Confused and scared as to go traditional or alternative?

[scully]

I have a 7 year old Pit mix.
I started noticing excessive water drinking and urinating and increased appetite.
Then one evening after walking her she had a funky collapse?
Did not no if it was a seizure or fainting spell?
I rushed to my vet on a ER call and another vet was on duty and examined her and thought she was having a spell of A-fib?
I had a appointment made with a cardiologist and had a Echo and EKG and blood pressure testing.
All were normal and cario suggested following up with regular vet for routine blood work and exam.
I did and the vet noticed a pot belly like appearance starting and did blood work and showed elevated liver enzymes and cholesterol levels.
Did urinalysis and had protein in urine but rest was okay.
She suggested possible Cushings and ordered a test for next Monday to go in 3 times for blood drawls to determine 100% if it is that and she feels it is.
I am scared because about almost 20 years ago now, I had a lab/ shepherd mix who was diagnosed with it and the vet gave her to much Lysodren and killed her adrenal gland off.
She kept crashing and we finally had to put her down.
My current vet says the new med Vetrosly is not as dangerous but I am honestly scared to death.
I feel my dog does have it with her symptoms.
I struggle already with the decision of traditional meds versus supplements.
I have researched The University of Tennessee incredible studies with Melatonin and Ligans therapy but no vets close to me understand it.
I am struggling with whether I trust and try and have faith in my vet and go ahead with traditional med or go it alone via research and try Ligans and Melatonin and adding liver support with Sam E and Milk Thistle?
Please feel free to post this when accepted as I really need help!
Thank you!

[labblab]

I’m so glad to see you made it here to the forum! I have only a moment to post right now, but wanted to let you know that I’ve moved your thread here, to our main discussion forum. This way, more of our members will be likely to see your questions and respond. I’ll come back, myself, just as soon as I can in order to write more. But in the meantime, welcome!

Marianne

[LeahCC]

Hi, Scully. Sorry your fur baby is having a rough time of it, and that you had a really bad experience the last time you heard this diagnosis. I have a pit who was recently diagnosed and we're making our way through the treatment process. Please bear in mind that I am not in any way a medical/veterinary professional so take what I say with a grain of salt. I can tell you that the treatment for Cushing's in dogs has advanced in the last 20 years, and the best way to arm yourself and your dog against over-prescribing or other complications is to be as informed as you can and be able to accurately judge your vet's familiarity and competence with treating Cushing's. You can ask questions about their experience treating the disease (how many former/current Cushing's patients they have,) the outcomes or current status of those pets, and their opinion of how you should proceed with treating your baby. And remember that you don't have to agree with or continue with their prescribed treatment if you don't think it's accurate or in the best interest of your dog. You can also choose to be referred to an internist who specializes in endocrinology and should have a good deal of experience with Cushing's patients. You can get a referral from your current vet, or speak with a bigger animal hospital in your area to see if they have some referrals.

As far as treatment goes, the common form of Cushing's is pituitary-dependent, and the most common treatment for that is Vetoryl (trilostane) and Lysodren (mitotane). My experience so far has only been with Vetoryl, which is a newer drug that works differently than Lysodren did to treat the issue. I won't go into detail about what Cushing's is and how it works, or how the drugs treat it, because there are a lot of good resources on this site and on the web that can do that with far more expertise than I can. I can tell you, though, that (according to studies) with accurate diagnosis and at proper doses, it is highly unlikely that they will kill your dog. I completely understand the concern; I was watching my dog like a hawk when she started taking it, ready to rush to the vet at any sign of distress. But I find that the more I educate myself and learn about the treatment, the more informed my decisions are, then the better I feel about it (and the better my dog feels!) This forum is a really great resource and the members have talked me off a panicked ledge several times, and I've only been on here a couple of weeks. Do the research so that you can trust the process.

