New member seeking advice for Heather.

[cairnscotland]

Hi, I have a 10 year old cairn terrier who just started on vetoryl last week. Initially she was put on 30mg and for the first four days she seemed a bit better. Not drinking as much and a bit brighter. Then she got twitchy and went off her legs a couple of times over the weekend. I didn't give her the vetoryl on monday and she was less twitchy and no more keeling over/ off her legs. I took her back to the vet. Electrolytes normal. She has now gone down to a new dose of 20mg started yesterday and again is not quite herself. Please can you tell me if it is normal for dogs to have these difficulties when first starting treatment? I think she has had cushings for about 18months so I am guessing it is a shock to her system. Just really want to know if it is sensible to persist with vetoryl in the hope these side effects subside. Thank you for all your help.

[labblab]

Hello, and welcome to you and Heather! We’re very glad you’ve joined us. My first thought about Heather’s reaction to the Vetoryl is that she may simply be taking too large a dose of the medication. Can you tell us how much she weighs? Over the years, the recommended initial starting dose has been steadily adjusted downward. At this time, the most generally accepted starting formula does not exceed 1 mg. per pound (2.2 mg. per kilogram). Unless Heather is quite a large cairn, the 20 mg. she is currently taking may still be too hefty a starting dose for comfort, even if not a safety issue. I am providing a link below that better explains the research and the rationale for starting with a lower dose and working upwards if needed, rather than vice versa.

http://www.k9cushings.com/forum/showthread.php?185-Trilostane-Vetoryl-Information-and-Resources&p=1251#post1251

It is a good thing that her electrolytes were normal, but her cortisol level itself may have fallen too low for comfort, and may remain lower than is ideal. Do you have an ACTH stimulation test scheduled within the next 1-2 weeks? Given Heather’s negative reaction, I do think it’s important to know exactly how her cortisol is being affected.

Also, can you tell us a bit more about her initial diagnostics and also the symptoms that led you to suspect Cushing’s in the first place? This info will help guide us with further thoughts and suggestions.

Once again, welcome to you both!
Marianne

[cairnscotland]

Thank you so much for your reply Marianne. Heather is actually quite a large cairn with a weight around 9.2 kilos. She is not overweight but tall with a large frame and even larger personality! She started having symptoms about 18 months ago. Initially drinking too much, some puddles and urge to urinate. She seemed to regulate this herself for a while and the puddles went away. Her fur began to thin about 11 months ago and around six months ago or so her muscles seemed tO become weaker and she generally felt boney. She also picked up an ecoli unrine infection and chronic rhinitis. The ecoli infection has gone but the rhinitis has continued. I agree about the overdose of vetoryl and did question it when the vet suggested the 30 mg. She is now on 20mg and so far so good. She is looking brighter today. No twitching and she did manage to leap up the two stairs to the kitchen when I took some turkey out of the fridge! She is a VERY greedy dog and her appetite has never changed.

I suspected cushings a while ago but it was only confirmed two weeks ago via bloods and adrenal stimulation tests. They are going to be repeated a week tomorrow.

Overall Heather is having a good day so I am more hopeful than I was this morningh. We are in Scotland. I think it may have looked like we posted in the midlle of the night but it was breakfast time here.

Ooo one other thing I wondered. When dogs have muscle weakness what is the advice re walks. I am guessing short walks would be good but not long ones or ones too cold.

Lovely to meet you all on here. What a wonderful forum. Thank you again from Louise and Heather x

[Harley PoMMom]

Hi and welcome to you and Heather from me as well!

Short walks are probably the best option right now. Hydrotherapy may help with rear loss muscle mass.

Lori

[cairnscotland]

Oh that is great Lori. Thank you. I had forgotten about hydrotherapy. Heather has always liked swimming and we are lucky because our vet has a hydrotherapy service - the only one in the north of scotland I think.