Tiger666-Someone please help me!

[Tiger666]

My dog has had many blood tests and an X-ray. The vet says the X-rays were fine. No tumours but he has cushings. He also said it's in the early stages. We have to start Vetoryl tomorrow and i'm so scared after reading all the stories about it. My dog eats, drinks, plays, he seems happy and i'm worried he'll get sick with this medication.

I've read a lot of people saying it's important to find a Vet who knows what they're doing but how would i do that? Whatever the vet says we have to believe it and can't really question him too much even though i sometimes feel he's been misdiagnosed. Or just hoping...

I really don't know what to do. I know this is going to sound really over the top but this is ruining my life. I can't sleep, i feel sick all the time. I'm getting headaches. I'm yawning all day and falling asleep during the day. I can't cope!

Is there any other medication? Or just Vetoryl and Lysodren?

[lulusmom]

He and welcome to the forum.

We are here to help you understand cushing's a bit better and to help you figure out if your vet knows what he is doing. To help us do that, it would be very helpful if you can give us as much information about your boy as possible and provide answers to the questions below:

1. What was going on with your dog that prompted you to take your dog to the vet and what prompted your vet to test for cushing's?

2. Does your dog have symptoms associated with cushing's such as excessive drinking and peeing; voracious appetite; panting; loss or thinning of coat; skin issues; muscle wasting; muscle weakness, especially in the hind quarters; exercise intolerant; difficulty or unable to go up steps or jump on furniture?

3. Can you please get copies of all testing that was done by your vet and post the results here. With respect to the blood chemistry & complete blood count (CBC), we need only see the highs and lows, and please include the normal reference ranges.

4. An xray really isn't useful as a diagnostic tool for cushing's. An abdominal ultrasound is valuable. Did your vet do xrays or an ultrasound?

5. What breed is your dog?

6. How much does your dog weigh?

7. What dose of Vetoryl was prescribed?

8. Did your vet provide you with instructions to always give the Vetoryl with meal?

9. Did your vet provide you with instructions to discontinue treatment if your dog becomes disinterested in food, vomits, has diarrhea, extreme lethargy, cannot walk? If you notice any of these, stop treatment immediately and contact your vet.

10. Did your vet tell you that you were to bring your dog in for an acth stimulation test no later than 14 days after starting treatment?

11. Did your vet tell you which form of cushing's your dog has? Approximately 85% of dogs have pituitary dependent disease and 15% have an adrenal tumor.

12. Does your dog have any other underlying diseases and if so what are they and what meds is he taking for it?

13. There are other conditions that have overlapping symptoms with cushing's, such as hypothyroidism and diabetes. Did your vet rule these out?

I am so sorry for so many questions but your answers will aid us in helping you understand what is going on with your boy as well as provide you meaningful feedback. It will also help us provide you with appropriate questions you should be asking your vet, if necessary.

Cushing's is a very graded disease, meaning it progresses at a snail's pace. If you have any concerns or doubts about an accurate diagnosis, I highly recommend that you not start treatment until those doubts are erased. There is a lot of misinformation on the internet but having an experienced vet is absolutely correct. Cushing's is one of the most difficult canine diseases to diagnose, which makes it one of the most misdiagnosed. A lot of us have learned that placing blind faith in our vets is a really bad idea and our dogs are the ones who pay the price. You don't have to believe anything your vet says. If you don't understand what your vet is telling you to do, don't blind follow.....ask questions and make the vet explain things to you until you understand. We are here to help you learn so help us get started by answering all those questions. Now I have to go get my yams in the oven. :D

We're so glad you're here with us now.

Glynda

[judymaggie]

Hi! Take a deep breath and know that you have found a huge number of friends here. Glynda has given you excellent guidance and, even though the questions are many, your information will be essential to our in-house experts.

You absolutely can question your vet's practices, recommendations, etc. You are the paying client and, more importantly, your dog's advocate. My vet is a wonderful person and I consider him a partner in my dog's health and well-being. That said, as difficult as it was for me, I found it necessary to question one of his decisions and, armed with the resources that were provided to me here, he changed his mind with my dog and I expect with other Cushing's patients. You may well find your vet is open to information from vets who are Cushing's specialists and the resources section here is a great place for you to start reading.

[camval1]

Sorry to hear the news.

Unfortunately, just the 2 meds. And they have some nasty side effects if not given correctly.

I'm dealing with the same thing with my Airedale.
My vet wants to give him the 120mg trilostane capsules when he only weighs 58 labs (that's 2mg/lb).
Most updated protocols say it's safer to start at 1mg/lb.

I have to fight with my vet tomorrow to lower his dose.
Not fun.

[molly muffin]

Hello and welcome to the forum. I want to encourage you to go through Glynda's questions carefully and answer them for us. This will help us to help you. It can be scary when you know very little, but the more you know, the better you are able to take care of your dog and be an advocate for them.
We all rather felt nervous and scared when we first came here, but it's a great group, very knowledgeable and we all help each other.

[Squirt's Mom]

Hi and welcome!

I wanted to point something out - you do NOT "have" to start the med today. It will not hurt one little bit for you to wait...in fact it would be prudent to wait until you talk with us a bit and we can get some more info. So take a deep breath, answer Glynda's questions, chat with us a bit, then take it from there. There is NO RUSH to start treatment. ;)

I know how scared you are. I remember those first days and weeks after Squirt was diagnosed. It was awful, filled with tears, panic attacks, and frustration. But you and your baby are in good hands here just as we were. You are not alone on this journey. We will be with you every step of the way.

The most important thing I can tell you today is this - cush pups can and many DO live out their normal lifespan and beyond. So take that deep breath and know your new family is right by your side.

Hugs,
Leslie and the gang

[Tiger666]

Thank you everyone. I have such a bad headache right now.

He's a 9 year old Pomeranian. He weighs around 10kg. He's been prescribed 2 separate capsules. One is 10mg and the other 30mg that has to be taken together with a meal. He has to go for another blood test in about a week.

I was going to take him to the vet anyway for his vaccination but wanted a blood test because felt he has been drinking and urinating a bit. He's always been greedy with food fom the day i got him at 6 weeks old but he begs sniffs around the floor all the time after eating. I went online and saw cushings, so asked for a blood test. He does pant a bit. Not all the time!

He's had blood tests and an x-ray. Leaving him for that X-ray nearly killed me...

He doesn't have anything wrong with his fur, or doesn't have a problem going upstairs, jumping on furniture at the moment. Thankfully and he runs really fast. Looking at him and how he acts it's like there's nothing wrong with him!

He's never been on any medication before other than a long time ago he was given pain killers. Our German Shepherd stood on him when they were both running to greet family!

What do i need to ask for at the vet? I have to go i think on the 7th or the 8th. I don't want to have to go there before then because it makes me ill. So would i be able to ask when i go?

The vet did mention a word beginning with H when he called us about the results but it's just another word for cushings. Sorry can't remember how to spell it!

Sorry i forgot to ask...

If i start these meds tomorrow would i be able to stop them after his test? Or would i have to keep him on them once he's started? And does he have to take them at the same time everyday? We were told 8am but he's always had his breakfast around 9!

Also we were planning a holiday next year but really don't want to leave him. Do you all carry on as normal? I feel like i have to watch him like a hawk now. When we go on holiday my dogs always stay at home with my grandparents. We never leave them at kennels. I've babied them too much, i know that, but i won't ever change!

Thanks again x

[spdd]

Just want to add my 2 cents worth. My dog too was diagnosed with Cushings, then we even to him to the Ontario Veterinary College (university of guelph) in Ontario Canada. They confirmed it. Turned out all along that we do not believe my dog ever had cushings but in the process we almost put him down due to their sheer carelessness. The people on this forum are far more knowledgeable on Cushings, believe it or not, then a lot of veterinarians and they have proved it over and over again. We gave our dog nothing as the meds almost did kill him and he lived to be 15 yrs and 3 weeks. No sign of Cushings right up until the end, so please, please, take what they say on here as gospel. I know that may sound far fetched because it's a forum, but they literally saved my dog.

[Tiger666]

Just want to add my 2 cents worth. My dog too was diagnosed with Cushings, then we even to him to the Ontario Veterinary College (university of guelph) in Ontario Canada. They confirmed it. Turned out all along that we do not believe my dog ever had cushings but in the process we almost put him down due to their sheer carelessness. The people on this forum are far more knowledgeable on Cushings, believe it or not, then a lot of veterinarians and they have proved it over and over again. We gave our dog nothing as the meds almost did kill him and he lived to be 15 yrs and 3 weeks. No sign of Cushings right up until the end, so please, please, take what they say on here as gospel. I know that may sound far fetched because it's a forum, but they literally saved my dog.


This is what i'm afraid of. What am i supposed to do? I should have joined this forum before paying for these tablets. They cost £50 just for 2 weeks worth. Vets are vultures!

[spdd]

Answer all of Glynda's questions above. You don't have to start the meds right away as mentioned. One of my vets was so bad and he wasn't a spring chicken either that when I moved to this new town he actually had to bring out a book on how to do the proper testing and I had to tell him how far apart the draws were. It's amazing how little some know about this disease, but you are there for your dog and you alone.... so if in doubt at all, ask your vet questions, and if you don't like the answers, find another one that knows what they are doing. The vet that misdiagnosed Keesh, ended up giving me all my money back both from them and the college fee that was charged, however in the meantime I almost lost my boy..... so the best information you can get in my honest opinion is on here. The bad vet I mention looked after my dog for years and still they were wrong.