I can tell you right now that the members will want you to post any relevant test results you have access to: blood tests, urinalysis results, the results of the test next week, etc, as well as your dog's weight. From your description (blood drawn three times,) it sounds like this may be an LDDS (low-dose dexamethasone suppression test) which is a good test to diagnose Cushing's, and determine which type it is (which will determine which treatment path to take.) The weight will determine the recommended dosage of whichever drug you and your vet decide to use to treat.

Alternatively, you absolutely have the option not to treat at all. Cushing's is a finicky mistress and sometimes the treatment is worse than the disease. If your dog has limited symptoms that don't appear to be significantly impacting his or her quality of life, you may decide to hold off on treatment and re-visit that choice if the situation changes. Some people find that a more holistic treatment (various supplements) works just fine at keeping symptoms at bay. There are different treatment options that are well documented here, so don't be afraid to explore and ask lots of questions.

I hope that this helps ease some of the initial concerns that you may have. Here is a handy general overview of Cushing's that you may find informative:
https://www.petmd.com/dog/conditions/endocrine/c_dg_hyperadrenocorticism?page=2

And here is the insert from Vetoryl that includes the results of their testing (it will download a PDF):
https://www.dechra-us.com/Admin/Public/DWSDownload.aspx?File=%2fFiles%2fFiles%2fProductDo wnloads%2fUS%2fvetoryl-30mg-pack-insert.pdf

There are a lot of additional resources in the Helpful Resources forum:
http://www.k9cushings.com/forum/forumdisplay.php?10-Helpful-Resources-for-Owners-of-Cushing-s-Dogs

And welcome! :)

Leah

[Squirt's Mom]

Hi, welcome to and your baby girl!

I am one who prefers Lysodren over Vetoryl and am willing to bet the vet that treated your Shepherd didn't know how to use the drug properly. When prescribed at the correct dose for loading and for maintenance, and when both vet and parent are educated and observant, Lyso does not cause the result found in your Shepherd. Vetoryl has the exact same risk factors when it is misused as Lysodren does - it can also destroy the adrenal glands causing a condition that is the opposite of Cushing's called Addison's - which is what your Shepherd more than likely developed. Addison's can be treated and, in fact, several other countries intentionally destroy the adrenals in cush pups because they feel Addison's is easier to treat. I don't agree with that approach personally. ;) HOWEVER, if her vet is more comfortable with and has had better success using Vetoryl then that is the drug you want to go with.

Melatonin and lignans as described by UTK (University of Tennessee in Knoxville) are used as a treatment for a form of Cushing's called Atypical in which the cortisol is NORMAL but two or more of the intermediate, or sex, hormones are elevated. For this form Lyso is the preferred treatment if the melatonin and lignans don't take care of all the signs and elevations. On their own, these two supplements will do very little to control elevated cortisol tho. Most cush pups do have elevations in these hormones even when the cortisol is elevated and some vets consider Atypical a precursor to conventional, or true, Cushing's with elevated cortisol. That was the case with my own Squirt - she started out Atypical with normal cortisol but after a few years her cortisol did start to rise so we added Lysodren to her melatonin in and lignans. btw - she was diagnosed at 7 and lived to 16 + a few months. :) I tell you that to prove Cushing's is not necessarily a death sentence - most cush babies who receive the correct treatment using the correct protocol and who have educated, observant parents live out their normal lifespan and beyond. ;)

Cushing's does cause weakness in the hind legs making it hard for a dog to jump on furniture, etc. and causing exercise intolerance. It also weakens tendons and can result in things like torn ACLs in the knees. Did any of the vets who saw your baby girl after her collapse discuss these possibilities? Were her spine and/or legs examined for problems?

Are you seeing any of the other signs common with Cushing's beside the pot belly - increased urination, increased drinking, HUGE ravenous appetite, hair loss or failure of the hair to regrow after being cut/shaved, panting for no reason? The signs are just as important in diagnosing as are the test results. It would help us give you more meaningful feedback if you will get copies of all the testing done so far and in the future and post them here. For now we would love to see the results on the test that showed elevated liver enzymes and cholesterol. We only need to see the abnormal results, too high or too low, along with the normal ranges and little letters that follow. It will look something like this when you type it in -

CHOL 135 80-120 ug/dl

The three-draw test the vet is talking about is probably the LDDS tho in Canada the ACTH uses 3 draws. So be sure to get copies of those results when they come in and share with us, too.

