Charlette - 10 y/o shih-tzu, Vetoryl

[Sydne Hoiness]

Hi, my name is Sydne, and I have a 10 year old permanent foster,Charlette, who was diagnosed with Cushing's disease. She is a sweet little shih-tzu who was turned into a rescue organization that I volunteer with, when her owner went into a nursing home. As a foster Mom, I am not really involved with her Vet visit. They do not confer with me or really give me any information. The rescue does pay for her meds and blood work, etc. I do have two other dogs,[one a senior) or would gladly adopt her. I did request and receive a copy of her lab results, and her records. She has been on Vetoryl capsules 10 mg. 2 in the a.m., but since her last lab work, they raised her meds to 3 per day. I have had her for 3 months, and was really surprised that her condition has gotten worse. I am faithful about her meds, and really try to monitor her diet. The vet said that her meds were at a low dose so that a increase wasn't unusual, but was wondering if I was giving her meds daily! Any suggestions of how to treat and support Charlette would be greatly appreciated. Thank you, Sydne

[labblab]

Hello Sydne, and welcome to you and sweet Charlette! Kudos to you for taking such good care of a special needs girl in addition to your two other dogs.

It is a shame that the rescue group is not sharing more information with you about Charlette's treatment and monitoring, because in conjunction with resolution of observable symptoms, lab results are a key component of treatment evaluation. By any chance, did the lab copy that you were able to obtain have the results of an ACTH stimulation test? This is the monitoring test that checks the effects of the triostane on the dog's cortisol level, and until the cortisol level falls within therapeutic range you can expect that symptoms will continue and perhaps even increase. So that is one of the first questions that I would want answered: what have been the results of Charlette's monitoring ACTH tests?

When you say that her condition has gotten worse, what exactly do you mean? Has there been an increase in outward symptoms? If so, do the symptoms seem to get worse later in the day? Trilostane has a relatively short effective life in the body, and some dogs need to be dosed twice daily in order to receive symptoms relief consistently throughout a 24-hour time period. Since you are giving Charlette individual 10 mg. capsules, this would be an easy shift to make: instead of giving 30 mg. all at once in the morning, you could give 20 mg. in the morning and 10 mg. in the evening. You should not make such a change without the vet's knowledge, of course. But if you were able to talk with the vet directly, this might be an option you could discuss.

So in summary, it will help us a great deal if you'll describe Charlette's troublesome symptoms, and also the specifics of the lab results you were able to obtain. Thanks very much in advance, and I'm really glad you've found us!

Marianne

[Sydne Hoiness]

Hi There, Thank you for being out there for people like me who are at a loss as to what to do with our little fur babies with Cushing's! I should have been more clear about her meds. She is now taking the two in the morning, and one in the evening. Her symptoms outwardly don't seem to be worse, it is just that her numbers are up. I am not very good at deciphering what her lab results mean, but I will share with you what I know. Her cortisol 1 level Result was 6.2ug/dl H, and her cortisol 2 was 19.2ug/dl H . Pre and Post. If this is the correct test, if not I will be more then happy to find it. I am trying to become more informed, as I have never dealt with this before. The rescue, as I said, are very good about paying for her tests, meds, etc., but they don't want me to become a pest, as they get big discounts on all of our rescues, as well as boarding. I have to get permission prior to taking her to the vet, and as I mentioned no contact with the vet is allowed. Any info, suggestions or more questions, I would be very grateful. Thanks so much, Sydne

[molly muffin]

Hi and welcome. Okay you said she is getting 2 in the morning and one in the evening, so total of 20mg in the morning and 10mg in the evening?

Yes 19.2 is too high post ACTH. You are looking for under 9.0ug post with symptoms controlled.

One question would be if any other values are abnormal on her blood test, something a future adopter would need to know about. (might be a way to phrase it).
Also, you could ask them to set up a schedule for testing with the vets so that you could take her in on a schedule for the follow up tests.