Side effects Vetoryl.

[Anne Mette]

Hello.

I m New in this forum-my dog- a Bouvier des Flandres female was diagnosed with cushings september 2015-she is now 9 and halv years old.Before that she had allergy problems and also pancreatitis flare ups.We took an ultrasound last August-and everthing was ok intestinal.She started on Vetoryl in september-2 x30 mg daily.At first she seemed a bit better-so i was hopeful-but a cuople of weeks ago she went sick -nausea-bad stomach and would not eat.The Atch test results was fine-but Ct of the abdomen showed enlarged liver with some small liver- infarcts-enlarged pancreas and adrenal glands.I took her of Vetoryl because i was suspicious if Vetoryl had the side effect to cause liver infarct-Do any of you heard anything about that side effect of Vetoryl.?I will try an alternative treatment now-homeopathy and acupucture-have read about some drops called Cushex drops-do anyone have anyexperience With these drops.?I feel so sorry for my wonderfull dog-it breaks
my heart to see her like this.

[Harley PoMMom]

Hi and welcome to you and your girl!

I took the liberty and moved your thread here to our main "Questions and Discussion" forum where the most folks will see you. ;)

If you could tell us more about your dear girl it will help us to be able to provide you with our best possible feedback, ok? So some questions I have are:

1) Could you get copies of all tests that were done on your girl 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.

2) What test/s for Cushing's were performed and could you post those results too?

3) Does your girl have any underlying illness that she is taking medication for? And if so, what is it and what is the medication for?

4) What symptoms did she display that led you or the vet to test her for Cushing's in the first place?

5) Does your furbaby have pituitary or the adrenal form of Cushing's?

6) How much does she weigh?

Adverse effects can be seen at any dose of Vetoryl, however we do see less ill side effects when a dog is started out with Vetoryl at 1 mg per pound of the dog's weight. We would really like to see those recent ACTH stimulation tests results as this may give us a better picture of what is going on with your sweet girl. Did they check her electrolytes when she was at the vets?

Pancreatitis can be a bugger to get under control, is your girl on a low fat diet? Is her pancreatitis being monitored with a spec cPL test?

Regarding the Cushex, unfortunately I have seen no truly effective alternatives to Rx medication when the goal is to lower cortisol levels significantly enough to eliminate/control the internal and external symptoms and damage caused by the disease. Cushex and Adrenal Harmony Gold have no controlled clinical testing whatsoever to back up their claims (we know this because we have contacted the manufacturers and we have been told that no testing has been done). However, we have had some members who told us that the drops worked very well in controlling symptoms but only for a short time period.

You have done the right thing in taking her off the Vetoryl while she is unwell, good job! How is your girl doing now? Any vomiting and/or diarrhea? Has her appetite picked up?

Hugs, Lori

[Anne Mette]

Hello.Thanks for answers.
My girl has pituairy Cusnings.
I have been to the vet with her today-new ultrasound showed that there was no changes ( maybe a bit better in the liver-and adrenals).I have been giving her Milk-Thistel to support her liver-and also some broccoli-carrot and dried beef in small amounts on her food.She eats id low fat and Royal canin gastro intestinal low fat.We also took x-rays of the lungs becuse she was panting a lot-seemed ok also-and also heart seemed ok.So the vet wants to take a New ATCH STIM test tomorrw-and we have taken new blood tests today also. They want her to start with Vetoryl again-and i dont think have any other opsions. I will give you all her test results when they come back from the lab ( also the previous ones)-i guess it will take some days.
With my dog it started after getting spayed when she was 6 due to a bad uterus infection.As a young dog she was allergic -and was eaten zd for this.I first noticed her not being herslf maybe one year after her uterus operation ( sorry if my English Word not always are right-i m from Norway)Then she had a pancreas attac-and was treated for that-diagnose are cronic pancreatitis with flare ups.Last summer she got depressed-lethargic-bad fur with dry skin-panting a lot-drinking and eating more-a pot belly-week hind muscles--wanted to sleep on cold surfaces-her stomach was rombling-her stool not so good in consitens and color- and i had to drag her after me on our walks.Thin urin.Also have calcinosis.Started on Vetoryl in september last year-30 mg x2-at first she got better-Atch Levels went down-but in the beginning of February she got very tired-slept a lot-did not want to eat-not good in her stomac-so we took the Ct which showed some small liver infarcts-enlarged liver- pancreas and adrenals. ( it is a possibilty that she had pancreas problems-and that it did not come from the Vetory-but i did not know what to do)So stopped Vetoryl-and she started to eat again-but her cushing symtomes are now getting back-tired-lazzy on walks -week hind mucles-more panting-but not more water drinking and not urinating more.She also got Horners syndrome-hanging lower eyelids in Januray-but that is better now.