Herbs like Milk Thistle can help with the liver but right now I wouldn't start any herbs or supplements OR change her diet. Get thru the testing phase first - some of those things may effect the test results and you want to see a clear picture of where she is today. Later you can look into supplements and so on if needed.

I fully understand how scared you are right now. When I first heard the word "Cushing's" and started researching the disease I nearly lost my wee little mind. By the time I found this group I was a full-blown basket case! :D Terrified, guilty, angry, frustrated, confused....and did I mention terrified? Squirt was my world and the thought of losing her was more than I could bear. But these kind folk took my hand and gently led me along until I could breath again...then they began to teach me what I needed to know to give Squirt the best care I possibly could. We will do the same for you. You and your baby girl are part of our family here at K9C now and you will never be alone on this journey. We will be with you all the way. Look at the top of the page - you will see the words "support....educate....encourage....remember". That is our motto, our mantra, and we live by those words. You are in the best of hands here with us, I promise.

I am very glad you came to talk with us. I can't wait to see test results and get to know you both better.
Hugs,
Leslie

[scully]

Thank you all for your responses!
Scully is my dog and she just had another mystery spell that I feel is a seizure.
I was able to video it so I can show my vet.
I also talked to University of Tennessee today and they confirmed Ligans and Melatonin was great for atypical Cushings but not for regular kind.
They suggested to also proceed after test on Monday and go from there with traditional first.
I am really worried and just read that seizures can be caused by Cushings.
It is so strange as most of the day Scully is beyond calm and quiet and then like clock work around 3 pm she starts panting and hyper until she gets her dinner and then back to quiet.
I had a Lab years ago that had seizures and that is what this looked like.
She gets scared to death and looks at me like she does not no me and just looks around with eyes dilated.
It is so hard not knowing for sure what is happening.
Trying to be strong but terrified.

[Squirt's Mom]

My Pug has a form of seizures called Focal Seizures or partial seizures. When she has an episode she acts feral -terrified of everyone and every thing. She acts as if she does not recognize her people, her places, or her things. She used to have them often but she was in a place that was not secure and she was alone much of the time. Since she's been with me her episodes have dropped dramatically in frequency. She does not require medication at this time. Her vet diagnosed her seizures and the type based on her behavior. There may be tests for seizures but I'm not familiar with them. Other members here have or have had pups with seizures of different types so hopefully they will drop by to share their experiences with you. Videoing her was a great idea and should help your vet with diagnosing what is happening with her.

And yes, seizures are one of the signs of Cshing's. Unless it is Iatrogenic Cushing's, caused by steroid use, this disease always involves a tumor - either in the pituitary gland in the skull or on the adrenals, which sit on top of the kidneys. The pituitary form, PDH, is the most common and in most of those pups the tumor remains microscopic, causing nothing more than the usual cush sign. In rarer cases, the tumor begins to grow causing what is called a macroadenoma and can cause many neurological signs. Unless you are seeing things like circling, head pressing, and so on I would not worry about a macro right now. In dogs without the macro seizures can occur.

So I would certainly discuss these episodes with her vet and if she is not seeing an IMS, Internal Medicine Specialist, I would try to find one nearby and let them check her out asap.