[Tiger666]

I've answered all the questions i can. I haven't got all his test results in front of me.

I'm a paranoid person at the best of times but my anxiety really is going into overdrive. The vet even said it could be of many things. So i'm asking Like what else? I don't get a proper answer. Finding another vet will be difficult because i don't know any one else. We've been going to this vet for over 15 years with other dogs as it's 1 minute away from us. We saw another vet at a different place who killed my German Shepherd years ago. We took him for an X-ray and they called us to tell us. This is a lot why i can't trust what anyone says!

[BettyF]

He's a 9 year old Pomeranian. He weighs around 10kg. He's been prescribed 2 separate capsules. One is 10mg and the other 30mg that has to be taken together with a meal. He has to go for another blood test in about a week.


Do you mean that the vet wants him to have 40mg of Vetoryl all in one go? This seems way too much to me for a dog that weighs only 10kg, but the more experienced here will advise you.

Please try not to stress too much, it seems very scary to begin with but you will get some excellent advice here and you won't feel so alone.

[doxiesrock912]

Please don't start the meds until you share the test results. The vet can't keep them from you. Dechra's protocol is to start low at 1mg per pound of the dog's weight.

[molly muffin]

I just have a minute, but I would say don't go over 20mg. At 10kg, your dog weights 22 lbs. So, either start with the 10mg or the 20 mg, but not both. That is ridiculous and we have such problems with the UK vets starting too high. If your vet where to call Dechra, then they would tell him, no more than 1mg/1lb as a starting dose is what they now advise, or 2mg/1kg
Here is a link you can print out and take to your vet:
http://www.vetsonline.com/news/product-news/140722-new-lower-starting-dose-for-vetoryl.html

As far as giving the meds, always give the dose with food, even on the day of the ACTH retest. The test should be done at 4 - 6 hours after the dose is given.

http://endocrinevet.blogspot.ca/2013/11/protocol-for-acth-stimulation-testing.html

[Tiger666]

Do you mean that the vet wants him to have 40mg of Vetoryl all in one go? This seems way too much to me for a dog that weighs only 10kg, but the more experienced here will advise you.

Please try not to stress too much, it seems very scary to begin with but you will get some excellent advice here and you won't feel so alone.

Thank you.

Yes on one box it says 10mg and the other it says 30mg. He's around 10kg. Maybe a little bit more. I will have to check with the vet, because he never keeps still on the scales!

[Tiger666]

Just spoke to the vet and he told me it says he's on the lower dose and that he's on the correct dose. So who do i believe? He did say if i'm really worried to just give him the 30mg to start. Then in 10 days to have his test!

This is really stressing me out!

[Robert]

You are getting some very good advice here. While there isn't a need to rush into dosing your bub one thing to keep on mind is that no outward signs of cushings does not mean it is not effecting 75the dog. My tommy had cushings and did not drink or eat excessively no pit belly etc but when they xrayed and diagnosed him with a completely unconnected to cushings kidney issue they also discovered that his adrenal glands were huge and pancreas was a funny shape both connected to cushings. There was also a couple of other minor things that I can't recall- I was very upset at the time as the unconnected kidney issue took his life that week.

[Tiger666]

He told me to start his medication because he needs it. (His words).

I don't suppose anyone knows a specialist in the UK? I'm in the Staffordshire area but obviously don't think i will find one here.

I'm up the creek without a paddle here!

[BettyF]

Just spoke to the vet and he told me it says he's on the lower dose and that he's on the correct dose. So who do i believe? He did say if i'm really worried to just give him the 30mg to start. Then in 10 days to have his test!

This is really stressing me out!

My vet wanted to Vera to start on 30mg but I ignored him and started her on 10mg. There are many people here who have far more experience of Cushings than UK vets do!

You don't have to do what the vet says.

My vet has told me many things about treating Cushings which I know are wrong. I just listen to him, then do what I believe to be right (after taking advice from people who do understand Cushings) I wish I had a vet who knew about the disease but unfortunately I don't. If I change vets there is no guarantee that the new vet would understand it either. At least this one does the blood and urine tests which I request and prescribes the Vetoryl which I ask for.

[Tiger666]

My vet wanted to Vera to start on 30mg but I ignored him and started her on 10mg. There are many people here who have far more experience of Cushings than UK vets do!

You don't have to do what the vet says.

My vet has told me many things about treating Cushings which I know are wrong. I just listen to him, then do what I believe to be right (after taking advice from people who do understand Cushings) I wish I had a vet who knew about the disease but unfortunately I don't. If I change vets there is no guarantee that the new vet would understand it either. At least this one does the blood and urine tests which I request and prescribes the Vetoryl which I ask for.

So shall i start him on 10mg tomorrow instead of the 30mg? and how do i get him to prescribe just 10 when he insists in 30-40? I can't make him do what i say as he's the Vet! :(

[Trish]

Hi

Yep he is the vet, but you are the owner and are the one putting those pills in your dogs mouth. You are the one paying the bills, so I always think I am also very involved in any treatment decisions and would never follow recommendations I thought could put my pet at risk, you need a vet you can work with as a team and we are seeing a few instances around the forum lately where that is not happening and I feel sad for them as it is stressful challenging them, but just do it calmly, present the information that proves your point and they really have no option but to listen and take on board what you are saying. Otherwise I would be out of there looking for someone I could work with.

So it comes down to you, I know the advice I would be taking is from these people who have a ton of experience with cushings as opposed to vets who might not see it as frequently as we do here. You have the information from manufacturers with dosage recommendations already provided. Read here and you can see all the complications that can arise from a dose that is too high to start with. Just because they are called "vet" they are not "god" (although some might think they are :D) so you must do what is right for your dog not just because you are told to do so.

Trish

[camval1]

I can't make him do what i say as he's the Vet! :(

Yes you can.

I JUST did with my vet.
(see this thread for details: http://www.k9cushings.com/forum/showthread.php?t=6775 )

She wanted to dose my 58 lb (27 kg) Airedale with 120mg of trilostane.
After consulting folks here, and talking with Dechra, I stood my ground and insisted on the 60mg dosage.
It has probably strained my relationship with my vet, but my dog is more important than a relationship.

[Trish]

And BRAVO to you Mark!! You did it in a positive way, presenting the facts like you did. I hope you have drawn a line in the sand in the relationship with your vet, she will know that you want to work as a team and are there not only as a loving owner but as a proactive advocate in the care of your dog. I honestly think this will improve the relationship you have with her. Well done you! I hope your example will empower others who face these tough decisions and help guide them to make the right decisions in the treatment of their pets :)

[BettyF]

So shall i start him on 10mg tomorrow instead of the 30mg? and how do i get him to prescribe just 10 when he insists in 30-40? I can't make him do what i say as he's the Vet! :(

Yes, he's the vet but he can't force you to give your dog something which you believe would be harmful. Be polite with him, but tell him that you want 10mg capsules so the dose can be adjusted if necessary.

[Tiger666]

I took the liberty and copied both of our posts from Lolita's thread into your boy's original thread. This way, it will be easier for our members to reply to you directly.


Hi and welcome to you and Lolita!

I only have a moment to post but wanted to share some of my thoughts.

In dogs with Cushing's usually high elevations are see in the ALP and the ALT is only moderately elevated. With the high levels from the bile acid test and along with those ALT values I am wondering if something is going on with her liver, has an ultrasound been performed?

Also, could you tell us what symptoms Lolita was displaying that led you or your vet to test for Cushing's in the first place? Is she taking any other herbs/supplements/medications?

Some dogs do well on Lysodren and some do not. The other drug that is used to treat Cushing's is Vetoryl/Trilostane, however a washout period of 30 days is needed when switching from one drug to the other.

With Vetoryl/Trilostane the starting dose can be initiated at a low dose, so for Lolita's weight of 13 lbs, a dose of 5 mg and no more than 10 mg would be appropriate to begin with. Has the vet mentioned using Vetoryl/Trilostane?

Is there a health reason as to why Lolita can not eat commercial dog food? There are some high quality canned/dry/raw dog foods which are much better than any grocery store brand.

Please know we are here for you both and we will help in any way we can.

Hugs, Lori


I don't understand when you say a low dose and not to go higher than that because on Dechra it does say a higher dose than you say!

[Harley PoMMom]

I don't understand when you say a low dose and not to go higher than that because on Dechra it does say a higher dose than you say!

Dechra has recently revised their initial dosing protocol and they now recommend a starting dose of 2 mg/kg, which when converted to pounds is 1mg per pound of a dog's weight. Information regarding this can be found here: http://www.vetsonline.com/news/product-news/140722-new-lower-starting-dose-for-vetoryl.html

[ShibaMom]

Hi Tiger666!

I hope you're also taking care of yourself through this. As you said, it can be so stressful, and it sounds like you have extra challenges, with your vet who seems to be not as receptive to other info (based on what I've read so far)!

I'm new to this whole Cushing's journey, too.

How's your pup doing? I hope he's well. Have you had any retesting done since he started on the medication?
It would be super helpful for everyone if you can get copies of his test results and share them here.

Hopefully your baby is doing well!

