Diagnosis with low dex text results

[Sweetbella]

Our 7 year old sweet cocker spaniel was just diagnosed with Cushings after 2 CBC tests where her ALP was over 2,000 and her low dex numbers at pre dex were 7.5, at 4 hours were .9 and at 8 hours were 9.0. Anyone's pups have similar numbers? She displays the classic symptoms of increased thirst and urinating, swollen abdomen and increased appetite and severe panting and muscle weakness in hind legs. Looking to get her on meds ASAP. Vet suggested 30 mg vetoryl 2x a day. Since this is all new to us, any advice is welcome. Thank you in advance!

[labblab]

Hello and welcome to you and your sweet girl! I have only a moment to post right now, but the symptoms and blood tests that you are reporting are indeed consistent with the pituitary form of Cushing's. My one concern right now is the size of the Vetoryl dose that your vet is recommending. In recent years, initial dosing recommendations have lowered, and the protocol most widely accepted at this time is to start with a daily total no greater than 1 mg. per pound, or 2 mg. per kilogram. If your girl weighs 60 pounds or more, then you're probably good to go. However, if your girl weighs less than that, I'd want to discuss the starting dose further with your vet. Vetoryl additionally comes in 5 and 10 mg. capsules, so many different dosing combinations are possible. Also, if your vet prefers to stick with twice daily dosing, the two doses don't have to be exactly even. If they're not, however, the larger dose should be given in the morning.

Here's a link to a reply that discusses initial dosing protocols in greater detail:

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

Marianne

[Sweetbella]

Thank you for your response. I also thought it was high and perhaps I misunderstood her in all the initial information that I was trying to process. My little girl is 32 lbs so maybe my vet meant 30 mg a day and giving it to her in two doses instead of all at once? I'm waiting on a call back now. Do their symptoms usually subside relatively quick on medicine?

[labblab]

Some dogs exhibit symptom resolution quite quickly; others can take a longer time. Excessive thirst/urination/hunger typically show improvement more quickly than things like muscle weakness, skin/coat issues, and pot belly. The real key is arriving at a dose of the medication that is therapeutic, and that can take some tweaking. However, as is written in that link I gave you, dogs experience fewer unwanted side effects when they are started at lower doses that are tweaked upwards, rather than vice versa.

I do hope your vet intends for you to start at a daily total no greater than 30 mg. And if so, perhaps she'd agree to letting you start out with once daily dosing in the morning. From a financial standpoint, that will be much more economical for you. If subsequent monitoring testing shows the need for a dosing change, then you could add an additional capsule of some dosing size in the evening, as well. But in getting started, one box of thirty 30 mg. capsules will be a lot less expensive than multiple boxes of 10 mg. capsules, for instance.

Marianne

[judymaggie]

Hi and welcome to you and your pup! I just wanted to add to Marianne's suggestion about discussing once a day dosing with your vet. Although most endocrinology experts recommend twice a day dosing when diabetes or high blood pressure are also present along with Cushing's, once a day dosing is typically recommended otherwise. I give my Abbie Vetoryl twice daily as she does have high blood pressure. This does present restrictions on my activities as the Vetoryl doses should be given 12 hours apart and after a meal. Abbie gets her morning dose at 8:00 am and her evening dose at 8:00 pm. Thus, I need to be home in the evenings. I am retired and honestly don't mind having to adjust my schedule to fit with hers but not everyone can do that on a consistent basis. Just something to consider ...

Also, after you have been able to determine your pup's accurate dose, there are ways to save money on the Vetoryl (as opposed to buying it from your vet). We can discuss those when the time comes -- at least a month after the Vetoryl is started.

Looking forward to learning more about your pup (name?)!

[Sweetbella]

All good advice! I appreciate it! I will for sure speak to vet about one day dosing and inquiry why she may be suggesting two. My little girl is Bella. A sweet, 7 year old cocker. ❤️

[molly muffin]

Welcome to you and Bella.

I'm sure she will feel much better once on meds, but I wouldn't start out at over 30mg total for the day, whether it is 30mg once a day or 15mg am and pm. That is the safest starting point.

You want to either way give one of the doses in morning so the follow up tests can be done at the appropriate time of 4 - 6 hours after the morning meds. Always give with food too, as they need the food to help with absorption.

[Sweetbella]

After more discussion with my vet, we are starting Bella on Monday on 30 mg a day vetoryl (one does in the morning) and I can't wait for her to hopefully start feeling better! Thank you, thank you for all your posts! We already feel like we have such a great support system to lean on as we start this process. I'll definitely post how she responds to the meds and her blood results in two weeks to see what you all think.

[Harley PoMMom]

The starting dose of 30 mg for her 32 lbs sounds just right ;) Keep us updated, please :)

Hugs, Lori