New to this Cushing thing

[hermine]

Hi. My Boston mix, Maggie, was diagnosed 2/18/16, following ACT stim. test. Started on 30 mg. Vetoryl, yesterday. She had a big weight gain, approx. 5 years ago, after a short course of Prednisone for a sprain to her leg. Started to notice big increase in water consumption, in 2014. Blood tests were negative for sugar. Vet said she was eating too much and to have her cut back in food consumption. Her water and food consumption continued to escalate. I decided to try a different doc, who practices functional medicine and homeopathy, as well. He did urine test to measure cortisol and then ACT stim test. We don't have the financial resources, so no other tests have been ordered. We are trying the Vetoryl and monitoring her behavior, for now. I saw another thread that said she should be on a low fat, low protein diet. Doc recommends homemade food, but I don't feel comfortable with this. I also saw some herbal supplements online for Cushings. Any recommendations would be greatly appreciated!

[Dakota Kubota]

Hello.

We are also on this Adventure. My dog , Dakota been on cushing's meds for 6 weeks. He takes Lysodren. His last ACTH test came back in great numbers.

When we first started Dakota weighed in at 133lbs. ( he's a lab/shar pei mix ) I belong to other groups also and reading tons on Cushing's. We changed Dakota's diet, to a No grain, No Gluten diet. and we watch his fat intake. If he gets any treats now, they are no grain, gluten free. He has lost weight. He is down to 124 lbs. and his water intake is almost back to normal. Not looking for food anymore, not eating poop anymore, he is peeing less and hasn't had any accidents in the house lately.

However he is still loosing hair.. Which our vet said it's from the loading phase and cushings. That the hair regrowth takes the longest to return. and he's wanting to play more!

Hope this helps.
Cheryl & Dakota

p.s here's a good article to read.. has tons of info.. also some herbal supplements too.. http://www.dogaware.com/articles/wdjcushings.html

[molly muffin]

Hello and welcome to the forum.

The key is starting vetroyl/trilostane at the 1mg/1lb ratio. Not over that. The recommendations have just recently been changed, so not sure all vets are aware of it.

This is a resource that Dechra the makers of vetroyl puts out, the flow chart is especially helpful.

http://www.dechra.us/Admin/Public/Download.aspx?file=Files%2FFiles%2FSupportMaterial Downloads%2Fus%2FUS-046-TEC.pdf

Moderate protein is usually good and I think good quality protein from a reliable source whatever that is that works for you, and lower fat because cushing dogs are prone to pancreatis usually works out well for our cushing dogs.

When dogs get older, things like a joint supplement and liver supplement are usually good to add in too just over all. Omega 3 for kidney health, that sort of thing.

[hermine]

Hello. My name is Hermine. My dog, Maggie, is a 7 yr. old Boston- chihuahua mix. She was recently diagnosed with Cushing disease. I suspect she has had it for a couple years, however. She started putting on weight, after taking prednisone, for a leg sprain. I had her tested for diabetes, but the vet said she did not have it; was just eating too much. At the time, she was also starting to drink a lot of water. So we struggled with the weight issue, awhile. I also started noticing her back legs were starting too look smaller, but I attributed this to her body size being bigger. She started to have increased difficulty walking, with her back legs failing her. Again, we attributed it to weight. Recently, the water consumption started skyrocketing to 16 cups per day, and all she would do was sleep. She started to look like a pot-bellied pig. I thought, for sure, it was diabetes and decided to try another vet. I told him I could not afford a lot of testing, as we are on a fixed income. One look at her, and he said she looked like a classic k-9 cushings. He checked for diabetes, which was negative. He did a special urinalysis, which revealed cortisol levels at 3x the higher end of normal. Maggie then had ACT stimulation test, which confirmed cushings. She was started on 30 mg. veteroryl. Within 2 days, water consumption dropped to 51/2 cups. Within 4-5 days, she was starting to perk up. She was agreeable to a short walk! It looks and feels like she has lost some weight, but we haven't been back to the vet. At this point, because of financial constraints, we are observing her, rather than proceding with more testing. It has been 2 weeks since we started the vetoryl. Water consumption is remaining at 5-6 cups. I'm going to start strictly monitoring it, for the next week. I'm concerned it isn't dropping any lower, although I do have another dog who drinks from same dish, but not so much. He's a Boston-miniature pincer. Please comment with any thoughts. Should we be seeing a big weight drop by 2 weeks of medication?? Much less water consumption? I am going to start walking her daily, now that we are getting a warm snap. We live in MI.

