Stella, 15 y/o terrier mix - new problems with walking (Vetoryl)

[jack2002]

My girl is a beautiful 15 year old (approx) terrier mix (some jack russel, pit, and whippet), weighing approx 40 pounds. I have had her since she was about 1 year old when I adopted her in 2002. She was diagnosed w cushings last year and has responded well to the veteroyl. Her symptoms subsided greatly but still exist. The panting and pacing still happens but not as often or for as long a period of time as Pre-cushings diagnosis. Anyway just last week her back legs gave out and she fell down the stairs twice and then fell off my bed. She has been having trouble walking and even getting herself up when she is lying down ever since. The vet gave her a pain killer and an nsaid to help w the pain of the fall. X-rays and bloods all came back normal. No broken bones or arthritis. My girl has led a generally very healthy life except for the damn cushings. The vet thinks she will get past this and that it's just the pain that is making it hard for to walk. Based on all my compulsive research on cushings, Im concerned that this is permanent and yet another manifestation of the horrible disease. My girl's walks are her life line. She lives for them, as do I. And she enjoys climbing on all the furniture in my house while I am at work so she can look out the windows. The post about Money Penny's front legs giving out really struck me. That's what happened w my girl, whose name btw is Stella. The night before it happened she was chasing me in our yard and was her usual active happy self. Now she looks miserable and upset that i have blocked off the stairs and furniture while I'm at work for fear she will fall and really get hurt while No one is home. I have done all the testing you can imagine with the exception of an MRI because frankly i wasn't convinced that by knowing there is a tumor in her head that the situation would be able to improve for Stella. I don't want to put her through chemo or surgery. But the MRI remains an unturned stone for me. It was a brutal decision to make not to get the MRI. But now I'm terrified i will have to make an even more brutal decision in the near future. Does anyone know if the legs giving out is permanent? Will my girl be able to walk happily on her long walks again? W cushings, how do we know if it's close to the end. I thought cushings patients could live long w medication and careful monitoring. I'm an absolute emotional mess about this. My thoughts have been spiraling uncontrollably. I can't stop sobbing. The thought of losing her is killing me. This disease is so awful.

[Joan2517]

I'm so sorry that Stella is not feeling well. Hopefully she just pulled something while running around and needs time to get better. Others will be along to try to help you figure this out.

[dsbailey]

What were the latest ACTH results?

I'm a believer that if a dog is having issues that involve leg / back / hip pain, possible arthritis, or joint swelling that adjusting the Cushings medication downward to allow the cortisol to rise slightly can in some cases give a better quality of life. That's what this is about - isn't it? The panting may be caused by pain and hopefully not neurological.

One thing to note is that NSAIDS aren't very liver friendly and Tramadol is the lesser of the two evils.

Darrell and Lolita

[labblab]

Hello and welcome from me, too! I just wanted to alert you that I've moved your post and created a new thread that is your very own. I noticed you had posted your reply to a thread that has been inactive for quite a while. This way, by having your own thread, it will be easier for our members to reply to you directly. ;)

Marianne

[jack2002]

Thank you so much.

[jack2002]

Last acth test was early this year. Feb. She has trouble maintaining the 40 pounds. She loses weight quickly despite her big appetite and frequent meals. Right now she is down to 38 pounds and she is on a 40mg dose of veteroyl (one 30mg and one 10mg- two pills a day) I hadn't considered retesting her bc I hate putting her thru that acth test and vet hasn't said anything yet. But I suspect he will soon. Poor thing went thru a lot last week w X-rays and urine and blood work. I had to leave her for a few hours at the vet and she and I both hate that. Should she be on smaller dose of veteroyl? Has anyone here had to adjust the dosage during treatment and been successful in seeing an improvement? Also I know that about nsaids. I'm worry about the liver but he only wants her on it for a week. She has some fatty tumors in her torso and vet has suspected for a while that there may be a fatty tumor under the muscle of one her hind legs that be causing her some discomfort. In the past I have had fatty tumors that have become uncomfortable for her surgically removed. But she isn't the ideal candidate for surgery now. Also yes panting is pain and I have given her an nsaid here and there for the pain. Her head gets very hot when she has an episode of pacing and acting nervous. She has responded well to it in those circumstances. And her bloods showed her liver was good- normal. Her bloods have always been normal except for her alk phosphate which has always been high ever since she was young. But the alk phos came back normal for her. The high alk phos is what gave the vet a clue that she was Pre cushings years ago.

