I’m new! 6yr old Rottie/Catahoula mix recently diagnosed and having quite the time...

[Jenbubs]

Hi all! I’m new here- and very glad to have found a forum to hopefully ease my worries/anxiety/general need to quit googling to the ends of the earth to help my sweet dog. Me, my husband, and his other 3 dog siblings just want him to get better. This is about to be a doosey of an introduction...

Eli is 6- he is a Rottie/Catahoula mix and quite the large dog he was 90lbs before all of these shenanigans started and is the sweetest normally full of energy dog.

It started around Aug 2019 when he became insatiably hungry and would walk around the house eating the other dogs’ food and licking everyone’s empty bowls. After about a whole month of it I finally said something is up and it isn’t getting better, I scheduled a vet appt. Interestingly enough the morning of his vet appt I wake up and he had peed in his sleep- which was a first. I take him in and tell the vet the symptoms- insatiable appetite, breathing heavy all of the time, just peed in his sleep.. you know the drill.

The vet wanted me to bring him back the next day to do the 8 hr LDDST test. So I take him ... that comes back and he says he more than likely has Cushings Disease and wants to do another test but at a higher dosage to narrow down if it is the adrenal or pituitary form... so I bring him back in two days for that. (This is early Oct 2019 by the way). In the meantime I realize that he has been drinking like a dolphin and just never noticed that symptom until then. After the next test the results come back that he more than likely has the pituitary form and the doc gives all of the options... which is essentially only Vetoryl. He then has me come back and pick up the prescription along with some dewormer because he had some hookworms too.

To recap- I took him to his first vet appt on a Friday and the following Friday I was picking up his Vetoryl for 120 mgs. I go home and give him his first dose. Wake up on Saturday and give him his second dosage. He seemed to not be drinking as much water but also not as interested in his food (it’s working I assume..) that day he seemed lethargic and stopped being himself. I wake up on Sunday and he’s super lethargic and isn’t interested in eating. I opt to not give him any more meds until I can solve what is going on. After googling quite a bit I go look around the backyard and find jet black poops. Given we have 4 dogs, that didn’t give me anything definitive to work with so I watch him like a hawk and start freaking out. He’s really just laying around and not moving much but I did get to see him poop and it was jet black and I began to internally freak out- it’s a Sunday the vet is closed, so I consider taking him to the ER but it I wasn’t quite there yet.. her was still moving some and the side effects mentioned lethargy.

Well Monday rolls around and he’s hardly moving- I call the vet and they say to take him straight to the ER.. so off I go. They run tests on him and throughout that day I find out that he has a stomach ulcer, pancreatitis, anemic and has lost a significant amount of blood and will need to stay overnight. They call that night to let me know they have to do a blood transfusion because his blood count was so low. Pretty sure my heart stopped that night.

After more days in the ER they say he can some home and I just watch him like a hawk. There’s no way for them to tell what caused all of that to happen. Did he eat something? I don’t know the dude wanted to eat everything the last month. Was it the Vetoryl? The vets aren’t sure but think it would be too soon for that given he only had two doses. No one has those answers.

All I can tell is that he came back verrry weak and needed to recover from being anemic and this terrible stomach ulcer had to heal and was down to 83lbs. During the next two weeks he got gradually better (from deaths doorstep) and some of the Cushings symptoms got worse. One being his muscles disappeared- and I mean overnight. He became skin and bones. They had him on blood thinners worried about his Cushings and anti stomach acidity Meds. About a week into the blood thinners his the water bowl showed blood in it and I noticed his nose was bleeding give he would also sneeze blood in the mornings (so we temporarily discontinued those meds) and come the 2 week mark I take him back to a check up. His blood count had gotten much better but now his blood pressure was showing high so they send me home with blood pressure meds and told me to come back in 4 weeks and then we would do more tests and consider restarting the Vetoryl at a lower dosage.

