Nimby newly diagnosed/CBD oil and Vetory - Nimby has passed

[NImby’sMom]

Hello everyone! My sister raves about this forum and website when her dog was being tested for cushings. He came back negative, but my best bud Nimby was recently diagnosed. So, in advance, thank you for any answers and information you can provide :)
Nimby is a JRT x, almost 13, and weighs 7.5kg. His ACTH level was 712, which is quite high. We just started Vetoryl 30mg once daily (about 2 hrs ago) He has also been prescribed Hycodan for bronchitis and a puffer which is not yet filled (and I have questions re:steroid use with Cushings treatment). This is all new to me and I’m really scared. So far, no signs of any major side effects other than possible lethargy. Thankfully I’m on holidays and can monitor him closely.
My first question is: how long do side effects typically last?
Thanks again
Erin :)

[DoxieMama]

Hi Erin and welcome to you and Nimby! Can you provide clarification on what you meant when you said "no signs of any major side effects other than possible lethargy"? This has me concerned. The starting dose you have him on is higher than the manufacturer recommends now. They have reduced their recommended starting dosage to 1mg per pound, or 2.2mg per kg. This would be 16.5mg; at 30mg it may be too high a dose to start with. I'm sure others will post with more information.

In the meantime, can you also share with us the symptoms that Nimby displayed which led to the testing?

Shana

[NImby’sMom]

Hi Shana! Thanks for getting back.
I did mention the starting dose and recommendations being lower, but didn’t hear back from vet. I have t had much support from my vet, therefore I will be going to a new clinic.
About an hour or so after giving him the medication, he became lethargic, but there has been to gastro upset, or anything else.
Nimby’s thirst, hunger, and urination had increased substantially. I suppose now when I look at him, he might have a bit of a pot belly as well.
Should I be concerned about relatively little side effects today or should I be relieved?
:)

[lulusmom]

Hi Erin and a belated welcome to you and Nimby. Vetoryl can drop cortisol rather quickly in the first few days and it is not uncommon for some dogs to go through cortisol withdrawal. They feel crummy but usually feel better after a few days. Since the starting dose is higher than recommended, make sure you watch for signs of cortisol dropping too low. Signs can be one or many such as not eating, extreme lethargy, vomiting, diarrhea, tremors and extreme weakness. Because Vetoryl is a short acting drug, with it's effects waning any time after 8 hours, cortisol normally rises enough over the course of the day to make the dog feel better rather quickly. Rule of thumb is if you see any symptoms I've mentioned above, withhold Vetoryl and call your vet. If Nimby's lethargy worsens, it might be a good idea to call your new vet and discuss the possibility of lowering the dose.

[NImby’sMom]

I don’t know what happened, but my response didn’t post. Not only am I new to Cushings, but also to posting on forums.
The only side effect he has displayed so far is lethargy. His BM’s are normal as well as no other gastro upset. Should I be concerned or relieved he doesn’t have any other side effects?
What led me to get him tested was not necessarily cushings related, but not normal either way. He was drinking and urinating more as well as his appetite being more voracious than usual, which was hard to notice because he loves food so much! Hindsight, he does seem a little more “pot bellied”, but nothing like what I have seen. Skin and hair appear normal. He also has bronchitis as the moment.
I spoke to the vet (via email) about my concerns re: his dose. She explained to me he fell under the “mid range” for his weight. Because of the lack of side effects, I’m ok with this now.
I DO, however, have a concern with his prescribed puffer (Flovent), as it is a steroid and counterproductive to his cushings treatment. My vet is not at all open to much communication (I have only “spoken” to her through email as she will not call me back). I am in the process of finding a new vet, but I can’t go again until he has his one month testing ($ is becoming an issue).

[labblab]

Hi Erin! I apologize that I have only a moment to post this evening. But I just discovered that your membership had not yet been finalized, and that’s why your replies were not publicly viewable. I’ve now manually approved your membership (an “automatic” email confirmation notice had been sent to you, but it may have erroneously ended up in your junk folder). At any rate, you are now fully approved, and you can just disregard the confirmation notice if it does end up finding it’s way to you ;-). From now on, your replies will become visible just as soon as you post them.

