Dog had stroke

[Pinkpossum]

PLEASE SEE POST 9/01/17 re restarting treatment.
I have a whippet ,who was a rescue and is about six years old. He has always been a greedy dog (he was starved as a puppy )so initially put his pot belly and greed down to this . His coat also has never been great so again we perhaps missed the initial signs .He use to have a chronic cough which has been better the last 18months or so .It was only when he started drinking and peeing more that alarm bells rang in my head.
He was tested at the vets and has Cushings and his high steroid levels could possible account why his cough was better.We decided to treat as he is a young dog .
Ten days on vetroyl he collapsed , confused disorientated and had a wonky head . Took him to the vets who checked his bloods all ok so not addisons but symptoms where that of a stroke. We stopped the vetroyl as the vet said that if he has a stroke or has got a tumour then his natural steroid level would help any inflammation in the brain .On hindsight he had a funny turn a few months ago too.
Anyway he is now recovered more or less from his stroke but is back showing signs of Cushings and I am back letting him out for a pee twice a night.
The vet is reluctant to recommence medication as she thinks this would worsen neurological symptoms again.
I feel we are stuck between a rock and a hard place , we are dammed if we do or dammed if we don't .
I welcome any comments or advice please . Thank you

[Harley PoMMom]

Hi and welcome to you and your sweet boy,

Gosh I am sorry that your dear boy is going through so much and that you are in such a dilemma. :(

We ask a lot of questions to our new members in which allows us to provide meaningful feedback, so here are some of mine. If you could get copies of his ACTH stimulation tests and post them here that would be great. Could you also post the results of the diagnostic test/s that were performed to diagnose his Cushing's? I see that a chemistry/CBC blood panel was done, could you post those values that are marked abnormal with their reporting units and reference ranges? When he collapsed did they check his cortisol level to make sure that it didn't drop too low? If not than his adrenal glands may not producing enough cortisol and this is known as an Addison's crisis, which is life threatening in itself and he would need a supplemental steroid treatment such as prednisone. What dose of Vetoryl was your boy taking and how much does he weigh?

Since the vet feels that your boy has a pituitary macroadenoma, I gather that your boy was diagnosed with the pituitary type of Cushing's, correct? If so, unfortunately, the only way to definitively diagnose a macro is through imaging of the head (CT or MRI) which can be very expensive. We do have some members that have had success with radiation therapy for their dog's expanding pituitary tumor, unfortunately this can also be very expensive. I'll provide a couple links to their threads in hopes that it may help you decide if this could be a viable option:

http://www.k9cushings.com/forum/showthread.php?p=174935#post174935

http://www.k9cushings.com/forum/showthread.php?t=6383&page=37

I am sorry for the reasons that brought you here but glad you found us and we will help in any way we can.

Hugs, Lori

[Pinkpossum]

Thank you for your reply.
I don't have access to his blood results but it wasn't Addison's and his bloods were ok ,his liver enzymes were still raised and his bp was high at 180.
I don't want to put him through an MRI or ct scan ,not only because of the expense but the stress for the dog . Additionally radiotherapy is not standard treatment in the UK ,so not sure if having a definite answer would alter things.

He was on 30mg vetroyl and he weighs about 17kgs .The vet said we could perhaps in a few weeks give him a very small dose just to try and stop the excess drinking and peeing but she wasn't to keen on doing that as it risked another neurological episode .

I will have a look at the links you have provided 😀Thanks again

[molly muffin]

He was on an appropriate dosage for his weight to start with but the vet is right if it is a brain tumor that is putting pressure on then it is a hard spot to be in. A very low dose Might help with the peeing and drinking, but you don't want to risk any other problems with the neurological. If you do try, do a very small amount, like maybe 10mg to see if it makes a different and closely monitor cortisol levels.

[Pinkpossum]

Thanks for your reply. I am coming round to the idea of just letting him enjoy his life , giving him a lose dose vetroyl would only be for my benefit ,would involve him having visits to the vets(which stresses him out), it would run risk of another stroke and a low dose would not perhaps be enough to stop the other problems associated with Cushing .

[molly muffin]

Quality of life is always one of the most important factors when considering what steps and treatment to do going forward.
I think it is right to evaluate that and take into consideration that there is a possibility of the medication not being beneficial for him.

[Pinkpossum]

I have an eight year old Whippet (Ash)who was diagnosed with Cushings two years ago . We began to treat him with vetroyl 30mg and his blood results indicated this was the current dose for him . However he had a very disturbing vestibular episode with high blood pressure,very odd behaviour it was almost like he had a stroke. The vet at the time suggested we stop treatment as perhaps the tumour was larger and the extra cortisone (caused by the Cushings) was actually keeping the tumour in check as it were.

Now two years on Ash is in a very poor state ,he has lost lots of muscle , we can no longer walk him ,he is incontienent , we are up at least twice in the night and he is very unhappy and is very uninterested in life.

We went to the vet and were told to either have him put to sleep or restart vetroyl.

We have restarted vetroyl on a low dose 10mg ( alternative days) .

My questions
1)As Ash is in such a poor physical condition ,will any of his symptoms be reversible. Will he regain muscle tone ? will his kidneys and internal organs be permanently damaged?

2) Is he likely to have another vestibular incident ?

Please has anyone had any similar experience . I can't decide what the kindest path to take is .

Thanks

[DoxieMama]

Welcome back to you and Ash, though I am sorry that he is not doing so well. Do you happen to have results of any tests that have been done on him for diagnosis/treatment? How long has he been on the vetoryl now? I don't know that there is any way for you to know if he will have another incident or not... just be very watchful for anything untoward to occur and stop treatment right away. Hopefully others with more experience will be along and can provide more helpful suggestions.

Shana

[Pinkpossum]

I haven't got his blood results . He is a very sick unhappy dog and I am not sure what level of physical improvement now he's at this stage we can expect . And if we did get him up a therapeutic level what are the odds of another vestibular incident. I was surprised the vet suggesting restarting treatment was an option.

[judymaggie]

Hi -- I just have a moment right now and will be back in a bit but I wanted to let you know that I have merged your original thread with your new one. This way everyone, including yourself, will have all of your pup's history in one place.

[molly muffin]

Oh your poor boy. I'm sorry he is having such a hard time. It sounds like the vet is thinking this is a last ditch effort. There is no way to say for sure how he will respond. The lowest dose of vetroyl that helps him would be the best of course, due to the effects he has last time.

I do want to let you know that there is also a 5mg of vetroyl.

[Pinkpossum]

Having had another night(I can't remember when I've not been up to him ) where he's needed to go out for a wee , which can take him easily ten minutes and coming back in after leaving him briefly today to finding a large puddle,I feel the kindest thing is have him put to sleep.

His condition is worse , he's been on vetroyl (albeit an ultra low dose) for over a month . He does display neurological symptoms and at his stage I fail to see trying to restarting treatment wil(or is) having any significant benefits.

[molly muffin]

I'm sorry to hear this but we do understand. You are there with him and know how he is responding or not responding. The neurological symptoms might only get worse and can be quite concerning to watch. Scary even and very sad.

Know we have you in our hearts during this really difficult time.

[DoxieMama]

Oh I am sorry he's having such troubles, and wish I had a suggestion to offer to help him. You know your boy best. Please know my thoughts and prayers are with you.

[judymaggie]

My heart goes out to you--often the kindest thing we can do for our beloved pets is to set them free but it is definitely the hardest for us humans.

[Joan2517]

It is such a hard decision to make, but sometimes it's the only one. Sending comforting thoughts.....