5 yo Golden Retriever diagnosed this morning :(

[kralowsk]

Hi everyone,

My 5.5 year old Golden Retriever was just diagnosed with Cushing's Disease. We have noticed that he has been drinking a ton of water, urinating frequently, and panting excessively for a while now (maybe a year). In the fall (September 2015) our doctor did a complete blood workup and urinalysis. The only thing that came back was diluted urine. They also did an ACTH test that came back negative and a low-dose dexamethasone suppression test that was positive (I believe that is what it was - one was positive for Cushing's and one was within normal limits). Since that time, we have noticed our dog (Oakley) drinking way more water (even throughout the night), urinating more frequently, developing a little bit of a pot-belly, and noticed that his hair had not grown back from where he was shaved almost a year ago. We held off on more tests for a while because they were so expensive! But this morning the vet brought in a specialist to do an ultrasound and they found that his adrenal glands were very enlarged and confirmed his Cushing's diagnosis.

Oakley is going to start Trilostane in a couple days - his starting dose is 35 mg 2x/day (he weighs about 75 pounds). I would love to get some info/hear some stories about your experience with Cushing's and with Trilostane! We are worried about side effects because we have heard such mixed reviews. Have you noticed your dogs feeling better after being on the meds? Should I be worried about serious side effects? It seems like they are starting him on a low dose.

Any help/info would be greatly appreciated!! Thanks!

[Harley PoMMom]

Hi and welcome to you and Oakley!

I have manually approved your membership so now all your posts will be seen right away. Also please just disregard the validation email that was sent to you from k9cushings.


Could you get copies of all tests that were done on Oakley and post any abnormalities that are listed? With respect to the blood chemistry and complete blood count (CBC), you need only post the highs and lows and please include the normal reference ranges. Does Oakley have any underlying illness that he is taking medication for? And if so, what is it and what is the medication? What tests were performed that diagnosed his Cushing's, and could you post those results too?

Oakley's Trilostane dose is right in line with what is recommended, which is 1 mg per pound of a dog's weight. Are you getting his Trilostane compounded? Has the vet mentioned that the Trilostane has to be given with a meal to be properly absorbed?

Trilostane does have some pretty scary side effects, however, adverse effects are usually not seen unless the proper treatment protocols are not followed. We have many members that are treating their cushdog with Trilostane and are experiencing success. The key to facilitating safe and effective treatment is an experienced vet and an educated pet owner, so the best advice I can give you is to do your research on Cushing's, the treatment protocols, and how it is diagnosed. With treatment dogs with Cushing's can have a good quality of life and there is every reason to believe that they can live out their normal life span.

If you have any questions please do not hesitate to ask them. I sure am sorry for the reason that brought you here but so glad you found us.

Oh, here's a handy link to our Resource thread where you will find a wealth of information about Cushing's:http://www.k9cushings.com/forum/forumdisplay.php?f=10

Hugs, Lori

[kralowsk]

Hi,

Yes I have Oakley's test results (these are from September). The only abnormalities were as follows:

- Blood glucose levels were slightly elevated (122 - Normal range is 63-114 mg/dL)
- Lymphocyte levels were slightly low (0.989 - Normal range is 1.06-4.95)
- Eosinophil levels were slightly low (0.052 - Normal range is 0.07-1.49)
- Urine was not very concentrated (both times it was tested).

I do not have copies of his ACTH and low-dose tests (also performed around September), but I know that the ACTH was within normal limits and his low-dose dexamethasone suppression test was indicative of Cushing's. His abdominal ultrasound just this morning confirmed pituitary-dependent Cushing's Disease due to enlarged adrenal glands. (We decided to bring him back for another test because his symptoms seemed to be getting worse and they were all consistent with Cushing's).

He does not have any other illnesses. He has been taking Dasuquin supplements for his joints because he was hit by a car a few years ago and broke his leg, and is a little stiff in that leg/joint at times. But he has not had any other illnesses and is not on any medications.

I am not sure if we are getting his Trilostane compounded, what does that mean? We were only briefly informed about the medication today. We are supposed to pick it up in a couple days and am assuming that they will give us more information at that time. However, I have read everything I can find about Cushing's and Trilostane!

