My Oscar

[Oscarsmom]

Oscar is a 10 year old wire hair dachshund recently diagnosed with CC and very recently started on Vetoryl. He is a chubby boy, and the vet correctly started him at 1 mg/lb...he is a bit over 30 lbs and was started on 30 mg. His LDDS showed Cushings although could not differentiate between pituitary or adrenal. I started to suspect Cushings a few months ago because of a skin thing and he seemed to be drinking more. The skin was a staph infection which went away with antibiotics but came back. He then experienced bilateral hair loss which was when I was pretty certain it was Cushings, and was determined that it was with elevated liver enzymes and of course the LDDS. I am hopeful, but terrified, about the Vetoryl. I am terrified of all of this! He has had no accidents, but had been experiencing some leg weakness...cautious about jumping on the furniture, which I attributed to his weight and age.
I am a lab tech by trade so I understand the lab values. I just love the positivity you all have for the newbies!
Just wanted to introduce us!

[Harley PoMMom]

Hi and welcome to you and Oscar!

I am sorry for the reasons that brought you here but so glad you found us. I took the liberty and added calcinosis cutis (CC) to Oscar's thread title so members that are dealing with calcinosis cutis will see this and can respond.

That CC can be difficult to get a control on and it seems that it gets worse before it gets better. Renee is our resident CC expert and I am pasting a post from her to a new member whose dog is experiencing CC:
Hi Kat, this statement is just not true.

What is true is that we have some documented cases on this board, in the past, where people have not had success controlling CC when using vetoryl. With what we know now, there are two reasons for this. First is that for some dogs, vetoryl just does not work in general. Secondly, (and I believe this to be the bigger reason) is that unlike lysodren, the acceptable range of control with vetoryl usage is much higher, at 9.0 ug/dl. What we know about CC is that the post cortisol, regardless of control over other symptoms, simply needs to get below 5.0 ug/dl and stay in that lower range long-term. If a dog with CC stabilizes on vetoryl at a post cortisol higher than 5.0 ug/dl, then they may think they have controlled cushings, but not see resolution of the CC, due to the cortisol still being to high to significantly impact the CC.

My pug Tobey has not had the very worst CC ever, but she did have it fairly bad, and likely one of the worse cases on this site. Her lesions are documented somewhat in my album. Before it was all said and done, she had lesions from the top of her head down to her tail. It took 6+ months to heal, and only when I got her cortisol low enough. Time and again, I have seen it reoccur when she's rebounded higher than 5.0 ug/dl. In fact, she has a small active lesion now, which I think may be to due being off her meds for 2-3 weeks in December.

Moving on to dear Maggie - it sounds like her CC has not erupted terribly and I do hope you have caught it early enough to head it off before it gets worse. My personal experience, through trial and error, has been that keeping it dry and bacteria free is most important while you wait for her cortisol to come down. If the lesions are not cracked, open, bleeding, or angry, then you are very lucky indeed. If any of the above happens, best to run a course of abx, since the lesions themselves are prone to secondary infection. Do not put any creams on the sores, especially not a steroid cream! I used tea compresses to soothe and moisten / loosen some of the harder patches so they could come off. I also dabbed with betadine when they started to dry up a bit. Sadly, CC does usually get worse before it gets better, but you may have caught it early enough that you won't experience that too much. I personally never bathed my pug during the bad part, but some people have used medicated baths to help. That's a personal choice. You may see some say that DMSO works. I'll leave that up to you. It can't hurt, but I found it to be a complete waste of time. The most important thing I can tell you is that there is nothing you will find to 'cure' the CC, other than to bring her cortisol down. There is nothing else that can cure it. Do not get too wrapped up in trying to find a cream, ointment, shampoo, etc that you forget your number one enemy - cortisol.

Could you tell us more about Oscar and share some of his medical history with us? We ask a ton of questions and then based on your answers it enables us to give you our best possible feedback, ok? So here goes some questions from me!

Did his CC get diagnosed with a biopsy? What symptoms did/does Oscar display that led you or the vet to test for Cushing's in the first place? Could you get a copy of that LDDS test and post those results? Is Oscar taking any other herbs/supplements/medications? Does he have any other underlying illness? Did the vet tell you that Vetoryl has to be given with a meal and that the monitoring ACTH stimulation tests have to be performed 4-6 hours post pill? Is an ACTH stimulation test scheduled in 10-14 days to have his cortisol checked?

Cushing's is a treatable disease and many of our members are having success in treating their cushdog with Vetoryl. It takes an experienced vet and an educated pet owner to facilitate safe and effective treatment and when one or both is missing is when dogs get into trouble. Vetoryl is a strong drug and does have some pretty scary side effects listed, however, adverse effects are minimized when the proper treatment protocols are followed.

I realize that you may have some apprehensions in starting treatment but you are not alone and we will walk this journey with you. If you have any questions please do not hesitate to ask them.