Regards,
Samantha

[Tiger666]

My dog was diagnosed in November last year. He was doing well but over a week ago he's started randomly yelping/sharp cry. not really sure how else to describe it, then jumping on us to pick him up, which i'm scared to do.

We took him to the vet and he was examined, the vet said he couldn't feel anything wrong but gave us painkillers, something beginning with C, sorry can't remember the name. He's still making those sounds.

He went for his blood test yesterday and the vet called to tell us his Cortisol is now low so to take him off the V tablets for a few days. Sorry i don't even want to spell it out. I suffer from severe anxiety and i've been put on antidepressants, i can't sleep, i can't do anything but have panic attacks all day long. I've stayed off the internet because being here right now makes me feel like i'm going to have a heart attack!

Other than the yelps he seems happy, he eats, drinks, plays, he does everything he normally does but he just randomly out of the blue does that cry and it scares me and it's not like we haven't taken him to the vet, we take him all the time for check ups.

Do you think it will make any difference now we have stopped the medication?

Are there any natural/herbal medicines i can try?

[molly muffin]

Okay, first things first, Deep Breaths.

Do you have the ACTH number from the test? If so can you post it please? If not can you call the vet and get it. That will let us know how low he has gone.

Was his electrolytes tested also? They can get out of range with an Addison crisis, so you want to be sure that isn't what is causing the yelping. If it is ,they give them fluids to help stabilize those levels.

You aren't going to be stopping for a few days. When you have a crisis, you stop until symptoms come back and then retest and start at a lower dose.

What does was he on? How much does he weigh.
Any other abnormalities in his blood work? If so can you post that too, the high lows only.

The more information we have the better we can answer your questions.

Now more deep breaths. You aren't alone now, not ever. You have a whole forum of people who will be there to support you through this.

Hang in there. Likely the cortisol Will come back up in a week or so, depending on how low he actually went and then you would just restart at a lower dose.

Welcome to the forum

[Tiger666]

Thank you so much for replying. I really don't know what to do anymore. I know i won't sleep tonight.

I really believe this vet doesn't know very much regarding this and i don't know where else to go. He weighs around 10kg but he gained a bit of weight over Christmas with all his Christmas treats, so he was just over 10kg. Then we cut down and he's just under now.
The vet kept insisting starting him at a ridiculous dose like 40, which there was no way in hell i was going to do. So i gave him 30. Well started at 10 mg then 30 because his blood tests were high. Then 40 and then 50 which is too much so i just gave him 40mg but on the day of his test 50. The test came back perfect so told me to carry on 50mg for 3 months until next checkup. Really i was giving him 40mg. So yesterday when had his test i gave him 50mg.

Sorry if i'm not making any sense.

I can't stop shaking.

I will call the vet tomorrow to ask for more information. Should i ask for some pain killers as he's off his other meds? Or won't it make a difference?

Really not looking forward to it, the receptionists a right miserable dragon and makes me feel so uncomfortable. I find them very heartless.
The vet told me he knew about cushings but looks like he knows nothing. I'm so scared!

My Mum also had cushings but had her tumour removed. Can you believe it? What are the odds the two most important things in my life. I really can't cope anymore!

[molly muffin]

Okay first off, you can't be changing the dosage up on the day of the test, not only that you are actually messing with his body, which you do not want to do. You want to lower the cortisol at a consistent level. No bouncing around. Right now the question is whether he is in an Addison crisis as your vet has suggested or what exactly is going on.

I see you gave the weight in kg, are you in UK, Canada, Australia or something? I am in Canada. The difference is that some places you can get trilostane compounded and some you can't. Which might offer you different options as far as dosage goes when you get to the point that he needs it again. Right now, he doesn't.

At 22 pounds (10kg) he should have been started on 20mg of vetroyl. An increase should not have been done till after 30 days. I am unsure what the results of the test are even going to tell us right now as by increasing the dose on testing day, you would have zapped his cortisol downwards and it might not be reliable. Hopefully though we can tell something from the numbers, so definitely get those.

No I wouldn't be giving anything, and it isn't that kind of pain that makes them yelp with low cortisol usually. Most often yelping from what I am have noticed is caused by electrolyte imbalance, but we don't know that for sure till we know if they tested his electrolytes and then see what those results are.

Hang in there.

[molly muffin]

Just to be clear, our next step is, call the vet, say you want to get the numbers of the ACTH test and ask if they checked his electrolytes. You also want the numbers for any blood work that was high or low, with ranges. Easiest is to just go pick up a copy of the test results.

[Tiger666]

I didn't know i was doing wrong but thank you for explaining everything. I wish you were our vet lol.

Speaking of the vet, he didn't even mention Addison's.

Should my dog get re-tested before we start his medication again?

And yes i'm in the UK :)

[molly muffin]

So it may not be an Addison crisis, just low, and it might be low because you gave him extra before the test. We'll need to see the numbers so we can try to figure it out.

We're just people who have been in the same position and worried about the same things. We always advocate to find a good vet that you can work with that has a lot of Successful experience with cushings.

One thing is that it is not uncommon in the UK for vets to start higher than lower, but the new guidelines from the manufacturer say to start at the low end which is the 1mg/1lb

We'll just see what you can find out and go from there.

Hang in there!

[Squirt's Mom]

Hi and welcome to you and your baby! :)

We gonna have a little chat, you and I. See I know exactly what you are feeling right now - that boulder sitting on your chest making it impossible to take a deep breath, that painful plug in your throat keeping you from voicing your thoughts, and the thoughts, oh my the thoughts, that are constantly dashing through your mind, horrible, horrible thoughts. The what-ifs and if-onlys. And the intense emotions that are always just beneath the surface ready to burst forth in an unstoppable flood. Eyes burning from tears just shed or those held back. Nothing makes sense that you read or hear tho you desperately want that info to answer the multitude of questions you carry. Fear, grief, and guilt color every aspect of your world at the moment. Yes, I know exactly how you are feeling because I felt the same way when Squirt and I first started down this path.

But these kind folk here saved us both and taught me what I needed to know to help my Sweet Bebe. They held my hand over every bump and mountain, they rejoiced with every triumph we experienced. They became our family. Now you and your baby boy are family, too.

From talking to a few folk, Cushing's seems to be worse in humans than it is in dogs. So don't compare what your mom had to endure to what your pup may be facing. In dogs, this is a very slowly progressing condition typically taking years to do any permanent damage to the organs. With treatment, a level of normalcy can be achieved and the pup live out their normal lifespan and beyond.

You and your baby boy are in good hands here. You are no longer alone on this journey. We will be with you every step of the way. Don't hesitate to ask questions and we will do our best to help.

I'm glad you found us. Now take a deep breath, lay your head back, and relax your shoulders. You are home and safe.
Hugs,
Leslie and the gang

[Tiger666]

Hi and welcome to you and your baby! :)

We gonna have a little chat, you and I. See I know exactly what you are feeling right now - that boulder sitting on your chest making it impossible to take a deep breath, that painful plug in your throat keeping you from voicing your thoughts, and the thoughts, oh my the thoughts, that are constantly dashing through your mind, horrible, horrible thoughts. The what-ifs and if-onlys. And the intense emotions that are always just beneath the surface ready to burst forth in an unstoppable flood. Eyes burning from tears just shed or those held back. Nothing makes sense that you read or hear tho you desperately want that info to answer the multitude of questions you carry. Fear, grief, and guilt color every aspect of your world at the moment. Yes, I know exactly how you are feeling because I felt the same way when Squirt and I first started down this path.

But these kind folk here saved us both and taught me what I needed to know to help my Sweet Bebe. They held my hand over every bump and mountain, they rejoiced with every triumph we experienced. They became our family. Now you and your baby boy are family, too.

From talking to a few folk, Cushing's seems to be worse in humans than it is in dogs. So don't compare what your mom had to endure to what your pup may be facing. In dogs, this is a very slowly progressing condition typically taking years to do any permanent damage to the organs. With treatment, a level of normalcy can be achieved and the pup live out their normal lifespan and beyond.

You and your baby boy are in good hands here. You are no longer alone on this journey. We will be with you every step of the way. Don't hesitate to ask questions and we will do our best to help.

I'm glad you found us. Now take a deep breath, lay your head back, and relax your shoulders. You are home and safe.
Hugs,
Leslie and the gang

Thank you so much for your kind words. I'm just really annoyed, as my little baby seemed to be doing well and now he keeps crying. Even when he doesn't do it i'm sitting there waiting for it to happen. It's just an awful sound, makes me jump. Then we go to comfort him and i'm scared to touch him even though he wants us to pick him up! :(

I'm just waiting for them to print out the results. I will update you all tonight!

I'm so glad i've found you all.

Thank you xx

[mytil]

Hi and a belated welcome from me. I truly am sorry you are dealing with both Cushing's and the vet problems.

Here is a link that may help in finding a specialist in the UK - http://www.k9cushings.com/forum/showthread.php?t=183

Any troubles looking this up, let us know. We are all here to help you and your pup through this.

Keep us posted
Terry

[Tiger666]

Hi again,

My mum just picked up a piece of paper from the vet. They told me they'd print it out but he's written some things i haven't got a clue.

I will write them the way i can see it.

15/01/15 Cortisol 46.1 Post Cortisol 107 (Correct response for dog)

18/03/15 Cortisol 27.6 Cortisol Post 27.6 (Post ACTH too low. Stop meds for 5 days then restart lower dose).