I also read somewhere that owners should be given prednisone to administer if the dog is showing adverse side effects. Is this still common/necessary with Trilostane?

It makes me feel so much better to know that so many dogs are living happy and healthy lives with Cushing's/on Trilostane! It really worried us since Oakley is so young relative to most dogs with Cushing's. Thank you so much for your help!!

[Harley PoMMom]

Trilostane is the chemical name of a drug that is used for Canine Cushing's. It is also the active ingredient in brand name Vetoryl which is manufactured by Dechra. Dechra markets 5 dosage strengths: 5 mg., 10 mg., 30 mg., 60 mg., and 120 mg. capsules.

Pharmacies can compound and sell their own versions of Trilostane for veterinary use. Some wee dogs may need to be started at a lower dose of Trilostane that what Dechra makes and in that case the compounded form of Trilostane is needed, also if a dose strength is required that Dechra does not manufacture than compounding is an option. Another positive factor for compounding Trilostane is that it is cheaper than brand name Vetoryl.

There are important protocols to follow with Trilostane: it has to be given with a meal to properly absorbed; it has to be monitored with ACTH stimulation tests; those ACTH stimulation tests need to be performed 4-6 hours post pill; it's very important to be consistent in timing for those ACTH stimulation tests when contemplating dosage adjustments. We don't want to start one test at 10 AM, then do the next follow-up ACTH stimulation test at 2 PM and compare the results. Because of the relatively short-acting effects of Trilostane, the results of ACTH stimulation testing varies considerably with the time of testing relative to dosing.

Some vets/IMS' feel that since Trilostane has a short half-life, meaning it leaves a dog's system quickly, there is no need for a pet parent to have prednisone on hand. If a dog does show signs of their cortisol dropping too low sometimes just stopping the Vetoryl perks them back up. However, for my own comfort I do ask for the prednisone, I'd rather err on the side of caution.

I'm including a link from our Resource forum that has information regarding Trilostane/Vetoryl: http://www.k9cushings.com/forum/showthread.php?t=185

Hugs, Lori

[molly muffin]

Hello and welcome to the forum.

We use trilostane for my dog. She hasn't had any adverse reactions to it.

You are looking for a post result of under 1.5 - 5.0 ug on the post acth test once treatment starts and it can be as high as 9.0ug if symptoms are controlled.

I love goldens they are so good natured. Just dolls. My dog prior to molly was a golden whom I loved dearly.

You also might be able to get your trilostane directly from one of the online pharmacies at a lower price than your vets office, so that is something to look into also as we know these tests are expensive. Diamondback is one commonly used by many members.

[kralowsk]

Thank you everyone for your help/info! I feel much better about Oakley's diagnosis. We were told that he was starting at a dose of 35 mg so I guess it must be compounded. And thank you for the resources, it definitely is an extremely expensive disease to manage. Thank goodness for CareCredit!

[Harley PoMMom]

Thank goodness for CareCredit!

I second that!!

[judymaggie]

Hi! I just wanted to welcome you and Oakley. You are in great hands here--you can ask tons of questions and should never feel like you are bothering us.

[kralowsk]

Thanks everyone!! I also had a question about the timeline of the follow-up tests. Our vet mentioned that she wanted to do follow-up ACTH tests at 2 weeks out, then a month out, and then every three months. Does this sound right? Also, does anyone do follow-up tests every 6 months once the dose is established? Oakley is only 5 and a half, so the idea of a $400 test every 3 months sounds a little daunting! He is supposed to start his Trilostane tonight so hopefully he handles it well!

[judymaggie]

Hi! Your vet is following the evaluation guidelines set out by Dechra, the manufacturer of Vetoryl. Here is a link to Dechra's flow chart which shows these:

http://www.dechrace.com/pdfs/vetoryl/VETORYLTechnicalBrochure.pdf

We have seen some vets who forego the two week ACTH if everything is going well in terms of reaction. I personally wanted confirmation that all was well at that point! Cortisol levels can change even if on what has been an appropriate dose so I believe that is the reasoning for the every three month testing. Others might have some thoughts about moving the timeline to six months.