Once again, welcome!
Marianne

[Harley PoMMom]

He also has bronchitis as the moment.
I spoke to the vet (via email) about my concerns re: his dose. She explained to me he fell under the “mid range” for his weight. Because of the lack of side effects, I’m ok with this now.
I DO, however, have a concern with his prescribed puffer (Flovent), as it is a steroid and counterproductive to his cushings treatment. My vet is not at all open to much communication (I have only “spoken” to her through email as she will not call me back). I am in the process of finding a new vet, but I can’t go again until he has his one month testing ($ is becoming an issue).

With our cushdogs it is preferred using medications that do not contain any steroids but sometimes this can't be done so you may see some Cushing's symptoms reappear.

[NImby’sMom]

Thank you for your thoughtful replies. This is all very new and scary to me, and you’ve calmed me down a bit for now ;)
I appreciate it so much!
He seems “depressed” this am and had a bit of a restless sleep. I’m so hyper vigilant right now that it seems like every little movement makes me nervous!
So far though, his BM’s are normal (soft but formed). Hey...where else can I talk about a dog’s BM’s!! ;) And no vomiting.
Wondering what everone’s opinions are on diets for Cushings pups? I switched Nimby to Instinct brand as well as making him some home cooked (chicken or hamburger, rice,spinach,squash,carrots) The home cooked is more of a “treat meal” right now as I don’t know enough to make it his staple.

[NImby’sMom]

Hi Erin! I apologize that I have only a moment to post this evening. But I just discovered that your membership had not yet been finalized, and that’s why your replies were not publicly viewable. I’ve now manually approved your membership (an “automatic” email confirmation notice had been sent to you, but it may have erroneously ended up in your junk folder). At any rate, you are now fully approved, and you can just disregard the confirmation notice if it does end up finding it’s way to you ;-). From now on, your replies will become visible just as soon as you post them.

Once again, welcome!
Marianne

Thank you Marianne!

[NImby’sMom]

Hi Erin and a belated welcome to you and Nimby. Vetoryl can drop cortisol rather quickly in the first few days and it is not uncommon for some dogs to go through cortisol withdrawal. They feel crummy but usually feel better after a few days. Since the starting dose is higher than recommended, make sure you watch for signs of cortisol dropping too low. Signs can be one or many such as not eating, extreme lethargy, vomiting, diarrhea, tremors and extreme weakness. Because Vetoryl is a short acting drug, with it's effects waning any time after 8 hours, cortisol normally rises enough over the course of the day to make the dog feel better rather quickly. Rule of thumb is if you see any symptoms I've mentioned above, withhold Vetoryl and call your vet. If Nimby's lethargy worsens, it might be a good idea to call your new vet and discuss the possibility of lowering the dose.

Thank you for your post! It honestly gave me more info than my vet has given me! I appreciate the supportive reply!

[Harley PoMMom]

There really is no "set diet" for a dog with Cushing's. A diet should be tailored to that dog's particular health issues. We usually suggest not switching a dog's diet because if new supplements/medications are going to be introduced and the dog were to start having some ill side effects than it makes it hard to distinguish just what the culprit is. Having said that, generally what is recommended is a feed with a high quality protein and moderate fiber.

[molly muffin]

Hello I just wanted to pop in and see how you and Nimby are doing. Everything a okay? Any issues you would like to discuss?

[NImby’sMom]

Hi there! My dog Nimby is doing well on veteroryl 30mg/day. Was diagnosed ~3 months ago. My question is about vaccinations and whether it is considered “safe” to do so. I haven’t found anything stating either way.
Thanks in advance.

[Squirt's Mom]

Hi Erin,

Good to see you again and very glad Nimby is doing well on treatment!

