Vetoryl not working - 8 years old Cavalier King Charles

[Rixo]

Hey guys and sorry for my english,
i've got Cavalier King Charles Spaniel, 8 years old, weight 10,5kg (which is +- 23 pounds), about two months ago diagnosed with cushing syndrome. Since that moment he is taking 30mg pill every day morning with food. Sadly without any improvement of his condition. He still drinks a lot, got big belly and mostly noticeable his fur loss is getting worse and worse. Recently i found calcinosis cutis on his skin. He is active, acting ok. So far.

His biochem test comes better after those 2 months, but some liver enzymes are still sky high (ALP 5,60 / GMT 0,56, was 7,16 and 1,14 in ukat/l) compared to how it should be and i really don't know what to expect from vetoryl. If values should drop to normal or just improve a bit?
Also his blood test comes with sky high values of white blood cells (17838, normal state is between 2500-10500). My vet told my it's because of vetoryl, but i don't know, i don't like it.

Since this disease is somewhat rare i can't find any vet in my country with enough experiences to help me more than write a recipe for a pills. So i googled and found this forum, maybe somebody will give me some advice and fresh new ideas what to do.

[Harley PoMMom]

Hi! Welcome to you and your sweet boy!

Have any monitoring ACTH stimulation tests been performed, If so, could you post those results? Also, what diagnostic test/s were done and would you post those results too? Even with treatment the increased drinking/urinating never resolve in some dogs and that it also true with the ALP. That high WBC could mean that an infection is brewing, has your boy been checked for an UTI (urinary tract infection) the best way to check for an UTI is getting an urine sample from your boy to be cultured.

I'm sorry this post is going to be short, I'm just on my way out, but hopefully the others will be by soon to share their thoughts and advice. I am sure glad you found us and we will help in any way we can.

Lori

[Rixo]

Thank you for your reply.

Diagnostic test were LDDT, far as i know it should be an alternative to ACTH. And then two tests for biochem and blood, no ACTH. My dog Mikey hasn't been checked for an UTI. Sounds like a good idea, i will see it done.

Cortisol basal level - 93,0 nmol/l (3.3 ug/dl)
Cortisol - 3,5 hod after application - 72,6 nmol/l (2.6 ug/dl)

Here is a link to pdf with latest (second) test results (http://www.ondrejvertat.cz/mikey_test.pdf) (on my own site, don't be alarmed by weird url :)). Blue values are different from the previous ones two months ago. It's in czech though so feel free to ask me for a translation if needed.

[Squirt's Mom]

Hi Rixo and welcome to you and your baby boy! :)

Here is a link from the manufacturer of Vetoryl for you to read. I don't see anything connecting a HIGH WBC count but it does mention a low count in some dogs during the trials.

https://www.drugs.com/pro/vetoryl.html


A count that high could indicate many things so I would want an IMS (Internal Medicine Specialist) to have a look at him if I were you. Not sure what veterinary options you have where you are (I am assuming you live outside the US based on your comment about English. ;) ).

Here is a link or two that talks about elevated WBC count in dogs:

https://www.vetinfo.com/high-white-cell-blood-counts-in-dogs.html

http://vetmed.illinois.edu/pet_column/white-blood-cells-in-dogs-and-cats/

http://criticalcaredvm.com/white-blood-cells-elevation-does-not-always-mean-infection/


There are some dogs who for several reasons simply do not do well with Vetoryl and need to switch to Lysodren...and vice versa; some pups on Lyso need to switch to Vetoryl. This may be something to discuss with your vet but first we need to see those ACTH results that Lori mentioned. That will help us help you a great deal. ;) For Calcinosis Cutis (CC) it is imperative to get the cortisol under control - and at optimal levels around 2.5-3.0 ug/dl. We have a member who's Pug has CC and she has done a wonderful job of getting that under control. You can read Tobey's story here - http://www.k9cushings.com/forum/showthread.php?5908-My-girl-pug-(confirmed-Cushings-amp-confirmed-calcinosis-cutis)-Introduction

I'm glad you found us and look forward to seeing those ACTH results soon! Never hesitate to ask questions and we will do our best to help.
Hugs,
Leslie

[Harley PoMMom]

The results of his LDDS results are consistent with the pituitary type of Cushing's and the findings of the blood work panel are what is commonly seen in a dog with Cushing's. What I am most concerned about is that an ACTH stimulation test has not been performed since the Vetoryl was started. Dechra, the makers of Vetoryl, recommend that an ACTH stimulation test be done 10-14 days after the Vetoryl is started and another one at the 30 day mark. I believe the most important thing that needs to be done right now is having an ACTH stimulation performed so as to see where his cortisol level is at.

Here's are handy link from our Helpful Resource Forum with information regarding Vetoryl/Trilostane: http://www.k9cushings.com/forum/showthread.php?185-Trilostane-Vetoryl-Information-and-Resources

Lori