Newbie - Bosco

[kboyce]

Hello. I'm so happy I found this site! My 11 year old male Australian Shepherd Bosco was recently diagnosed with Cushings after many months of testing, etc. I guess he is a-typical, the first vet I saw about his symptoms (excessive drinking, accidents in the house, excessive hunger, weight gain, etc.) refused to test for Cushings as he did not have elevated liver values, etc. 2 months later a different vet at the same clinic who I saw for the same symptoms suggested testing (go figure) and he came back positive for Cushings. I will get the test results from the vet on Monday and post them. Started him on Vetoryl last Friday and I take him back Monday for testing. I've noticed a change already in the amount he is drinking and the accidents in the house. This morning for the first time ever (in his life!) he walked away from his food dish and left some kibble. Now I'm worried he is having an adverse reaction to the meds. Is this normal? He weights approximately 74 pounds and is on 30mg 2x per day. I have so many questions, I am going to spend some time reading the posts, I'm sure they have been asked / answered before. Thanks! Kristine and Bosco

[Squirt's Mom]

Hi Kristine and welcome to you and Bosco!

It will really help us to see those test results so I am looking forward to that soon. Now is the perfect time to get in the habit of asking for copies of all test results from now on - not invoices but the actual numbers from the tests.

The typical testing schedule is to have the first ACTH 2 weeks after the Vetoryl is started but the dose is never increased in the first 30 days because the cortisol can continue to drop during that time. You will be taking him in more than enough for testing without increasing the number of tests unnecessarily. ;)

Can you tell us if there is any loose stool/diarrhea, nausea/vomiting, lethargy since starting the med? Walking away from his bowl in and of itself is not a big deal but combined with any of the other things I just mentioned could indicate the drug needs to be stopped for a bit. We want to see that appetite drop a bit with treatment and return to a more normal level instead of being the little piggies an untreated cush pup can be. :D His starting dose seems to be fine - the recommended starting dose is 1mg per lb and Bosco is within that range. However each pup is different and we have seen many larger dogs gain control on a much smaller dose that would be expected. So if you see anything else like the loose stools, nausea, etc. stop the med and call you vet asap.

I'm glad you found us and look forward to learning more about you both as time passes.

Hugs,
Leslie and the gang

[dsbailey]

Welcome Kristine,

As Leslie said the decreased appetite alone is nothing to worry about. What was important is all dogs being different and larger ones may require less Vetoryl.

Please search for my thread "Lolita". She's and Aussie Mix, weighs 57 lbs and and was started on 60 mg once per day. I tested her after 7 days and her levels were 1.2 with a range of 1.5 - 9.1 (Low). She was showing no negative clinical signs, just positive ones ie. less drinking, less rabid, etc. We stopped meds for a week, had an electrolyte test, and gave her 1/4 of a 20 mg prednisone to bring her levels up a bit. Long story short (All in my thread) I restarted her on 30 mg once a day and that brought her levels up to 7.0. Then I added 5 mg in the morning which brought her to 4.2. She started to show some arthritic problems so I stopped the 5 mg in the morning and that seemed to help. I expect our next test to be back in the 7 range.

The points are - It's all a balancing act that you'll soon get the hang of, all dogs are different, when in doubt stop the vetoryl, and most importantly ALWAYS have some prednisone on hand.

I hope this made sense.

Darrell and Lolita

[kboyce]

My vet did not prescribe prednisone with the Vetoryl. I will call and ask about that (or ask Monday). I have not noticed any loose stool and there has been no vomiting. But I will keep a close eye! Honestly I'm not sure what the levels even mean yet. I have lots of learning to do! My vet said they test 10 days after starting the Vetoryl and it has to be 4 hours after they are given meds. Is that not normal practice? Testing is expensive (around $400 they said) so I don't want to do it more than necessary.

Thanks,
Kristine and Bosco

[Squirt's Mom]

10 days - two weeks is the correct timing and doing the test at 4 hours after the dose is also correct. I misread and thought your baby was being tested 4 days after starting! :o:p:rolleyes: So you are on the right track with timing!

[kboyce]

Still reading through everything. My boy Bosco is having really severe muscle weakness. He can not do the stairs any longer and has to be carried. Is it normal for Cushings to cause this and will it get better once he is stabilized on meds? I see my vet Monday...

