Kodi my pomeranian has cushings

[cinnabar99]

My 10 year old Pom was finally diagnosed with Cushings Disease in Jan. 2015 after a couple of years of telling me the dog's hair loss and black skin was caused by food allergies. When change in diet didn't help he finally looked at testing him. He also took X-rays which showed he has an enlarged heart and liver He put him on Vetoryl (Trilostane) 10 mg. once a day. Yesterday the vet called to say his last blood test shows the dose will have to be increased. I am heading to his office today to pick up copies of the cortisol blood tests so can't give numbers yet. And I am also going into see a pharmacist today to see if he can possibly get the pills cheaper than what my vet charges. Worth a try. Get back to you later after I get blood test results and find out what the pharmacist says

[budindian]

I'm new here also so I just wanted to welcome you and tell you there are a lot of smart people here that will come by and help. What I do know is you do not want to increase the vetoryl to much at once. As you will find out you will need to get copies of all your test results that helps also. Welcome and look around the site there is a lot of information about this disease and the medications on here.

[Harley PoMMom]

Hi and welcome to you and Kodi!

It would help us gain a much greater understanding of Kodi's case profile if you could provide more information, ok? So here goes some questions :eek:

What symptoms did Kodi display that led you or your vet to test for Cushing's in the first place? How much does he weigh? Is he taking any other herbs/supplements/medications? Could you get your hands on copies of all tests that were done on Kodi and post any abnormalities that are listed...e.g....ALT 150U/L (5-50). Was an urinalysis done, and if so, could you post those findings too? What tests were done to diagnose Kodi and can you please post the results of those tests? How many monitoring ACTH stimulation tests have been performed and could you post those results along with their timelines. Does Kodi have pituitary or adrenal dependent disease?

Regarding the cost of Vetoryl, you can get compounded Trilostane but only in doses other than those Vetoryl doses approved by the FDA. Finding a trustworthy compounding pharmacy is very important. A lot of our members use Diamondback Drugs for their compounded meds. http://www.diamondbackdrugs.com/

Please know that we are here to help you in any way we can, and do ask all the questions you want.

Hugs, Lori

[labblab]

I also want to pop in to add that even if you stay with brandname Vetoryl, the odds are that you can buy it online for a better price than your vet is charging. Just "Google" Vetoryl at whatever capsule strength you are using and you will find several internet veterinary pharmacies that carry the medication.

Marianne

Oops! Edited to add that I see you are writing from Canada, so my understanding is that the situation is a bit different up there re: both compounded and brandname trilostane products. One of our Moderators, Sharlene, lives in Canada -- I'll bet she will be dropping by before long and hopefully she can give you some advice re: medication sources.

[cinnabar99]

Kodi's symptoms were hair loss and black skin. I didn't notice increased thirst or hunger.
Kodi is 10 pounds.
His Cotisol results and lab comments
2015-01-07. Cortisol (pre) 153. Cortisol (post) 610
Exaggerated adrenal response to ACTH administration-the elevation is mild and Cushings is possible, however consider chronic stress or illness, interpret in light of clinical signs
2015-01-29. Cortisol (pre) 75. Cortisol (post) 116
Control not too bad-correlate with how Kodi is doing
2015-03-05. 202. 251
Up from previously
2015-05-09 191. 370
Normal adrenal response to ACTH administration. Interpretation with new history provided. The stim reflects poor control of Cushings. Post should be less than 100nmol/l to have good control of Cushings

The pharmacist gave me the name of a company in Canada where I can order the Vetoryl from. It takes 14-28 for delivery so I will have to order one months supply from the vet. His price $128.94, the phone order company $81.48. Only problem is I need a prescription from the vet. They are going to call my vet for it?
I don't think Kodi has had a urine test. I think the vet said it was pituitary but I really can't remember.

[cinnabar99]

Kodi had a complete blood work up on 2014-12-18. I will put down the numbers that are more or less than they should be
Urea (BUN). 1.9. Reference 3.2 - 11.0 mold/L
Albumin. 40. Reference 27 - 39
ALP. 582. Reference 5 - 160
GGT. 20. Reference 0-13
CK. 258. Reference 10-200
Reticule yet 129.6. Reference 10-110

Lab comments Hematology
Increased relics in absence of anemia could be transient, physiologic or pathological-recheck in a month or two

Lab comments Biochemistry
Low Urea-decreased synthesis, renal loss?
Increased ALP is a non specific induction enteropathies, mess. Diseases which cause secondary liver charges including cardiac disease, intestinal disease, endocrine disease, dental disease, should be excluded where relevant. GGT would support biliary lesion

Has thyroid been checked recently?

[molly muffin]

Hi I'm Sharlene and in Canada also.
Which pharmacy did your vet recommend?

With him being on 10mg and being controlled, it sounds like there might be something else that they are concerned about causing the cortisol to go up.

Have you had an ultrasound done yet? I think it would be worth it to do if it is feasible. The GGT is a liver specific. So my concerns are liver and kidney. (the renal loss comment)

I think that if you aren't yet seeing a specialist then maybe a consult would be worth it, an ultrasound and just a general frank discussion on why he would have slipped control like that and what the latest lab tests could signify. I think that would be my next steps.

Welcome to the forum.

[cinnabar99]

On June 7, 2016 I changed vets as Kodi's cushings disease was not improving and was getting very costly. At that point he wasn't eating, had dropped in weigh from 10 lbs to 8 lbs and was very weak. The new vet took x-rays and then put him on Metronidazole and Cerena. She called to say his liver and spleen appeared enlarged and did a geriatric panel with urine and blood and arranged to do an ultrasound. That was when they put him on Clavaseptin, Metronidazole, Ursodial, Hepato Support and Metronidazole liquid. When the Clavaseptin and Metronidazole were gone I was told to keep him on Ursodial (0.3 mg) twice a day and Hepato (1 ml) twice a day. His Cushings disease (the hair loss and oozing sores) has not reoccurred. I brought him in on Jan. 4, 2017 and the vet did a liver panel blood test and said he has improved to the point where his numbers are almost back to normal and to continue with this medication and return in 6 months for another liver panel. I am so happy. He is like a puppy again though he will be 12 in May.

[Harley PoMMom]

Hi and welcome back!

Thanks so much for the latest update on Kodi and I am so happy to hear that he is doing well. I see you mentioned that his Cushing's hasn't reoccurred so I'm assuming that the new vet took Kodi off the Vetoryl, correct? Has Kodi's skin issues resolved? And one more question I have :o why was Clavaseptin prescribed?

Again, it is wonderful that Kodi has improved and I know how thrilled you must be to have your sweet boy feeling so much better!!!!

Hugs, Lori

[cinnabar99]

She prescribed Clavaseptin because the ultrasound showed a dark area around his liver and spleen. I trust her and her results worked. He's not on Vetoryl any longer and his treatment is so much more reasonable than before and there are results. I'm so happy I changed vets and that this vet is much more knowledgeable and has more equipment to test him.
Thanks for suggesting the ultrasound and your encouragement. I really appreciate it...Gail

[molly muffin]

This is excellent news. And so glad that there is no more need for cushings meds. Since cushings doesn't just go away (it's caused by a tumor) then it is most likely that Kodi never had cushings and instead had something else going on with his liver/spleen.
good job on keeping at it till you got him better!