Oh, here's a link to info regarding Trilostane/Vetoryl, it's in our Helpful Resource forum and you will find loads of information there.http://www.k9cushings.com/forum/showthread.php?t=185

Hugs, Lori

[judymaggie]

Hi to you and Oscar! It is only natural to be terrified of a disease that most of us were completely unfamiliar with prior to diagnosis. My peace of mind comes with reading and more reading. Lori has gotten you off to a great start with info and questions. Do take some time to read the articles in the Helpful Resources forum. Ask as many questions of us that you need to and we will all be walking right next to you as you continue down the treatment road!

[molly muffin]

Hello I just want to say welcome to the forum and reiterate that what we have seen on the forum is that a post of under 5ug is most helpful with getting control over cc long term. It is a bit of a journey, but very possible to get under control.

[Oscarsmom]

Obviously I'm a newbie, because I thought CC was canine cushings! He does have a skin condition that was diagnosed as a staph 8nfection and has cleared up in the past with antibiotics. It was that , an increased water intake and bilateral hairloss that led me to the vet a few weeks ago. I was suspecting Cushings about 3 months ago but there was nothing definitive. We went to the vet and he did a blood panel which showed elevated liver enzymes, specifically ALP, and cholesterol. That paired with the hairloss was enough to test. He had the LDDS last Tuesday which was positive for Cushings. Started him on 30 mg of Ventoryl on Friday.

My vet is fantastic...I am so comfortable with him. He talked to me for about 45 minutes on the phone. He manages quite a few dogs with Cushings in his practice and all are doing well. Hi mother used to work with me so he's very patient with my craziness.

Thank you for your responses! I'm hoping to be as knowledgeable as you are someday, but until then I am thankful to have you all to help me through this!
Barb

[WeLoveAthena]

Hello
We are still very new here with a newly diagnosed Silver Lab that has Cushings. Just wanted to say you found a great place with awesome people and you don't have to go through this alone. This place has been a lifesaver for us all.
Thinking of you and Oscar.
T~

[Harley PoMMom]

Obviously I'm a newbie, because I thought CC was canine cushings!
Barb

Oh crap, I am so sorry, I shouldn't of assumed that you were talking about calcinosis cutis...my bad...and I will correct your thread title.

Hugs, Lori

[Renee]

Obviously I'm a newbie, because I thought CC was canine cushings!

This gave me a good little laugh. :D So glad your baby doesn't have calcinosis cutis (otherwise known as the dreaded CC). Don't worry, with or without CC, we are here to help!

[molly muffin]

Yay! Calcinosis cutis is one of the hardest things to deal with with Cushing's so if your furbaby doesn't have that particular symptom that is a good thing!

[Oscarsmom]

So we are 16 days into Vetoryl...he is 30 lbs (he's a standard dachshund who is fat!)...and my (wonderful) vet started him on 30 mg 1x day. So far no side effects and first stim test was promising, although not perfect...preliminary was 6.9 and post was 17.8. My vet wants to stay on the same dosage for another two weeks then repeat the stim test. He thinks we will go up 10 mg, 2x/day, possibly either 20 and 20, otherwise 10 and 30. I see some relief from the unquenchable thirst...and he never peed in the house. I can't see any food differences, but he's always been a good eater, hence the 30 lbs. I do notice on the once/day dosine, he seems to drink more at night and his leg weakness appears more at night than in the day! No questions here, but I love your forum and just wanted to let you know how he's doing!

[My sweet Ginger]

Thank you for your update and I like your vet, too.
Will look forward to see the results of his next ACTH test.

[labblab]

Thanks so much for this update, and I'm so glad Oscar is doing well. I'm in total agreement with your vet's approach, and the only suggestion I would make is to switch the dosing to 30/10 (rather than 10/30) if that is the twice daily option that you choose. If twice daily doses are going to be unequal, Dechra specifically recommends giving the larger of the two doses in the morning. That way, the monitoring ACTH testing will proceed 4-6 hours after the larger dose, thus still capturing the cortisol level at its lowest point during the day. Especially for safety's sake, this is important.

I might add that if twice daily dosing is less convenient for you, you might not wish to immediately rush into it if Oscar's cortisol level is still higher than therapeutic range after the next testing. You might just opt for the morning increase to begin with, because once Oscar's cortisol is lowered sufficiently after the morning dose, you may find that his symptoms no longer rebound later in the day. If twice daily dosing is no biggie to you, then it's a moot point. But bear in mind that trilostane must always be given with a meal to ensure adequate absorption.

Definitely continue to let us know how things are going for you guys.

Marianne

[Oscarsmom]

Twice daily wouldn't be a big deal...he used to only eat in the evening, now we feed him twice so it wouldn't be a problem! Thanks for the advice about the twice daily dose!

[Oscarsmom]

Update...we had our second stim test on Tuesday. The results are better but not perfect...the pre sample was 1.6 and the post was 13 (down from 9 and 17)! My vet was calling a specialist to see what dosage we should adjust. He still is hungry and drinks a bit, and has some leg weakness but his skin looks better. I'm hoping to get adjusted and start fixing some of his symptoms!

[molly muffin]

Remember that cortisol will continue to decrease on the same dose for approximately 30 days.

What did the specialist recommend?