She weights 45 kilo-and she has not been on any special medications regulary.
So i will get back to you With the test results from today and tomorrw when i get them-and also the previous ones i have.

Thank you very much-i m glad i forund this forum.
A big hug from a worried dog mother.

[Harley PoMMom]

Your English is fine ;) Yep, getting those test results and posting them will help us greatly. So she has calcinosis cutis (CC)? Was the CC diagnosed through a biopsy?

Dogs with Cushing's do usually pant more due to a few things: the increased fat deposition over the thorax, an enlarged liver (which is common in a cushdog) that puts pressure on the diaphragm, and with the fat distribution to the abdomen along with the muscle loss in the abdominal area these are factors that can cause the panting.

Hugs, Lori

[Anne Mette]

Hello again-
i now have all the results of my dogs tests-i took some time due to Easter.

2014.ALKP Normal values beetween 23-122.Lipase Normal values beetween 200-1800.
4.4-pacreas Lipase-499 High
9.4-ALKP398-H ( 23-122 Normal.)
Lipa 2140 H ( 200 1800 N)
15.4-ALKP 3711 High
LIPA 2300 High
25.8 -ALKP 501 High
LIPA 2530-High
HCT 60% High ( normal 37.0 55.0)
MCHC 27.9 Low ( normal 30- 37.5 )
21.11 LIPA 5562 Very High-acute pancreatitis.

2015.
28.2-Lipa 749 HIGH
ALKP-597 HIGH

3.6-
T4 11.6 LOW ( 12.9-51.5 NORMAL.)
9.9-ALKP- Over 2000----HIGH
ALT 597 HIGH
GGT 21 HIGH ( 0-7 NORMAL)
LIPA 2886 HIGH
ATch before stim-52.4
2.Sample 345 ( 440 normal)

19.9-ATCH Before adm 81.7 ( 24,8-124.2) normal
2.sample 30.9
3.sample 67.3

8.10 before adm 110,7
2.sample 157.6
4.11-basal 135
post atch 181.9 ( 50-200) normal

5.11-cort before adm-135 high
2.sample 181.9
she was positive on Cushing at that test.+a lot of clinical signs that confirmed the diagnosis.

10.12-15- before cort 100.2 ( 24.8-124-2)normal
after 155.4
ALKP-OVER 2000
ALT-129
NA 144-K5,6=25.7 A BIT LOW
2016.

9,2-basal Court 76.56
2.sample 105.7 ( 50-200) normal
ALT 151 HIGH
ALKP 1933 HIGH

17.2 EOS 0.07 LOW( 0,10-1.49)NORMAL
GGT 21 HIGH (O-7 )NORMAL
ALT-159 HIGH
ALKP-1933 HIGH
after atch 105
Stopped With Vetoryl DUE TO Liver infarcts-enlarged liver-pancreas and adrenal glands found on CT.

20.3 16-before ATCH 81
2.Sample-220 ( up to 440 is normal)So now neither the vets or i understand anything as her atch values is normal after haven not taken vetoryl for a month

Alkp 1851-high ( 23-212 NORMAL)
Lipa 2909 HIGH (UP TO 1800 NORMAL)
GGT 23 High ( 0-7 normal)

So -ultrasound showed an enlarged liver 20.3-16-but the infarcts was better than in february 2016.Also enlarged pancreas and adrenal glands. Bloodwork showes Liverproblems-but i dont know why-We took ultra sound in august 2015 before she started on Vetoryl-and everything looked fine-so in Mars this year the ultrasound showed
this changes.My vet has reported the liverinfarcts as a possible side effect of Vetoryl.I dont know what to belive or think at this stage-my dog is eating and drinking normal-her poop are a bit loose sometimes-she is sleeping a lot-are lazy on walks-and the last week she has been panting more than usual-.So where to og now-i dont have any idea what to due-the vet said stop Vetoryl and take a New bloodtest and ATCH Test in May.Do you have any thoughts what is going on here.??I know she has cronic paancreatitis with flear ups-but can this make her liver bigger-and cause the panting.?
Thanks for Your time.Hope you may help.
Anne.

