Paralyzed with Vetoryl in My Hand

[TrixiesMom]

Hi everyone. I wonder if any of you could answer a question for me? I have a 12-14 year old pup (a rescue so I don't really know her age) who has probably had Cushing's for many years. My vet was never very concerned about it so I wasn't either. I wish I had done more research but alas, "if wishes were changes..."

Anyway, my girl has all the classic symptoms but the one that finally made me act is somewhat labored breathing. Anyway, I am sitting here paralyzed with a Vetoryl pill. My vet did not give me any prednisone and what I wanted to know is this--

Is it remotely possible that her very first dose could cause the Addison's response? I want to start today but am fearful without having an emergency dose of prednisone. Do you guys think I can start today and call the vet first thing in the morning and pick up some prednisone then? She weighs 14-15 lbs and the dose is 30mg.

[Squirt's Mom]

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[addy]

Hi and Welcome,
I understand how fearful you are feeling. Could you possibly tell us what tests were done to make the diagnosis? Do you have the results? Does your dog have any other health issues? Has she ever been diagnosed with any heart problems?

The dosage given to you is higher than Dechra now suggests. Most are starting at 1mg per pound. My specialist did not given me prednisone when we started because she wanted my dog brought in to be seen by her if a problem arose. Easy to say except on the weekends.:)

Are you working with a specialist? How much experience does your vet have treating Cushings?

We see quite a few dogs start at the higher doses but honestly, it would be better to start at a lower dose and work up. It is better to bring that cortisol done at a slower rate. Do you feel comfortable discussing that with your vet?

Sorry this is so short, running out of time. You can always wait to start if you are feeling so nervous. Our Specialist told me the odds of having a serious event the first day are low. That was just her opinion. The larger dogs seem more sensitive to the the drug than the smaller dogs.

Others will be by soon to provide links for you. I just wanted to hold your hand a minute and tell you to breathe in and out and it is ok to wait if you are that nervous.

[Harley PoMMom]

Hi and welcome to you and your girl!

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.

Dechra's most recent recommendation is that dosing is started at a formula no higher than 1 mg. per pound (or 2 mg. per kg.). So for your girl's weight of 14-15 pounds, the 30 mg is a bit high. Vets may not be knowledgeable regarding this new initial dosing recommendations, so here is a link to that information: http://www.vetsonline.com/news/product-news/140722-new-lower-starting-dose-for-vetoryl.html

Although I think it is unlikely that the first dose will send your girl into Addison's I want to make you aware that Dechra does state in their published literature that hypoadrenocorticism (Addison's) can develop at any dose of VETORYL. http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf When Vetoryl is started at the recommended dose of 1 mg per pound of the dog's weight less adverse side effects are seen. Vetoryl has a short half life so if a dog starts to feel unwell, they will usually bounce back simply by withholding the dose. If this does not happen than a visit to the vets office is needed.

We always have a list of questions for our new members to answer which enables us to provide more meaningful feedback, so here are some of those questions: Could you get copies of all tests that were done on your girl and post those values that are marked abnormal with the reference ranges and units of measurement..e.g....ALT 150 U/L (5-50)...thanks! What test/s were performed that diagnosed her Cushing's and could you post those results too? Does your girl have any other health issues? Is she taking any herbs/supplements/medications? Is it known whether she has the pituitary or adrenal type of Cushing's? What exactly are her symptoms?

Well I think I have bombarded you with enough questions and look forward to hearing more about your sweet girl. And bless you for giving her a forever home.

Hugs, Lori

[TrixiesMom]

Thank you! I went ahead and gave it to her but I am going to call the vet in the morning and ask for a lower dose and some prednisone.

My little girl is quite a difficult case. She has epilepsy, a mild age related mitral valve issue, thyroid issues, horrible allergies and is a bit OCD and good grief I couldn't love her more. She takes potassium bromide, levothyroxine, Zyrtec and Lasix. I truly wonder now if she hasn't had Cushing's since the day I adopted her (when she was five-ish) and whether a little tumor isn't the reason for half of her ailments. I'm trying not to punish and torture myself with all the dreaded What Ifs. I know I won't have her much longer but I want her to feel as good as possible.

I do not have her results but will ask for them tomorrow, too.

[MBK]

I will let the others here respond to your medical related questions...you are in good hands with them. I just wanted to welcome you and tell you how beautiful Trixie's smile is. No wonder you are so in love. She is lucky to have you. It sounds like you have done, and continue to do, everything in your power to give her a good life. Wishing you the best in your continued journey with Trixie!

[TrixiesMom]

Have any of you Vetoryl users had a dog that reacted poorly? My 12-14 year old girl collapsed today. My vet gave me a starting dose of 30mg for my 14.5 lb girl. I was concerned about the high dosage and discussed it with my vet and we agreed to try the 10 mg but it was not in stock. After everything I read I decided to give her the 30mg on Sunday, then skipped a day, gave her the 30mg on Tuesday and then a 10mg on Friday. She was a little more lethargic than usual on Friday morning in hindsight but with Cushing's its so hard to tell. Anyway, 2 hours after her 10mg dose she collapsed. Thank goodness my vet was only a couple of blocks away. They gave her fluids, prednisone, and a diuretic. They couldn't decide what exactly was going on. My pup is epileptic so there was a chance she had a seizure and was/is postictal or she had the Addisonian response to Vetoryl.

I brought her home and of course her appetite is fine. She has always been food obsessed. She is still lethargic and she gets up, walks to the bowl, takes one sip, paces a bit, takes one more sip and lies down. This behavior seems very much like a postictal response but I wonder if it's the Vetoryl reaction?

Has anyone else experienced anything like this? The Vetoryl site said most recover quickly but in some rare cases it takes longer to get back to "normal". I'm beating myself up for giving her the 30mg pills even spaced apart. If she passes away from this I feel I will have caused her death to happen sooner than later.

[labblab]

You will see that I've merged your new post into your original thread about Trixie. This way, we will be able to keep track of her entire health and treatment history all in one place.

I am very sorry she is feeling poorly, and I surely understand why you are feeling so worried. As to whether or not this was a true Addisonian reaction, your vet should have been able to determine this fairly easily by analyzing Trixie's blood when you took her in on Friday. Did they check her blood chemistries and cortisol level? Is the vet still awaiting those results? If the blood tests turn out to be normal, then it is far more likely that the collapse was indeed a seizure, or some other issue. So to me, that would be the first step in the process -- clarifying what diagnostic testing the vet did or did not do on Friday.

If the blood results do point to sodium/potassium imbalance or low cortisol (Addisonian condition), the good news is that these abnormalities can be remedied and most likely the problems would only be temporary. But that would definitely mean rethinking the Vetoryl dosing from this point onward.

Marianne