Lil Lacey's Mom
06-08-2015, 01:09 AM
Hi Everyone,
I joined the forum but haven't posted until now. I am so thankful that there is a place like this to read other people's stories and get feedback from those who have been down this path. Until we suspected Lacey had Cushing's after searching for possible causes for her symptoms, I had never heard of Cushing's and many people I've tried to talk to about it are not familiar with this disease. I was hoping to get some advice or at least find out if other dogs experienced extreme lethargy and bloody diarrhea while taking Vetoryl.
My dog, Lacey, a nearly 14 year old Bichon Frise, was diagnosed with the pituitary form of Cushing's last August after a low dose dex test, although we suspected she had Cushing's for a long time prior as she displayed most of the symptoms- pot belly, ravenous appetite but not putting on weight, increased thirst, elevated liver enzymes, enlarged liver, increased panting, pacing, thinning coat and head pressing. Our vet also did an ultrasound to rule out the adrenal form of Cushing's. It took a long time to get an official diagnosis of Cushing's because she wouldn't test positive- her results were not considered high enough out of normal range.
Following the diagnosis, my vet (who is doing the best he can given his limited knowledge on Cushing's) suggested we try the lowest dose, 10 mg, of Vetoryl (trilostane) once per day in the morning. Her subsequent ACTH test suggested that her cortisol levels were almost unchanged even on the medication so we increased the dose to 20mg per day. We would occasionally give Lacey days off because she would experience side effects especially diarrhea and extreme lethargy. Those days off seemed to alleviate the symptoms but then too many days off in a row resulted in her Cushing's symptoms returning, mostly ravenous appetite (where she would bark and beg for food every hour or so all night long) and head pressing. Anyway the increased 20 mg dose with days off here and there seemed to work for a while and her test in November revealed that her cortisol levels were properly controlled. We maintained the dose but Lacey's lethargy got worse. She slept all day and after dinner. She was almost unresponsive so we told our vet and started giving her days off. That seemed to help for a little while but then Lacey started getting bloody diarrhea, a symptom I've never seen her have in her whole life. At first it was just a small amount but then she would have it multiple times/days in a row. We told our vet but he didn't suggest taking her off Vetoryl but rather told us to give Lacey medications including Diagel, Endosorb and metronidazole. It cleared it up for a while but once she went back on Vetoryl to curb her Cushing's symptoms, it returned again. During this time Lacey also took another ACTH test and the results indicated that her cortisol levels were very low. (Later found out from the endocrinologist that read Lacey's results that those levels can be fatal for some dogs and to only give Vetoryl as needed with days off because bloody diarrhea is very troublesome. And to discontinue use for a while should she have bloody diarrhea.) Our vet said no more 20mg doses, only 10 from now on but if Lacey is on even the 10 mg schedule for more than a few days in a row she gets very lethargic and has diarrhea, sometimes bloody. Today was the most recent time she had bloody diarrhea and she only had the 10mg dose 2 days in a row. She also had another ACTH test that we are waiting for results on.
My questions are: is anyone else having this problem with their dog? Is there something else we can talk to our vet about trying as a treatment? Our vet does the best he can but this is a rare thing for him to treat. It's frustrating because for a small amount of time, Lacey was doing well on Vetoryl - no head pressing, sleeping better, no ravenous appetite, even her fur started to become thicker and healthier looking. But now the bloody diarrhea and even lethargy worry me. I know based on research that Vetoryl is supposed to be easier on dogs than some of the other medications which is why I think my vet clings to it as treatment.
Thank you for reading this and for any help/advice you can provide. We want Lacey to have the best quality of life we can give her.
I joined the forum but haven't posted until now. I am so thankful that there is a place like this to read other people's stories and get feedback from those who have been down this path. Until we suspected Lacey had Cushing's after searching for possible causes for her symptoms, I had never heard of Cushing's and many people I've tried to talk to about it are not familiar with this disease. I was hoping to get some advice or at least find out if other dogs experienced extreme lethargy and bloody diarrhea while taking Vetoryl.
My dog, Lacey, a nearly 14 year old Bichon Frise, was diagnosed with the pituitary form of Cushing's last August after a low dose dex test, although we suspected she had Cushing's for a long time prior as she displayed most of the symptoms- pot belly, ravenous appetite but not putting on weight, increased thirst, elevated liver enzymes, enlarged liver, increased panting, pacing, thinning coat and head pressing. Our vet also did an ultrasound to rule out the adrenal form of Cushing's. It took a long time to get an official diagnosis of Cushing's because she wouldn't test positive- her results were not considered high enough out of normal range.
Following the diagnosis, my vet (who is doing the best he can given his limited knowledge on Cushing's) suggested we try the lowest dose, 10 mg, of Vetoryl (trilostane) once per day in the morning. Her subsequent ACTH test suggested that her cortisol levels were almost unchanged even on the medication so we increased the dose to 20mg per day. We would occasionally give Lacey days off because she would experience side effects especially diarrhea and extreme lethargy. Those days off seemed to alleviate the symptoms but then too many days off in a row resulted in her Cushing's symptoms returning, mostly ravenous appetite (where she would bark and beg for food every hour or so all night long) and head pressing. Anyway the increased 20 mg dose with days off here and there seemed to work for a while and her test in November revealed that her cortisol levels were properly controlled. We maintained the dose but Lacey's lethargy got worse. She slept all day and after dinner. She was almost unresponsive so we told our vet and started giving her days off. That seemed to help for a little while but then Lacey started getting bloody diarrhea, a symptom I've never seen her have in her whole life. At first it was just a small amount but then she would have it multiple times/days in a row. We told our vet but he didn't suggest taking her off Vetoryl but rather told us to give Lacey medications including Diagel, Endosorb and metronidazole. It cleared it up for a while but once she went back on Vetoryl to curb her Cushing's symptoms, it returned again. During this time Lacey also took another ACTH test and the results indicated that her cortisol levels were very low. (Later found out from the endocrinologist that read Lacey's results that those levels can be fatal for some dogs and to only give Vetoryl as needed with days off because bloody diarrhea is very troublesome. And to discontinue use for a while should she have bloody diarrhea.) Our vet said no more 20mg doses, only 10 from now on but if Lacey is on even the 10 mg schedule for more than a few days in a row she gets very lethargic and has diarrhea, sometimes bloody. Today was the most recent time she had bloody diarrhea and she only had the 10mg dose 2 days in a row. She also had another ACTH test that we are waiting for results on.
My questions are: is anyone else having this problem with their dog? Is there something else we can talk to our vet about trying as a treatment? Our vet does the best he can but this is a rare thing for him to treat. It's frustrating because for a small amount of time, Lacey was doing well on Vetoryl - no head pressing, sleeping better, no ravenous appetite, even her fur started to become thicker and healthier looking. But now the bloody diarrhea and even lethargy worry me. I know based on research that Vetoryl is supposed to be easier on dogs than some of the other medications which is why I think my vet clings to it as treatment.
Thank you for reading this and for any help/advice you can provide. We want Lacey to have the best quality of life we can give her.