[kralowsk]

Hi everyone!

My pup, Oakley, has only been on Trilostane for a day or two so I am probably getting a little ahead of myself. However, I had a question regarding long term monitoring of side effects. We were told to immediately call our vet and possibly stop administering the Trilostane if Oakley vomited or had diarrhea. This makes sense in the short term, but Oakley is only five years old and my dogs usually vomit/have diarrhea a handful of times throughout the year for whatever reason (just isolated events). I assume it's usually because of something they ate, stress, etc. (we have been told that sometimes our Golden throws up when we leave on vacation). I was wondering - for families who have had their dogs on Trilostane for a while - do you need to take them in for a big ACTH test and stop the meds temporarily every time they throw up or have diarrhea? I hope that all makes sense. Thanks for your help!

[Harley PoMMom]

Hi! As you can see, I've merged your new post into your original thread about Oakley. This way, Oakley's entire health and treatment history are all in one place.

Anytime a dog is not quite acting normally the Trilostane should be withheld. Since Trilostane leaves a dog's system rather quickly sometimes just stopping the Trilostane will perk the dog back up, if it doesn't or the dog continues to feel/look unwell an ACTH stimulation test is needed.

[molly muffin]

It doesn't hurt them to with hold the trilostane till they are better and it's safer to do so too.
I've done it several times since my molly has gastric upsets off and on throughout the year too. She doesn't vomit but she does get diarrhea from it. Then a bit of pumpkin helps and a probiotic.

[kralowsk]

Thank you for all of your info! Oakley seems to have diarrhea whenever he's stressed and we have visitors coming in a few days (with their dog and cat) so I wouldn't be surprised if he has some symptoms then! But he has been on the Trilostane for two days now without any side effects!

[molly muffin]

That is great he is doing good. If you start to see some soft stools maybe introduce about a tablespoon of pumpkin plain canned. Not the pie filling with spices and see if that helps. Don't over do it. Just a bit.

Hopefully he won't stress though

[Oscarsmom]

I am new to this as well.,.my 10 yr old dachshund was diagnosed in January, and has been on Vetoryl for 16 days. He takes it like a champ in a bit of cheese and we have had no side effects. We did our first stim test (I'm lucky, my vet only charges $150), and it showed improvement but will repeat in a another 14 days before we increase dosage. I was terrified to start it because of what I was reading, but it has been uneventful for us. Good luck...this site is great for questions!

[kralowsk]

Hi,

Another random question - since we have to give Oakley the Trilostane twice a day, does anyone know how close to 12 hours we need to be? Does it matter if we give him the meds about 10 hours apart with his meals? It can just be a little hard to do his meals exactly 12 hours apart some days. Thanks for your input!

[WeLoveAthena]

Hi There

I'm still fairly new here but just wanted you to know we have a Silver Lab, Athena, who is 4 and a 1/2 years old and just recently diagnosed with Cushing's which is young for this disease according to our Vet. She was started on Vetoryl. Her dose was just increased yesterday because we asked she originally start a low dose to see how she would do with the meds. It was apparent she needs a bit more. We know the feelings you are going through. You want the best for Oakley.

You found the best place possible here. I will tell you that these wonderful people here were a godsend to us. We came here in a state of shock and with big concerns for our Athena and everyone here helped us through that first awful week. They are so kind here and let me tell you they know their stuff.

We were a little worried today when we gave her the extra medication for the first hour but she seemed to perk back up. Praying that this dosage starts to really help her.

We wish you and Oakley the best. Happy you found this site. It will be such a lifesaver to you in so many ways

Welcome :-)

[judymaggie]

Hi! The main goal of twice daily dosing is to maintain an even level of cortisol. With that in mind, I don't think that deviating from the 12 hour schedule on an occasional basis would be significant. My Abbie gets her dose twice daily and I know how hard it is to stick to that schedule. The Cushing's experts who talk about twice daily dosing say that one of the downsides is lack of owner compliance.