In front of the 27.6 theres a squiggle, don't know if that's meant to be a number/line or anything else!

I hope this helps a bit!

[Harley PoMMom]

Hi again,

My mum just picked up a piece of paper from the vet. They told me they'd print it out but he's written some things i haven't got a clue.

I will write them the way i can see it.

15/01/15 Cortisol 46.1 Post Cortisol 107 (Correct response for dog)

18/01/15 Cortisol 27.6 Cortisol Post 27.6 (Post ACTH too low. Stop meds for 5 days then restart lower dose).

In front of the 27.6 theres a squiggle, don't know if that's meant to be a number/line or anything else!

I hope this helps a bit!

So these ACTH stim results are from January of this year? And no other ACTH stim tests have been performed since then? These values, are they in nmol/L? I am assuming they are, and converting to ug/dl, which is the units we are used to seeing; pre and post is 1.0 ug/dl. This is way too low, meaning your boy was/is in an Addison's crisis and needs to be given prednisone and possibly mineralocorticoid supplementation too. How is your boy doing right now? Did the vet give you prednisone to keep on hand in case of an emergency such as this?

Hugs, Lori

[Tiger666]

Nope the "Vet" hasn't given us anything, that's what i'm telling you all, it seems like he knows sweet FA about this and it's making me very angry. All they're good for is taking my money.

One time i said i'm just going to put my dog in the car and i'll be back to pay in a second & the receptionist chased me out. Such vultures.

Anyway all i've been told is to wait 5 days and then start on a lower dose. I really don't trust them. I trust you all far more than i trust a vet. How bad is that?

Btw sorry i made a mistake the 18th is actually March, meaning yesterday not January. I've now edited!

[Harley PoMMom]

Sweety, in no way do I mean to scare you but, you really need to get your boy on some prednisone, those ACTH stim numbers do reflect a dog in an Addison's crisis, which can be life threatening. His electrolytes need to be checked also.

Absolutely do not start the Vetoryl until he has had an ACTH stimulation test showing that his adrenals are producing enough cortisol, ok?

I am glad to hear that he is not throwing up or having diarrhea.

[Tiger666]

Ok thank you. I will call the vet tomorrow. Will it be ok to wait till then because it's 10 in the evening here.

Can i ask, why hasn't the vet told me any of this??? & told me to start in 5 days???

[labblab]

If your dog is acting normally (eating, drinking, no vomiting or diarrhea), then it is probably OK to wait until morning to contact the vet. Since you did give him the higher dose of Vetoryl on the morning of testing, it may be the case that his cortisol level was not typically running that low, and it may already be rebounding since the medication has been stopped. So if he does not exhibit any ill effects, he may not need to take prednisone. But as Lori says, you still need to have it on hand in case he does worsen unexpectedly.

Some of the published instructions for Vetoryl do say to stop the drug for a few days if cortisol has dropped too low and then restart at a lower dose. But many vets who use the drug regularly do not believe it is safe to restart again until testing has proven that cortisol has again rebounded to a higher level.

Marianne

[Tiger666]

I realize i'm to blame here aswell but this is because i don't feel comfortable with what i've been told. I don't mean to be rude about the vet but i can't help it. This dog means the world to me.

I don't want to jinx it but he hasn't cried at all since this morning. I hope he's feeling better. I'll keep an eye on him until i call the vet in the morning.

Thank you again to everyone who has replied to me!

[Harley PoMMom]

Please don't beat yourself up, it's not that uncommon for general practitioner vets and even IMS' to lack the knowledge and experience with the proper protocols in treating Cushing's. Many of us have learned this the hard way, our dogs pay the price for placing blind trust in our gp vet. We pay the price too on an emotional and financial level.

The best advice I can give you is to educate yourself regarding canine Cushing's so that you don't have to take anybody's word for what is best for your boy. You can find some great reference material in our Helpful Resources sub-forum to help you understand the steps in diagnosing a dog, the treatments used, adverse reactions to those drugs and even a great deal of information on concurrent diseases like diabetes and hypothyroidism. Here's a link: Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10)

If you have any questions don't hesitate to ask them. ;)

Hugs, Lori

[Tiger666]

Just spoke to the vet. The one we normally see isn't there today so spoke to another one.

It took me a while to get to speak to her. I always find the receptionist very rude and believe it or not i've never once been rude to them. She said "So you believe someone who isn't qualified over a vet!" All i did was explain the problem and i mentioned "prednisone" which they've never heard off. She said they use so something called something cordisol.
So what am i supposed to do? I'm so lost.

I've booked him in for another test on Monday!

[Squirt's Mom]

A vet who's never heard of prednisone?! Run, run very fast from this vet, that is what you do. geez....they are either inexcusably ignorant of their own job or arrogantly dangerous, or both. Either way, no way I would let this vet treat my dog for anything especially not something as complex as Cushing's.

Starting today, your job is to find a vet who will treat your baby right. ;)

[Tiger666]

A vet who's never heard of prednisone?! Run, run very fast from this vet, that is what you do. geez....they are either inexcusably ignorant of their own job or arrogantly dangerous, or both. Either way, no way I would let this vet treat my dog for anything especially not something as complex as Cushing's.

Starting today, your job is to find a vet who will treat your baby right. ;)

I don't know where else to go! :mad::(

[molly muffin]

The vet can and should call dechra the manufacturer for guidance.

It isn't about believing us over a vet. We believe in being team players With our vets. They should however believe the manufacturer of the drugs they use. They should read the latest research that comes from experts in the field of Cushing's.

Is there no other vet within driving distance or vet hospital. Or emergency clinic?

[Tiger666]

I called a specialist but they said the vet has to refer us. Then i called another vet which is close to us but they wanted to know who are vet is now. The lady on the phone told me they have a few animals being treated at the moment and it's just managed with medication, which i already know.

I think i'm going to go to the appointment Monday morning and speak to the main vet and see what he says!

I know my mum isn't a dog lol and it's different but when she was having treatment she says they gave her medication when she was low etc, so don't know why these people don't!

[Harley PoMMom]

Some vets/IMS' feel that since Trilostane has a short half-life, meaning it leaves a dog's system quickly, there is no need for a pet parent to have prednisone on hand. And when a dog does show signs of their cortisol dropping too low sometimes just stopping the Vetoryl perks them back up. I am hoping this is the case with your boy because he is not vomiting, not having diarrhea, and is drinking/eating normally, which are really good signs that his adrenals may be starting to regenerate.

Keep us posted, ok ;)

Hugs, Lori

[Tiger666]

Some vets/IMS' feel that since Trilostane has a short half-life, meaning it leaves a dog's system quickly, there is no need for a pet parent to have prednisone on hand. And when a dog does show signs of their cortisol dropping too low sometimes just stopping the Vetoryl perks them back up. I am hoping this is the case with your boy because he is not vomiting, not having diarrhea, and is drinking/eating normally, which are really good signs that his adrenals may be starting to regenerate.

Keep us posted, ok ;)

Hugs, Lori

Thank you, i will..:)

[molly muffin]

One possibility is to tell your vet that you would like to go see the specialist and get a referral. I had to do that. It worked.

[Tiger666]

Took my baby to the vet today, he examined him very thoroughly, he told us it wasn't necessary to have a blood test today but i wanted one anyway, so we did. The vet called us and told us everythings functioning fine, and to start on a lower dose.
Also when i told you all the other day the vet i spoke to on the phone didn't know about prednisone but the vet we normally see knew about it. Which i'm relieved about.
And now he's not low anymore he's no longer yelping which is a relief.

I also want to thank you all for helping me through the last few days. Honestly felt like hell. So thanks again!

Until next time hey!

[Harley PoMMom]

Please get those ACTH stimulation results and post them here for us. We have seen many a time a vet state that the dog's results are good when in fact they are not, so please do get a copy of those ACTH stim results and post them.

[Tiger666]

Hi,

Yes i have no idea what this means but i was told...

141 then they told me something between 20 and 250

Then after

381 and something about between 60 and 550.

I hope you know what this means because i don't. What is it meant to be? Like what should the perfect number be?

Sorry i also forgot to mention, they have this new system where instead if going back 2 hours later you go back in an hour. Does anyone know about this?

[labblab]

Thanks so much for these numbers, and yes, it does look as though it is safe for you to resume the Vetoryl again at that lower dose. For our American readers, the numbers translate into these units of measure:

Pre-ACTH: 5.1 ug/dL
Post-ACTH: 13.8 ug/dL

Once your dog is back taking the Vetoryl again, you will be aiming to lower that post-ACTH number back down into a range between 40-250 nmol/L (or 1.45-9.1 ug/dL). Take a look at the monitoring chart in this Product Insert for Vetoryl, and you'll see these numbers broken out more clearly:

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

I believe the timing for the test changed because your vet has shifted to using a different stimulating drug that only requires one hour to work.

Marianne

[Tiger666]

Thanks so much for these numbers, and yes, it does look as though it is safe for you to resume the Vetoryl again at that lower dose. For our American readers, the numbers translate into these units of measure:

Pre-ACTH: 5.1 ug/dL
Post-ACTH: 13.8 ug/dL

Once your dog is back taking the Vetoryl again, you will be aiming to lower that post-ACTH number back down into a range between 40-250 nmol/L (or 1.45-9.1 ug/dL). Take a look at the monitoring chart in this Product Insert for Vetoryl, and you'll see these numbers broken out more clearly:

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

I believe the timing for the test changed because your vet has shifted to using a different stimulating drug that only requires one hour to work.