Well he came back from that day of tests and he seems to have gone a bit backwards and become lethargic so I watched him like a hawk. Also I went to my usual new best friend google to search for hours to try to solve all of my questions, concerns, and problems. In my googling became nervous to give him the blood pressure meds because of the side effects. My poor dog has been in such a fragile state since his near death experience I grow skeptic of anything and everything. Well I made the executive decision to just not give him those meds... this was the first time in a series of 5 recent visits that said high blood pressure, he hadn’t had high blood pressure in any of the other visits.

In the meantime Eli literally has lost all muscle mass it seems. He’s almost the size of a Great Dane and struggles to get his back legs stable to stand up by himself on the hardwood. He can manage to stand on other surfaces after a little persistence but most of the time we have to lift his back end up so he can stand. His fur isn’t growing back from where the ER had shaved spots and he has black bruising or pigmentation where the IV was. Poor guy looks sickly- his head is sunk in too. My next 4 weeks consisted of me scouring the internet trying to find some miracle. I came across the petwellbeing Adrenal Harmony Gold natural drops and after reading tons of reviews decided to give that a shot for two weeks. During those two weeks his water consumption seemed to go down, his breathing was more normal, maybe his hair started getting a little fuller (he never lost hair in his symptoms though just where the vet shaved).

Where I am now is that I skipped his 4 week checkup on Friday because he has been doing better and last time he got tests done he declined for a bit. I stopped the drops two days ago in preparation of trying Vetoryl again at a much lower dosage. Today we picked up the Vetoryl 30mg for him and I haven’t given it to him yet.

Where I really am now: I’m just lost. It’s November and in September I had a perfectly healthy energetic dog that just seemed to want to eat everything in sight. I’m nervous to put him back on Vetoryl because I have no idea what caused his ER episode. I want a magically muscle fairy to visit my sweet boy in the middle of the night and give him all of his muscles and strength back that evaporated into thin air.

I’ve googled and googled and haven’t known what to trust and found myself nose deep in a Canadian scholarly article sifting through the findings at 2am. I somehow just found this forum and am so glad to find actual people that aren’t giving a review on some products website.

I’m sorry again for the lengthy hello and background but I wanted to get it all out just in case someone has had a similar situation or has any advice.

-Jenni

[labblab]

Hello Jenni, and welcome to you and Eli. I love your avatar photo — Eli looks like an absolute sweetheart! I apologize that I’m not able to take the time to write a more substantive reply to you right now, but I want to welcome you, nevertheless. I’m so sorry that Eli has been going through such a rough time, and I hope we can help you sort through some of your options. So I’ll be returning tomorrow, if not today, in order to add further thoughts. In the meantime, I’m so glad you’ve found us, and I surely look forward to talking more.

Marianne

[Joan2517]

Hi Jenni, and welcome from me too. Poor Eli! I'm no expert, but that starting dose was pretty high. My Gable was about 80 pounds when we first started him on the Vetoryl at 40mgs. He did well for a while, but last January his cortisol dropped way too low. We had to stop, restart at a lower dose and keep tweaking. Right now he's on 5mg in the morning and 5mg at night. He's still drinking and panting a lot, but I am leery of raising it.

It would help if you posted Eli's blood work, only the highs and lows. Also the results of the LDDS test and if they did an ACTH test.

[Jenbubs]

Thank you for your advice Joan! I'm going to reach out to get the results from the vet.

Only thing I question a bit is if he possibly had the pancreatitis while we were testing (and that would affect the numbers) and just never knew or the mega dose of Vetoryl caused all of the pancreatitis/stomach ulcer.

Last January did you find out it dropped too low after a regular check in test or was Gable acting different?

[Squirt's Mom]

Hi Jenni,

Welcome to you and Eli!