I read back through your thread and I couldn't find a reason given why you have Oakley on twice daily dosing. Did your vet decide from the outset that that is how you should dose him? My Abbie is being treated for high blood pressure and proteinuria so, hopefully, the twice daily dosing helps to control any cortisol spikes. Some dogs start to show an increase in symptoms as the day progresses; twice daily dosing can help keep the symptoms on an even keel. I am thinking that it might be a good idea to discuss with your vet the possiblility of you switching to once a day dosing.

[kralowsk]

Hi,

Thank you everyone for your posts! I am not sure why they started him on 2x/day. I assumed it was to ease him into it but they never gave me a reason. Would his cortisol levels still be under control for the full 24 hours with 1x/day doses? He drinks a lot of water in the middle of the night, I am not sure if that made a difference in their decision.

[kralowsk]

Hi,

I've also noticed that Oakley has developed a rash on his belly (he's been on the Trilostane for 11-12 days). Has anyone else noticed this? I am not sure if it is irritated from his belly being shaved for the ultrasound or a side effect of the meds.

[labblab]

Hi! It's possible that Oakley is having an allergic reaction to the trilostane, and I'm afraid you really need to report this to your vet. They may want to see him in order to assess what's going on. Just as the case with any drug, trilostane can trigger an allergic reaction and if so, this could turn serious (respiratory problems, etc.) if it continues. Is trilostane the only change that has been made during this time period? Any other new foods or supplements?

Marianne

[kralowsk]

Hi,

Thanks for your reply. I just left a message with the vet :) Oakley is acting fine in every other way and it doesn't seem to be bothering him at all. Luckily we already have a vet appt in two days for his follow-up test, so we will mention it then. There have been no other changes since then (aside from his belly/abdomen being shaved). He had a superficial yeast infection a year or two ago and it almost looks like the same thing. I guess I will continue to give him the Trilostane until we hear from the vet or notice any other symptoms. Thanks again!

[judymaggie]

Hi! If you are still having trouble with the timing of the twice-daily dosing, you might want to discuss this with your vet at your upcoming appointment. Hopefully, the belly rash is easily treated -- it could very well be from the ultrasound shaving.

[kralowsk]

Thanks! I called our vet and she said the rash didn't sound concerning and is most likely not related to the Trilostane, but we are going to get it checked out on Wednesday :) I will also bring up the 2x/day dosing and see what they think.

[kralowsk]

Hi,

So Oakley is supposed to get his levels checked today but he threw up a tiny amount about an hour ago (he regurgitated about a fistful of his food). The vet is closed for another half hour so I thought I would try to get a response on here! We are supposed to give him his Trilostane now so we weren't sure whether to withhold it or still give it to him since he will be getting his levels monitored at the vet today. He seems fine in every other way :)

[labblab]

I would definitely reschedule the test for another day. The trilostane must be given at the same time as a full meal to be metabolized properly. So there are two issues here: the fact that Oakley has a GI upset and threw up in the first place, and also that the trilostane won't be properly absorbed. This can falsely skew the test results.

I would withhold his trilostane this morning, and then if he otherwise continues to seem normal, I would resume again tomorrow and then hopefully retest on Friday after also being dosed appropriately on Friday morning.

Marianne

[kralowsk]

Shoot well I had already spoken to the vet before reading this and they said to go ahead and give him his medicine with his food (since I had not fed him yet) and bring him in for his test since they would be monitoring/testing to make sure the levels aren't too low. Hopefully he doesn't have any GI issues that would skew the results!

[labblab]

No, under these circumstances I think it was fine that you took him in. I had misunderstood and thought he had regurgitated his breakfast that he had already eaten. But if he was able to take his trilostane with food and he didn't throw up again afterwards, it should be OK. And as they say, it will be good to make sure that low cortisol isn't the reason for the upset in the first place.

Do let is know the results!
Marianne

[molly muffin]

Oh yea the key is that he didn't throw up after he took the trilostane with his breakfast. Since he didn't it will be fine to do the test.

Timing is everything with these tests.