Thanks,
Kristine (a very worried fur mom) & Bosco

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about muscle weakness into Bosco’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. Thanks!

[Squirt's Mom]

This does happen in cush pups with uncontrolled cortisol and it can take some time to get better for some babies. But I am glad you are taking him in tomorrow. Is he ok otherwise? No other changes you've noticed?

[kboyce]

He is not himself but hasn't been for months. He went from a very active healthy dog to a dog who doesn't want to do any exercise and is very easily tired. He is irritable. Just not my normal goofy happy boy who has acted like a puppy all his life. His appetite is definitely lower, he is leaving food in his bowl. But still seems to be drinking a fair amount of water (but no longer searching for it in weird places lol). Sorry, I'm just worried. I hate seeing him like this.

[kboyce]

Bosco had the atch test yesterday, waiting for results. I have to go back and get copies of this previous tests and results as well. Today he is peeing all over the place, can the atch test cause the increased urination? I hope we don't have to do that test again, it was $500. How does everyone afford the testing / treatment of this disease??

[Squirt's Mom]

The ACTH is a stimulation test and it can cause some stronger Cushing's signs but that will usually go away in a day or so. But $500 for an ACTH?! That is pretty high tho pricing varies a great deal across the country and world depending on where you live. Was the ACTH performed by the GP vet or in a specialty clinic? That can have bearing, too. Was the ACTH the only test done? I would check all the charges on my invoice and see exactly what I was being charged for. Sometimes a vet will do more than one test at the same time as the ACTH so check your billing and see what makes up that $500.

Let us know what those results are when you get them.

As for how we afford this disease- we all have our ways. Personally I gave up everything that wasn't absolutely required. If I didn't HAVE to have/do it, I didn't get/do it. No new clothes or shoes, no hair appointments, cut my grocery bill to basics, no eating out except for very rare occasions, no travel, nothing that wasn't absolutely necessary to survive. Squirt got every spare penny I could find. I had yard sales and sold things online, too.

One way some folks can save is by extending the agent used for the ACTH. This works best for smaller dogs since larger dogs do require the full vial but it's worth talking to your vet about -

How to Extend Your Supply of Cortrosyn and Lower the Cost of ACTH Stimulation Testing
http://endocrinevet.blogspot.com/2012/03/how-to-dilute-and-store-cortrosyn-for.html

How are his legs these days? Any more strength in them? Hope you are seeing some improvement in his strength as well as other signs.

Hugs,
Leslie and the gang

[kboyce]

Ok just looking at the invoice it also includes a full CBC, electrolytes and some antibiotics because he has a hot spot / infection on a leg. The Cortrosyn was $188. and the ACTH test $100, plus courier, blood collection, hospital stay, etc. The test was performed by the GP vet, we don't have any specialty clinics here (in Winnipeg, Manitoba, Canada). I will have to make some serious lifestyle changes to continue to afford this disease. I have 3 other dogs to take care of as well (one almost 17, a 6 year old and a new 1 year old). I train and compete in dog sports (agility, disc dog, rally, etc.) with my dogs so competitions may have to take a step back. Thanks!

[kboyce]

Ok I have Bosco's test results from his ACTH test on Monday. His Cortisol level was 43 pre test and 147 1 hour ACTH. Goal is 55 - 200 so he is within the normal range. The second page has a ton of results, not sure what anything means. All looks normal except for LYM which is low (.93). Any other results you would like to see?

Had a meeting with my vet this am and he confirmed (don't know why they don't tell you this) that we can get the trilostane compounded for approximately half the price. So going to do that in a month when he needs more meds.

Thanks,
Kristine

[Harley PoMMom]

Are those ACTH stim results in nmol/L units?

Lori

[kboyce]

Yes it says nmol/L

[Harley PoMMom]

Since most of us are used to seeing those results in ug/dl I'm converting them ;) so the pre would be 1.56 ug/dl and the post is 5.32 ug/dl. That post number is great but that pre is kinda low, I really think he'll be fine but just in case, you are looking for symptoms of too low cortisol such as diarrhea, lethargy, vomiting, or Bosco just not acting himself, if you would see any one of these symptoms stopping the Vetoryl is required.

You're doing a great job!!!

Hugs, Lori