[jack2002]

And thank you all again. I appreciate the feed back so much.

[dsbailey]

I hadn't considered retesting her bc I hate putting her thru that acth test and vet hasn't said anything yet

You should have her tested, take her to the park or a place she enjoys between blood draws. Don't sit in the waiting room for any length of time, in the door, out the door.


Should she be on smaller dose of veteroyl? Has anyone here had to adjust the dosage during treatment and been successful in seeing an improvement?

Very possibly to a smaller dose, my girl started at 57 lbs on 60 mg, then 30 mg, now 25 mg at 52 lbs. This has been since March 2016.

Darrell and Lo

[jack2002]

Were there physical signs telling you that your girl should be on a lower dose? And what kind of improvements or changes did you notice once her dose was reduced? I noticed from what you wrote that she is on a dosage that doesn't match her weight. My next vet appt is monday. I'm going to discuss retesting Stella to see if she needs a reduction. I'm still so perplexed by the new difficulty in walking and sudden giving out of her back legs. She has gotten a little better these past few days because she is determined and can't stand being inert. But progress is slow. I'm worried.

[dsbailey]

Actually I was mistaken she's been on 15 mg per day for three weeks now and going for an new ACTH test on Monday. Her last ACTH test post results were 2.1 and I wanted them to be a bit higher because of some arthritic problems. What made me notice that her cortisol levels were low each time is that her arthritis and rear end weakness were getting worse and I was trying to increase her cortisol levels by lowering her dosages. She was also becoming more lethargic and didn't have that snappiness I was used to.

Each time we lowered her vetoryl her cortisol would drop instead of rise. Her last ACTH Test on 11/4 her post was 2.1 on 25 mg Trilostane down from 3.8 on 30 mg Vetoryl on 9/14. Her Cortisol should have risen by lowering her dosage and it did the opposite.

We lowered her dosage again and seems to be doing the best finally on 15 mg. She has a snap in her step, read end weakness seems to be much better and arthritic-ally not as sore. She is showing no Cushings symptoms.

If after testing Monday and her levels have dropped again on 15 mg which is 1/4 of the starting dosage we're going to cease Trilostane for a while and see if her symptoms return.

I hope this isn't too confusing to you because it is to me. I guess the point being TEST TEST TEST if something seems off. All dogs are different and unless you try something new don't expect different results or a problem to be solved.

Best Wishes - Darrell and Lolita

[molly muffin]

Hello and welcome to the forum. I agree that she really needs an ACTH test to find out her levels.
It isn't uncommon for a dosage adjustment to be needed into treatment, either an increase or a decrease could be needed.
High cortisol weakens tendons and ligaments over time so that Could be a factor, but it also could be that she hurt herself in the multiple falls. Pulled something.
If so, and that is my initial thought since she was fine the night before, is restricted movement, no jumping at all. It might be her back that was tweaked even. An anti-inflammatory will help, but definitely watch the liver values as NSAIDs filter via the liver and aren't good for a cushing dog.
I got my dog a like doggy playpen and while she hated it, it did help with the restricted movement and helped her heal. It took mine about 4 - 5 weeks. No jumping up or down during that time and no stairs.
So that is a possibility.
Another thing to have checked is her eyesight as that can also cause them to start having issues on stairs. It can change very quickly. How is her BP? (this is a rather remote chance as an issue but something you want ruled out)
Again, welcome to the forum.