[kralowsk]

Thanks everyone! We just got Oakley's results. His results pre and post were 6 and 8 respectively. The vet said they want to keep him on the same dose since his symptoms are subsiding and under control and we will check again in 3 months :)

[molly muffin]

Good to hear that he is doing okay on that dose! Great news. :)

[labblab]

Yay, that's great news, indeed! Since this test was performed after two weeks on the trilo, I definitely would not increase Oakley's dose right now, either. I do want to point out, though, that if he is still exhibiting some symptoms after he's been on this dose for longer than a month, a retest and increase may be warranted at that time. In other words, I wouldn't wait for a full three months before checking him again. These current results will be considered therapeutic long term as long as he experiences symptom resolution. But if symptoms remain, his cortisol can safely be lowered even a bit more. His cortisol may continue to decrease a bit during this first month, all on its own. But as I say, I'd retest again at that time if he is acting unwell in either direction -- symptoms remain or if he instead starts acting as though cortisol may be dropping too low.

By the way, what did the vet think about his rash?

Marianne

[kralowsk]

Thanks! I will keep that in mind. And his rash went away on its own the next day! I am not sure what it was, something must have irritated him.

I do have another question - Oakley just vomited a little again just like he did two days ago (regurgitated a little of last nights food about 2 hours before breakfast). We have had visitors in town who have been feeding him table scraps this week and I'm assuming something is upsetting his belly. Do I need to withhold Trilostane for a day? Or continue giving it to him since we know his levels are good? He has been fine otherwise and is not showing any other symptoms or acting sick.

[labblab]

I think I'd go ahead and give it to him if he otherwise seems fine. But you really need to be firm with your guests about NO TABLE SCRAPS! Cushpups are thought to have a vulnerability to developing pancreatitis, and a sudden change in diet (especially fatty scraps) may be a trigger. Trust me, you do not want to prompt a hospitalization for acute pancreatitis! It always fries my brain as to why a guest or other family member would think it's OK to give somebody else's dog scraps. But definitely tell them to cut it out. Seriously.

Marianne

[kralowsk]

Hi everyone,

More stuff with Oakley! We had to take him to the vet today to get something removed from his paw. They aren't sure what it was (it looked like a second nail growing from his paw), but they said it was something he grew, not something he stepped on. They pulled it and it came right out! Anyway, he's on antibiotics and anti-inflammatories for a few days since he had an open wound on his paw pad. I just wanted to check that we should keep him on the Trilostane while he is on these new meds? We are going to double check with our vet, as well. Thank you in advance for your help/advice!!

[labblab]

Poor boy!!! Yes, unless your vet thinks differently, I'd see no reason not to continue his normal trilostane dosing.

What are the anti-inflammatories? If they are NSAIDS, then I'd think you'd have added reason to keep the cortisol in check (the combo of NSAIDS and elevated steroids is not good). And if they are instead steroids themselves, I'd think you'd want to keep the natural cortisol production stable so that you are giving a controlled dose of supplemental steroid. But let's see what your vet says.

I hooe Oakley's paw heals quickly!

[kralowsk]

Thanks! I am not sure what the anti-inflammatories are yet (my husband was the one who took him to the vet). Our vet said to keep him on the Trilostane but to stop giving him the anti-inflammatories if he begins to have side effects (vomiting or diarrhea). She also advised that we could give him some Pepcid AC to balance it all out.

[kralowsk]

Hi!

I feel like I have asked a million questions already haha but I have a quick question about stopping/starting their meds. My husband and I had a crazy week and didn't realize until yesterday that Oakley only had 2-3 days of Trilostane meds left. We called the vet and put in a refill order, but they won't get it in for another 5-7 business days. So Oakley will have to be off his Trilostane for at least 4 days before we get his prescription in :( I'm sure he might just develop some temporary symptoms again, but I was wondering if any of you have dealt with this/if this is really detrimental in any way (other than the inconvenience). Thanks!

[Renee]

I'm sure it will be fine, but it may delay your testing schedule.

Is there no other vet clinic in town that you can purchase a box from? I cannot believe it takes your vet 5-7 business days. What a bummer! My vet gets them over night .. but, of course, I buy mine online now, but still. Now that I buy online, I usually order 6 boxes at a time.

