Fergus - Just diagnosed

[Lynne H]

Hi everybody thank you for letting me join,on Monday I got the devastating news my little boy has cushings,it stated a few weeks previous where I though he had a urine infection,he was drinking so much and peeing all over and panting,at the vets they tested his sample and discovered his urine was very dilute so did blood tests which came back with high enzymes in his liver,my vet suspected Cushing so he got tested,it came back positive and his cortisol levels are through the roof,my vet told me the treatment could be much worse than the disease and to think about it,I decided yesterday to go ahead with the treatment because I want to do everything I can for him but must admit I'm still worried,my boy is 42kg and the vet wants to start him on the rise for a 40kg dog and give him 110mg,I have heard some positive things about the treatment but also some negative things too,any advice would be greatly appreciated please.
Thank you very much X

[DoxieMama]

Hi Lynne,

I'm at work so haven't a lot of time to post, but I wanted to reply and let you know that if you're going to treat with Vetoryl (Trilostane) then the suggested starting dose from Dechra is now 2.2mg/kg (1mg/lb), once per day. This means that your boy should be starting on a dose of no more than 40mg... certainly not 110mg. Please please do not start on that high dose.

Here is a link to the manufacturer's website where treatment and monitoring are discussed.
http://www.dechra-us.com/therapy-areas/companion-animal/endocrinology/canine-hyperadrenocorticism/monitoring-cushings

Shana

[Lynne H]

Hi,thank you for your reply,I'm even more worried now because the vet said he would be on it twice a day,I will be speaking to him before I agree to anything,I do not want my little boy to be taking the wrong dose.
Thank you
Lynne X

[Bassetmum]

Hi Lynne
Glad you found your way here I hope that you get some useful advice.
Yvonne

[lulusmom]

Hi Lynn and welcome to the forum.

I wanted the chime in and validate what Shana has told you. A 100 mg dose twice a day is much too high for your precious boy and I encourage you to use the link Shana provided and read, read, read so that you familiarize yourself with dosing and monitoring protocol. If your vet prescribes these unsafe doses to all of his patients, I can understand why he thinks the treatment is worse than the disease. He probably has had some sick dogs on those high doses. I am always suspicious of vets who make this statement because it simply is not true. Once you've had a chance to look at other members' threads, you'll see that for yourself.

Please share the link below with your vet or print out the article and give it to him/her so that s/he does not place your dog or any other patient at undue risk.

http://www.vettimes.co.uk/news/new-lower-starting-dose-for-vetoryl/

It is also known that dogs weighing more than 30 kg may require smaller doses that little dogs so please also share the link below with your vet so that s/he is current on the very latest developments in the appropriate dosing of Vetoryl (trilostane).

http://veterinarymedicine.dvm360.com/journal-scan-bigger-dogs-may-need-less-trilostane-control-hyperadrenocorticism

Glynda

[molly muffin]

You could do twice a day at 20mg am and 20mg pm, but not 100mg, that is just too high to start with.

Do you have the actual numbers for the cortisol test? Was it the LDDS or the ACTH that was performed? What other numbers on the blood work were high/low?
And one more question, when the urine was found to be dilute did they proceed with a culture? Often dogs that drink a lot will have dilute urine and bacteria won't necessarily show up in a regular urinalysis.

Did the symptoms come on suddenly or gradually build up?

I know that is a lot of questions but the more we know about your furbaby the better feedback we can provide.

Welcome!

[Lynne H]

Hi Lynne
Glad you found your way here I hope that you get some useful advice.
Yvonne

Thank you Yvonne,so nice to be here xx

[Lynne H]

Thank you Glynda,I have printed those articles off and will take them with me next week,I will not allow my baby to come to any harm on a too high a dose,the whole purpose of treatment is to help him not harm him.
Hi Sharlene,I'm afraid I don't have any of these things although my vet did tell me readings for his cortisol levels and the test that was performed on him was he was kept all day with blood taken every 4 hours,I'm sorry if this is not much help but I have not been in the right frame of mind to take everything in,I have been so worried and did not know what to think and yes a culture was done on his urine and no bacteria was found,his symptoms came on quite quickly as he started to pee where he was lying and could not make it out in time and he started drinking gallons of water,panting lots and sleeping a lot,also he gained quite a lot of weight and has a very pot belly,when the results came back the vet told me Fergus ticked all the boxes,at the moment I'm very unsure about anything.
Lynne xx

[molly muffin]

Okay so the test that was done to check for cushings was LDDS which is really considered the gold standard for diagnostic purposes.

What this tests is a baseline of cortisol and then they are injected to see what they will suppress at 4 and 8 hours.

Is it possible to get the results of that from your vet.