I have merged your post about vaccinations into Nimby's original thread. We like to keep all posts about each dog in one thread. That way is it easier to look back thru the history if needed plus the thread serves as a sort of diary of the Cushing's journey for us parents. ;)

The question of whether to vaccinate or not is personal. Some of us do, some of us don't. Many factors play into the decision - age, how long the dog has been taking vaccines, health issues, reactions to vaccines to name a few. Various vaccines have differing guidelines per state and per country so that is something else to consider. Many here have the vets perform titers to see the status of antibodies...often those titers show the antibodies are still very high making the vaccine unnecessary. But you will need to research your state/country laws and guidelines, talk to your vet, and consider all of Nimby's health issues to make the best decision for him. Personally, I have 3 dogs - a senior Pug with focal seizures, a geriatric Chihuahua, and a young mixed breed. The Pug and the Chi do not get vaccines, the young dog does and will for another year or so (our vet uses the 1-year vaccine VS the 3-year). BUT once he has had a few years of vaccinations he will no longer get them as the antibodies will be built up and likely good for several years. He will get titered to see where he stands.:D You can google "canine vaccines" and learn quite a bit in general then go from there. I'm sure others will be along soon to add their 2 cents. :)

Hugs,
Leslie

[labblab]

Hi again from me, too, Erin! It’s great to hear that Nimby is doing well on his Vetoryl — we love reading success stories here! As far as vaccinating, Leslie has done a great job of mirroring my own thoughts. No dog should receive vaccinations during a time that he is acutely ill, and a dog with uncontrolled Cushing’s may well fall into that category. However, once treatment has been in place such that elevated cortisol levels drop and symptoms normalize, it’s my thought that vaccination decisions should then be based on the individual situation of any given dog. As Leslie says, I’d take into account factors such as overall health, lifestyle, risk factors, geographic incidence of disease, likelihood of exposure, and previous vaccination history/experiences.

Given Nimby’s age of 13, he may already have received enough vaccinations to continue to protect him for a length of time. As Leslie says, one way to check this is to perform titer testing for those diseases for which the testing is available. If the testing shows a sufficient level of response is still in place, then you can safely hold off on revaccination for those diseases. I think another big factor, though, is lifestyle. If Nimby mainly stays in the house with little exposure to other dogs, then risks of contracting disease may be minimal. If instead he has a lot of contact with other dogs on walks, at a dog park, or through the groomer, for instance — then his potential exposure to disease will be greater.

In summary, I don’t think that Cushing’s, per se, generally makes vaccination a better or worse option. As long as the Cushing’s is under control and my dog isn’t actively ill, then in addition to the Cushing’s I’d want my vet to take into consideration the same variables as for any other dog in his/her care.

Marianne

[molly muffin]

Hello from me too and great to hear that Nimby is doing so well. Yay!

I vaccinated but as Leslie and Marianne mentioned, it is a person decision, environement (is Nimby in an area with quite a few wild animals, etc) And of course a titer would show if a vaccine was even needed.

[NImby’sMom]

Hello!
I’m new-ish to this. Nimby is a 13 year old JRT X, ~15lbs. He is on 15mg of vetoryl per day. He is stable with this dose (although I don’t have any of his level numbers with me).
My question is: does anyone have experience with giving their dog CBD oil? If so, is there any concern about drug interaction/side effects? I could ask my vet, but I’m pretty certain she won’t have an opinion because this is a “natural” medication.
I appreciate any and all feedback. Again, I don’t have any of his levels but want info/opinions on CBT oil.
Thanks in advance :)

[b&b]

I've been giving my old JRT CBD oil for nearly 2 years. He isn't on vetoryl so I have no idea about this but It is recommended to wait 3 hours between supplements and meds & giving the CBD. This was recommended by his holistic vet and the dose set by him. It is quite expensive and theraputic dosing is quite high, There are some good groups on facebook & advice from some of the manufacturers on dose/contraindications.

[NImby’sMom]

Thank you so much for your reply and info!

[Harley PoMMom]

Hi Erin,

I've merged your latest post into Nimby's original thread, we like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. I also added CBD oil and Vetoryl to his thread title.

