11 year old boxer recently diagnosed

[Maddiesmom]

Hello everyone! Our 11 year old boxer, Maddie, has been recently diagnosed with Cushings. After her first ACTH Stimulation test, the doctor recommends her dose be increased from 60 mg to 120 mg.

From my research - I am finding that it might be best to keep the dosage the same, and adjust, if necessary, after the second ACTH test. Has anyone had experience with this?

Maddie weighs 62 pounds. She is 11 years, 2 Months old and otherwise healthy. Her clinical signs seem to be improving (her main issues were excessive drinking and frequent urination)

Her baseline yesterday was 4.7 ug/dl. Her final read was greater than 10 ug/dl. (Doc said goal was to be between 1.4-5.4).

Thanks for any help you might have! Thank you for welcoming me to this wonderful forum.

[DoxieMama]

Hi! Welcome to you and Maddie.

How long has Maddie been on Vetoryl? If less than 30 days, then your research is spot on with the recommendation of Dechra, the manufacturer. Here is a link (http://www.dechra-us.com/Admin/Public/DWSDownload.aspx?File=%2fFiles%2fFiles%2fSupportMa terialDownloads%2fus%2fUS-046-TEC.pdf) to their monitoring chart which clearly states that if the post result is > 1.45, to continue on the same dose after that first (even if it is > 9.1). After the 30 day test, THEN the dose is adjusted if needed.

It's great that she is responding and you're seeing some improvement in her symptoms. :)

Shana

[Joan2517]

Definitely wait for the 30 days before increasing. There is no rush. I learned that the hard way. Research and learn so that you can make an informed decision.

[Harley PoMMom]

Hi and welcome to you and Maddie!

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.

Cortisol levels do tend to continue to drift downward throughout the first month of treatment so you are right to be concerned with increasing her dose. Unless cortisol numbers are dropping too low, the recommendation is to leave the initial dose unchanged for the first 30 days prior to increasing.


Her baseline yesterday was 4.7 ug/dl. Her final read was greater than 10 ug/dl. (Doc said goal was to be between 1.4-5.4).

Dechra, the makers of Vetoryl, recommend a therapeutic range between 1.5 ug/dl - 5.4 ug/dl and that post number can be as high as 9.1 ug/dl if clinical symptoms are controlled.

Is Maddie getting her Vetoryl with a meal and are those monitoring ACTH stimulation tests being performed 4-6 hours post pill?

Cushdogs have diluted urine and are prone to UTI's, symptoms of an UTI are increased drinking/urination. Was Maddie's urine cultured to see if any bacteria was present to rule out an UTI?

I'm including a link to our Helpful Resource Forum where you will find an abundant of information regarding Cushing's, I'm also including a link to info about Vetoryl/Trilostane: http://www.k9cushings.com/forum/showthread.php?t=185

Resource Forum: http://www.k9cushings.com/forum/forumdisplay.php?f=10

If you have any questions please do not hesitate to ask them ;)

Hugs, Lori

[Maddiesmom]

Thank you guys!! I am still monitoring Maddie and she seems to have had a bad week. She is now newly deaf, her back legs are weak and yesterday she went through a 2 hour spell of rapid panting. She's lethargic and her appetite has greatly decreased. I phoned the vet Friday and on the phone the tech suggested it was not Cushings related. I took the weekend to dig further into research and I believe these are all Cuhsings side effects. Has this rapid decline happened to any of you? Is it something she can recover from? I phoned the vet twice today and am waiting to hear back. I don't know if it's worth putting her through another ACTH test - or if maybe some of you have been able to improve life at this point doing anything you can share with me!
Maddie is supposed to live forever - so - there's that. :)
Thank you in advance!

[Maddiesmom]

Hi and welcome to you and Maddie!

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.

Cortisol levels do tend to continue to drift downward throughout the first month of treatment so you are right to be concerned with increasing her dose. Unless cortisol numbers are dropping too low, the recommendation is to leave the initial dose unchanged for the first 30 days prior to increasing.



Dechra, the makers of Vetoryl, recommend a therapeutic range between 1.5 ug/dl - 5.4 ug/dl and that post number can be as high as 9.1 ug/dl if clinical symptoms are controlled.

Is Maddie getting her Vetoryl with a meal and are those monitoring ACTH stimulation tests being performed 4-6 hours post pill?

Cushdogs have diluted urine and are prone to UTI's, symptoms of an UTI are increased drinking/urination. Was Maddie's urine cultured to see if any bacteria was present to rule out an UTI?

I'm including a link to our Helpful Resource Forum where you will find an abundant of information regarding Cushing's, I'm also including a link to info about Vetoryl/Trilostane: http://www.k9cushings.com/forum/showthread.php?t=185

Resource Forum: http://www.k9cushings.com/forum/forumdisplay.php?f=10

If you have any questions please do not hesitate to ask them ;)

Hugs, Lori

Thank you Lori!! Maddie is getting her trilostane with food and they did do UTI tests - you have great advice and I'm grateful!! Thank you so much for adding me to the group!

[DoxieMama]

Hi again. I'm sorry that Maddie is having a rough time of it. Have you had another ACTH test done since that first one? If so, when was that and what were the results? If you can also provide the results of the electrolytes tested at that time, it may prove helpful.

Have you increased her dose or is she still taking 60mg?

Lethargic and a depressed appetite could be signs that her cortisol has dropped too low. It might actually be a good idea to have an ACTH test done, especially if you haven't had one done recently. Be sure it is started 4-6 hours after giving her the Vetoryl with a full meal.