Believe me, we all came here scared to death and worried sick for our dogs.
The more you learn and understand the disease the easier it is to deal with the vets, the medication, the testing.

I am a bit concerned that cushings does not normally come on quickly, it builds up and then symptoms start to show, this is quite often attributed to age related, etc until you know for sure that it is cushings.

I would probably just say, this is what I feel comfortable with, I've read the recommendations from the manufacturer of the medication (and give it to him) and say you want to start at the lowest and see how he does on that.

[DoxieMama]

Hi again Lynne,

The all day test with blood taken every 4 hours was probably the LDDS. What has helped me in absorbing the information is to request copies of all the test results, then I can post them here and get additional feedback, but also refer back to them whenever I like. It's also been extremely helpful to have others with more experience who can share their knowledge and help me to make the best decision for my dog, especially when, as you've come to find out as well, the vet (or their staff) don't always have the most current information or as much knowledge about Cushing's as some of the people here who have been around for years. Between my own research, comments on my thread and others, I've learned so much more about Cushing's than I knew only a month ago.

My vet wanted to start my dog on a dose of 2 or 3 times what we (and the manufacturer) are recommending here. I told the vet's office that I would really prefer to start on a lower dose, the 1mg per pound, because of that. They initially disagreed with me and said that dose would not be enough to prove effective, but I was persistent and refused to budge. The staff understood the idea that giving him a smaller dose initially would be a good way to make sure he didn't have any adverse reactions or side effects, and the vet was willing to go ahead at that dose. Now, just under four weeks later, we are actually going to decrease it because 1mg per pound has proven to be a bit too much for my dog.

Cushing's is so very treatable and you don't have to worry about all those scary side effects, so long as you follow the protocol. :)

Shana

[DoxieMama]

Just want to point out to everybody that Lynne's dog weighs 42 kg. and not 42 lbs. Per our recommended formula, a reasonable starting dose would be a daily total of approx. 92 mg. (42 x 2.2). So it is actually not all that far off from the vet's figure of 110 mg. But that needs to be the daily total, and not doubled if he is dosed twice daily.

Marianne

Oh jeez, good catch Marianne! I read that, twice, and wrote 2.2mg/kg but still didn't calculate it right. Oops. :o

[labblab]

Thanks for quoting me, Shana! I had just gone back to edit my post and stupidly pushed the wrong button and totally deleted it :eek:. So I am really glad you had quoted me!

[molly muffin]

God ca h!!!! I was totally in pound land. Argh. Maybe a 60 morning 30 night. As is not easy to get compounded if at all in UK

[Lynne H]

Hi everybody,thank you so much for replying,I feel I have learned a few new things already,I will ask my vet for a copy of the results so that I can post them and be sure to ask many questions before I go ahead,since being on here I have taken In more information than I did before and I'm very sorry I have not been much help with your questions but I have just been so frantic with worry about my boy,he is 10 years old and I hope to have him with me quite some time yet,to be honest I have not spoken to my vet face to face,only on the telephone so I intend to go and see him next week,I feel I have so much more to understand and your help is so very much appreciated please.
Thank you
Lynne xx

[Harley PoMMom]

Hi Lynne,

Welcome to you and your boy from me as well! The others have gotten you off to a really good start, I just have one question :eek::) Has diabetes been ruled out? Increased urination and drinking are symptoms of diabetes.

Hugs, Lori

[lulusmom]

Shanna and Sharlene, you may have been thinking in pounds but Lynne did mention in a subsequent post that her vet wanted her pup on 110mg twice a day so even in kilograms, your concerns are more than justified.

[Lynne H]

Hi Lynne,

Welcome to you and your boy from me as well! The others have gotten you off to a really good start, I just have one question :eek::) Has diabetes been ruled out? Increased urination and drinking are symptoms of diabetes.

Hugs, Lori

Hi Lorie thank you,yes,diabetes as ruled out,I thought it could be that too but it came back negative xx

[Lynne H]

Hi everybody,one of my concerns about my boy is weight gain,he has put on quite a bit of weight recently despite nothing changing in his diet,I'm quite careful about not over feeding because he only has little legs,since finding out he has cushings I've cut back even further but he seems to be still gaining,I know this can be because of this condition and this may seem like a silly question but when he starts treatment will it help stabilise his weight? He also has a very large fatty lump on his side which is so close to the ground my vet told me if it gets scrapped it will become ulcerated and dogs with Cushing don't heal the same,it's started to scrape on the ground and now I keep him on grass but it's still a worry
Thank you very much
Lynne xxx

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about weight into Fergus’s original thread. We like to keep all posts about each pup in a single thread as it makes it easier for members, and parents, to refer back to the pup's history when needed. I also change the title of his thread to add his name, making it easier to find. Thanks!