Marianne

Thank you very much. The only problem is i would have prefered to put him on 20mg but the vet says 30mg! :(. I don't have any 30mg left just 10mg. Should i just give him 2 10mg capsules to begin with?

[labblab]

The vet kept insisting starting him at a ridiculous dose like 40, which there was no way in hell i was going to do. So i gave him 30. Well started at 10 mg then 30 because his blood tests were high. Then 40 and then 50 which is too much so i just gave him 40mg but on the day of his test 50. The test came back perfect so told me to carry on 50mg for 3 months until next checkup. Really i was giving him 40mg. So yesterday when had his test i gave him 50mg.


Thank you very much. The only problem is i would have prefered to put him on 20mg but the vet says 30mg! . I don't have any 30mg left just 10mg. Should i just give him 2 10mg capsules to begin with?

I am going to give you a very stern warning here :o, that you've got to stop juggling around the dosages without your vet's knowledge! Otherwise, you will be constantly trapped in this situation where the vet is proceeding with testing results and dosage Rx's that are based on false information and erroneous expectations.

Do the vets yet know that you were previously only giving 40 mg. except just on the day of the test? If not, I think you have to come clean and tell them. Because if they know that, then they may agree that 20 mg. would be a safer amount to start back on.

Even if you don't feel as though you can confess the past history to them, you still need to be upfront with them from now on if your decision is to only use 20 mg. to begin with. They cannot be thinking you are dosing at 30 mg. if you are not!!! From this point onward, they need to know exactly what you are doing, OK? It is simply not safe for you to be making all these adjustments behind their backs.

Marianne

[Squirt's Mom]

Marianne is so right, honey. This is a VERY powerful drug that has the potential to take your baby's life quickly. So please, please, please don't give doses like you have been....and talk to the vets to let them know what has been going on. That is truly the only way they can understand the test results.

We always tell people they need a vet that will work with them as a team. The flip side of that is that we must be team players as well and keep all up to date with what is going on. ;)

[Tiger666]

Yes the vet knows i was giving 40mg but still told us 30mg. I will have to call them again because i do not want to give 30mg.

[molly muffin]

All you have to say, is that I feel more comfortable right now, dosing at 20mg and then we will test and see where that puts us and go from there.

That is it. You can do this!

[Tiger666]

All you have to say, is that I feel more comfortable right now, dosing at 20mg and then we will test and see where that puts us and go from there.

That is it. You can do this!

Sorry i haven't been here fir a while. We did start on the 20mg and he was on that dose for over a month but he went low again. He's on 10mg now and been having 10 for a few weeks. He had a test last week and we've been told to continue on this dose. His kidneys etc are ok, but he has this fatty lump by his belly which he's had for years. When we first found it, we had it tested straight away and we were told it was just a fatty lump and to keep an eye on it. It has gotten bigger and we asked the vet to check it and he told us it has gotten quite big and it feels irregular/abnormal. I didn't think it felt weird to me just that it's gotten bigger but then i'm not a vet. So we're waiting for the results for this now.
I can't imagine us getting good news about this. The vet scared me when he said it felt irregular. So if he has cancer aswell as this i really don't know what i'm going to do!

I'm finding this whole thing very tough!!!

[molly muffin]

Of course you are finding this very tough. It is scary.

I will tell you though that we have seen some very Massive lipomas (fatty tumors) grow into all sorts of weird shapes and sizes and they can go Very deep too.

This is a link to Flynn our super trooper dog who has had what seems to be numerous surgeries. This is after his lipoma removal. His were HUGE!

http://www.k9cushings.com/forum/album.php?albumid=559&pictureid=7005

So, lets wait and see what the test say and take it from there.

[Tiger666]

Thank you molly muffin. Aww poor Flynn, i hope he's doing ok.

I'm just dreading that phone call. I'm worried if he has to have surgery, putting him under gives me really bad anxiety. The worst part is there's absolutely nothing you can do about it. This happens to all of us but i still don't want to believe this is happening!

[molly muffin]

I understand. I have the same fears about Molly ever having to have surgery.

It isn't even necessarily rational. Just what if's.

Most of the time nothing happens. They go in. Have their surgery and come home. That doesn't make the worry any less though does it. We still worry about those drafted what if's.

[Tiger666]

Exactly. I know there's a lot of people like us who worry but there's people we know that don't let anything bother them. I wish i was a bit more laid back.

We worry about absolutely everything. Like yesterday he was walking quite slow and limping/raising his paw but this only lasted a minute. Then he starts running around the garden really fast. And today he's running around playing with his toys as usual. I'm just trying to enjoy the time we have and remember all the good times but sometimes it's difficult.

The vet called this morning and told us it's benign. What a relief. We just have to keep an eye on it, Which of course we always do!

http://www.k9cushings.com/forum/album.php?albumid=1011&pictureid=7704

[molly muffin]

How cute is he!!!! :)

Probably just stepped on something. Molly will do that if she steps on a pine needle and being a mini diva will lift her paw and wait for me to remove the offense item.

So glad to hear it is benign, so yep, a lipoma.

[Harley PoMMom]

AAWWW!!!!He is a real cutie pie!!! So very happy that his lump was benign! YYAAA!!!!

Hugs, Lori

[Tiger666]

Aww Mini diva Molly, sounds so cute!

Thank you both. I love him sooo much haha. My brother laughs at me the way i treat my little pom. He says "You act like you gave birth to him!" That's true i do but i can't help it!

[molly muffin]

yes we do love them a bundle! They are members of our family, they are our kids that we love and protect from harm. It is what it is. :)

[Tiger666]

yes we do love them a bundle! They are members of our family, they are our kids that we love and protect from harm. It is what it is. :)

Exactly, he's as much family as anyone else in my family! 👍👍👍

[Tiger666]

Hi everyone,

My pom was diagnosed November last year. I've been finding it very difficult even though he's doing very well. We had a check up today and again we've been told he's doing well. We used to be at the vet every week trying to make sure he's on the correct dose but for months now we go back for check ups every 3 months. I just wanted to ask you all about if it's ok for my baby to take Fortekor while he's on Vetoryl. He has 10mg vetoryl every day at 11am with some food and then at 5pm he has a small dose of fortekor. I think 2.5mg. He's been on this for a few months but would like to know if anyone can give me advice on this?

Thank you

[labblab]

Hello and welcome!

Regarding Fortekor, the manufacturer of Vetoryl does recommend using caution when combining ace inhibitors such as Fortekor with trilostane. This is because both drugs have the potential to increase potassium levels, and this can create a dangerous condition under certain circumstances. However, here is a related reply that I had posted a while back to another member.


That is excellent that your vet is aware of cautions about combining trilostane with ace inhibitors. However, it may not be necessary to completely discontinue the Fortekor. I say this only because we have indeed had other members whose dogs continued taking ace inhibitors after treatment began. The combination may require some dosage adjustment, however, and closer monitoring of potassium and sodium levels.

Probably the technical representatives at Dechra could offer the best guidance in this regard. It may be the case that switching to a different ace inhibitor might be better, or, as your vet is currently thinking, it may be worth discontinuing that class of drugs altogether in Kooky's situation. I'm sure the Dechra reps are well familiar with this issue and would be happy to discuss it in detail with your vet.

Marianne
As was the case with this other member, my best advice would be to request that your vet discuss this drug combo with a Dechra technical rep. If you are in the U.S., here's contact info for Dechra's Kansas office:

http://www.dechra-us.com/Default.aspx?ID=365

In the meantime, it would be great if you could tell us more about your dog's Cushing's history: symptoms, original diagnostics, trilostane dose, results of the most recent monitoring ACTH stimulation testing. Thanks in advance for any additional info!

Marianne

[Tiger666]

Oh my god i don't know what to do now. I haven't stopped worrying since this started. This is going to kill me. I haven't got the results from his last test at the moment.

I feel like going on forums is doing me more harm than good tbh :(

[labblab]

Gosh, I surely don't want to worry you excessively about this. If your dog has been successfully taking the Fortekor for several months now with no problems, I wouldn't expect any acute crisis to surface now. The possibility for drug interaction is just something to be aware of and to clarify with your vet, especially in the event that your dog's dose needs to be increased in the future. I always figure it's good to be armed with the most complete info possible so that you'll know better what to watch for in terms of any ill effects surfacing.

Marianne

[Tiger666]

Hi Marianne

I'm so sorry i came across very rude. I apologise. I know you don't mean to worry me, you're just being honest. I stopped going online/googling etc but now i started again. Which needs to stop.
I just don't know how much more i can take of this worrying. I suffer from severe anxiety. Not in the way how a lot of people use the word 'anxiety' very loosely. It really does ruin my life. I was doing a little better but then my grandad had a stroke in august then passed away 2 weeks ago after suffering terribly and it's really started me worrying even more about everything else. Sorry to go on. Just explaining to you why i'm like this.

I love this dog more than anything and i know no one lives forever and every one has to go through this but people deal with things differently. I don't deal with things well at all and i really don't know what to do..

[labblab]

There is no need at all all for you to apologize. I truly did not think you were being rude; just that what I had written had worried you. I feel as though I can relate to that, because I tend to worry pretty obsessively, myself :o. For me, it helps me to cope better when I gather as much information as I can. But for other folks, and perhaps for you, a lot of info can feel overwhelming. What helps one person can be hard on another person.