Joan is correct that the starting dose is WAY too high. Recently there has been another change with using Vetoryl and it has to do with the size of the dog....larger dogs need a much lower starting dose than stated in the drug literature. Here is some info concerning this change -


Dechra recommends starting treatment at 1 mg/lb (2.2 mg/kg). A UC Davis study suggests that dogs weighing >66 lbs (30 kg) tend to be more sensitive to Vetoryl and require less of the drug to control the clinical signs of cushing’s than dogs weighing less <66 lbs (30 kg) Based on that study, UC Davis’ established protocol for treating larger dogs starting at doses ranging from .3 to .5 mg/lb (.66 to 1.1mg/kg).

https://www.k9cushings.com/forum/showthread.php?8925-GENERAL-GUIDELINES-for-Dosing-and-Monitoring-Treatment-with-Vetoryl-(trilostane)

Some info you can share with Eli's vet about this (in addition to our internal link above ;) ) -

https://www.ncbi.nlm.nih.gov/pubmed/22708554

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2012.00956.x

And I agree with your concerns about the pancreatitis - if Eli was tested while this condition was in play I would be highly suspect of those test results. AND I would not want to restart the Vetoryl at any dose in light of the fact that his signs are not as prevalent; plus I don't think he has had enough time to fully regain himself after all he has been thru recently. In your shoes, I would hold off treating Cushing's and give him time to fully heal. I would keep an eye out for the typical cush signs - ravenous appetite, excessive peeing, excessive drinking, panting for no reason, seeking cool places to lay - while getting his weight and strength back with some good nutrition and gentle exercise as tolerated. Check into hydrotherapy availability in your area for Eli - that would be gentle yet give him the opportunity for him to start rebuilding some muscle mass.

Regardless of what you decide, stick around, keep reading and learning and asking question, and keep us informed about your sweet baby boy.

Hugs,
Leslie

[Jenbubs]

Thanks Leslie!

He definitely displays the Cushings symptoms - all of the ones you mentioned: ravenous appetite, excessive peeing, excessive drinking, panting for no reason, seeking cool places to lay, along with hind leg weakness and shakiness, hair that was shaved has not grown back at all, bony head appearance.

His symptoms were significantly reduced (some hunger, thirst, possibly a little weight gain, and energy) on the Adrenal Gold drops for the two weeks we put him on that. As soon as I stopped them his water intake and hunger came back full swing. I am weighing on continuing the drops in the meantime or starting back the Vetoryl at the 30mg dose.

[Joan2517]

Thank you for your advice Joan! I'm going to reach out to get the results from the vet.

Only thing I question a bit is if he possibly had the pancreatitis while we were testing (and that would affect the numbers) and just never knew or the mega dose of Vetoryl caused all of the pancreatitis/stomach ulcer.

Last January did you find out it dropped too low after a regular check in test or was Gable acting different?

All of a sudden I realized he was drinking a lot again. Being a Cushing's mom twice now, I am on high alert for all the signs. I almost raised his Vetoryl because there was wiggle room with his last numbers, but then decided to have him tested. It was really low, .5 or .4, something like that. We think he was over-suppressed with his thyroid medication, which caused a lot of extra stress on him. He also has a sensitive stomach, so I'm never quite sure whether his symptoms are from that. I've taken him off the meds and restarted at a lower dose until it looked like we can raise it quite a few times since last year. I would rather his numbers were high than risk Addisons again.

[Jenbubs]

Thank you again! Every little bit of information seems to help because it is such a complicated disease. Hearing that even with increased symptoms Gable was so low on the tests definitely makes me want to wait a bit to ensure he has had plenty of time to recover and get retested before trying to start Vetoryl again. I had thought that since the symptoms were back in full swing ( even gotten worse) that surely his levels were high as well.

I’ve been so worried that with his new more lethargic state due to all of the increased symptoms and lack of muscle strength that it would be hard to guage any additional increase in lethargy if his numbers dropped too low on a new dosage.

[labblab]

Hi again, Jenni. I’m sorry it’s taken me this long to get back to you, and I’m very glad that Leslie and Joan have been here to help you in the meantime. They’ve given you good info, and I just have a few thoughts to add.

