Tremors and Shaking with Lady Banana Bug

[Banana Bug]

Hi all,

First time poster here. My dog Banana Bug was diagnosed with adrenal Cushings in September and she's on 80mg Vetoryl (40 mg twice a day - upped from 30 mg twice a day). She initially responded very well to the Vetoryl and upon the fist ACTH test the vet recommended upping the dose a little.

She started a downward trend when there was a mix up at the vet and they did not okay her 3rd refill of Vetoryl. She went off the meds for 5 days and then back on. Now, while her pot belly, excessive drinking and urination, and hair loss has all improved significantly - she suffers from body tremors and panting. I haven't been able to figure out a patter but usually in the afternoons she starts getting restless. Starts panting excessively, and often times has body tremors. This continues until she eats and has her second dose of Vetoryl. After she eats she usually calms right down and passes out/puts herself to bed. Sometimes the shaking continues and sometimes it doesn't. Then when she wakes up the next morning she is usually shaking again. I just can't find a patter but she seems uncomfortable with the shaking.

She is also taking 6mg of melatonin at each meal. I haven't asked the vet or tried adding lignans yet, but that's the next step I think.

Oh AND she is definitely losing muscle function on her back legs. Constantly sliding her back legs and has been falling a lot more. I take her on two walks a day to keep her moving, but it is worrying seeing her so stiff and wobbly.

Does anyone have any other recommendation for my sweet girl?

Thank you!

[labblab]

Welcome to you and your sweet Banana Bug — I love her name! In order to offer our thoughts and suggestions, it’ll help us a lot if you can tell us more about Bug’s overall health history and also the actual numerical results for the test that diagnosed the Cushing’s. When you say that she has adrenal Cushing’s, I’m wondering whether the vet has concluded that her Cushing’s is actually caused by a tumor in one of her adrenal glands, or whether it is more likely a tumor on her pituitary gland that is causing her adrenals to overproduce cortisol. In addition to cortisol release, certain types of adrenal tumors can also overproduce other hormones that can trigger symptoms such as restlessness, panting, high blood pressure, etc. So that’s a reason why I’m wondering whether your vet believes that Banana Bug does truly suffer from an adrenal tumor as opposed to a pituitary tumor. Pituitary tumors are far more common, but perhaps Banana Bug does have an adrenal growth.

It’ll also help us to find out the actual numbers for that first monitoring ACTH test. If it was performed back in September or October, it’s really time for another one to be done. Even while staying on the same dose of Vetoryl, cortisol levels can change over time. Especially if a dose has been increased, the cortisol level needs to be regularly checked. So for safety’s sake, the manufacturer recommends that monitoring ACTH tests be performed every three months, regardless of an increase, including basic blood chemistries. Vetoryl can sometimes throw off the balance of potassium and sodium in the body, for instance, and such an imbalance can trigger additional side effects.

Before writing more, I’ll give you the chance to answer some of these questions. Thanks in advance, and once again, welcome!

Marianne

[Banana Bug]

Hi! Yes she has an adrenal growth, I'm new to all the lingo :-) I will reach out for the specific numbers but her last ACTH test was in December and that's when we upped the Vetoryl by 10mg twice a day.

As far as health history she's been relatively healthy aside from a large lipoma removed about 5 years ago, and in the last 2 years and string of bladder infections which eventually led us down the road to cushings. She tested positive for cushings through a adrenal ultrasounds and a few blood test, plus she had all the symptoms: pot belly, ravenously hungry, constantly drinking and peeing/accidents in the house, bilateral hair loss, muscle tremors in her legs.

That makes sense on the other hormones being out of wack. I will be due to see the vet again in February and will have lots of questions.

Will get back with test results! Thank you for all the knowledge, this has certainly be a difficult road.

[Squirt's Mom]

Hi!

Just popping in to welcome you and your precious Banana Bug! Marianne has gotten you off to a great start and I don't have anything to add but did want you to know we are so very glad you found us. I look forward to learning more about your sweet boy as well as you.

Hugs,
Leslie

[labblab]

Hello again from me, and thanks for the additional information! One quick question for you: since Banana Bug suffers from an adrenal tumor, has your vet talked with you at all about surgery? Surgical removal of adrenal tumors offers a complete cure, but the surgery is very expensive and quite risky. For many reasons, it is not a viable option for all dogs, but I’m wondering whether it has been discussed with you at all.

In the absence of surgery, Vetoryl is indeed an approved medical treatment for the symptoms caused by cortisol-secreting adrenal tumors. When I talked earlier about other hormones that may be involved, an example is a particular type of adrenal tumor called a pheochromocytoma. This type of tumor can cause overproduction of epinephrine and norepinephrine, resulting in some similar symptoms and also hypertension, panting and restlessness. Your vet may have already drawn some conclusions about Bug’s tumor type based on the ultrasound images. But for diagnostic purposes, I think it’ll still be important to let him know about her ongoing tremors and restlessness.

Please do keep us updated!
Marianne