Max - all blocked up

[Annalie]

Hi, this is my first post on the forum, I hope someone will have some good advice for me. my golden retriever, Max has cushings and until recently was on 120 ml of Votaryl. After becoming very ill his dose was reduced to 60 ml and has just finished a course of antibiotics. he has lost most of his hair, his skin seems to turn a blackish colour after a few days and now his nose is severely blocked with mucus and his eyes are also mucky. Is this all to be expected? How can I help him? thanks in anticipation for any advice you can offer. Annalie

[Annalie]

Hi again, have read some replies to other messages and gained some information. Max weighs 29 kg and originally went to the vet for an anal gland infection and excess drinking. He was tested for cushings as he showed a number of symptoms and was tested over a period of 2-3 hours. I'm afraid I don't have the results but cushings was confirmed. This was 8 weeks ago and he was placed on 120 ml of votaryl daily. He became quite ill over the next two weeks, losing his hair across his back end and tail, his skin becoming dark in colour where the hair loss occured. He is very weak and at times is unable to squat for the toilet. taking him back to the vet thinking he was constipated they explained that the votaryl can unmask athritis which was not at all apparent before the treatment started. after a month the dosage was dropped to 60 ml a day as his levels had dropped so severely there was fear he may get addisons disease which is the opposite to cushings. he has improved a little but doesn't drink enough, doesn't eat much and has trouble breathing as his nose is very blocked and his eyes mucky. Should I stop treatment? he seems so much worse than when we originally took him to the vet 8 weeks.

[Squirt's Mom]

Hi and welcome to you and Max!

If he were my dog, yes, I would stop the Vetoryl and ask for another ACTH now. The drug should have been stopped completely when he first got sick and the dose was lowered. Lowering was not the correct response - stopping the med until signs reappear AND an ACTH shows the cortisol is elevated again is the correct protocol when the cortisol goes too low. His electrolytes should have also been checked at that time. Please let us know how he is doing over the next few hours and days.

Hugs,
Leslie and the gang

[Annalie]

Thanks Leslie, I will keep you updated. I can't tell you how helpful it is to speak to someone who has some idea of what we're dealing with. Max always filled the house with his character before this all started and within weeks he is a hairless shell of his former self. Thanks again.

[Harley PoMMom]

Yes, please do stop the Vetoryl. If Max's cortisol has dropped too low his electrolytes could be unbalanced too. Both of these conditions have to be addressed ASAP. 120 mg of Vetoryl is almost twice the amount of Vetoryl recommended for a dog weighing 29 kg (63.8 lbs). Dechra, the makers of Vetoryl, have recently published a revised initial dose protocol, which is 1 mg/kg, so Max should have started out at no more than 60 mg.

I am really worried about your sweet boy, is he eating normally, how about his drinking, any diarrhea? Please do let us know how things are going, ok?

Hugs, Lori

[Annalie]

Hi
I am still trying to get hold of our vet. Max is a little better in himself, but still very far from his former self of 8 weeks ago. I'm hoping they will release the actual results from his last blook tests so that I can share these with you. Would they normally test his electrolytes when doing the monthly blood test?
Annalie

[judymaggie]

I'm hoping they will release the actual results from his last blook tests so that I can share these with you.
Annalie

Annalie -- I believe that, since I paid for every one of my Abbie's tests, I am entitled to get hard copies of all test results. I know that some folks here get the test results e-mailed to them -- my vet's office doesn't do this but you can ask if this is a possibility at Max's vet.

[Harley PoMMom]

Here in the U.S., by law in most states, when a client has written a request for their dog's medical records, they have to given to them, now, the vet does have the right to charge for copies.

Generally with a chemistry blood panel the electrolytes are included. But, when a dog is on treatment for Cushing's, whether it be with Lysodren/Mitotane or Vetoryl/Trilostane, and they are showing signs of their cortisol going to low it is a good idea to have the electrolytes checked along with the ACTH stimulation test.

So Max is feeling better? And is his appetite normal? Any diarrhea or vomiting going on?

Hugs, Lori

[molly muffin]

I just want to welcome you to the forum. The others have covered the basics, yes you need and should have no problem getting copies of all test results.

When was the last ACTH done?

Retrievers can be very sensitive to the ups and downs of steroid. One of the first thing that happened with my retriever (she was on a steroid for allergies) was the hair loss and her skin seemed so sensitive she wanted to be touched and loved on, but her skin just rippled at the smallest touch. Also it smelled all the time, which I think was yeast infections. This was many years ago and I didn't know any of the stuff I know now, but too low of cortisol can have bad effects on any dog.

I'd definitely not be giving any vetroyl until symptoms of cushings came back and then only after a test to verify the levels where rising.

[Annalie]

many thanks for all your comments and help guys, it's been a huge help. After a lengthy discussion over the phone with our vet, they agreed Max' original dose of 120ml was too high and confirmed that they had not tested Max' electrolytes at all. They have now offered to do this test free of charge as a good will gesture, and I took Max this morning. He is now off the Vetaryl for the near future, I want to see if he improves without medication. He hasn't been sick but does eat a large amount of grass and went through a few days last week of retching but not bringing anything up. This however has passed now and his bowel movements look pretty normal except for the excess grass! I am also picking up a printed copy of all the test results Max has had over the past 10 weeks and will post these when I have them as they won't make a lot of sense to me no doubt! All in all Max is having an ok day today. Thanks again for you support and I well post the results tomorrow. Annalie x

[Annalie]

he began his treatment at the end of April and has had two sets of blood tests since not inlcuding this morning.
A

[Annalie]

well Max has been off Vetoryl for his third day and is wagging his tail and looking for food! his electrolyte test came back and the vet was happy that Max is not addisonion as I was beginning to fear after the initial overdosing. He is now off all medication and we are monitoring him ourselves. we may even go for a short stroll later! Didn't get printed results as I requested, but my faith is slowly coming back in our vet and they have been really helpful over the last two days as has everyone here. So will keep you all posted with Max' progress but at the moment our tails are wagging in Wales! Diolch xx

[molly muffin]

Excellent news! And tales again in Wales is just as it should be.

Yay!

[Harley PoMMom]

I am so happy to read that Max is feeling more like his "ole" self!!! My tail is wagging right along with Max's!! :D