We are really here to do our best to support each other, though, so I'm hoping you'll want to keep on talking to us. Even in the midst of our differences, we are united in our love for our dogs!!!

Maybe we could start off by talking about some less stressful things -- just telling us some fun things about your dog and your lives together?

Marianne

[Tiger666]

Thank you for your kind response.

It's really weird because when i look at my pom i don't see him as being sick at all. He eats, plays with his toys, runs around. Acts tough towards our German Shepherd showing him who's boss.
He looks like he's enjoying life. He doesn't act like you'd think an old dog would (fingers crossed). I still see him as a baby. I'm seriously in denial, but honestly he is exactly the way he was when i first bought him home when he was 6 weeks old, he's 10 now :( (Something i hate thinking about).

I have good days when i'm grateful that he's still with me because i know people have lost younger dogs a lot sooner. Like at the vet today a lady had a dog who's seriously ill and he's only 3 years old. So i just say that i have to enjoy him while he's still here rather than cry all the time because i'm not enjoying the time we have left but then i have bad days where i can't stop panicking about everything.

I took him to the vet a year ago this month because i noticed he was drinking a lot of water and he had to urinate a lot. He has never had an accident in the house though. (Touch wood/fingers crossed).
He had a swollen pot belly. He's always been a greedy pig lol and loves to eat but it had gotten worse. Sniffing around the floor looking for anything to eat. Bullying our German Shepherd and taking his treats out of his mouth lol.
After many tests he started on Vetoryl and pretty much straight away i noticed a difference. He drinks normal amount of water now. And he doesn't have that swollen belly anymore. His weights fine and he has a lovely coat. Still greedy but like i said he was like that from the very beginning. He jumps on the furniture to sit next to us but he has a step for one of the beds in the house because it's so high. He can jump on the others. He has a lot of energy.

Sorry i've gone on. Hope you haven't fallen asleep, but as soon as i start talking i can't stop!! :o

[labblab]

You definitely haven't gone on too long! We're a very nosy bunch here, and we love hearing all about our doggie members! ;)

Unfortunately, today is a very busy day for me, so I can't stay and write any more. But I will be back again, hopefully by tomorrow, in order to add a few more thoughts.

In the meantime, thanks for this additional info and I look forward to reading even more whenever you have the time to write more yourself.

Marianne

[Tiger666]

Thank you. I hope you have a good day.

Lisa

[molly muffin]

Hi and welcome to the forum. One thing we all have in common on here is being worriers. It comes with the territory. I'm sorry that you also have anxiety on top of everything else. That doesn't make any of this any easier.
However, what I would say, is that you have the electrolytes tested every once in awhile in addition to the testing every 3 months to make sure that the vetroyl dose is in the right place. If the potassium starts to go up too much, then you can decrease the Fortekor or look for an alternative drug. It doesn't sound like it is a problem for your little pom though right now as he is doing so well and that is a good thing.
It's hard sometimes not to worry, but unless you actually see the potassium going up, then I think you're okay. Just have your vet check it so you will have one less thing to worry about. :)

[Tiger666]

Hi Sharlene and Molly Muffin

Thank you for welcoming me :)

We do have the electrolytes tested regularly tbh. We're so obsessed with this little dog. My dad even jokes and says if he farts we rush him to the vet straight away meaning any little thing and we take him for a check up.

I'm feeling a bit better about being on the forum and trusting the vet a little more as i'm learning more about this as i go along. It was very scary to begin with when i knew nothing about it. I was terrified the first time we had to give him his first dose.

I love animals but i don't think i will ever be able to have another again. My mum says we're not strong enough for this. It will kill me when i lose him! :(

[molly muffin]

Oh we know all about the if he farts get him to the ER. Probably the funniest one that I did, was after an increase of BP medication (due to it still being high and since on Benazepril [ace inhibitor], when I came home from work, molly didn't come to greet me at the door and was just snoozy. Off to the vet we went immediately to get the BP checked. It was fine, she as playful and having a fantastic time at the vets. I just had a snoozy dog. I don't regret it one bit though, and told them, be prepared for me to show up at the last little thing. :)
So that is all natural.

[Tiger666]

Haha that made me laugh. Thank you for that. We're all the same when it comes to our furbabies.
He's costing us a fortune lol but i don't regret it either. He's family and worth every penny we've spent and i'd pay it forever if i had to..

[molly muffin]

Hi, I thought I'd stop in and say hello and see how you and your little pom are doing.

Hope all is well

[Tiger666]

Hi, I thought I'd stop in and say hello and see how you and your little pom are doing.

Hope all is well

Hi Molly muffin. Thank you for asking. Sorry i haven't been on in a long time, only just seen your post. Everything was going very well but Tuesday night my baby started raising one of his back legs and hopping along. Took him to the vet next day and told us he might have dislocated his knee. Found it strange because he doesn't seem to be in much pain. I know we don't know for sure but whenever we've touched his leg he doesn't cry or anything and the vet examined him and he never made a sound. We took him for an X-Ray yesterday which almost gave me a heart attack. He hadn't dislocated it he's injured it. He's still hyper and jumps around off furniture and i'm always running after him if someone comes to the house so he doesn't hurt himself but i must have missed it this time. I don't know how he did it. He needs plenty of rest. He's still trying to run around and he's eating and drinking as normal. He's going to have a check up in a week.

Hope all is well with you :)

[molly muffin]

Okay I know it sounds silly but pet playpen
My molly injured her back a couple years ago and so I got a pet playpen off amazon one of the bigger ones that was see through on top and sides, but zippered so no jumping out, and she was in that when she wouldn't be quiet on her own until she healed. Worked like a charm, she wasn't happy but she did heal up great, so it was worth all the whining and carrying on like I was killing her. I also got steps up to the window seat, and wooden gates for everywhere I didn't want her to.

[molly muffin]

Ohhh, actually this picture gives you an idea of what we did with the window seat to keep her from jumping up and down on it (it is her favorite spot)

http://www.k9cushings.com/forum/album.php?albumid=518&pictureid=7186

[Tiger666]

Oh my life that's so cute :D Unfortunately my Pom would hate it. It's our fault, we've babied him too much and made him into a spoilt brat. He hates it when we close him in a room even if there's someone in there with him because he usually knows someone's coming to the house and we've locked him away and he hates that. He wants to see everything that's going on. He'll just whine and whine until we open the door. He likes all the doors open so he gets the run of the house.
My brother put him in one if those crate things when he was 6 weeks old but it had a door on the top and he left it open and he climbed out of it. Was quite funny. He's a little terror even now.

I'd love to buy one and give it a try but i know he'd hate it because he's used to going everywhere he wants.

[Tiger666]

Can someone please help. My dogs been on Vetoryl for 2 years. He's doing well thankfully. I haven't been giving him his medication everyday. Sometimes it's been my mum and other times it's been my gran but today when we collected the medication it says wear gloves and not to touch the tablets if you're of child bearing age. I'm 30.

Have I done damage to myself by not wearing gloves when giving my dog his medication? Like i said it isn't every day. The past year it's been other people who have given him the tablet but the last week I have handled the medication everyday and I'm worried.

Sorry forgot to mention, I wash my hands thoroughly after touching the tablets but doubt that makes a difference or else it wouldn't say wear gloves etc. What about coming into contact with his pee? Is that dangerous? Honestly don't know what to do. Will wearing gloves be ok? Or should I not handle them at all?

[labblab]

You may certainly contact Dechra, the manufacturer of Vetoryl, in order to talk to them directly about your concerns. But my own understanding is that the specific warning to women of child-bearing age relates to possible danger to an unborn child as opposed to the mom herself. Trilostane, the active chemical in Vetoryl, can cause birth defects. So if there is a possibility that a woman might be pregnant, even before she herself is aware of it, the medication should not be handled directly.

If you have not been pregnant within the past two years, then I don't believe you, yourself, have been under any special risk. Trilostane can cause skin irritation, and if a great amount was absorbed through skin contact, I suppose the human could possibly expect to experience some adrenal suppression just as does the dog who is taking it orally. But as I say, it's really possible damage to an unborn baby that warrants the major concern.

Also, I have never heard of contact with urine being a concern.

By the way, welcome to our group!! :). We'd love to hear more about your dog and how he's doing.

Marianne

[Squirt's Mom]

Hi Lisa and welcome back again! :p

You had four threads going over the years so I have combined them all into one thread and edited the title to include your user name (Tiger666) so it would be easier for you to find in the future. ;) You might also bookmark your thread so it will be easy to find when you need to talk. I looked and looked for your baby's name but in all this time I didn't find it so I used your user name instead.

Since it's been almost a year since we heard from you, can you fill us in on how your baby boy has been progressing? What have the ACTHs shown? How is he feeling? acting? Any problems or concerns?

Hugs,
Leslie and the gang

[Tiger666]

Thank you both for taking time to respond to me.

Thank you for putting all the threads together :) I can't believe i've never mentioned my babies name. He's called Foxy.

I haven't been around in a long time just because of my really bad anxiety. I've been told to stay off the forums and Google haha. I do sometimes Google though. I don't think I'll ever stop. Every one tells me it's for the best just because I'm really not mentally stable for all this. My grandad past away last year and now my nans not very well. On top of everything i got a puppy last week. I must be crazy!