[kralowsk]

That's smart! I am wondering if his takes longer because it is compounded (35 mg)? Either way I am going to order another refill after a week or two!

[Renee]

Oh yes, I didn't even think of that. Compounded would take longer. I've only used brand name vetoryl.

I am sure you'll be fine!

Also, in the interest of science, lol, you'll be able to see how quickly or not that your pup will rebound. I have found it takes a week or less to see re-occurrence of symptoms in my girl.

[molly muffin]

I'm sure he will be fine, just as Renee mentioned, you're testing schedule will be off probably.

I get mine compounded but I get it usually the day after the order is called in, but it is a local pharmacy for me and they send expedited mail.

[kralowsk]

Hi everyone,

I was wondering if Cushings and/or Trilostane is associated at all with a little bit of nausea or upset stomach? My dog, Oakley, has been doing great on the Trilostane. However, recently he's been throwing up a little bit in the middle of the night (mostly undigested food) once or twice a week. Other than that he's been fine (no lethargy, loss of appetite, or diarrhea). It hasn't been enough for me to think he's sick since it's just every now and then. But when it happens it's always in the middle of the night and always undigested food. Just curious if any of you have come across this? We haven't switched his food recently, but maybe we are feeding him too much. Thanks as always for your thoughts!

[Harley PoMMom]

Trilostane is known to cause gastric upset and some members use Pepcid AC 20-30 minutes before the Trilostane is given, but please talk it over with your vet before using the Pepcid AC,

[judymaggie]

Hi! Trilostane can cause stomach upset for some dogs. I have given my Abbie pepcid AC (original) 20 minutes before each meal since she started on trilostane. I read back in your thread a bit and couldn't find if you are giving Oakley the trilostane once or twice a day. If you are giving it to him in the morning and you are seeing regurgitation (which is throwing up undigested food) in the evening, my inclination is that trilostane is not the cause. I have also read that you have seen this issue with Oakley for a while, albeit sporadically. How many hours after eating does Oakly regurgitate? Have you discussed this with your vet?

[kralowsk]

Thanks for the responses! I am giving Oakley Trilostane 2x/day. I give him one dose in the morning and one in the evening with his meals. At night he usually throws up anywhere from about 6-12 hours after his evening dose, so I am not sure if the Trilostane is the cause or not. I have spoken with his vet in the past but we decided it was most likely a mild gi upset. It has happened twice this week again so I will give our vet a call if it happens again.

I also just remembered that his dog food brand changed all of their recipes 2-3 weeks ago. We introduced the new recipe gradually but maybe his tummy isn't agreeing with the new stuff. I hate to switch his food if it's not the issue, but I will continue to monitor it.

Thank you!

[judymaggie]

If I were you, I wouldn't wait to call the vet. You have enough info to talk to him now. There is a distinction between regurgitation and vomiting. Here is an article that talks about the distinctions:

http://www.cliniciansbrief.com/sites/default/files/Regurgiation%20or%20Vomiting.pdf

Interestingly, the article indicates that timing of feeding is not a distinquishing factor.

[kralowsk]

I just heard back from the vet. Our normal doctor wasn't in but another vet told us to try 20mg of Trilostane twice a day (since he gets his meds twice a day). Does that sound right for a 70 pound pup? Thanks!! Hopefully this takes care of it :)

[labblab]

Honestly, before decreasing Oakley's trilostane dose, I believe you'd want to first perform another monitoring ACTH test to recheck his cortisol level on his current 35 mg. twice daily dose. The trilostane may or may not have anything to do with Oakley's vomiting/regurgitation. If they are unrelated, then lowering the dose won't help with the regurgitation and may worsen other problems.

I just checked back through your thread and it looks as though Oakley has only had one monitoring ACTH test done, and that was at the 14-day mark. At that time, his results were 6 and 8. Those results were definitely not too low, and would be considered "good" as long as all Cushing's symptoms remain under control. Otherwise, a dosing increase would actually be recommended. Since it is now about six weeks later, however, another ACTH test really would be appropriate and desirable.