My very first suggestion is that, if possible, you request your regular vet to make a referral for a consultation with an internal medicine specialist. If you live near an urban area, there are likely specialty veterinary practices nearby, or even perhaps a vet school. Asking for a specialist’s opinion doesn’t mean you’d need to lose the general oversight of your regular vet, but the specialist can act in tandem with your regular vet to guide treatment in difficult or complicated cases. The fact that your regular vet started Eli out on 120 mg. of Vetoryl suggests that he’s not 100% current on Cushing’s research guidelines. This is not surprising, since a GP vet can’t have cutting edge knowledge about every condition. But for quite some time now, lower starting doses have been recommended by clinicians who regularly see Cushing’s patients. When you add in Eli’s additional complications — the bleeding ulcer, pancreatitis, possible hypertension — he’s got an awful lot going on, and having a specialist with particular expertise in Cushing’s could be a big help. You may spend a bit more money upfront, but it could save you a lot of money in the long run. As I’m sadly aware from my own experience, Eli’s ER visit was undoubtedly both emotionally and financially very stressful! A regular scheduled office visit with a specialist would be a whole lot less expensive.

Turning to Eli’s specific situation, it’s hard to think that two Vetoryl doses would cause a bleeding ulcer. The medication, in tandem with the dewormer, perhaps could have aggravated a pre-existing condition. But it just may have been a coincidence. Bleeding ulcers have not been commonly reported here, either among treated or untreated Cushpups. But I know that non-Cushing’s patients who are taking supplemental steroids for treatment of other medical conditions are vulnerable to GI problems. So the high level of circulating cortisol associated with uncontrolled Cushing’s may have this same effect. If so, starting back on the much lower dose of Vetoryl may actually be a wise thing to do, but also perhaps in conjunction with a stomach soothing medication (and also always with a full meal, for several reasons). This is the kind of thing that a specialist will know better, however.

In addition, if Eli truly has high blood pressure, then effectively treating the Cushing’s as well as the hypertension will be important. Hypertension can indeed be associated with Cushing’s, and it can result in vision loss and kidney damage if left unchecked. However, blood pressure medicines need to be selected and monitored carefully when given alongside Vetoryl. So this is yet another reason to enlist the guidance of a specialist.

It’s interesting that you report that Adrenal Harmony seems to have helped Eli in the short run. We’ve had some similar anecdotal reports from other folks. However, we’ve directly contacted the makers of Adrenal Harmony for any actual research data to support the use of the supplement, and none has ever been performed. So it’s impossible to know if it genuinely helps or if so, why. In the long run, virtually all the people who have tried Adrenal Harmony here have ended up shifting to a researched prescription medication in order to effectively control cortisol levels and symptoms. In Eli’s case, given the damage his body may suffer if his cortisol level remains uncontrolled, I believe I’d want to get going sooner rather than later with a medication that has been scientifically researched. At his relatively young age, I know you want to give him the best chance of living out his normal lifespan with a quality life.

Given the rapid rebound of so many classic Cushing’s symptoms in addition to his worrisome lethargy, once again, I believe I’d want to seek out a specialist ASAP. I know it may feel awkward to ask your vet for a referral, but I really do believe it may be in Eli’s best interest to do so. Heck, it may even be a relief to your vet to think that somebody else is sharing the responsibility in choosing the best path forward! Do think it over, and regardless as to what you decide, please continue to ask as many questions as come to your mind.

Marianne

[Jenbubs]

Thank you Marianne!!

Interestingly enough we landed at the internal medicine specialist with our ER stint, so we have been going to them ever since the ER episode for all of the checkups. The doctor in there is very smart and right away she knew the 120mg dose was too high. I do feel some nervousness there because she seems to very quickly put him on additional meds and before this I would have just done it no questions asked. My first time I questioned this is coming home from the ER with him to recover from the ulcer and pancreatitis, she put him on blood thinners (because of the Cushings) saying that Cushings dogs are more prone to blood clots and he would likely stay on them the rest of his life. A week later when his nose was bleeding daily I looked up the medication and it cautioned not to take blood thinners if you have internal bleeding or a stomach ulcer?