Please keep in touch and let us know how she is doing!
Hugs,
Leslie

[scully]

I am gonna be honest with everyone.
Something in my gut is saying stop.
I of course do not want to lose Scully and I am afraid but I see her right now and she is at least eating and drinking and functioning.
I also feel in gut she does have Cushings.
I just have done enough research and for myself feel the drugs side effects and constant monitoring is gonna put her through a lot.
Financially, I am also struggling with all it is gonna involve.
I have spent 1,000 on tests already and cannot afford to think where I am gonna get the rest for 2 weeks and one month and three months and 6 months of blood work plus the meds.
My vet cost per blood chemistry and cortisol test each time 500.
Thats not even meds.
My own research is also this med itself.
This is a awful and cruel condition for sure and looking at treatment side effects is making me wanna run for hills.
I think in my heart if Scully was 10 or older it would come easier for me to choose but the fact she will be only 8 is harder.
I think I am gonna try holistic approach.
Ones that jumped out is Adrenal Gold formula by petwellbeing and possible adding Tumeric and added liver supports?
I wanna do right for her but I cannot shake this feeling that the drug is to strong and harsh on system and she is already overloaded.

[scully]

A lot changed in a couple of hours.
I had a call to talk to vet and list of questions and addressed all of the big concerns.
My vet was aware of dosage issues with bigger dogs needing smaller doses.
She shared about every 3 months they our getting a dog with Cushings.
She has used Vetorly for 8 years now and shared that in that time period only 3 dogs stopped from not handling the drug.
She said she was aware of the death to gland from drug but she had not experienced it and only about 2% of cases have happened and drug company reported this.
She said that she would use lowest dose on my dog she could since she is very sensitive to meds.
She said she felt we proceed Monday with test and results should be back by Wednesday.
She said the fact that my dog would only be 8 years old next month factors in even more to try and fight.
She said most issues arise when the dose is to much for the dog.
She said she understood how scared I am both because of past dog that had it and bad result from over use of Lisodren but she said today this new drug was safer and worth it.
I cannot believe I am gonna say this but I am also understanding there comes a point and time you have to have trust and faith in you have a good vet and I feel I do.
I guess it just depends whether my dog can handle the dug honestly?
Scared but surprised to say I am moving foward.
Will take one day at a time both health wise and financially too.

[labblab]

We surely understand why you’re very worried, but we’ll do our very best to help you and Scully, every step of the way! It sounds like your vet is doing a really good job of keeping up on all the latest research, so that’s a very good thing. In that vein, here’s some brand new info that we just learned, ourselves. It’s a new method for monitoring Vetoryl/trilostane treatment, and it can be a lot less expensive. Your vet may not know about it yet, so you may want to print out this post and share a copy with your vet. Since she’s treating other Cushpups, as well, she may be very interested in this information.

http://www.k9cushings.com/forum/showthread.php?185-Trilostane-Vetoryl-Information-and-Resources&p=1252#post1252

Definitely let us know how things go next week, OK?
Marianne

[scully]

Thank you!
Will print off and take with me and let you no what happens!

[molly muffin]

I am impressed with your vet's knowledge regarding cushings and just from what you say it does sound like you and Scully would be in good hands with her. She knows the dosage and having treated so many is aware of any risks and she is taking steps to limit those from the beginning.

Crossing fingers and lets see how the test go.

[scully]

Yesterday went and had the three draws for testing for Cushings and should have results tomorrow.

I also went ahead and got copies of blood work from October last year and this months and will list things that were high.

She did really good through the stress of all day and better than myself who has chronic conditions and sent me into a flare from stress.

Here our previous tests:

October 2017:
ALP= 902 = (20- 150)

Triglycerides= 253 = (20- 150)

March 2018:
ALP= 1225 = (20- 150)
ALT=150= (10- 119)
AMY= 1628= (200- 1200)
GLU= 130= (80- 110)
CHOL= 322= (125-270)

I thought there was a copy of her urinalysis in there too but was told on phone all okay except some protein in urine which can be common as well with Cushings?

I should no for sure tomorrow and gave vet new protocol from drug company and she was gonna call a internist she knows as well for more input.

Here is where I still am at.
I look at my dog right now and see her eating and drinking and will give you typical to much with Cushings but still herself is still in there.

My greatest fear is I start Vetoryl and she goes from that to possibly not eating and not herself etc..