[Harley PoMMom]

Hi Hermine,

You will see that I've merged your new post into your original thread about Maggie. This way, we will be able to keep track of her entire health and treatment history all in one place.

How much does Maggie weigh? Also, could you a copy of that ACTH stimulation test and post the results here?

It's impossible to know exactly where Maggie's cortisol level is without an ACTH stimulation test being done. It is recommended that an ACTH stim test should be done within 10-14 days after starting treatment. The main reason for this is to make sure that the dog's cortisol level has not dropped too low. If the dog appears well than some vets are waiting until the dog has been on treatment for 30 days to perform an ACTH stimulation test. Is she lethargic? Is she still eating good? Any diarrhea? If she is not acting unwell and she is still displaying Cushing's symptoms I would believe her cortisol hasn't dropped too low.

A weight decrease is likely but you don't want to see a great reduction in weight in just 2 weeks of treatment. Improvement in the increased drinking and urination is generally seen with in 10 -14 days, so if Maggie is drinking and peeing less than that's a sign that treatment is working. Normal water consumption for dogs is an ounce of water per pound of weight daily, so if you could find a way to measure her water intake than you would be able to judge if she is drinking excessively or not. Just keep an eye on her and if you would notice any behavior that is odd for her I would with hold giving her the Vetoryl and contact the vet.

Hugs, Lori

[hermine]

hi. maggie was diagnosed this past feb. Had ACTH text to confirm. Doc put on vetoryl, 30 mg. and we saw drastic reduction in water consumption, from 16c to 6c in a few days. she was gradually increased to 120mg, which was too much. She became weak and lethargic. Dropped her back to 90 mg. She has been at 90 mg for almost a month, now. I can't afford all the testing, so we are going by her behavior. the water is down to 4-5c per day. she goes outside about 4-5 x per day and walks the grounds of our home at least 5-10 min. per day. appetite isn't as voracious. she is unable to walk as much, because of the weight and atrophied musculature in her legs, but she tries. I take her in my dog buggy and let her out the last 5 min. The one thing that isn't changing is her weight. It's not coming off. Anyone else having trouble with weight loss??

[judymaggie]

Hi and welcome to you and Maggie! A couple of thoughts -- I read on another post that your dog weighs 30 lbs. Her initial dose of 30 mg. of Vetoryl does fit Dechra's (the manufacturer) current recommendations of 1 mg./1 lb. but the dosing that follows is concerning to me. I understand that the testing can be expensive but, unfortunately, the testing is most important in keeping your dog out of harm's way with too high a dose. A dog's cortisol can continue to drop after 30 days on a particular dose so it is not recommended that a dose not be increased before that time and especially important if an ACTH is not done at that time. With you just starting Vetoryl in February and going from 30 to 120 and back to 90, it does not sound like your vet is following Dechra's recommendations with regard to dosing. I can certainly understand why you saw negative signs (lethargy/weakness) with an increase to 120 mg. After you stopped the 120 mg., did you wait to start the 90 mg.? Even 90 mg. is an extremely high a dose for a 30 lb. dog.

Please take a look at the brochure from Dechra at the link below. Page 11 shows the flow chart outlining dosing:

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

If you would share more information about Maggie, that will help us in providing you meaningful feedback and we get that info from asking a ton of questions so here it goes:

Could you get copies of all tests that were done 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. Would you post the results of the diagnostic tests that were performed on Maggie that diagnosed the Cushing's? Does Maggie have any underlying illness that she is taking medication for? And if so, what is it and what is the medication? Is Maggie's urine diluted and does she have a low urine specific gravity? Is she taking any supplements or herbs?

The test used to monitor treatment in dogs with Cushing's is the ACTH stimulation and it's the stimulating agent that drives that cost up. There is a cost savings tip for those tests. Most vets use Cortrosyn as the stimulating agent. The vial of Cortrosyn is 250 μg and instructions say to use entire vial but not all dogs need the entire vial. There have been studies done that show using just 5 μg per kg is all that's needed. Some vets are not aware of this so we always provide the url to Dr. Mark Peterson's blog which instructs vets on how to dilute and store Cortrosyn for future use: http://www.endocrinevet.info/2012/03...rosyn-for.html

Others will be along to address your concerns but, if you can get the requested info in the meantime, that will help.