My second time with the last checkup he went to was he first time I've been told his blood pressure was high. We left that appt and she prescribed the blood pressure medication and set another check up appt. His blood pressure might very well be high- but he stayed at the vet the whole day and he had been "more himself" when I took him in. He gets worked up and excited when he sees other dogs and really any animals so I wondered if he was excited and anxious in at the vet when he got these tests done. So I come home and look into the medicine she prescribed and the side effects aren't very encouraging. I don't know, I'm not trying to overthink everything and go against what the vet says but I also don't want to unnecessarily put him on medications that his sensitive system/stomach right now might not need. I want to give his body the best chance with the Vetoryl and not have him on a drug cocktail where I cant diagnose what medicine is causing an adverse reaction if there is one.

She also said that she isn't a fan of the LDDS testing- and prefers the ACTH test - any thoughts on this with all of your experiences?

I probably need to go back to them for testing and quit running in circles in my head. I do feel a little alienated with that place though because they are an Emergency Vet and have a whole slew of different specialists so every time I call with a question I find myself talking to someone new and trying to give his history recap to explain my thought process on something and its a bit exhausting.. wondering if that person even conveyed it correctly to the doctor.

Sorry for all of my lengthy posting!!

[labblab]

Jenni, thanks so much for all this additional info! There’s never a need to apologize for a lengthy post — the more you can tell us, the better ;-).

I have to say that all of your concerns sound perfectly reasonable to me. It’s true that Cushing’s is thought to increase a vulnerability to blood clots, but putting an animal who’s recovering from a GI bleed on a blood thinner is definitely a head scratcher for me, too. In our experience here, blood thinners are not routinely prescribed for Cushpups, and I definitely agree with you that it seems like a very odd choice in Eli’s situation. I also understand your questioning of the high blood pressure. I believe I, too, would want to have more than one elevated reading taken during a high-stress situation to confirm the finding before starting on medication. So after encouraging you to rely on a specialist, I’m coming away with some of the same questions as you.

As far as the LDDS vs. the ACTH, it seems to me as though the majority of experienced clinicians actually prefer the LDDS as their leading diagnostic, but with the following caveat. Both tests are vulnerable to “false positives” if a dog is suffering from an illness or physical stress other than Cushing’s. However, the LDDS is more likely to be skewed in this manner than is the ACTH. So if a dog has other known physical ailments, the ACTH may indeed be the more reliable test. The trade-off is that the ACTH is more likely to miss diagnosing Cushing’s (“false negatives”) in a dog who truly suffers from it. So in my own mind, which of the two tests is “better” really depends upon the situation that is specific to each individual dog. Now knowing that Eli was suffering from these other underlying issues, the ACTH might indeed have been a more reliable diagnostic option for him. But given his overall symptom profile, I personally don’t doubt that he truly has Cushing’s.

So what to do now... I agree that it’s far less than ideal to have to speak to a different vet whenever you have questions. In a non-emergency situation, it seems as though you ought to be able to arrange to consistently talk with a single specialist who’s in charge of Eli’s care. If this practice can’t make that happen, then perhaps a different group would be a better option. However, if logistics are such that you’d rather stay with them, I’d encourage you to press them on scheduling a time that you know you’ll be able to speak to the vet you prefer. And then I’d proceed with explicitly asking whether it wasn’t risky to prescribe a blood thinner while Eli was recovering from a GI bleed. And I’d also advocate for a few additional blood pressure readings in less stressful conditions, too. If the answers you get don’t satisfy you, then I’m afraid I’d encourage you to investigate other vet options :-((((. Sheesh!

Marianne

[Jenbubs]

Hello all, I'm back!

