Newly diagnosed

[Kellieb@bresnan.net]

I have a 12 year old dandie dinmont terrier recently diagnosed with cushings . She weighs 25 pounds and is on 90 MG vetoryl (up from 60 mg today) not responding at 60mg. I am getting very discouraged. Ant thoughts?

[labblab]

Hello and welcome! Can you please tell us more about your dog's entire medical history, as well as the symptoms and testing that led to the Cushing's diagnosis? 90 mg. is a very hefty dose for a dog weighing only 25 pounds, so I'm anxious to know for how long a time she has actually been treated, as well as the timing and results of monitoring ACTH blood tests that have led to this large of a dose. It is really, really dangerous to increase a dose so significantly without monitoring actual cortisol levels and blood chemistries.

So please fill us in re: the specifics of your dog's symptoms and testing history. Thanks so much!

Marianne

[Kellieb@bresnan.net]

Still getting used to navigating this site. Diagnosed 1 month ago, started vetoryl 30mg. After two weeks raised to 60mg and today to 90 mg. They do blood work each visit. Today cortisol was 4.8 up from 3.0 two weeks ago. Also monitoring urine which is very dilute, 10.01 I think. Symptoms are ravenous appetite and thirst, frequent urination ( every hour during day), muscle deterioration, vet tells me I must be patient, it may take a couple months to get this under control

[labblab]

OK, now I am really nervous for the safety of your dog. Are those cortisol readings post-ACTH levels, or simply resting cortisol levels? Monitoring ACTH tests involve two readings: a baseline cortisol level, and then a second cortisol level taken one hour after injection of a stimulating agent. Monitoring ACTH tests should be performed within 4-6 hours after the morning dose of Vetoryl is given along with breakfast.

Baseline cortisol levels, alone, cannot be relied upon for making dosing increases. Baseline cortisol levels are highly variable from day-to-day, even hour-to-hour for any dog -- even for a dog without Cushing's.

If the cortisol levels you are reporting are post-ACTH values, then both results are within the desired therapeutic range (even though the second result is a bit higher), and it is quite unsafe to increase the dosing so significantly so soon after beginning treatment. In honesty, a dog with a post-ACTH level of 3.0 after only two weeks of treatment should never have had a dosage increase at that point. I'll explain why in another reply.

Let's also please revisit the diagnostic testing that resulted in the Cushing's diagnosis in the first place. Lots of questions here for us to take a look at.

Marianne

[PennysDad]

Welcome to the right place! There are many people here who are experts, and I am not one of them. Just another dog lover who is 18 months into the adventure that is Cushings disease.

Try and take the advice of the people here who know what they are talking about. My dog penny, 90 lbs, is on 180mg/day. 120 in the AM and 60 in the PM.

It did take a few weeks for the symptoms to start going away.

Sorry you have to be here, but welcome to the club.