Hello! I wish I didn't have to be here, but...

[Dollydaydream]

our Ruby has just had a diagnosis of Cushing's Disease :( I'm glad I found you all, I think we might need a bit of help and advice through this to be honest.

Ruby is an 11 year old mini chocolate Labradoodle. We've had her from age 4, from a rescue centre. She has always been a greedy little thing, but we noticed over the last few months she has gradually lost the fur from her back end, stopped playing with our other two dogs, gained a huge beer gut without eating much (we're strict with all of their diets to keep them as healthy as poss).

A trip to the vets and several blood tests later, we have been told it's Cushings and we have to pick up a prescription for 14days worth of Vetoryl, she will be on 2x60mg pills a day (she's 25kg which is about 8 kg over what she should be! :o ) The vet says it's her adrenal glands causing the problem.

I feel really sick to be honest. I thought I would be over the moon to get a diagnosis and to get her fixed, but I'm thinking about lots of things and not feeling very positive.

That dose seems high, I'm sure the vet knows what he's doing but he says it will cost £150pm for her medication. She's covered for the first year and then we'll be getting her meds from the internet once we know what we're doing (at least, I'm hoping the pills are covered and not just the prescription charge!).

The money is a concern but hey ho, I'd rather than have our Rube than a bottle of wine a night! The side effects are worrying me too. I'm just feeling a bit panicky, really.

Sorry for the long intro! Just all over the place at the moment. Poor Ruby. She's such a lovely dog, she sits watching the other two playing these days looking sad and it's awful to see.

I don't want to think about the fact she's poorly and she's getting on a bit, I suppose. :(

Anyway, I'm looking forward to getting to know people, and thanks for having me! :)

Dolly

[Harley PoMMom]

Hi Dolly,

Welcome to you and Ruby! I am sorry for the reasons that brought you here but sure glad you found us.

It would help us a great deal if you could share more information about your sweet girl, in this way we can provide you with our best possible feedback, and we get this information through a ton of questions so here goes some of mine. ;)

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

As for the dose of Vetoryl, in 2014 Dechra, the makers of Vetoryl, revised there starting dose protocol and now recommend that treatment should be initiated at 1 mg per pound of a dog's weight. Here's the link to where this information can be found: http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf.
So, yes, I agree with you that Ruby's starting dose is quite high for her weight of 25 kg (55lbs).

We have a wealth of information regarding Cushing's in our Resource thread, which does include articles written by some of the most renown veterinarians that specialize in endocrinology such as David Bruyette, Mark Peterson, and Edward Feldman. Here's a link to our Resource thread: Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10) Please know we will help in any way we can, and do not hesitate to ask all the questions you want.

Looking forward to hearing more about dear Ruby.

Hugs, Lori

[labblab]

Hello and welcome to you and Ruby, we are so glad you've found us! I apologize for having only a moment to type right now, but I do want to caution you that your own instinct is correct -- 60 mg. twice daily is much higher than the starting dose that is now recommended by Dechra, Vetoryl's manufacturer, and also by most specialized clinicians around the world. When Vetoryl was first introduced several years ago, the dosing protocols were much higher. But experience has shown that it is much safer to start at lower doses and work upward, if need be, rather than doing the reverse. So your vet may still be following what has become an outdated dosage recommendation. Here's a link to a post on our Resources forum that discusses all this is greater detail. Please have a look, and you can even print it out to give to your vet if you'd like. But as you'll see, Dechra now recommends starting at a total daily dose that is no larger than 2 mg. per kg. In Ruby's case, this would mean no more than 30 mg. twice daily (which still exceeds the formula by just a bit).

http://www.k9cushings.com/forum/showthread.php?p=1251#post1251

I'll try to stop back by later on with some more thoughts, but the dosage issue seems most important to me to begin with.

Marianne

[molly muffin]

hello. I just want to welcome you to the forum as Lori and Marianne have gotten you off to a good start.
Agree with them both about the 1mg/1lb or 2mg per kg. That is a safer starting dose and what the manufacturer now recommends.

Was any other labs off (high/low) and if so could you tell us what they are with the result and range?

the medication can be very helpful for dogs with cushings. Usually the problems we see are from too high of doses, so that is why we caution to follow the new recommendations. Perhaps you could tell your vet that you feel better starting with one 60mg per day rather than 2, then test in 14 days and 30 days and see where her cortisol is at?

You can also print out the pdf and take that into the vet.

[tyry]

Welcome to the forum, the folks on here are amazing and I swear sometimes know more than our vets. I wanted to let you know I was also completely freaked out when I had to start our dog on the meds, if she even sneezed I was making sure it wasn't anything bad from the meds. I drove her crazy! It will get a teeny tiny easier as you get somewhat used to the new normal. I've even said to my husband that if we ever had another Cush pup I would not hesitate (like I did with our current girl) to start them on Vetoryl/Trilostane.

That said, our girl was 22lbs when we started treatment with 10mg 2x day. Granted it meant more testing, but we went low and slow and didn't have any issues. I'd go back and let the vet know you'd prefer to start with a smaller dose. Hopefully with the meds Ruby will bounce back and be playing again, I know that worked for us.

[DoxieMama]

Hi Dolly,

The others have covered the questions and suggestions I have, so I'll just say, welcome! I think we all felt the same way when we were first presented with the possibility of Cushing's. I know I certainly expected to feel differently when I finally knew what was wrong with my little one, yet hearing and reading about all the testing and possible side effects of treatment just did not put my mind at ease. Today is 15 days since we started on Trilostane, and I watch my baby boy like a hawk, even waking him during naps to make sure he's doing ok. I'm sure I'm driving him nuts. ;)

Hang in there, Dolly. Hopefully Ruby will respond to the meds and you'll see your playful girl again before long.

Shana