So today I took Eli in to have blood work checked and to run another Cushings test before starting medication. (This was at the specialist that we have seen since his ER stint)

I will be picking him up in a few hours and will get exact printouts of the results but the doctor just called and originally said " we are going to start him back on the Vetoryl at a much lower dosage though - 60mg twice a day."

I immediately said that I was hesitant to go that high because of the research I have found showing the scale is more like .3-.5 / lb. So she suggested that we could do whatever I felt comfortable with, maybe 30mg twice daily. I said I even wanted to start just 30mg once daily and see the results to then maybe go 30mg twice daily.

Her input was with how high the test came back and how progressed his symptoms are ( specifically stating the muscle degeneration in his legs and his head) she thinks that a higher dosage will be needed to make a difference. She is fine with me slowly weening him onto it and seeing the results as I go.

I was/am mildly bothered by the original suggestion of 60mg twice daily being the suggested "much lower dosage" of the very first trial or 120mg once daily. I would say that basic math puts you at the same dose within 24hrs....

I will post the ACTH test results as soon as I get them today -

[Jenbubs]

ACTH pre. 16.9 ug/dL
ACTH post. 28.1 ug/dL

[Squirt's Mom]

Good for you, Mom! :cool::cool: Way to hold your ground! :cool::cool: I am also glad the vet was willing to listen and work with your wishes on the 30mg dose. She just may be surprised with the results. ;) Word of caution....DO NOT increase the dose until at least 30 days have passed on the 30mg a day dose. Cortisol continues to drop those first 30 days without a dose increase so Dechra says do not increase during that time frame. If the 30 day ACTH still shows elevated cortisol AND the signs are still strong then a dose increase of no more than 25% is the next step. fyi, Eli should have an ACTH at the 2 week mark after starting then again at the 30 day mark after starting....and it is this 30 day mark that will tell if an increase is needed. And btw a 28ug/dl isn't all that high; my own Trinket registered as greater than 50ug/dl and she was misdiagnosed because of her numerous other conditions. ;) We see post ACTH numbers higher than 28 ug/dl very often so don't let that worry you. You're doing a great job, Jenni!
Hugs,
Leslie

[Jenbubs]

Truly it is so nice to find an outlet where people are actually knowledgable! The doc said that I could just up his dose whenever I felt comfortable - so I’m so glad you told me about the 30 days. Also, she said that 28 was a high reading which is one of the reasons she thought the low dose wouldn’t be very helpful.

Started him on 30mg once a day today so we will see how it goes!

I forgot to mention in my last post that his blood pressure was normal so that made me feel good about never giving him the prescribed blood pressure meds.

So with my experience with the specialist, I am inclined to go back to my regular vet and just continue there- only thing is that he doesn’t do the ACTH testing.. it would be the LDDS testing. Do you think that would be okay to test on in two weeks and 30 days? Or do you think I need to continue with the ACTH?

[labblab]

Well, after encouraging you to seek out a specialist’s guidance, I remain disappointed in the feedback that you’ve been receiving from this particular vet. It just doesn’t appear as though she has had much hands-on experience with Cushing’s treatment. As Leslie has written, a post-ACTH level of 28 isn’t unusually high. Even if it was, it really ought not to have a bearing on the initial dosing formula. Initial dosing is based on weight alone. Period. That is the starting point, and then subsequent testing will reveal how efficiently any given dog is metabolizing the medication, and whether dosing changes are in order. A small dose may significantly reduce cortisol levels in some dogs, whereas a much larger dose is required in other dogs. Again, this has nothing to do with how high the cortisol level was to begin with. Instead, it’s a reflection of how each individual dog physiologically responds to the medication.

