New Cushings Diagnosis and Medication Problems

[Stevie]

Good morning everyone.....my dog, Stevie, was diagnosed with Cushings disease a week ago. She is a 13 year old, 21.6 pound Pembroke Welsh Corgi. She was started on a 30mg dose of Vetoryl. After 5 days she began to vomit and have stomach troubles and we stopped the medication. After another 3 days, she had still not improved and was struggling with diarrhea and some tremors (almost like seizures). After blood work, it looks like her kidneys are not working effectively. She has been on fluids and at the vet for the past 48 hours. She will be coming home for the day today, back tomorrow for a few more hours of fluids. And continue on as necessary and I'm being hopeful for her recovery.....

I would really appreciate hearing if any of you have had to deal with this challenge. I am praying that her kidneys will begin to function in the next few days and that the blood work will improve. If you have any thoughts or ideas, can you please share. Her appetite is off, but she will eat boiled chicken.

Thank you, Jackie

[Squirt's Mom]

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

Did the vet do an ACTH or just tell you to stop the Vetoryl? If an ACTH was not run and Steve is still having problems I would want an ACTH immediately plus a check of his electrolytes. The new starting dose for Vetoryl is 1mg per lb so at 30 mg that isn't really very much over 22 lbs....but some dogs are very sensitive and those extra 8mg may have been too much for Steve. The signs you mentioned are indicative of a level of cortisol that is much too low - which is a life threatening condition. So please get Steve in for an ACTH asap if he is not improved.

Can you tell us what tests were run to diagnose the Cushing's? And would you please post the actual results here including all normal ranges and the little letters that follow each value as well as comments that may have been made on the labs? The more you can tell us the better we can help you and Steve.

I'm glad you found us and look forward to learning more very soon.
Hugs,
Leslie

[labblab]

Hi Jackie, and welcome from me, too. Leslie has already given you a great introduction, and I want to second her concern about Stevie’s cortisol level. If Vetoryl has ended up oversuppressing the adrenal glands’ production of cortisol and/or aldosterone, an “Addisonian” condition can result. Laboratory abnormalities associated with an Addisonian crisis can mimic kidney failure. So for a dog who becomes ill after taking Vetoryl, the first concern is to make sure that any problems or abnormalities have not been caused by a deficiency of those adrenal hormones. If they have, in addition to giving fluids, either or both of those hormones may need to be given to a dog to supplement the decreased natural production. I am truly hoping your vet is aware of all this, and has already been monitoring Stevie’s adrenal hormone levels as well as her electrolytes.

To take a step back, though, as Leslie says it will help us a lot to find out more about Stevie’s Cushing’s diagnosis as well as her overall health history. What symptoms led to the diagnosis? Was there any evidence of kidney problems prior to starting the Vetoryl? Sadly, we have just lost another member’s dog this weekend to worsening kidney problems after starting Vetoryl. However, in his case, there was evidence of genuine kidney dysfunction beforehand, so the Vetoryl probably should not have been started in the first place. This is the reason, though, why we’re anxious to find out about any previous problems for Stevie.

We’ll surely hope she soon shows improvement, and we’ll be anxious to learn more about your girl. Corgis are such great dogs!

Marianne

[Stevie]

Thank you for your reply, Leslie.

Because I am new to this and now so much going on...is the ATCH test the blood work that is done three times a day with results the next day? My vet did that testing and the results came back as Cushings and the medication was started the next morning with food. When I am at the office on Monday, I will get a copy of the most current blood work and post it for you.

What led to all of this is that, since she is 13, I have always done blood work as she reaches another year of age. Her most current blood work showed liver levels that were high. Her vet put her on Denamarin for three months and there was no change. And I had noticed other symptoms that concerned me - increased drinking of water, increased urinating, dry splotches on her skin, pot belly,
panting, her coat not looking very good....Because of these concerns I asked him if there could be something else and the Cushings testing was done.

When she had taken the Vetroyl for 5 days and began to have stomach issues and the tremors - I took her back to the vet for more blood work. She was dehydrated, potassium levels off, and kidney levels critical (I will get these results on Monday and post) - after 48 hours on fluids, her electrolyte levels are normal but the kidney numbers are unchanged. Her appetite is ok as long as it's boiled chicken and she is drinking water on her own.

I will answer the next response and then look forward to any thoughts you might have....glad I found you also!! Jackie

[Stevie]

Thank you, Marianne
Please read my response to Leslie....and thank you for your thoughts. I will see my vet in the morning and ask the question relating to what you have shared above. I did answer, with Leslie, some of the reasons he decided to check for Cushings. It seems like her symptoms were pretty right on. She had even had an ear infection that would not go away about 6 months ago no matter what antibiotic she was on. It did go away when I began to use vinegar and water to flush it out daily. As far as I know she did not have any kidney issues before the medication was prescribed. I will let you see the results when I can get the print out on Monday.

I asked today what might be the longest she would need to be on fluids to see an improvement - and he said he had a dog that took 3-4 weeks daily of IV fluids to make a turn around. I am willing to do anything for her. That is why I was searching for kidney support and thoughts from others who might have dealt with this. She is a wonderful dog and has been the best friend ever....we started doing agility together and she recently had a very fun retirement party.

thank you very much, Jackie

[Harley PoMMom]

Having an ACTH stimulation test performed to check her cortisol levels (pre and post) is something I highly recommend as she may need steroid supplementation if her cortisol levels have dropped too low.