Shana

[Maddiesmom]

Thank you for replying! I called the vet today (twice) with the intent to request a second ACTH test. I'm still waiting for a call back, but I will make sure to get the information you suggested. After her first test, the vet wanted to double her dose. I was not comfortable doing that so I phoned and talked to a different vet at the clinic and she told me to hold at the current dose since the clinical signs were good and to redo the ACTH this summer.
What does it mean for Maddie if the cortisol dropped too low?
Maddie isn't eating her regular food at all. I am able to get her to eat chicken and brown rice and tuna. Is there something else I should be trying?
Thank you for helping me!!

[Maddiesmom]

Hi again. I'm sorry that Maddie is having a rough time of it. Have you had another ACTH test done since that first one? If so, when was that and what were the results? If you can also provide the results of the electrolytes tested at that time, it may prove helpful.

Have you increased her dose or is she still taking 60mg?

Lethargic and a depressed appetite could be signs that her cortisol has dropped too low. It might actually be a good idea to have an ACTH test done, especially if you haven't had one done recently. Be sure it is started 4-6 hours after giving her the Vetoryl with a full meal.

Shana


Maddie has a doc appt at 10am today. I spoke with her vet for a long time last night - and she thinks the episode Maddie had was maybe a vascular episode.
If Maddie can do it - she will stay for the ACTH test. I'm cooking up some breakfast for her now to make sure her pill is given with a proper meal (she won't eat dog food anymore). Is there anything specific anyone would recommend to make sure I ask the vet today? I'm fortunate because both vets Maddie sees (they both love Maddie - and both work part time) will be working when we are there this morning!
THANK YOU!

[DoxieMama]

The ACTH test should only take about an hour, but it has to be started at the right time (between 4-6 hours after she has her med). I always take my dog home in between, as we only live a few minutes from the vet's. I would also request a copy of all the test results.... we'll probably have questions about them afterward. ;)

Good luck today!

[molly muffin]

Where they able to do the ACTH test today?

Symptoms of too low of cortisol is not eating, diarrhea, vomiting, lethargy (more than usual) wobbly when standing.

I hope they also checked electrolytes as those being off can cause some of those symptoms too, including the rapid panting.

Do let us know how it went.

[Maddiesmom]

Maddie is just about back to normal! The vet did not do the test - because in usual boxer style - Maddie walked in there wagging her tail. We are going to watch her for a bit and then schedule the test because the vet believes she had a vascular event - or a mini stroke. She still isn't eating her dog food - but I am giving her homemade dog food - and I probably wouldn't go back to the other stuff either. :) Apparently now that she's had a "stroke" - she will likely have more.

Maddie is TOTALLY deaf now - which came about what seemed to be rapidly. She could have been disguising some deafness - but her hearing is 100% gone now. She can't even hear high pitches. The vet wasn't sure if it was related to either cushings or her vascular event.

Have any of you found your cushings dogs to go deaf or become more prone to vascular events? She seems perfectly content following me around (and the rest of the family when I'm not available). So I'm happy for that for sure!!!

Thanks again! I'm learning a lot by reading through people's messages. I am very thankful for this page!

[Joan2517]

Yes, my Lena went deaf a few years before we even knew she had Cushing's. Before she died she could still hear very loud noises, like me whistling for her. Took me a while to realize she couldn't hear anymore, I just thought she was ignoring me.

[Maddiesmom]

Maddie had another ACTH test today and is doing great!!! All numbers are exactly where they should be. Happy to have a positive report!
:)

[Maddiesmom]

Yes, my Lena went deaf a few years before we even knew she had Cushing's. Before she died she could still hear very loud noises, like me whistling for her. Took me a while to realize she couldn't hear anymore, I just thought she was ignoring me.


I'm sorry Lena passed away. I also thought Maddie was ignoring us! We thought it might be temporary - but it seems to be permanent. Now the deafness is a non-issue for her and our family which is great. It's not causing her any visible anxiety at all! That makes me very relieved.

[rolfecms]

Maddie had another ACTH test today and is doing great!!! All numbers are exactly where they should be. Happy to have a positive report!
:)

Good to hear!

Can't wait until we can report the same for our Peggy Sue.

[Joan2517]

Good news...the deafness really doesn't seem to bother them once they get used to it. I cried for a week when I realized she was deaf, but we all got used to it.

[Squirt's Mom]

Glad to hear Maddie's test came back good. I take it all the signs are controlled? Doesn't that make your world brighter when you can see they are getting better? I'll never forget that day Squirt grabbed a toy to play with for the first time in ages.....my old heart just soared knowing she felt that much better.

[Maddiesmom]

Glad to hear Maddie's test came back good. I take it all the signs are controlled? Doesn't that make your world brighter when you can see they are getting better? I'll never forget that day Squirt grabbed a toy to play with for the first time in ages.....my old heart just soared knowing she felt that much better.

It is a brighter world!! She will do her boxer wiggle and enjoys playing with the cats again. Not bad for an 11.5 year old boxer! I love that she follows me around wherever I go too. Her signs are just about all wonderful. She is waking up sometimes in the middle of the night (and barks at the kids to get up too!) - but the vet thinks she might have a touch of doggie dementia. So we will monitor that and see what happens. I didn't know that was a thing.

[Maddiesmom]

Good to hear!

Can't wait until we can report the same for our Peggy Sue.

I look forward to seeing you post good news!! We've been getting adjusted since Maddie was diagnosed in April. Our last couple months have been stable -and it's nice to have the proof in the numbers. Peggy Sue will get there!