[molly muffin]

Inflammation of the pancrease can cause enlarged liver according to what I've found when looking for information about enlarged livers.

I would think this might also result in the panting increase.

Any chronic disease, and this includes chronic pancreatitis can cause the ACTH to be high. Cortisol secretion increase is a bodies natural response to any chronic disease. So in this case, it could be that during flare up, her cortisol levels increase.

Are you seeing or can you be referred to an Internal Medicine specialist?

[Anne Mette]

Hello.
Thanks for answer-i also think that the pancreas might be the main problem-and not cushings.I dont have an internal specialist-but we took the abdominal Ct in a specialist clinic.I will talk With my vet about this.

[Harley PoMMom]

Has a pancreas test, such as the spec cPL, been performed to confirm the pancreatitis?

[Anne Mette]

Hello.Yes we have taken this tests -and it is always high-last time it was 741 ( in February)-and every value over 180 is high-also the lipase values in bloodtests that indicates pancreatitis is always very high.+ livervalues ALKP AND GGT (an liver enzyme)is high. Normal Lipase value is up to 1800-she have always beetween 2500-and 3000.Once it was 0ver 5000-and then she was very sick and had to be on fluid at the vet Office.-and take pain medication.I m so confused what to do-she seems to pant a lot more the last week-a bit strange the whole thing-in the morning she seems fine-no panting-but in the afternoon and evening the panting gets worse when she walks or are moving-but not when she is laying down-dont know if she is in pain-or if this is stress related somehow.She is on low fat diett-but i have given her a small amount of carrot-broccoli and dried chicken meat in her food-i will take this away from her food-maybe it irritates her pancreas even thoug her stomac and stool are fine-Do you have any suggestions what to do-i m still not sure about the Cushings diagnose-although last test showed negative.Will take a new test in a month-and check again.-i dont like the incresed panting-but as you said it can come from the enlarged liver and pancreas-Thanks for your support.

[Harley PoMMom]

Pancreatitis can cause elevated liver enzyme levels. I would ask the vet if any valuable information could be found in checking the liver function with a bile acid test.

Pain will cause a dog to pant, and pancreatitis can be painful so I would check with the vet if a pain medication is an option in trying to see if the panting subsides.

Hugs, Lori

[Anne Mette]

Thanks-i will do that.What is a bile acid test??

[Harley PoMMom]

A bile acid test measures the bile acid before a meal and than 2 hours after the dog has eaten a fatty meal. If the bile acid is high than there may be a problem with the function of the liver.

[wendyweneki]

Watching this thread carefully. Please keep us posted. My Panda Bear will be starting the meds today. Am a little bit concerned about the side effects she may have. Wishing you the very best.

[Anne Mette]

Thank you Lori-for your advices- i have taken a new ATCH STIM TEST and also a new cpli test for the pancreatitis-will wait see how the values are now-she wants to eat-so hopefully she is not in pain-but are still panting-the GGT values have gone up from 23-to 32 in three weeks-so i will ask my vet about gall/bile problems-maybe the problem is there-as the ct showed some mineralisasing in the gallbladder.If the bile is not flowing right it can also make problems in the liver and pancreasn area.

[Anne Mette]

Watching this thread carefully. Please keep us posted. My Panda Bear will be starting the meds today. Am a little bit concerned about the side effects she may have. Wishing you the very best.

Thanks-the best of luck to you and your dog-Be very sure that it is realy Cushings before you start on vetoryl-and follow up closely With the bloodtests.

[molly muffin]

Hopefully the new tests results will give you a clue about what is the best path to follow at this point to make her feel better.
Let us know what the results are.