Vet Refuses to start on lower dosage

[Lucy1125]

My boxer Lucy confirmed Cushings and followup Ultrasound showed Right Adrenal Gland tumor. Long time vet gave options including surgery (consult with IM specialist) or starting on Vetoryl. She stated that it would be 60mg and test at 10-14, 30 and 90 day to monitor and adjust dosage. I expressed my opinion as an advocate for my dog about the harm of starting her on 30mg and looking at numbers during the testing times and adjust from there. Worst case is first test at 30mg the dosage might not be high enough. What is the harm of that .VS. making her go through possible side effects like diarrhea, vomiting, etc., stopping the meds and restarting in 7 days as the manufacturer recommends. She stated absolutely not, her recommendation is 60mg and if I didn't like it I could go to the IM specialist and they could deal with Lucy !!!

My dilemma is that I did just that, after this vet taking care of my dog for 9 of it's 11 years and to be so steadfast and unreasonable I told her I would take her somewhere else. My problem is I can't get into an IM until 6/23/2020 and my current vet won't RX the meds for me.

Is there anything I can do to help Lucy for the next 2 weeks, biggest issues are eating and drinking, urinating alot but outside so it's not too bad, no other symptoms. Thanks.

[labblab]

Welcome to you and Lucy! Good grief, I’m so sorry to hear that your longtime vet is being so stubborn and difficult. There’s really no good reason for her to be so obstinate about refusing your request to start Lucy on a smaller dose of the medication. You’ve not yet told us how much Lucy weighs, but regardless, I agree with you that there’s little to be lost by initially starting lower and then increasing the dose if warranted.

Currently, the generally accepted starting formula is 1 mg. per pound (or 2.2 mg. per kg.). However, some research suggests that, at least in the case of treating pituitary tumors, larger dogs may actually only require smaller doses per pound in order to maintain effective control. Since apparently Lucy suffers from an adrenal tumor, she may instead end up needing a higher rather than lower dose. Adrenal tumors can prompt the secretion of variable amounts of cortisol. But again, I don’t see why you couldn’t start out with a lower dose within your first month of treatment and work upward if needed.

Sadly, I don’t know of any other treatment that would be effective during this time that you’re waiting to see the specialist. But hopefully the time will pass quickly and you’ll soon be in. Once again, though, I’m so sorry that your regular vet has made this all so difficult for you. Since she has, though, I surely hope that Lucy is better served in another vet’s care! Oh, and by the way, can you please tell us how much Lucy weighs?

Marianne

[Harley PoMMom]

Hi and welcome to you and Lucy from me as well!

I agree with everything Marianne has said, and I can't believe how unprofessional that vet is acting. You are Lucy's advocate, her voice, and only you know her best so that vet should be willing to work with you, I'm so sorry for the situation the vet has put you in. Unfortunately I don't know of any truly effective holistic/alternate substitutes to the Rx medication when one wants to lower cortisol levels significantly. Having said that, if clinical symptoms are not that bothersome to the dog or owner, some members have told us that Cushex and Adrenal Harmony Gold worked very well in controlling symptoms but only for a short time period. Now, Cushex and Adrenal Harmony Gold have no controlled clinical testing whatsoever to back up their claims (we know this because we have contacted the manufacturers and we have been told that no testing has been done).

I know how big of an appetite Cushdogs can get so giving carrots or green beans in between meals may help with that hunger. Regarding her increased drinking, please do not restrict her water consumption, that elevated cortisol makes the kidneys work harder and thus, the dog has to drink more water to keep up with the output from the kidneys.

Please know we are here to help in any way we can so do not hesitate to ask any questions you may have.

Hugs, Lori

[LtlBtyRam]

All I can say is Wow. I would definitely do what you are doing and seeking care elsewhere.