In looking back, I also see that Oakley has been experiencing vomiting or regurgitation episodes all along, even when his cortisol level tested OK on that 14-day test. So personally, I have to wonder whether something else is going on with him that is unrelated to the trilostane or his cortisol level. However, just to make sure his cortisol has not dropped too low, I think it is time for another ACTH. And as I say, I'd want to see those results before altering his trilostane dose and ordering a new round of medication that may not be an appropriate dose for him.

I realize this puts you into a bit of a awkward situation, given the recommendation of this different vet. Have you ever worked with him before? When will your regular vet be available once again?

Marianne

[kralowsk]

Oh I'm sorry I meant that the vet recommended 20mg of Pepcid twice a day, not Trilostane. His Trilostane will stay the same :) sorry for the confusion! I was just curious if the Pepcid dose seemed normal.

And yes, he will sometimes do this where he throws up a could times a week in the middle of the night and then it will go away for a couple months. I'm hoping hes just had a sensitive tummy/some reflux since starting the Trilostane. He's been fine otherwise (no lethargy, diarrhea, or lack of appetite).

Thanks!!

[Harley PoMMom]

According to the websites I've looked at the Pepcid AC dose sounds right to me:
The dosage most often recommended for treating dogs is 0.25 to 0.5 mg/lb administered twice daily.

http://www.veterinaryplace.com/dog-medicine/famotidine-for-dogs/

You want to make sure that it is the regular pepcid ac, not the pepcid complete. I have used the generic version, Famotidine, which worked well.

Hugs, Lori

[kralowsk]

Thank you! We gave him 20mg of Pepcid before his dinner tonight but now he isn't wanting his food :( He ate most but over a longer period of time with lots of breaks. That's really not like him so we're going to withhold the Trilostane tonight and probably take him in to the vet tomorrow. It's always something with this one lol

[Harley PoMMom]

After a period of time taking Famotidine my Harley started to get nauseated on it so I switched him to slippery elm bark (SEB) which worked great. One caution note with SEB is that it slows down the absorption of other drugs or herbs so it is recommended that it be given 2 hours before or after other herbs or medications.

Hugs, Lori

[kralowsk]

Thank you! We are going to give the Pepcid one last try this evening but if it upsets his stomach again I will ask my vet about SEB :) The Trilostane seems to be the culprit. We withheld the Trilostane yesterday and he was fine - no GI upset. We gave it to him this morning with breakfast and he hasn't vomited but we could hear his belly gurgling audibly. It seems to just cause some mild GI upset (stools and energy levels have been normal throughout). Anyway, thanks for the suggestion!!

[kralowsk]

Hi everyone,

So Oakley's GI upset went away when we started him on 10-20 mg of Pepcid AC a day. However, I had another question (I feel like I'm always posting questions haha) - we have noticed the hair on Oakley's tail thinning over the past week and can now see the actual tail on the end/on the side. Have any of you noticed their tails balding? It looks pretty nasty :( He seemed to be feeling better in general but maybe his trilostane dose isn't high enough. We are traveling in a week or two so we don't want to increase his meds right before leaving him with a dogsitter for 8 days. Let me know if you have any thoughts/suggestions! Thank you!

[Joan2517]

Yes, Lena's tail got very sparse....it used to poof when she was groomed. About a year before her diagnosis, I noticed it didn't poof anymore and got very straggly looking...didn't know why until we found out she had Cushing's.

[Harley PoMMom]

My Harley got a rat-tail, he used to have such a beautiful bushy tail. Improvements in the hair issues can take a while to see, the hair follicles have to go through a cycle so they die off and then regrow.

[labblab]

Yes, I just wanted to add that Oakley's cortisol level may be just fine. But as Lori has said, many Cushpups go though a "molting" period soon after their treatment begins. The elevated cortisol of uncontrolled Cushing's disrupts the normal hair growth cycle. Once the cortisol is reduced and the growth cycle resumes, a whole bunch of hair may be lost in clumps. I can't speak for the tail, but the good news for my own Cushpup was that after the massive shedding, new hair started regrowing once again in the areas where he had been suffering from severe bald spots prior to his diagnosis.