I posed theses fears to my vet yesterday and she said most of the time that happens from to strong of a dose of meds or intolerance but mostly to strong of a dose.

I cannot get past this feeling in my gut still is this the right things to do?

Is putting her through countless trips for blood work and possible side effects gonna effect the true quality of her life?

Or will the meds have a ability to let her have both a longer life and reduce symptoms and still have quality?

Why do I feel almost like it is a 50/50 crap shoot?

My vet is saying push on and if it is positive start meds and I even asked how many dogs she has treated have went into a Addison collapse and she said only 1.

She discuss a syndrome called the honeymoon phase is some dogs?

She said they start off doing really good and all of a sudden this stops and only things can be done is to stop meds and break and start over?

That still has me going back to quality of life issues?

I can tell you that both my mom and myself after yesterday were done in and both looked at each other and said this is a lot to put her though in 2 weeks and then 1 month and then 3 months and then 6 months?

Of course those our if all goes well?

I would like some honest feedback before I start anything about peoples experiences on this process of monitoring to get right doses and did you honestly feel your pet still had quality of life on this drug too?

Thank you ahead of time! <3

[Squirt's Mom]

I have merged your new post with test results into the original thread. We like to keep all posts about each pup in one thread. That way it is easier to keep track of history for both members and you. ;)

Sorry I haven't replied to you very much. Posts with repeated single sentences are hard for me to read - it hurts my old eyes to try. :(

[Catbud]

I am new here too but I wanted to say I am also struggling with what to do - in some moments I want to fly off to see a specialist and do surgery and in other moments, I want to stop everything. My dog Teddy has an adrenal tumor. He started Vetoryl in July and I think there was some improvement - but from December to January there was a marked decline in his physical appearance. The only sign of actual distress is he has stinky gas and his stomach makes loud gurgly sounds - otherwise he is active and eating. He looks awful - bald patches, large distended belly, stained fur under his eyes and wart like growths in a couple places and calcified spot on his bald tail - but he acts like himself (just famished). I really just want a crystal ball to know that if I opt for surgery he will survive - and since that is not available, I am am posting, reading, asking questions and hoping to find peace from others' wisdom and experiences. Good luck to you - I am following your posts to see how Scully is doing.

[scully]

I so understand what your saying!

There our times I am saying to myself let me give her whatever time she has here and live as normal as she can without constant tests etc..

It is so hard to no if I should start Vetoryl and hope it gives her longer life span but fear it will diminish the quality or will she take it and handle it and have extended time and quality.

I read so many posts of so many side effects and of course the testing but also am smart enough to no doing nothing will result in things ending faster?

My vet keeps saying that the dose is everything upon whether she has major side effects or just if she is intolerant but she feels that is low percentage rate.

If she was older and let me say around 10, I doubt I would do anything but natural things to try.
I struggle that next month she will only be 8 and it makes it harder feeling if I do not try and wonder if she could had handled it and done okay?

I should no tomorrow for sure and what type she has.

Wishing Teddy well too!

[scully]

Also I forgot to ask did Teddy have regular follow up blood work at 2 weeks and then 1 month and then 3 month etc?

Just curious if he did what the tests showed as far as improvements in his levels.

Also what kind of dose is he on?

[Catbud]

Teddy was first treated as if it was thyroid - his symptoms of hair loss, excess drinking and peeing continued and he was then diagnosed with cushings after a test.

I am not very knowledgeable on the tests - I posted all his lab work last night. He weighed 34 lbs and was first put on 10mg Vetoryl once a day. He had ACTH tests at a couple of short intervals then at about 3 months (December). At first he seemed like he was looking a little better - all his ACTH tests were in safe range as far as not Addisons, but I do not know enough to say if his levels improved.

From December to January his appearance got worse and he was eating random stuff around the house (paper towels, my credit card statement with a new card, my son's school work, a bag of ibuprofen that led to a trip to hospital to force vomiting...) so I got frustrated and started calling other vets asking about treatment, costs etc...the receptionist at one place said she couldn't tell me about treatment until they determined what type of cushings he had - I didn't even know that was a thing - and that's when I asked my vet and got upset when she had no idea and I had to request an ultrasound and he has an adrenal tumor.