Unfortunately, the LDDS only has value as an initial diagnostic test. It cannot be used for trilostane treatment monitoring purposes. The only alternative to performing full ACTH tests is the possible use of pre-pill resting cortisol levels. Dechra, the manufacturer of Vetoryl, has recently issued some recommendations in this regard, and apparently pre-pill resting cortisol levels are becoming widely used for monitoring purposes in the U.K. and parts of Europe. It is not a technique that is as commonly accepted here in the U.S., but you and your regular vet can read more about the related protocol here:

https://www.k9cushings.com/forum/showthread.php?8925-GENERAL-GUIDELINES-for-Dosing-and-Monitoring-Treatment-with-Vetoryl-(trilostane)

Even using this technique, though, there are still times when complete ACTH tests may be called for. So if you remain with your regular vet, you’ll need to have a backup plan in that regard. It’s really a shame that this particular specialist has turned out to be of such little help to you, but perhaps there’s another clinician in your area with whom you and/or your regular vet can consult. In the meantime, I do hope that Eli responds positively to the medication with as few problems as possible.

Marianne

[Jenbubs]

I come with good news today!

Eli has been on Vetoryl 30 mg once daily for 30 days now and we just got our first test results back after starting the meds

ACTH results before taking any meds:
Pre- 16.9 ug/dL
Post- 28.1 ug/

30 day check up after starting meds:
Pre- 2.5 ug/dL
Post - 4.8 ug/dL

I went back to my regular vet for this test and going forward vs. the specialist because I just feel more comfortable with him - he listens and if I'm the one doing the research and dosage suggestions - might as well!

Another plus the ACTH test at the specialist was $400 and at my vet it was $165

Within the last two weeks Eli has started regaining strength and can now get up on his own (which is a huge improvement to us!!) even on the hardwood. He has much more energy and is waking me up every morning with a nose in my face ready for neck rubs.

All of the Cushings symptoms have gone down - He is still super hungry most of the time but he is also 75 lbs and was at 90lbs before all of this started so.. I am hopeful his weight will come back now that he is starting to regain muscle mass :)

Once again I want to thank all of you..finding this forum has been a Godsend for me! 30 days ago, having the vets tell me that his test results were so high that 30 mg /a day wasn't going to make a difference and wrote me a prescription for 30mg and 60mg because she was so sure that within 30 days I would already switch to the 60mg. Also 30 days ago telling me that with all the muscle mass that has wasted, his Cushings must be so progressed and the muscle loss is more than likely Neurological so it wont get any better.

Having you guys as resources and backup verified my hesitancy to their dosing suggestions and we have already come so far in just 30 days!

[Joan2517]

Isn't it wonderful to see good results?? It is such a relief and gives us a chance to breath!

[labblab]

Thanks soooooooo much for returning to us with this great update! It definitely cheers all our hearts to hear that things are going well for you guys! Keep up the good work, and please continue to check in. Especially for other newbies who are fretting about treatment decisions, it can be so helpful to know how things are turning out for others who are in the same situation. I’m so glad you feel we’ve been helpful to you, and by returning to us, you are really “paying it forward” by offering inspiration to others who are just a few steps behind you in their own journey.

So once again, thanks so much, and Happy New Year to both you and Eli!
Marianne

[Squirt's Mom]

What a great update! I am so very glad that Eli is doing so well and beginning to enjoy life again with renewed energy. I don't think I will ever forget that day when Squirt grabbed a toy and started playing for the first time in ages. My heart swelled to 10-times its normal size with pure joy!

Thank you so much for coming back and letting us know how he is doing!

[Jenbubs]

Hi Everyone!

I'm checking in to ask how do you know when the meds need to be adjusted - what symptoms do you all experience?

Eli has done very well for months and recently his legs seem to be a little weaker and his breathing is faster again. I contacted the vet to get an additional 5mg (on top of his 30mg that we've been taking) I really don't want to take him in for another ACTH test if possible because he seems to take a bit to recover from it (also he got a big hematoma from the last test that freaked me out).

I really wanted to check and see what other people's symptoms have been when they needed a dosage adjustment before I overthink anything.

