Do not trust my Vet?

[Junebug49]

My Dog was diagnosed with Cushing's and was on the same dose of trilostane 10 ml for over 1 year and she did a test every month for the twelve months and did not change the dose. It was costing me more than I could afford so after the year (and the complete check up with extensive blood work (kidneys and liver) she had a good results) I told my vet that I could only afford the test every 4 months and that she had no signs of any side affects of cushing's. 3 days later she called and said they were changing my dog to 5 mL of Trilostane half the dose. She said after a month I would need to do another test. I did what she said but the test still was not what she wanted It has been 2 1/2 months and my dog has all the symptoms of cushing's (hair loss, drinking and hungery, and agitated. Now my vet wants to put her back on 10 ml Trilostane and a test in one month. She was perfect on the 10 ml for over a year before and lab work was good. Why did she change it and not wants to change it back and more tests every month for 3 mo at least now. I do not trust her. Why did she not leave her dose alone and just test her every 4 months?

[judymaggie]

Hi and welcome to you and your girl!

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.

Dechra, the manufacturer of Vetoryl (brand name for trilostane), recommends an ACTH test 10-14 days after starting Vetoryl, then a re-test at the one month mark. If the results at the one month are within the desired range and no symptoms reappear, then an ACTH is recommended every three months. I have to be honest and say that I am stumped as to what your vet might be thinking.

That said, it will help us a great deal if you would provide us with some test results. If the monthly test the vet did was an ACTH, then please give us the "pre" and "post" numbers for the last one when your dog was on 10 ml. If the vet was doing some other test monthly (maybe a "resting cortisol"?), then post those results. Please also post the "pre" and "post numbers for the test that was done when on the 5 ml. With regard to blood work, please post the highs and lows indicated along with the range and date of test, i.e., ALKP 560 (10-100) 6/10/16.

If you don't have actual copies of the test results, we would recommend that you obtain them from your vet -- it is always a good idea to keep a running record for yourself as well as any specialists or other vets you might consult with.

I expect others will post and have more thoughts (as well as questions ...).

[DoxieMama]

Welcome from me also. What's your pups name?

I agree with Judy - I have no idea why your vet would suggest the actions taken so far. Please do get copies of those test results. If you can share them here (just type out the pre/post numbers for the ACTH or anything out of range, as Judy mentioned).

I look forward to learning more about your girl.

Shana

[molly muffin]

Hello and welcome from me too. I'm curious, you said she was on 10ml, she is on the liquid trilostane? or did you mean 10mg?

Changing the dosage is usually dependent upon what the ACTH shows and if it shows the levels going low, then they tend to lower it. Without knowing what the numbers actually are, it is hard to guess as to why the vet changed, but that is the usual reason for a lowering dosage.

If you put her back on 10 and she is then testing fine, you could likely go to a longer period in between tests.

[BrittanyandJJ]

Hi There!
Wow! Sounds like your vet doesn't know how to handle Cushings or is ripping you off. I found that the vets in my area do not know much about treating Cushings and that I was actually educating THEM once I learned about the disease. As a result I sought out an internal medicine specialist a couple hours from where I live. I had actually been to him before. I asked him about his experience treating Cushings and learned about the protocols myself. The specialist has been very nice and willing to work with me and I trust he knows what he is doing. I get my ACTH test done where I live and email the results to him. Since I do not trust the vets to be honest about their ability to treat this condition I now ALWAYS have the bloodworm results emailed to me (your vet should do this if you ask) so that I can see them for myself. Also, it sounds like you have spent a LOT of money. A specialist should not cost more than you have spent and your testing should not be monthly, so it is well worth it. Also, be sure to see the results yourself so that you can know if what the vet is telling you makes sense. I am so baffled that vets can get away with this kind of stuff. It makes me sad because we have to trust that they have our babies best interest at heart and I am finding that this is not the case. :-( I am glad you found this forum and please do not give up. Find the right person to treat your baby... or if you have to use the same vet make sure you have all the bloodworm emailed to you and that you have some idea what it means. I am coping and pasting some info that someone (Doxiemom) posted on my thread. I hope it is helpful.

Hi - I just wanted to share a link to Dechra's website with a page that might help answer some of your questions, especially regards to the desired test results.

http://www.dechra-us.com/therapy-are...ating-cushings

On that page is a link to their treatment and monitoring flowchart, which I am going to link below as well:

http://www.dechra-us.com/Admin/Publi...50030-0615.pdf

[labblab]

Hi again from me! I am going to give you two updated links for the citations that I believe Brittany was offering above. Dechra has recently revised their links, so unfortunately those original links are no longer functional.

http://www.animalhealthinternational.com/animalhealthinternational.com/media/Animal-Health-International/Training/Dechra/VetorylClientBrochureSpreads4_20HighRes.pdf

http://www.dechra.us/Admin/Public/Download.aspx?file=Files%2FFiles%2FSupportMaterial Downloads%2Fus%2FUS-046-TEC.pdf

Marianne

[Squirt's Mom]

Sweetheart, if you do not trust your vet, find a new one you are more comfortable with asap. This is not a disease that needs to be in the hands of a vet we cannot trust. We need a vet who will work with us, listen to us, and keep our babies health foremost in their plans. So look for another vet asap. ;)