Elvis - Just diagnosed (Vetoryl); appetite problems

[elvis's mom]

Hi,
I am Elvis's mom. He was just diagnosed this week and it has been a rough one. I have suspicioned for some time that he had a problem, but just didn't know what and our vet was not very helpful until I insisted we do a senior panel blood work-up. This showed a thyroid problem, so we started thyroid medication. We were a week into that and all hell broke loose. Lots and lots of water drinking and going out every 2-3 hours 24-7. Needless to say, Elvis and all of us were totally exhausted. Also, Elvis stopped eating. We went back to the vet and he cut the thyroid medicine dosage. Because of Elvis' behavior and lack of food intake, I did not give him any more medication, called the vet and we went in Fri. for the ACTH testing. It showed Cushings and we started Vetoryl yesterday. The main problem I am having right now is getting Elvis to start eating. I fixed chicken rice soup two days ago and he ate a little yesterday morning, but hasn't eaten a thing since then. If anyone has a suggestion to help me get him to eat something--please let me know. I am happy to have found this forum. I am hopeful that with treatment, Elvis will improve. He is not that old--7, maybe. He is a rescue dog, so we are not sure of his age.

[labblab]

Hello and welcome! I have only a moment to post right now, but I confess to feeling worried about the accuracy of the Cushing's diagnosis, given Elvis' total lack of appetite. This is not characteristic of Cushing's, but could be consistent with other problems (kidney problems, pancreatitis, etc.) that could also elevate cortisol levels and return a "false positive" on the ACTH.

In honesty, if my dog was not eating at all, I would not feel comfortable giving Vetoryl, not only due to risk of misdiagnosis but also because Vetoryl could suppress appetite even further. Getting Elvis to eat would seem to be the first priority right now, and I'm afraid Cushing's meds are not going to help with that and instead may even make the problem worse due to possible GI upset from dosing on an empty stomach.

Aside from the low thyroid, did the senior blood panel show any other irregularities? There are certain abnormalities that are consistent with Cushing's, and others that are not. If you can let us know about any abnormal blood or urine results, that will give us a starting point for trying to help figure things out.

Marianne

[elvis's mom]

According to the vet, the only abnormal finding on the panel was the thyroid issue. He started Elvis on Soloxine, .8 mg. When all of this started, Elvis weighed over 100 pounds. He has dropped around 10 lbs. in the last two weeks. At first, it seemed like the Soloxine was going to be the answer to the problem, but when the extreme drinking and urinating began, and the lack of appetite, I called back to the vet and said I thought we had another problem. They did another thyroid check and it was normal. They also checked his sugar again and it was normal, so the vet decided to do the ACTH test and it showed elevated cortisol. I have not given the Vetoryl unless Elvis ate something with it. The other piece of this puzzle is that Elvis had surgery in Jan. to remove a fatty tumor in his front right leg joint. He was on an antibiotic and pain meds at the time. Don't know if this has anything to do with that, but there is definitely something wrong. I talked with a friend about doing a second opinion. What do you all think about that idea?

[elvis's mom]

I'm not sure they even took a urine sample. I wondered about that.

[molly muffin]

I think I am concerned right along with Marianne that Cushing's is actually the reason for the high cortisol. ACTH will be high if cortisol is high for any reason. Where steroid or prednisone for example given after surgery and if so is it still given. UTI could also be a culprit or the leg is still healing.

A lack of appetite with Cushing's isn't the norm. Something else would usually be causing that. I agree with Marianne and am concerned about the Cushing diagnose.

Welcome to the forum

[Angel's Keeper]

So sorry about Elvis. Please, please, think about the Vetoryl and be sure to have her looked at by a Specialist that has experience with Cushings. I also would NOT give her Vetoryl or any other Cushing's meds. My healthy and vibrant maltese Angel was 7 years old and was taken in for a possible UTI. I left with a diagnosis of Cushing's 5/2015, placed on various mg's of Trilostane. She declined quickly, not eating at all, losing half of her body weight and passed 2/25/16. She died a horrific death that I will never get out of my mind. I feel she was misdiagnosed, overdosed and died from the Trilostane. I wish, wish, wish I would have immediately stopped the medication and did things differently. I struggle with my choices and am devastated.

If you have time, please view my initial post of Angel's story. If I can help other's learn from my lack of understanding and mistakes I will continue to share my story.

[molly muffin]

Vomiting, lethargy wobbly, diarrhea are all signs of over dose or not responding well or perhaps. Ot trul Cushing's and meds should be stopped immediately.
Never give Cushing meds to a sick dog, stop and take to vet.

Most important right now is to get Elvis to eat and regain strength.

[elvis's mom]

I plan to call the vet ASAP. I had already decided to discontinue the medication until we get an exact diagnosis and Elvis is eating and feeling better.

[labblab]

I an so sorry that Elvis is doing so poorly! I received your message about his lethargy and vomiting, and I am very worried about him, too. It is possible that he may be suffering from acute pancreatitis, and that might take a specific blood test to diagnose. But that is just a total shot in the dark on my part. I do believe Elvis urgently needs a second opinion. I would ask your vet for an immediate referral to a specialist this morning. Hopefully there is a specialty group that they have experience partnering with. Some internal imaging like an ultrasound may end up being recommended as a first step.

Please keep us updated today, OK?
Marianne

[molly muffin]

I wanted to check in and see what the vet said about Elvis today. Has he started to eat yet?