Sorry going through his whole history again - but long story short - new vet, just upped his Vetoryl - no side effects except maybe indigestion (passing gas). He is still playing, eating, etc.

The NCSU vet just called and I was thinking about your post and asked about side effects and maybe not having him on anything at all and she was pretty adamant that he needed to be on something and even talked about upping his does to 30 (15mg 2x/day) and she did not feel side effects with Vetoryl were a concern, just suggested I cook him chicken and rice to comfort his tummy. I asked her about natural remedies and she was skeptical - she was familiar with milk thistle but said it would not help his cushings.

He is having another ACTH test on Thursday but he has no signs of Addisons and is still symptomatic so I am not expecting surprise. I do not know if any of that is helpful to know.

[scully]

Thank you for your input and asking questions to your new doctor as well.

I am still waiting on test results and my doc missed me last night and left voice mail around 7:00 pm and said to call today and I did but she is with patients.

So hopefully soon will get complete results.

Good luck with Teddy on Thursday and your new doctor and new protocol!

[scully]

Really need input and got test results.

Test shows :
first level at 8:00 am was 5.4

second test at noon was .6

third test at 4:00 pm was 3

She felt is it very early stage and Pituitary type.

Now here is where I am not sure what choice to make?

I was offered two ways to go.

Her first way was starting 30 mg of Vetoryl and Scully weighs 67 pounds but knows both history of larger sizes needing smaller doses and Scully is very sensitive to everything as well.

Waiting 1 week and if she is tolerating it okay then at 2 weeks do regular blood chemistry only as she said electrolytes tell a great deal and up the dose to twice per day and shoot for a total of 45mg for the day by dividing the dose?

Then in one month do stem test and see where the cortisol level is and go from there?

I am not happy with that plan off top, I am totally fine with 30 mg to see how she would tolerate it but feel that reading protocol and it saying that no dose should really change until 1 month as it can still be dropping?

Also why I hate all of the testing, Would worry that not doing stem at 2 weeks is only a estimated guess on how it is really doing?

Option 2 was to do nothing and wait 6 months and retest?

She said that with time and this condition that she will get worse of course but if we did not do it now, To go ahead with liver support and monitor her at home.

The other concern was her mystery spells?

Still not 100% that she is not having arrhythmias and the vet said if we wait and watch her for the 6 months in case there is a heart related something and might require a different direction?

She said she felt she does have Cushings but early and her recommendation was option 1.

I feel by watching her symptoms and her cholesterol and livers up that she does have it but also worry about a heart issue?

The cardio said that while she did great on those echo and ekg and blood pressure tests, That it still did not mean she is having episodes of arrhythmias?

I asked if we started Veteroly and if it is early, Do we delay onset and give her more quality and quantity of life and she said yes.

Thoughts please????

[scully]

Was trying to find a resource on here for the values and what normal and abnormal is on the diagnosis test for Cushings.

Mine came in at first one 5.4

Second one .6

Third one 3

Thank you!

[labblab]

I only have a moment to post right now, but here’s the link to a chart that will help you interpret Scully’s LDDS results. You’ve not included the “normal” lab range for the 8-hour value, but usually it’s about 1.5 ug/dL. I do believe Scully’s results are consistent with pituitary Cushing’s, because the 8 hour value was larger than 1.5, and the 4 hour value was less than 50% of the baseline value. Here’s that chart:

http://www.idexx.com.tw/pdf/zh_tw/smallanimal/snap/cortisol/cortisol-low-dose-dexamethasone-protocol.pdf

I went ahead and merged your new post into your original thread, and I’ll try to return later to write more.

