New diagnosis 8 year old Cocker Spaniel

[TartanFeet]

Charlie is our Cocker Spaniel, now just over 8 years old and mix between a Working and Show type. He's the most amazing dog, recently diagnosed with Cushings and now on week 3 of 30mg of Vetoryl daily.

Compared to 3 weeks ago he's much improved. Initial symptoms were insatiable thirst, and a hunger all the time. He was never a big eater and would only eat from the family, never a stranger. Mild incontinence followed which was unheard of which is what alerted us to the possibility of an underlying issue.

The vet was fantastic - checking for usual stuff. Prostrate, etc etc. A blood test in two parts an hour apart diagnosed a heightened level of cortisol somewhere around 750 (don't know units), and resulted in treatment of a 30mg daily dose of Vetoryl

He's much more himself now, drinking less (but still more than normal), still hungry and putting on a bit of weight, fur/hair is getting poor quality but vet says it will improve. A second blood test after 2 weeks shows a level of 160 now, but vet says 40-150 is the aim. He's staying on 30mg a day for another 3 weeks then a further test as vet says level will probably continue to drop without increasing dosage.

No real side effects to speak of. The only odd one is that twice he has had a small episode where he seems to get anxious, loses his balance and whimpers a lot. Most unusual, and only only lasts 5 minutes then he's back to normal. Anyone else seen this kind of reaction?

I've read a lot on this forum, I thought I would tell our story from near the beginning of what I now think is for the rest of Charlie's life, and how we manage this condition in him. The contributors and commentators I have found here are so generous with their time and compassion, it's very supporting to be involved.

[Squirt's Mom]

Just wanted to pop in and say Welcome! to you and your precious baby boy! We have many here who use Vetoryl and I am sure they will be dropping by to chat with you soon. I can say that in the first month the dogs on this drug can experience a bit of a withdrawal from the cortisol so that may be what you are seeing. Do you know if he has the pituitary or adrenal form? It would help us a great deal if you would get copies of the testing done to diagnose him - LDDS, ACTH, and/or abdominal ultrasound - and post the results here. It would also be beneficial to see the test that shows things like ALP, CHOL, T4, etc - we only need to see the abnormal values, too high or too low. Based on the 2-week ACTH, you vet was right to leave him on the current dose - the cortisol will continue to drop for the first 30 days in most dogs. ;)

I'm glad you found us and look forward to learning more about the both of you!
Hugs,
Leslie

[labblab]

Welcome to you and Charlie from me, too! Leslie has already posted a great introductory note, and it sounds as though you and Charlie are off to a great start re: his treatment journey. All of your vet’s comments seem spot on :-). I’m afraid I don’t know what to make of Charlie’s odd little episodes, though. It’ll be interesting to see whether they continue after his cortisol has consistently stabilized.

In the meantime, we’re so glad to have you with us, and I’ll certainly be watching for your updates.

Marianne

[molly muffin]

Hello and welcome to the forum from me also.

Cortisol can be expected to drop for 30 days on the same dosage and I am wondering if Charlie might not have some arthritis or something which the high cortisol was concealing and now is not. That does happen sometimes. Joints don't always hold up well over the years, and higher cortisol levels control that pain but then it's lowered so not covering it up any longer. It might be that the vet could check that out and if it is arthritis, then you'd want to adjust perhaps where you want to see the post levels at in order for Charlie to be as comfortable as possible.
Just something I thought of and you might want to discuss with our vet.

[TartanFeet]

** Update ** Now 8 weeks after initial diagnosis and Charlie is 90% back to normal. Is insatiable thirst has gone, and he now leaves water in his bowl as per normal. The same with food, he's back to his old eating habits of leaving food until he's hungry. We have though now for the first time started to measure his food to try and shift a bit of weight. He's now 15kg where he was once normally 12-13kg. His hair quality is returning although not quite as good as it used to be. His hair is growing much more slowly than before the Cushings

Last blood test showed his Cortisol level now 'normal' in the sub 40 region. The summary is that it took about 6 weeks from the start of the 30mg Vetoryl for Charlie to stabilise and return to near normal behaviour

Next check up in 3 months, and I'll keep you all posted

Best wishes to everyone and their furry friends !

[Harley PoMMom]

Glad to hear that Charlie's symptoms have improved, however, I am a bit concerned with his cortisol result. Could you get the actual numbers from that ACTH stim test and post those results for us? I'm guessing that the units of measurement for his cortisol test are nmol/L so that sub 40 would be around 1.45 ug/dl, it always makes me uneasy when I see a post cortisol below 2 ug/dl (55.18 nmol/L).

[TartanFeet]

OK, I'll get the results and post them here. Thank you for you concern and attention

Charlie is going in for a small routine to treat hyper-keratosis on one of his paws which he has had for a number of years, I can ask then

[molly muffin]

Did you get the results? You don't want Charlie to go too low either. So be on the look out for any kind of diarrhea, wobbliness, not eating, and if you see anything like that, discontinue the vetroyl and get him in for a stim test immediately.

This is probably just us being worry warts, but its what we do. How did his surgery go?

[TartanFeet]

Hi everyone

Not sure if anyone is reading this but I thought I would post an update now we are 8 months into our Cushings journey. The news is good. Charlie's condition looks like it is under control. All the symptoms he exhibited in March (2018) have gone - his bladder control is normal (that was really quickly sorted), eating and drinking patterns are normal (he is a fuss pot), his coat is back to fully grown, glossy and he looks very healthy, and his dry nose has gone. the later we initially treated with artificial tears but these are not required now.

My non expert opinion is that we caught this really early and the Trilostane (Vetoryl) at 30mg daily has controlled the excess hormone production before it did any lasting damage to him.

At the moment all is good.

I'm paying £2.70 or so per 30mg capsule whilst the treatment is covered on insurance. After 12months and that stops I'm online for purchases. This looks like it is around £1.27 per capsule. https://www.petdrugsonline.co.uk/vetoryl-capsules-30mg No wonder pet insurance is so expensive!

[Harley PoMMom]

Thanks so much for coming back and giving us an update on your sweet boy and I am very happy to hear that Charlie is doing so well on treatment, such great news!! I was wondering if you would share the results of his most recent ACTH stimulation test.

Lori