reggiedog
06-09-2019, 01:09 AM
Hi everyone,
Has anyone come across an issue where the high cortisol levels actually helps in managing a paw inflammation?
My staffordshire bull terrier, Reggie, was diagnosed with Cushings about 6 weeks ago. She is 8 years old, and weights 14kg (approximately 30lbs). She also has calcinosis cutis on her back (:().
Her first ACTH tests results:
Pre: 247
Post: 1415
I believe these are the LDDS results? (I admit the technical side of things completely confuses me:confused:)
She then started on a 30mg dosage of Trilostane.
Dispute this being the “usual” dosage, it was clear very quickly that the 30mg dosage was too high for her (Although the vets said this was the Trilostane "working"). She became withdrawn (just has a general “down” demeanour), the skin on her tummy became very dark and she lost her appetite (and we had to hand feed her). She also developed an inflamed front right paw (to the point where she lost all the hair on the paw), and the vet wasn’t sure what caused this. The paw also didn’t seem to be bothering Reggie, so we just left that issue alone.
We did see improvement in her Cushings symptoms her in these first four weeks – her hair regrew significantly, her pot belly got smaller and she stopped drinking excessive amounts of water (although perhaps she has now gone too far the other way and does not drink enough).
After 4 weeks, we did the second ACTH test, which (unsurprisingly) revealed that her cortisol levels were drastically low. Unfortunately, we had to wait 4 weeks rather than the usual 2 weeks for the second test due to the vet failing to give us complete instructions as to how to take the Trilostane. The second ACTH test results came back:
Pre: Less than 14
Post: Less than 14.
After receiving these results, she stopped the Trilostane for 10 days. We saw improvement in her general mood and appetite, although her water intake remained low. Her front right paw which was inflamed also started getting better – the swelling came down and the hair was growing back.
After 10 days we restarted the Trilostane, two 7.5 mg twice a day (ie. 15mg per day). This dosage seems more appropriate for her because sheÂ’s more active, but not showing any cushing symptoms. This was 1 week ago.
However, since restarting the Trilostane, her front right paw seems to be getting more inflamed and is losing hair again.
I understand that cortisol assists with keeping managing inflammation, but we have a strange situation where the high cortisol appeared to keep her foot inflammation under control.
I am very tempted to reduce the Trilostane dosage to 7.5 mg once a day – to stop her paw from getting worse. Is this a good idea?
Alternatively, we can keep going on 7.5 mg twice day for another week and then schedule a ACTH test.
The vets seem a bit lost with what to do. Over the last few months, they have put her on 4 antibiotics to deal with various bacterial issues (apparently related to Cushings), but IÂ’m not sure if those antibiotics are even workingÂ…. (Frustratingly!)
Many thanks :p
ReggieÂ’s mamma
Has anyone come across an issue where the high cortisol levels actually helps in managing a paw inflammation?
My staffordshire bull terrier, Reggie, was diagnosed with Cushings about 6 weeks ago. She is 8 years old, and weights 14kg (approximately 30lbs). She also has calcinosis cutis on her back (:().
Her first ACTH tests results:
Pre: 247
Post: 1415
I believe these are the LDDS results? (I admit the technical side of things completely confuses me:confused:)
She then started on a 30mg dosage of Trilostane.
Dispute this being the “usual” dosage, it was clear very quickly that the 30mg dosage was too high for her (Although the vets said this was the Trilostane "working"). She became withdrawn (just has a general “down” demeanour), the skin on her tummy became very dark and she lost her appetite (and we had to hand feed her). She also developed an inflamed front right paw (to the point where she lost all the hair on the paw), and the vet wasn’t sure what caused this. The paw also didn’t seem to be bothering Reggie, so we just left that issue alone.
We did see improvement in her Cushings symptoms her in these first four weeks – her hair regrew significantly, her pot belly got smaller and she stopped drinking excessive amounts of water (although perhaps she has now gone too far the other way and does not drink enough).
After 4 weeks, we did the second ACTH test, which (unsurprisingly) revealed that her cortisol levels were drastically low. Unfortunately, we had to wait 4 weeks rather than the usual 2 weeks for the second test due to the vet failing to give us complete instructions as to how to take the Trilostane. The second ACTH test results came back:
Pre: Less than 14
Post: Less than 14.
After receiving these results, she stopped the Trilostane for 10 days. We saw improvement in her general mood and appetite, although her water intake remained low. Her front right paw which was inflamed also started getting better – the swelling came down and the hair was growing back.
After 10 days we restarted the Trilostane, two 7.5 mg twice a day (ie. 15mg per day). This dosage seems more appropriate for her because sheÂ’s more active, but not showing any cushing symptoms. This was 1 week ago.
However, since restarting the Trilostane, her front right paw seems to be getting more inflamed and is losing hair again.
I understand that cortisol assists with keeping managing inflammation, but we have a strange situation where the high cortisol appeared to keep her foot inflammation under control.
I am very tempted to reduce the Trilostane dosage to 7.5 mg once a day – to stop her paw from getting worse. Is this a good idea?
Alternatively, we can keep going on 7.5 mg twice day for another week and then schedule a ACTH test.
The vets seem a bit lost with what to do. Over the last few months, they have put her on 4 antibiotics to deal with various bacterial issues (apparently related to Cushings), but IÂ’m not sure if those antibiotics are even workingÂ…. (Frustratingly!)
Many thanks :p
ReggieÂ’s mamma