Marianne

[Harley PoMMom]

To treat or not is a very personal decision and one that can only be made by the pet's owner because only the pet parent knows their dog best. Now, having said all of that, my opinion regarding treatment is; The goal of treatment is not to cure the disease but rather to help control those bothersome symptoms and get that superabundant supply of cortisol down within the therapeutic ranges, so when a dog does not have strong clinical Cushing's symptoms initiating treatment is usually not recommended.

Your vet is correct that most dogs get into trouble when their dose is too high so starting low and going slow is the best route. Safe and effective treatment is also dependent on the proper protocols being followed, that the dog is monitored appropriately, and "owner observation" is always a crucial component of treatment.

If you decide to start treatment with Vetoryl, I think 30 mg would be a reasonable dose for Scully even though she weighs 67 lbs. And many vets are foregoing the ACTH stimulation test at that 10-14 day window and testing instead at the 30 day mark, unless the dog presents symptoms of being unwell or not acting right. It does sound like your vet is on top of things and has some experience managing dogs with Cushing's but one should have a vet that is willing to work with them and will really listen to what the pet parent has to say, is Scully's vet a team player?

[scully]

Retalked to vet again later same evening and feel better.

Gonna start at 30 mg and stay that way for at least 1 month is she is doing okay on.

Gonna retest in 2 weeks just regular chemistry and then in 1 month stem test and will choose then based on results whether to increase the dose.

Just scared but wanna do right by her as she will only turn 8 this April.

[labblab]

I think this sounds like a great gameplan! Be sure to ask us any questions that come up, but I’m betting she’ll do just fine. You can always stop the medication if there are any problems, but this way you’ll know you’re giving her the chance to get better. Keep updating us often, OK?

Marianne

[scully]

Thank you!

Will do!

[scully]

Scully started 30 mg of Vetoryl and she eats early at 4:30 am and ate and took pill and went back to bed.

Weird schedule is because my mom goes to work that early and she has always ate then.

Maybe not so bad as going back to bed with myself she might had slept off any weird changes.

Got up and it snowed where I live and went out in yard and checked everything out and seems okay so far.

She ate lunch as usual and has not panted as much today but at times seems a bit tired but guessing normal as body adjusts to meds.

One day at a time and will go back to vet in 2 weeks for just normal blood work and then back again in 1 month if everything is okay and do stem test.

[scully]

Sorry I have been absent, bad storms and computer got fried.
Hopefully will be getting new one up and running this weekend.

So far so good but notice as the day wears on that symptoms return.
Still on 30 mg and gets it in morning and usually holds off panting and peeing all day.

She starts panting late afternoon and it seems after she eats dinner it settles back down but drinking returns and peeing.

Will go in 2 weeks for electrolytes checked and in 1 month retest cortisol.

Thinking she may be working towards twice per day dose?

She for most part seems okay but did have another spell and still seems to be a debate as to whether it is a seizure or not?

[molly muffin]

She is getting her dose once a day? There are some dogs who do better on a split dose treatment. Instead of 30 mg once a day, she would get 15mg in the morning with food and 15mg in the evening with food. So that might be something to talk to vet about if she continues to have symptoms returning in the evening.

[scully]

I had to ask if anyone else noticed a strange issue on th skin of there dogs nose?

It is like her skin is coming off?

We go back to vet next week for electrolytes check which will be official 2 weeks on Veteroly.

She is still on 30 mg once per day.

Seems okay and good days and bad days but thinking that is typical with this condition and medication.

[Joan2517]

That could be a sign of high blood pressure. Lena had the dry nose, too.

[Harley PoMMom]

My Harley experienced a dry crusty nose and he later on developed high blood pressure. I used vaseline on his nose but read where applying Vit. E to the nose may be a better substitute.

Lori

[scully]

Scully goes tomorrow for her 1 month check up blood work from being on Veteroyl.

I just wanna be sure we our doing it correctly.

She eats and takes her Veteroly at 4:30 am and am I correct that the stem test should be done 4 to 6 hours after that?

I am scheduled to do at 9:30 am.

What is the time between the first one and second one?