Marianne

[kralowsk]

Thanks everyone! That makes me feel better, I was worried that his meds weren't working. We have noticed him shedding again so that makes sense. He is due for an ACTH follow-up test in July I believe so we can double check then :) Thanks!

[kralowsk]

Hi everyone,

So Oakley has had a growth coming out of his paw pad, we have noticed it getting bigger since the Spring. We brought Oakley into the vet yesterday to take a look at it (they've recommended letting it be in the past). They ended up taking a sample from the growth and said that it looks like a malignant tumor under the microscope. The sample was sent to the lab and we should get the results in a few days, but the vet said she definitely thinks it's some sort of cancerous tumor. My question is - is there a link between Cushing's and cancer? Does this mean that there might be a malignant tumor on his adrenal gland? Thank you for your help!

[Joan2517]

I'm sorry about Oakley's paw. I hope the results come back as benign.

[labblab]

Hello again, but I'm very sorry to hear about possible issues with Oakley's paw pad. In answer to your question, though, no I do not think that this skin cancer (if that's what this is) makes an adrenal tumor seem any more likely. I think if cancerous adrenal tumors spread, it's usually in the area of other internal organs.

Uncontrolled Cushing's does cause the overall immune system to be suppressed, leaving the dog generally more vulnerable to infections, etc. But as far as directly causing this paw tumor, no I don't think it's the case. Hopefully this is just a very localized growth, however, and can be totally removed. Does the vet have a game plan yet?

Marianne

[dsbailey]

Hello,

I just went through a semi-similar episode with my girl. It's possible what they were looking for and diagnosed was a Mast Cell tumor. I know they can do that with a scraping and in the vets office under a microscope. Google and read about it. If that's what they found then it was sent out to be graded. Even though they said "Malignant" it doesn't mean that it has spread or will, it all depends on the grade.

Grade I: Occur in the skin and are considered non-malignant. Although they may be large and difficult to remove, they do not spread to other areas of the body. Most mast cell tumors belong to Grade I.
Grade II: Found below the skin into the subcutaneous tissues. Their cells show some characteristics of malignancy and their response to treatment can be unpredictable.
Grade III: Originate in areas deep below the skin, are very aggressive, and require extensive treatment.

Have Hope - Darrell and Lolita

[kralowsk]

Thank you everyone! The growth was bleeding so the vet was able to extract some fluid to test. I believe she said she though it was either a mast cell tumor or round cell? I can't remember, but one was supposed to be easier to manage (probably taken care of by removing his toe) and the second was a more aggressive type which would have likely spread 😕 Maybe the grade I mast cell tumor is the one she was referring to, in which we could remove his toe and take care of it. We should get the lab results in a couple days so fingers crossed! Thanks again, I will let you know what the lab finds!

[rolfecms]

We hope the best for Oakley

[labblab]

Yes, absolutely! Just to let you know, my Lab had a mast cell tumor removed from his flank when he was about Oakley's age, and he never experienced any further problems once it was gone. I'll be hoping for the same with Oakley.

Marianne

[molly muffin]

Oh I do hope that it is fine once removed.

[LauraA]

My 13 year old Cush girl just had one removed from her paw a few months ago, it was growing rapidly and bleeding. We have had no regrowth of it and the vet is confident they got it all and it shouldn't be a problem.

[kralowsk]

Thank you everyone for your support! We just got a call from the vet and the lab thinks the fluid from the mass looks like a benign plasma cell tumor! They would like the full growth to be sent in after surgery to be sure that it isn't malignant. We are going to remove his toe on Thursday (at the vet's recommendation) since the growth has become so large/invasive. We are just relieved that it isn't a more aggressive/malignant type of tumor.

[Whiskey's Mom]

Wow that's great news! You must be so relieved!
A friend has a 13 yr old Sheltie who had part of his foot removed 5 years ago due to a malignant tumor, and he's still running around with the other pups, so try not to worry

[Joan2517]

That is good news!