[Squirt's Mom]

When you see the same signs you noticed before starting treatment that is a good indication the cortisol is rising again. Signs like excess drinking, ravenous appetite, excess urination, heavy panting for no reason, etc. In addition the regular ACTH or PVC monitoring tests will catch any increases or decreases in cortisol which is another way to know if a dose change is needed. The testing schedule is every 90 days for life unless you see signs that indicate the cortisol is too high or too low then testing is needed at that time. Any time the dose is changed the testing schedule starts all over at the 2 week mark - 2 weeks, 30 days, then 90 days if all is well. The signs that the cortisol is dropping too low, which is a critical situation, are loss of appetite, loose stools/diarrhea, nausea/vomiting, and lethargy. If you see any of those signs stop the med and call the vet asap. Maintaining that testing schedule is important and I am so sorry Eli had a bad reaction last time with bruising. My Squirt used to bruise quite often from the tests but she healed and it didn't seem to bother her tho it really bothered me! :o

The dose should never ever be increased without doing an ACTH that proves the increase is needed. This is a very very risky move even tho the increase is only 5mg. Please keep a very close eye on Eli for any of those signs of low cortisol. Vetoryl is a very powerful drug so should be handled with extreme care. Low cortisol is a life threatening situation while high cortisol is not so it is always better to be sure any increase is really needed. The signs you mentioned could be due to any number of other reasons that have nothing to do with Cushing's or cortisol so always test to be sure 1) nothing else is going on and 2) that the cortisol is actually too high again. We don't want any posts saying Eli is sick and I know you don't want that for him. ;)

Hugs,
Leslie

[Jenbubs]

My dog Eli has had Rimadyl in the past (pre- cushings) and no issues- although it was only for a week time period. He recently needed a dosage increase of Vetoryl and already has delicate muscle mass in his back legs. I think he has a sprain or strain in one of his back legs (based on a vet visit with an x-ray) He has been favoring one of his back legs and has avoided putting much weight on it.

Well the vet saw some swelling and prescribed Rimadyl at 75mg twice a day (75lb dog)... okay. I’ve done this in the past.. no problem.. until- 2-3 days later he threw up and then had fire hydrant poops for 2-3 days like I’ve never seen. I stopped his meds day one of symptoms- day 3 of meds.

Come a week later he has either taken another tumble something and is favoring that leg pretty hard again.
How have the other Cush pups done on Rimadyl?? I’ve known that Eli’s GI system is sensitive since the Cushings diagnosis and the previous pancreatitis last year..

He was prescribed 75mg twice a day and that was too rough on his system. Wondering if anyone has had any issues or luck with a different thought process??

Almost thinking about trying 75 mg once a day with an over the counter stomach easing pill (forgetting the name right now ??)

Going to ask my vet in the morning but I trust this message board quite a bit better.

Any thoughts/ experiences with Rimadyl while taking Vetroyl with Cushings?

[Harley PoMMom]

Rimadyl is an amazing anti-inflammatory that does bring much needed relief to severely arthritic dogs but it is tough on the stomach and the liver, and our cushdogs already have a liver working harder, Metacam, I believe, would be a better option.

Lori

[Squirt's Mom]

Personally I wouldn't use Rimadyl even in a dog without Cushing's because of how hard it is on the liver and digestive system. Look into Gabapentin and an newer med called Galliprant.

[Squirt's Mom]

I have merged your thread about the Rimadyl into Eli's original thread. We like to keep all posts about each dog in one thread. That way it is easier to keep up with the history plus this thread can serve as a sort of diary for Eli's journey, making it easier for you to see patterns, etc.

[Jenbubs]

Hi All!

I'm back on with good news that Eli is doing really well! He is still on 30mg of Vetoryl per day and I have been giving him MYOS Canine Muscle Formula for the last 4 months for his hind leg muscle wasting and his muscles has built back up a bit which is wonderful in our house! He can run a little now and can get up and down from the couch without falling.

Hope everyone is doing well :)

- I've added a few albums showing his before and now progress

-Jenni