Could you do us a favor and get those monitoring ACTH stimulation test results and post them here? And when/why was his Vetoryl reduced from 30mg to 15 mg? Also, I was wondering if you would share why CBD oil is being looked into...thanks!

Lori

[NImby’sMom]

Nimby’s dose was decreased as the vet suspect that the medication may be causing side affects of the aggressive tendencies. Although it hasn’t improved, I prefer him bring on a lower dose as there hasn’t been any changes in his health/symptoms since decreasing it.
The CBD oil was recommended by a trainer/behaviourist bc of his anxiety/aggression. He was prescribed Trazadone from the vet but I would prefer keeping his pharmaceutical use to as little as I can (he’s also on a puffer for doggy asthma/copd)
Thank you! .

[Harley PoMMom]

Aggression can be a symptom of hypothyroidism. Have the thyroid levels been checked?

[NImby’sMom]

I thought the same thing. I believe they were but I have to look it up again.

[NImby’sMom]

It’s with a very heavy heart to say that my beautiful boy, Nimby, passed away yesterday. He had slowed down significantly and was eating very little. His liver was failing and he became jaundice. It was time to help my beautiful boy cross over to THE Rainbow Bridge.
Thank you all for your support over the last few months. It was very comforting.
Erin
PS: we hadn’t even tried the CBD oil

[Squirt's Mom]

Dear Erin,

I am just so sorry to hear about your sweet Nimby. :( We are never ready to let them go no matter what but I am sure Nimby is so grateful to you for sparing him any suffering. One of our members said that we take their pain so they can be free. No greater love..... Today, your precious baby boy is watching over you just as you watched over him so many years. He will carry the love you share in his heart until you are reunited once again.

Please feel free to open a thread in the In Loving Memory section when you are ready. We would be honored to help celebrate his life with you. Nimby's name has been added to the 2018 thread for pups who have passed this year. We would love to add a photo to that album if that is something you would like. If so, please send a copy of your favorite pic to k9cushings@gmail.com and we will take care of that for you.

Know we are here anytime you want to talk, cry, scream, vent, whatever. We DO understand and we are here for you.
My deepest sympathy,
Leslie



My Friend, My Companion, My Pet

C’mon, old friend, the time has come
For you to finally rest.
You’ve given me your finest years
And I feel truly blessed.
We’ve walked many trails together
The best of times we’ve known
And now your aging body aches
And I must let you go.

You’ve taught me things I want to know
How to love, to share, to give,
To play, to laugh, and most of all
How wonderful it is to live,
And perhaps the most important thing-
How to graciously let go.

Good-bye, old friend, we’ve shared it all-
Our youth, our aging years
The best of times, and some hard times…
I’ve shed my share of tears
Worrying about you, watching you,
Fearing when we’d part
And now old friend, the time has come.
You know you take my heart.

I’ll miss you every moment
My heart hurts so inside
But you’ve suffered much too long, my friend
And that I can’t abide.

I pet you, gently hugging you.
I hear you softly moan.
You must depart,
You take my heart,
But you must go alone.

I’ll hold you in my arms, my friend
And my tears will wet your fur.
And you’ll know I’ll always love you
Our loyal bond endures. . .

by Christina

[labblab]

I am so very sorry to learn of your loss of precious Nimby, but thank you so much for returning to let us know. This way, we can join you in honoring his life and all that he’s meant to you. We hope it may bring you a small measure of comfort to know that Nimby has now joined our other angel babies on our special memorial thread of honor:

http://www.k9cushings.com/forum/showthread.php?8846-Remembering-All-Who-Have-Left-Us-(2018)

Please know that we’ll always be here to welcome you back should you wish to tell us more about your sweet boy, or to talk to us about how you’re doing. We truly understand how much Nimby’s life, and also his passing, matters to you and all those who loved him dearly.

Sending many hugs to you from across the miles,
Marianne

[Joan2517]

I am so sorry for the loss of your sweet boy. It is never easy losing our babies. Many, many hugs to you.