Foxy's been doing well but of course i panick at everything. Even if he farts i think it's something terrible lol. He's been having his check up/test every 3 months. The last one was Tuesday. Levels are all ok at the moment and still on a low dose which makes me feel a bit better about it all. He does sometimes dribble a tiny bit while he's laying down even though i let him out to pee regularly. He's enjoying his food. He's still psycho when the postman delivers the mail. Runs around. Plays with toys. He's the same as he's always been.

Hope every one else is well :)

[Squirt's Mom]

Even if he farts i think it's something terrible

Ok...this is what I call twitching which makes you a sister! We be twitchin' sisters! You know....every little things makes your heart thunder, your breath disappear, your tummy roll over, your mind start running 9000mph with the absolute worst thoughts ever! Yep, twitchin'! :p:D:p And tell your family that is perfectly normal for a cush parent. :eek::D:p

[Tiger666]

Ok...this is what I call twitching which makes you a sister! We be twitchin' sisters! You know....every little things makes your heart thunder, your breath disappear, your tummy roll over, your mind start running 9000mph with the absolute worst thoughts ever! Yep, twitchin'! :p:D:p And tell your family that is perfectly normal for a cush parent. :eek::D:p

Haha that's exactly how i am. Thank you for making me laugh. I will never change. I use have to try deal with things the best i can even if i do have horrific days!

[molly muffin]

Many of us can share those sentiments. :) :)

[Tiger666]

Hi again everyone.

My 12 year old Pomeranian has been doing well for 3 years but a few days ago he started squeaking randomly. Like a high pitched squeak. The last time he did this was because his medication was too high. So after testing we reduced his dose. Then he was perfectly fine.

Anyway it happened again and he was tested Friday. Vet just called and told us to give him 30mg. He was on 20mg before. I was expecting the vet to tell us to give him a lower dose not a higher one. After saying i didn’t feel comfortable giving him 30mg he said to continue 20mg and to retest. He even said the 30mg might be too high. So why the hell is he telling us to give him a higher dose? I really don’t think they know much about this and last time i said about the squeaking being part of him being on a high dose i could tell they were pissed off because i’m not qualified but they are.

He said the number should be 200 and it was 259. I don’t know what this means. He doesn’t have a clue why he’s making that high pitched sound. They examined him well and he didn’t seem like he was in any pain at all. He’s still eating and drinking normal. He just makes that sound a few times a day, which startles is!

[labblab]

Hello and welcome to you and your little guy! Before writing anything more, I’m giving you a link to the U.S. Product Insert for brandname Vetoryl. It contains a chart that will outline for you the desired cortisol levels for dogs being treated with this medication.

https://www.dechra-us.com/Admin/Public/Download.aspx?file=Files%2fFiles%2fProductDownload s%2fus%2fvetoryl-5mg-pack-insert.pdf

I’m assuming the numbers you’ve given us are post-ACTH stimulation test results? This is a test that involves a resting blood draw, and then a second blood draw an hour later, after a stimulating agent has been injected. You’ll see by the chart that a result of 259 nmol/L (9.4 ug/dL for our American readers) is just slightly above the desired cut-off for a Cushpup. However, as long as all symptoms are resolved, I don’t think I’d probably opt to increase the dose for a dog of my own, either. However, if a dog was still exhibiting symptoms with a test result of that level, I’d want to increase the dose a bit.

I think the big question mark for you is, what’s causing the squeaking? I honestly don’t know of any direct link with cortisol levels, so it may just be coincidental that your dog was squeaking back when his medication dose needed to be lowered. I don’t know that it has any relationship to his cortisol level now, either.

It’ll help if you can tell us a bit more about your dog’s overall health history. Also, what Cushing’s symptoms did he exhibit prior to treatment, and is he otherwise truly symptom-free at this time?

Marianne

[Tiger666]

Thank you for taking time to respond to me. Yes the numbers given are post ACTH test. The vet did say it was slightly high so will continue the 20mg dose. As when he was on 30mg it was far too much. I just don’t know what to do about this squeaking. It’s very strange. It’s just random.

Other than that he does urinate a lot. Hes eating and drinking normally. He’s active. Last year he had a bit of hair missing underneath on his neck but it’s grown back. I don’t really know what else to say. No body knows why he’s making that sound.

[molly muffin]

Hello and welcome from me too. Are his other lab's all normal?

If he doesn't do it for the vet to see maybe you can use a smart phone or camera and record him when he squeaks?

Have they taken a good look at his trachea? That is one area that Poms sometimes have problems.

[Tiger666]

Hi molly_muffin, he did do it a couple of times at the vet. They examined him well. They just don’t know what it is. I’m pulling my hair out here. If the vet doesn’t know who will?

Will see how he is tomorrow x

[molly muffin]

What about an internal medicine specialist?

[DoxieMama]

Welcome to you and your boy. What is his name?

I'm curious if you know the results of previous ACTH tests. Were his levels controlled before, so now they are higher? Maybe he just needs a little bit more vetoryl to bring that number down... and maybe that will stop his squeaking. Though you probably can't do that easily with brand name meds unless you can go to 25mg instead of 30, which would be more costly. Another option could be to switch to Trilostane, where you could fine-tune the amount.

Sorry, I'm rambling this morning. I hope you can figure out what is causing his squeaking! That's got to be frustrating.

Shana

[Tiger666]

Hi Shana, his names Foxy.

Yes he’s been doing very well for a long time. Everything controlled. As they don’t do a 5mg capsule we can’t half if. Would be perfect if they did. I wonder why they only have 10mg as the lowest in capsule form.

I was given the results of previous tests but don’t know them at the moment.

It’s definitely something else going on. It’s like he has something happen when he gets up or something. It can happen when he’s already standing a well though. Maybe he has pain in his leg? Like i said it’s not constant. The vet examined him well and he didn’t seem bothered at all. I suppose it could be like when we can get a sudden pain but because they can’t talk and tell us the problem it’s so frustrating!

[labblab]

Welcome back — when I replied to you yesterday, I didn’t realize you’d been a member for quite a while! Anyway, wanted to let you know that Dechra does make a 5 mg. Vetoryl capsule. It’s available here in the U.S. and Canada, but very strangely, it is not sold in the U.K. I can’t imagine why not, but there you have it. In the past, we’d been told that vets in the U.K. could make special requests to Dechra in order to obtain 5 mg. capsules for patients who really needed that dosage strength. So you might ask your vet to see whether that’s still possible. If not, perhaps you could import some 5 mg. capsules from the U.S. or Canada if you want to increase Foxy’s dose and they truly are unavailable to you. Once again, I know this doesn’t help solve the problem of Foxy’s squeaking. But I wanted to mention it anyway, since I believe the rules relating to getting compounded medication are much tighter there in the U.K., as well, so it may not be an option either.

Marianne

[Tiger666]

Oh i didn’t know. Have they always made a 5mg capsule? Or just recently?

[labblab]

Although it was not one of the original dosage strengths, I think the 5 mg. capsule has been available here in the U.S. for at least a couple of years now. I had assumed it was also now being sold in the U.K., too. But I just checked the database for the Veterinary Medicines Directorate, and it’s not listed. Nor is it listed on Dechra’s U.K. website. Sooooooooo strange!!

[molly muffin]

That is so weird that they still don't sell it in the U.K. I didn't realize that either. You can have your vet ask Dechra for it though if needed.

[Tiger666]

We’ve agreed to keep him on 20mg and then retest. He hasn’t made that crying noise in a couple of days but did it once this morning as he got up after laying down. I believe he might just have a pain sometimes how he might move/walk etc.

[molly muffin]

Maybe arthritis? Tramadol might help. Small dose or a shot for joints.

[Tiger666]

Yes i’m back again and i really don’t know where to begin. We’re all so upset. Foxy has taken a really bad turn. He can barely walk and can’t raise his head. He’s eating and drinking and going outside to pee but then will just lay there all day. He’s vomited last night and had diarrhea this morning. I fed him boiled chicken and brown rice this evening and he’s just been outside. His stools are still soft but not as bad as this morning.

Were going to the vet again tomorrow morning. I just want to know if this is it now? He’s always been tough and bounced back but this time it’s worse than ever. I keep thinking he’s had a stroke or something. Does anyone know what could have happened because it’s just happened suddenly. The last time this happened was in January but when we took him to the vet he was fine so was a quick recovery. We tried describing his symptoms but they didn’t have a clue what it could be.

[labblab]

Is Foxy still taking Vetoryl? Given the vomiting and diarrhea, my first worry would be that his cortisol may have dropped too low or his blood chemistries may be imbalanced from the Vetoryl. There may be something else going on as well, but an overdose of Vetoryl is a very serious matter and could account for some of these problems. I would stop the Vetoryl immediately if he’s still taking it, and definitely take him in to be seen as quickly as possible.

Marianne

[Tiger666]

Hi Marianne

Foxy hasn’t had Vetoryl today. We are going to take him to the vet in the morning. I’m really dreading it. I know they’re going to give us bad news.

Our luck was bound to run out!

[lulusmom]

How did the visit with the vet go yesterday?

