Mia not responding to Vetoryl

[sadie1949]

Hi folks. Our whippet Mia was diagnosed with Cushing's in Feb 2021. She was put on 10mg Vetoryl a day and we have had her cortisol levels measured every month since. The two times the Vet called in at the house her levels came back at 90. The rest of the time they have been 150 to 230. She has the distinctive pot belly, and until recently the typical thirst and hunger. Over recent weeks her thirst has diminished. She is at 60mg Vetoryl now given morning and evening. No change in her levels or the belly and now her skin is appearing thin, flaky, and her coat is thining. Her nails are chalky too. As she doesn't enjoy her walks she has put on a stupid amount of weight, although she was chubby following being spayed in 2020. Mia is 9. I am about to talk thru the benefits of keeping Mia on Vetoryl today. She is no better and the good parts of her body are showing the side effects of this strong drug. Since being Cushingoid Mia has developed a slightly enlarged heart and murmur. We have her on a crazy amount of meds for a little whippet! My question is: has anyone had experience of slowly withdrawing from Vetoryl and found a benefit from doing this? 18 months in and Mia is worse than she was at the beginning and we are def financially worse too! That wouldn't matter if she were improving but as she hasn't what's the point? Are we compromising for the sake of treating her with something??? She weighs a crazy 19kg. Our previous boy had the same condition for 15 months before passing due to a stroke. Cushing's stinks! Thanks. x

[labblab]

Hello and welcome to you and Mia, although I’m very sorry she’s doing so poorly right now. As you’ll see, your membership has now been approved and you are free to publicly post, so you can disregard replying to a “confirmatory” membership email should you receive one.

I have a limited amount of time to post right now, so I’ll quickly throw out a couple of questions/thoughts. First question: is Mia receiving a total of 60 mg. daily given in two split doses, or is she receiving 120 mg. daily? If it’s the latter, you’re right — that is a whopping big dose given her weight. It does fall right at the very top of the published dosing range, but in reality, that’s one of the bigger doses I’ve seen given to a dog of her size in recent time. Does she get every dose along with a meal? Vetoryl must be given with food in order to be metabolized properly. Like you, I’m searching for reasons why her cortisol doesn’t seem to be particularly responsive to such a high dose of medication, and that’s one possibility that comes to mind.

Secondly, does Mia exhibit abnormalities on her other labwork? There are certain elevations in bloodwork that are commonly found with Cushing’s, such as high levels of liver enzymes and also cholesterol. Given the worsening of certain of her symptoms, I’m also very curious about her thyroid function (T4 on a basic blood chemistry test). Low thyroid levels can be responsible for many symptoms that overlap with Cushing’s such as thinning coat, flaky skin, and general lethargy. Hypothyroidism can be a tricky problem to diagnose alongside Cushing’s, because low thyroid readings can be secondary to the Cushing’s itself. However, some Cushpups also suffer from hypothyroidism in it’s own right and require daily medication to supplement their low thyroid levels. So Mia’s thyroid function is something I’d want to discuss in detail with the vet today.

Jumping ahead to your specific question about discontinuing Vetoryl, it can actually be done immediately without going through a taper period if that’s what you’d like to try. Some medications do need to be lowered slowly over time, but Vetoryl is not one of them. However, you can certainly choose to experiment with gradually lowering the Vetoryl in order to see whether a lower dose provides some benefits as opposed to seemingly worsening Mia’s appearance and behavior.

I’m afraid I’ll have to leave things at that for right now. But I did want to at least have the chance to welcome you two, and to wish you good luck with your vet visit. We’ll be anxious to hear what you decide. Having already lost another dog to Cushing’s, I can surely understand why you’re so anxious to find a better solution for Mia and we’ll try to help in any way we can.

Marianne

[Joan2517]

Hi and welcome! That does sound like an awful high dose to me. If Mia was my dog, I would definitely stop the Vetoryl for a awhile and see if anything changes. I've had two dogs with Cushing's and with my last one, Gable, we stopped the Vetoryl many times over the almost seven years that he was on it. It doesn't hurt to stop...

[cat]

I just had my second Galgo (rescue Spanish Greyhound) Darwin die in his sleep while seemingly doing well 5 weeks ago. He was about 85lbs. and was getting 80mg vetoryl a day in 2 doses.My dog 5 plus years ago was on another drug, I think Lysodren, and it was when dogs were getting on Vetoryl. Carlos seemed to respond better than Darwin, saw an internist and his heart was followed. Both my dogs acted their normal selves but older. Age was unknown due to the rescue situation but each had definitely passed 10. Carlos was at the vet with our 2 Greyhounds. After my husband took
the girls home, I was waiting with Carlos in the exam room, He walked towards me and to the door. As I opened it he collapsed and was dead. They did CPR and all. He had had an MRI on his pituitary and it could not be seen. My internist believed it was a stroke and said that being a sighthound and having Cushing's raises the risk for stroke via blood clots. When Darwin developed initial signs, I knew it was probably Cushing's right away. Same breed, same age group as my first Galgo. In discussion with the internist due to his high blood pressure, he was on blood pressure meds. A check of blood coagulation was also done, a TEG test I think. It was within normal range but he did go on a dose of Plavix, a blood thinner. He went off of it twice for surgery with no problems. He was lying peacefully asleep stretched out on my husband's leather chair and ottoman. He head was stretched out between his paws and he never made a sound. My husband went to rouse him to eat and he was dead. To this day I am sure I did something wrong. Because he did not have an MRI, I wondered if he had a macrotumor. I don't know if having an MRI wold give you any useful information. Does he have high BP? Pills were hard. I ended up buying capsules online that would fit his pills. It was much easier to pill a capsule and he got some oat or rice milk after. I also found he loved wet cat food my daughter fed her cats, a sensitive stomach or something. I don't know how long my first dog Carlos lived with Cushing's; but Darwin lived 18 months from his diagnosis. Sudden death whether you are there or not, I find horrifying. Somewhat akin to when your animal dies during or after a surgery or when ill in the hospital. If your dog is not doing well, make a change. I wish I had done more for mine but like a lot of us, I did not know what more to do. I find there is a real lack of in depth knowledge even among internists. I wish I had asked more questions and made a pest of myself. Best of luck to you and Mia