11 year old basset, recently diagnosed

[billthedog]

Hi, I am so grateful to have found this forum. We have a beautiful 60lbs, 11 (almost 12) year old basset who was after 3 years of trying to determine the cause of his housebreaking regression (I think he's peed in every corner of our house!) he was finally diagnosed with Cushings. He is on vetoryl, has been for over a month and has had his levels checked twice. He has not seemed to respond well to vetoryl, including bouts of diarrhea and lethargy, not to mention that his Cushings symptoms have not really changed. I know a month is not that long, but we have with the vet's recommendation decided to keep him on a lower dose of the vetoryl in hopes that he will tolerate it better. The vet said that if the cause of the Cushing's is a tumor, then the only answer is surgery. We are not going to perform a surgery on our very senior (he was also diagnosed with early stages of Canine Cognitive Disorder) because he has a very bad history with anesthesia. Can someone speak to whether or not they have dealt with a similar path and how they kept their dog comfortable? It is our primary concern. We want to keep his quality of life up. He has a decreased appetite, which is insane because he is a food-hogging basset after all. He is pretty lethargic, which is not atypical of the breed, but it's difficult to rouse him for a walk. Thoughts? Thanks so much in advance. Our poor Bill, we love him so.

[Harley PoMMom]

Hi and welcome to you and Bill!

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.

If you could get copies of those monitoring ACTH stimulation tests and post those results here that would be a great help to us in figuring out what is going on with your dear boy. Also what Vetoryl dose was he started on and what is the new lower dose?

The symptoms Bill is experiencing, the loss of appetite, lethargy, and diarrhea, are signs that his cortisol may have dropped too low and if this happens the Vetoryl should be stopped and a supplemental steroid such as prednisone is needed. When the cortisol drops too low an imbalance in the electrolytes can also occur, a chemistry blood panel would be required to check those electrolyte levels.

I would definitely recommend having his cortisol and electrolyte levels checked because if one or both of those levels are abnormal, which is known as an Addison's crisis, it can be life threatening. How long has Bill be displaying these adverse symptoms?

I am sorry for the reasons that brought you here but sure glad you found us and we will help in any way we can.

Hugs, Lori

[judymaggie]

Hi -- I wanted to welcome you and Bill! With the information that Lori has requested, we will do our best to help guide you.

We have found that an educated parent along with a knowledgeable vet is an important duo in the understanding and treatment of Cushing's. I am a bit concerned about your vet's statement that, if the cause of Cushing's is a tumor, the only treatment is surgery. Please take some time to read some of the many articles in our Helpful Resources forum. Here is the link:

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

Within that forum is the Client Brochure from Dechra, the manufacturer of Vetory. This brochure has an excellent overview of Cushing's. Here is the link:

http://www.dechrace.com/pdfs/vetoryl/VetorylClientBrochure5mg.pdf

Page 11 of Dechra's Technical Brochure is an easy to understand flow chart which outlines the use of Vetoryl:

http://www.dechrace.com/pdfs/vetoryl/VETORYLTechnicalBrochure.pdf

We look forward to learning more about Bill!

[billthedog]

Thank you for your fast responses, I am going to try and get his test results to share. To be honest, I have never looked at them. Never even thought to ask.

Quick question: is prednisone a longterm solution or is it simply to "reset" levels?

Thanks again, I can see that I have come to the right place.

[judymaggie]

Hi-- if cortisol levels have dropped too low and the dog is exhibiting negative symptoms such as vomiting, diarrhea and/or lethargy, the prednisone is used to stabilize (or, as you have said "reset") the dog. Most vets who are familiar with the protocols for treating Cushing's recommend that the owner have prednisone on hand when starting treatment. It is considered an "emergency dose" and should, as Lori has explained, be followed immediately with cortisol and electrolyte levels checked.

With regard to getting copies of all test results, your own file can be very helpful if you would ever have to take Bill to an emergency clinic.

[dsbailey]

Hello billthedog,

What dosage of vetoryl is your 60lb boy on? (Did I miss it somewhere in the conversation?)

Darrell

[kanga]

Hopefully, you'll find useful post here. How's your baby now?

[billthedog]

Sorry for the lack of response.

I appreciate everyone's help. We have been dealing with so many things with the end of school for kids, our Frenchie got a nasty UTI, my own health stuff, etc.