[labblab]

Hi and yes, if you are in the U.S., starting the test at 9:30 should be fine. In the U.S., the test takes only one hour to complete. In Canada, it can take two hours as their testing protocol can be a bit different.

Marianne

[scully]

Scullys test results were:

1.3 and then 1 hour later 7.8.

The vet gave us two options.

She said she would like to get her to average 4 for 2nd reading but there was still a possibility when retest in 3 months it could still come down lower.

So either we continue with 30 mg once per day and retest in 3 months or add 10 mg at dinner and still retest in 3 months.

We have chosen to go slow and continue on and see where she is in 3 months.

Some things have improved as she is not panting all of the time nor drinking as much but still hungry and still has bouts of while sleeping heavy breathing.

So we will see.

[Harley PoMMom]

Since her symptoms aren't totally controlled you could add the 10 mg in the evening, however you would need to recheck her cortisol levels with a full ACTH stimulation test in 2 weeks.

[scully]

Scully just had her stem test at 6 months out and her levels went up from the 3 month stem.

Going back at 3 months the vet offered 2 ideas after being on 30 mg of Veteroryl and said stay on just that and see if she comes down anymore or ad 10 mg at dinner.

We went conserative and stayed on just 30 mg.

Now with the current stem she jumped up on both post and then hour later.

Post jumped a great deal from like 1.4 to this one 5.4 and the hour later test slightly from lastime 7.2 to current 8.5.

She said could be honeymoon phase?

Now suggests adding 30 mg at dinner?

Scullys weight is still 67 pounds but I fear the jump and wanna go slower at adding 10 only.

Also my vet does electrolytes at 2 weeks and then stem at 1 month.

Thoughts.

[Squirt's Mom]

I have merged your latest post concerning a dose increase into Scully's original thread. We like to keep **all** posts about each dog in one thread. Thank you!

[labblab]

Welcome back to you and Scully, and thanks for this update. How is Scully doing in terms of symptoms? Unless she’s still troubled by a fair amount of outward symptoms, I think I’d agree with you that I’d feel more comfortable about gradually adding in the 10 mg. evening dose rather than jumping clear to 30 mg. Especially if you start gradually, I think that testing the electrolytes at the two-week mark with the ACTH following at thirty days is similar to what a number of vets are recommending these days.

Marianne

[scully]

She is still hungry a lot but not drinking and peeing like she did and she has bouts with the panting at times more than others but I was just afraid to jump to 30 that quickly.

I was disappointed her numbers went up but vet said honeymoon phase happens with some?

Thanks for the welcome back!

[Harley PoMMom]

Generally there is "tweaking" involved in getting the appropriate Vetoryl dose that will control the cortisol, especially in the first few months. Adding just the 10mg in the evening, I think, is a good idea since she still has symptoms. An ACTH stimulation test will be needed to be performed in 10-14 days after the 10 mg is added to see where the cortisol levels are at.

Lori

[scully]

Really confused right now.

Scully got the 10 mg added a week ago Monday and things seem kinda of different?

She has went from eating and drinking all over place to scaled back and not wanting to eat more than half her cup at breakfeast and takes her 30 mg of Veteroyl then and now eats her other half cup at lunch.

However she seems more pooped out and yesterday did not wanna complete her normal short walk?

I ran over to vet after that and she checked her heart and body temp and then did electrolytes early.

Liver came down slightly but Bun and Creatine were elevated at a normal high?

She said it seemed like maybe she was dehydrated but when we come back in a month for stem test to catch first mornings urine to check it further to make sure no kidney issue starting?

She usually eats 1 cup at dinner and vet thought maybe she is being fincky as she has done this before Cushings and will eat human food.

She gets some turkey on top of her dog food now.

It seems like one step forward and two backward?

[Harley PoMMom]

After an increase in dose an ACTH stimulation test needs to be performed in 10 - 14 days, you really don't want to wait a month especially since she is acting different. And to clarify, the electrolytes were normal, right?