13.5 y/o golden retriever - Vetoryl

[Nina Fancy]

Hi everyone -

I also have a question about Cushing's and rear-end weakness. My 13 1/2 year old golden retriever was recently diagnosed with Cushing's. His symptoms included drinking lots of water and then having accidents, heavy panting, and hunger. He has been on vetoryl for a little over a month and the symptoms are starting to subside somewhat. However, for the last year or so his back left leg occasionally "slips" when we are walking. It doesn't bother him or even slow him down so I've never worried about it and if it is increasing in frequency, it has only increased slightly. We usually walk half a mile and he might do this 3 times. I am now wondering if this is related to the Cushing's or if I should be worried about it. A friend's dog was recently diagnosed with degenerative myelopathy and I am now worried about his back leg slipping. But then I read that Cushing's can cause muscle weakness so maybe that is the cause. Has anyone else's dog done something similar because of Cushing's? Thank you!

[labblab]

Hello Nina, and welcome to you and your boy! You'll see I've moved your reply so as to create a thread that's your very own. Unfortunately, the thread to which you originally posted has been inactive for several years now, so it's much more likely that our members will be able to reply to you directly here. ;)

We'd love to learn more about your boy's overall health history, and especially his Cushing's diagnosis and treatment. That's great that you're seeing improvement during this past month, and we'll surely hope it continues. What dose of Vetoryl is he taking, and has he been scheduled for a monitoring ACTH test in order to evaluate the internal effect that this current dose of Vetoryl is having on his cortisol level?

As far as his back leg, at his age, I think he could have any number of degenerative issues that may or may not be directly related to Cushing's. I just lost my own beloved 12y/o nonCushpup Lab last summer due to a combination of orthopedic issues: failing hips, spinal stenosis, ligament damage. I would think the easiest first step would be for your vet to just take some simple x-rays of your boy's rear end. That should be both quick and relatively inexpensive, and may identify a treatable issue.

Anyway, welcome once again, and I'll forward to learning more about your sweet boy.

Marianne

[Nina Fancy]

Hi Marianne,

Thank you for your prompt response. It took awhile for my dog to get diagnosed. The first noticeable symptom was drinking large quantities and having accidents. My normal vet, who I've used for years, tested for diabetes, which was negative and then dismissed it. I didn't worry for a few months but the accidents became more frequent and bothersome. Then I took him to a vet I'd met through volunteering at a shelter and he was more persistent and suspected cushing's. He gave him a test other than the ACTH test which came up negative (sorry I can't find my receipt for that). He then diagnosed him with a urinary tract infection from a urine culture. But after treatment, the symptoms continued - drinking large quantities, having accidents, panting, being very hungry and restless. So he then suggested the ACTH test. I didn't receive results but was told his cortisol level was 19, which did indicate cushing's. Since then he has been on 120mg of vetoryl and symptoms have reduced somewhat but not completely. He is less restless, doesn't pant as much (but he still does sometimes), and accidents are fewer but not entirely gone. He was retested after 2 weeks of treatment and I was told that his cortisol levels were now normal. He is still excited to go on his walks and runs around and is playful, although he does sleep a lot, but he is also quite old for a golden.

The vet recommended the prescription diet K/D food, which I am feeding him. Does that make sense? He has also been on a joint supplement by Platinum Performance for 4 years and we could see a big difference when he started taking it.

I did read through many of your posts and learned that his dosage may be too high. He weighs 75 pounds. But now that he's started, is it too late to reduce it? Should I be concerned? I also read about getting an ultra-sound, which he didn't, but now it is too late? What is the risk in not having that done? And does panting always indicate pain? He seems to do it when it is dinnertime or he needs to go out. Thanks for your input. It is much appreciated. My goal is to keep him as comfortable as possible and give him a good quality of life while I can as he is part of our family. At this point, he seems healthy and happy in every other respect so I hope to have him for a little while to come. And I will monitor the leg slipping and mention it to my vet at his next appointment.

Thank you!

[labblab]

Hello again, Nina, and thanks for all this additional info. In answer to a couple of your questions, it's true that 120 mg. is a higher starting dose than I would have wanted for my own dog. However, the appropriateness of continuing at any given dose is subsequently determined by a combination of symptom improvement as well as monitoring blood testing since individual dogs have varying responses to the medication. That is good that your boy was tested at the two-week mark. However, he should be tested again right around now -- at the 30-day mark. This is because cortisol levels can continue to fall within the first month of treatment, even when the dose has remained unchanged. So you want to make sure that he has stabilized at a healthy level. If he has, then the 120 mg. may indeed be the appropriate dose to continue.

As a Cushmom, one thing that will be very helpful is for you to ask your vet for actual copies of your boy's test results. I don't mean to cast doubt on your vet's representations, but we've learned the hard way that a fair number of general practice vets are not thoroughly familiar with the optimal test results for a Cushing's dog. Right off the bat, one thing I'm wondering about is an ACTH result of 19. For most lab results we see, that actually would not be high enough to confirm a Cushing's diagnosis. So if you can request a copy of that test so that we can actually see what the true "normal" range is for your lab that will help. Ditto for the second ACTH test, although for your own information, the desired cortisol level for a dog taking Vetoryl is different for the normal range for a dog with the disease.

As far as the prescription K/D food, have lab tests indicated that your boy suffers from impaired kidney function? If so, the food may be appropriate. If not, I'm not sure why your vet is prescribing it. Again, copies of your boy's actual test data (blood chemistries and urinalysis results) will help shed light.

At his age, quality of life is obviously of prime importance for your dog. So if you are seeing improvements after starting the Vetoryl, that's great. But you do want to make sure that he's being monitored properly, and so educating yourself about his testing is a really valuable way to begin.

Marianne

[Nina Fancy]

Okay, thank you very much for the advice. I will ask for a copy of the test results tomorrow. I know when he said that the test result was a 19, he said that 20 was usually the cutoff, but he thought it was elevated enough to warrant treatment given his symptoms. But I will get copies of the results and hopefully that will provide more information. Thanks again!

[judymaggie]

Hi Nina -- welcome to you and your pup (name?)! Marianne has provided you with excellent guidance and info. You might also spend some time reading in our "Helpful Resources" forum. I have found that one of the pamphlet's offered by Dechra, the manufacturer of Vetoryl, is particularly helpful. Here is the link:

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

Another thought re the "slipping" you are seeing during walks -- my Abbie does this and her chiropractor (yes ... she goes every three weeks due to interverbral disc disease) believes that it is related to weak reflexes on the side that is involved. You might have your vet test your dog's reflexes the next time you have a visit.