Bill the basset has been on 120mg of Vetoryl. He clearly can't tolerate it. When he is on it he is lethargic and clearly uncomfortable. I believe that the Cushing's has been masking his arthritis. Off of the meds he eats his food, gets excited about his walks, begs like a proper basset, asks to be pet. The peeing is kind of insane but we've been keeping him in a diaper and just dealing with it.

He's old for a basset of his size. We want the time he has left to be pleasurable for him. I can find very little about the effects of untreated Cushings beyond the continuation of symptoms.

We have an appointment with an animal hospital in the city that helped us in the past.

We will do another diagnostic work up and ultrasound to see if an adrenal tumor is the culprit.

Thoughts about adverse reactions to meds versus untreated Cushings would be really helpful. Thanks so much!!!!!!!

[judymaggie]

Hi! The current recommended starting dose of Vetoryl is 1 mg/1 lb. Bill was on twice that dose. This could account for him being lethargic and uncomfortable. The dose your vet has prescribed has been the suggested dose in the past but Dechra, the manufacturer of Vetoryl, has changed its recommendations. It does not sound as though your vet is aware of the changes. It is really important for you to obtain at least the results of the ACTH tests that have been done since Bill started on Vetoryl. Those test results, along with symptoms, dictate changes up or down in the dosing.

What is the lowered dose that Bill has been on? Are you still giving it to him? Since Bill seems so much more comfortable off the Vetoryl, if I were in your place, I think I would keep him off the Vetoryl until you have completed your appointment and tests with the vet at the hospital.

When Vetoryl is correctly prescribed and then monitored regularly, the chances of adverse reactions are greatly minimized. Symptom relief can be significant and that is really the goal of treatment.

Here are some of the issues that Dechra lists that can arise with untreated Cushing's:


The overproduction of cortisol has a negative impact on your dog’s body and if left untreated your dog runs a greater risk of developing other serious conditions such as:
• Diabetes mellitus (high blood sugar levels)
• High blood pressure
• Inflammation of the pancreas (pancreatitis)
• Inflammation and infection of the gallbladder
(mucocele formation)
• Infections of the kidneys and urinary tract
• High levels of protein in the urine that can
lead to kidney damage
• Chronic infections of the skin and ears
• Pulmonary thromboembolism (blood clots in
the lung)

[molly muffin]

Yikes.
120 is a lot to start on. Have you had an ACTH on that dose to see his levels?

[billthedog]

Bill was started on 60mg of Vetoryl. Then his levels were tested and the dose was raised. I am taking him tomorrow for an ultrasound. He has had blood in his stool and his back legs are becoming increasingly weak. I'm sorry for being so slow to respond. I hope to return home tomorrow with all of his test results from his levels both before and after the vetoryl, plus the results of the ultrasound. Poor beautiful Bill, it's breaking our heart to see him in such decline. Thanks for your help.

[dsbailey]

Poor Guy,


Bill was started on 60mg of Vetoryl. Then his levels were tested and the dose was raised

Please post all of Bill's ACTH results, with dates and what medication adjustments were made based off of those.

Darrell and Lo

[billthedog]

Unfortunately, today we received the results of Bill's ultrasound. Bill has at least two cancerous masses in his intestines. Thanks for your help. Our journey has taken an unexpected change. We will now focus on making him comfortable as possible, rather than treating the Cushings.

Thanks so much.

Oh Bill. Sweet, sweet Bill.

[Joan2517]

Oh, I am so sorry that you received such sad news about your beloved Bill.. My heart breaks for you.

[DoxieMama]

Oh no. I'm sorry to learn of the ultrasound results. For what it's worth, I agree with your decision. Give him lots of love.

Many hugs your way, Shana

[judymaggie]

My heart goes out to you -- please spoil Bill and enjoy every moment you have with him!

[molly muffin]

Oh no I am very sorry to hear this. :( I'm sure you will make him as comfortable as possible He will love being with you no matter what and doesn't know he has cancer at least.

[Allison]

Belated sympathies on your sad news. My husband and I have been in similar shoes. Just when we started getting help for Cushings, our dog Gizmo started to struggle with pancreatisis. We treated him for it, and spoiled him for as many months as he had left. Love your sweet Bill in the time he still has. Hugs.


Unfortunately, today we received the results of Bill's ultrasound. Bill has at least two cancerous masses in his intestines. Thanks for your help. Our journey has taken an unexpected change. We will now focus on making him comfortable as possible, rather than treating the Cushings.

Thanks so much.

Oh Bill. Sweet, sweet Bill.