weigh and what dose are you giving him?

[Chaka's servant]

Thank you again for your support. I am pleased to hear that Dixie is doing well. I hope that both of our lovely furbabies do manage to have long lives. I was so distressed when I read that I could only expect Chaka to survive 2 years. Dogs live short enough without their longevity being halved.

I am also comforted to be told that I have done the right thing by reducing the dose of Trilostane that I started Chaka on. He is nearly 9lbs and I have started him on 10mg, so it sounds like I might be on the right track. I will tell the vet. I am just a little upset that the vet did not give me more information about the tests they did on Chaka and the results.

I was not really told anything about Trilostane, only that it is better than medication that was previously available. The nurse saw me when I went to collect the Trilostane and simply told me that if he starts to act "strange" to give him Prednil. I now feel better equipped to assert some control, at least to require the results of the tests and to ask more questions about the medication.

[Dixie'sMom]

The 10 mg is a good starting point for a weight of 9 lbs. Just be sure to follow up with the ACTH stim test at 10-14 days tell the vet that you are giving 10 mg instead of what they recommended.

I think the 2 year lifespan is totally outdated information that floats around the internet. Do not pay any attention to that. With close monitoring and proper treatment our girls can live out their normal lifespan and we will both do our best to see to it that they do! Right? Hang in there... you are doing great. And if you have questions, post them. No question is a dumb question.

[Squirt's Mom]

I was not really told anything about Trilostane, only that it is better than medication that was previously available. The nurse saw me when I went to collect the Trilostane and simply told me that if he starts to act "strange" to give him Prednil.

To me, this is poses the greatest risk factor for Vetoryl (Trilostane) - ill-informed vets who still believe this is a "safe" drug, who don't bother to keep up themselves or teach their staff any better, and who don't inform the parents of their clients about the dangers. If they would only sit down and simply read the product insert of the drug they are prescribing..... ;)

[Harley PoMMom]

I am also comforted to be told that I have done the right thing by reducing the dose of Trilostane that I started Chaka on. He is nearly 9lbs and I have started him on 10mg, so it sounds like I might be on the right track.

I believe that you absolutely made the right decision in starting Chaka's at 10 mg of Trilostane...Great job!!!


I was not really told anything about Trilostane,

We can help you out there, our Resource thread has a lot of info regarding Trilostane/Vetoryl, here's a handy link to it: Trilostane/Vetoryl Information (http://www.k9cushings.com/forum/showthread.php?t=185)

Hugs, Lori

[Dixie'sMom]

OOPS... I keep calling Chaka a girl. Sorry. :D :D :D

[Chaka's servant]

Chaka doesn't mind being referred to as a girl. He bathes in the love and care whatever you call him. Thanks again to all of you for the support. I have just picked him up from his sitter after leaving him for the day. He also bathed in her love and attention all day.

Hi Lori, thank you for sending me the link. I will read from it shortly.

Fortunately, I have always checked for myself about anything I am told my animals are suffering from and sought out my own information about proposed treatment. I suspect that the vet was extremely busy when I picked up the Trilostane but they have never been inclined to provide a great deal of information even when asked at that clinic, hence me doing my own research. On this occasion however, I am really very concerned. I am seriously considering changing our vet but I must be careful that I do not act in haste and put Chaka at risk.

Warmest appreciation to all

Lorraine

[molly muffin]

Hi, checking in to see how you and Chaka are doing.
I too subscribe to the start low and go slow with any medication. Hope everything is going well.