[Tiger666]

The vet thoroughly examined Foxy and he didn’t seem to be in any pain at all. His temperature was fine, she said it looks like he’s having a vestibular episode. Which is what happened last time when i thought he’d had a stroke but dogs recover quick from them. This one just lasted longer. It can be mistaken for a stroke. He was given an injection for his sickness and some paste for his diarrhea. He hasn’t been sick today and has been a lot better, like walking around and snapped out of the episode. Still interested in food, water, treats etc but he was during the episode which is a good sign. He’s going back Monday for blood work due to his urine sample being a bit strange. We think it’s to do with his kidneys.

Thank you for asking.

[lulusmom]

Thank you so much for the update. I am very happy to hear that your precious boy is doing much better. I hope his next appointment goes well and I will be looking forward to your update.

[Tiger666]

Thank you. He’s slipping a lot on the tiled floor and we have a lot of it unfortunately. He walks ok on the carpet and outside but as soon as he gets on the tiles no matter how slow he walks he slips. We have put rugs/mats everywhere now. The last time we bought them out was years ago when our German Shepherd kept slipping due to hip dysplasia. He was huge though and very difficult to help him. Because Foxy’s a small dog we can lift him easier. Just want to keep him as comfortable as possible.

[lulusmom]

I can so related. My first cushdog, a 4 lb Pomeranian, dislocated her hip on the tile floor and after that she wouldn't move on any smooth surface. She would stand stock still forever if I put her down on a tile floor. I too had to put rug runners and area rugs everywhere and if there was bare space and she could get to another rug, an old towel would do. We do what we have to for our beloved pups. Luckily my two wee ones and my big girl have no problem on hardwood floors and tile.

[Tiger666]

Aww 4lb Pomeranian sounds so cute.

I’m really not sure what’s going on with Foxy. Yesterday i woke up really worried thinking he was going to be worse. Slipping on the floor/not moving etc but he was the opposite. He’s back to normal. Walking on the tiles. Really mobile. Like his old self. And he’s ok today too. Not that i’m complaining. We’re so happy to see him like this.

He went to the vet this morning for his blood test. We won’t hear back till Wednesday.

[lulusmom]

Woohoo! I am so glad to hear about the miraculous change. I'll be interested to get your update when you get results on Wednesday.

[Tiger666]

Sorry it’s taken me this long. Foxy had his test and they really don’t know why his urine was strange. His bloods came back fine but apparently they had a meeting regarding cushings and they’ve told us to give him his vetoryl twice a day rather than once. He’s on 20mg a day so we would give him two capsules at 11am but the vet has told us to give him 10mg twice a day 12 house apart. Does this sound normal to you? i’m really not sure. Won’t it affect his ACTH test? Because when he’d have his medication at 11am he would have his blood test at 3pm and then an hour later. So for example if i give him his first dose at 9am he’d have to have the other at 9pm. I’m really not sure about all the change.

[Harley PoMMom]

Was an ACTH stimulation test performed? Is Foxy exhibiting any Cushing's symptoms? If not, and if this were me, I wouldn't restart the Vetoryl until his cortisol levels are known.

Lori

[Tiger666]

Yes his tests are stable at the moment but we’ve just been told to give him his dose twice a day rather than both at the same time.

[Squirt's Mom]

Dosing twice a day is not uncommon. When a pup moves from once to twice a day, the dose the pup is on is simply divided in two and given AM and PM - WITH FOOD as always. So if a pup is getting 20mg once a day they will take 10mg twice a day. One or both of those doses may change in time but that is how to start - simply dividing in two. Twice a day often helps a pup not start to feel the effects of the Vetoryl wearing off. Vetoryl has a very short life in the body, starting to leave in 2-12 hours. So twice a day dosing helps keep the level of cortisol more consistent.

[Tiger666]

Thank you for responding �� I feel a bit better. It makes sense giving him 10mg twice a day as you say it has a very short life in the body.

[Tiger666]

Quite bad news. Last week Foxy took a turn for the worse. He’d become really weak and couldn’t really move much. If he’s laying on the tiles he slipped and couldn’t get up. Friday morning i woke up and found him laying in urine and diarrhea. The first time this has ever happened so i was shocked. No matter what he would always get up and wake me up and stand by the door to go out.

We took him to the vet that day and got really bad news. He was severely dehydrated which i didn’t understand as he’d drink a lot of water. The vet said this is one of the worst cases she’d ever seen. She said we had an option of leaving him over night on a drip or taking him home and giving him something called Oralade but had to give him a lot overnight. She gave him an injection as well. He was examined and now he has a tumor, think it’s cancer. So not much else we can do. We were told if he doesn’t make a bit of a recovery and he’s back on his feet (because he couldn’t walk or stand for long) we had to have a discussion as a family to have him put to sleep the next day. I really wasn’t expecting him to get any better as he was so ill. The next day he was back to himself. Walking and eating. I boil him chicken and give him some broth. He loves the oralade and drinks a lot of it. I can’t believe how he’s made a bit of a recovery. He’s a fighter. I really had a feeling we were going to lose him last week. We don’t have months and months left but i want to enjoy what time we have left and just make sure he’s as comfortable as he can be. I don’t want him to suffer but he does have a lot going on and it’s not good for us at the moment!

[Squirt's Mom]

I am so glad Foxy has turned toward the better and pray he remains feeling well for some time to come. It is very hard to see our babies feeling so badly. Please let us know how he is doing as time passes....and know we are here for you anytime.

[Tiger666]

Thank you so much Squirt’s Mom.

It’s really strange. Considering the weathers really hot, He’s had a very good day today. Really active, playing around with Eddie my other Pomeranian. I would have thought he’d be just laying there sleeping all day but no it’s as if he’s totally healthy, but then tomorrow i could wake up and he’ll be in a bad way. Just have to take each day as it comes.

[Budsters Mom]

Yes, that is how we ALL get through. One day at a time. Sometimes one minute at a time. Enjoy the little things, while making memories to last forever. The here and now is all we have.


Just have to take each day as it comes.

[Tiger666]

Exactly ��

What would your opinion be with Vetoryl at this stage? Would you continue to give the medication? He’s just had his last tablet and not sure whether to get some more. Is it worth it? Or maybe just getting a weeks worth? I really don’t know.

[Harley PoMMom]

You may be able to judge continuing the Vetoryl if his symptoms become worse and if he seems uncomfortable without the Vetoryl.

[Tiger666]

Very bad day today. I knew it wasn’t going to last long. He hasn’t eaten anything but a piece of ham. He won’t drink either. We’ve had to use a syringe. This is the end now. I’m so upset. I’ve had him since i was 19. 13 wonderful years. The whole families devastated. I don’t know how we will get through this :(

[Budsters Mom]

You will get through. Hearts do mend in time and you'll find a way to plod on, just as many of us have. Feel free to scream, cry, vent, etc. We understand. I am so sorry to read this news today. Gather strength from your family. It sounds like you have a good support system at home. Foxy knows how much he will always be loved.

Kathy

[Squirt's Mom]

Instructions To a Guardian Angel of Dogs

Hello. I’ve been expecting you for quite some time.
Here, come sit beside us for awhile
and let me tell you about this old friend of mine.
He might look tattered or maybe old
But I won’t say goodbye until you’ve been told.
He had the brightest eyes I had ever seen,
And wore a beautiful fur coat that would out shine a king.
He was never prissy but walked with an aire.
And oh so polite, you could take him most anywhere.
He could run like the wind and could catch anything he chased
But he protected and sat with me when I had problems to face.
You could not find a friend nearly so dear.
Because no matter the trouble he always stayed near…
He has never asked for much from me;
Just to love and respect him and I think you’ll agree
To give him a good meal plus a nice warm bed is not much to ask
When he has given me all his love and to him this was no task.
Now I understand you have a schedule to keep
But I have a small favor before he nods off to sleep.
Please fold your wings around him and let him feel young while in no pain.
Dear Guardian Angel of Pets,
please keep him safe and happy until I see him again.

By Ginger Patton

My thoughts are with you and your family.
Hugs,
Leslie

[Tiger666]

This is going to kill me.

If things aren’t bad enough people that work at the vets are so heartless. My brother went to pick something up and it took a lot for him not to say something rude back. We’re all really struggling with this and on top of things we have them cold hearted individuals being the way they are.

[Joan2517]

Some people, even if they work with animals, just don't get the bond we have with our beloved pets. They don't understand the lengths we will go for them and have the nerve to say something. Those are the ones who will never know what it's like to love and be loved unconditionally.

[Tiger666]

We’ve spent a fortune over the past 4 years on helping him live a comfortable life and we never begrudge it one bit. The receptionist is a right dragon and my brother had to stop himself from saying i bet you dread the day he dies because you won’t be getting thousands from us. Before he got sick he just went to the vet once a year for his annual health check and vaccine but after he got sick we might as well have moved in we were there so much. We’ve always been polite but don’t get the same in return. I would change vets but we did that once and really regret it as my other dog died in their “care” and the one we go to now is a minute away from where we live so it’s ideal. I just wish that old hag would leave. She’s been there for around 20 years. The same amount of time we’ve been going there.

[Joan2517]

You should let the head vet know about whatever it is that has you so upset. They may not know that the receptionist is being rude or disrespectful, and could be chasing their patients away, and might be very grateful to hear your concerns. Plus, for all you know, they might want a reason to get rid of her.

[Tiger666]

Thank you Joan but i highly doubt it. They all stick together. If i didn’t have two other dogs i’d really say what i think :(