Border collie diagnosed with Cushing’s

[jmancine]

Our 11 year old border collie Jack (55 lbs) was diagnosed with Cushing’s and has been on liquid Trilostane for 10 weeks today. He is still panting and rapid breathing after 10 weeks on his meds. His initial dose was .4 mL twice a day; after his second ACTH the vet increased his dosage .5 mL twice a day and after second ACTH The vet increased to .63 mL. Jack is still panting and it seems worse in the evening and overnight. We have tried several anti-anxiety/calming meds and nothing seems to help Jack relax during the night time. We have had ultrasounds, echocardiograms, x-rays, numerous routine blood work ups, urine, fecal tests. We have had his oxygen which came back at 95, we have had his blood pressure checked numerous times. His bloodwork up comes back normal. It simply is the panting and the rapid breathing that causes us to feel Jack may be uncomfortable. We are waiting for a medical internist appointment that took over six weeks to get. This appointment is on 9/30. I called the emergency vet hospital to see if there was an internist there today as we were willing to take him over just to get checked out. Unfortunately no internist at this office today. We have taken him to the vet weekly for all of the countless test just to make sure he’s not uncomfortable with the breathing. It’s so disheartening. We just don’t know what to do at this point!

[labblab]

Hello and welcome to you and Jack! We’re really glad you’ve found us, but also sorry that Jack is still having these issues with his panting and breathing. Prior to beginning treatment, was he exhibiting other Cushing’s symptoms that *have* resolved, or has the panting been the primary problem all along?

Also, it’ll help us a lot if we can translate his liquid dose of trilostane into a mg. measurement. For instance, the bottle should indicate how many mg. of trilostane are contained within each mL (or something along those lines). Finally, it’ll be great if you can give us the numerical results for any cortisol monitoring tests that have accompanied these dosage increases. Sometimes vets do misunderstand which cortisol parameters comprise the desired therapeutic range for dogs being treated with trilostane. Given all of Jack’s followup visits, it seems unlikely to be the case for him. But still, we always like to double-check because the most obvious explanation for unresolved symptom resolution is a cortisol level that is still running too high.

I’ll hold off on speculating any further until we have the chance to talk over these initial questions. So do fill us in when you have the chance, and in the meantime, once again we’re so glad you’re here.

Marianne

[jmancine]

Thanks Marianne! Yes, prior to starting treatment 10 weeks ago Jack was exhibiting excessive thirst (for him), which led to waking us up in the middle of the night to urinate and we also noticed his appetite was ravenous. The milligram on Jack’s Trilostane prescription bottle is 50.

I don’t have paper copies of the numerical results of the cortisol from the various ACTH tests. However, we are in the process of getting paper copies from our local veterinarian before we see the internist on 9/30. When our veterinarian calls with the results she verifies Jack is “in range” and that the Trilostane is working, but his numbers are at the “high end” so that’s why she has bumped him up twice so far from his initial .4 ML dosage. Jack is scheduled for his next ACTH test on 9/24. I will definitely have more information for you as to the prior and new numerical results then. Thank you so much for your quick reply. I am learning so much through this networking site.