No appetite with medication

[Tanglewood]

My border collie is 13.5 years. She has just been diagnosed with adrenal Cushing's. She weighs 20kg and is on 40mg Vetoryl per day. She stopped eating on the 3rd day. As it was the start of a 3 day public holiday, the vet said stop giving the tablets for a couple of days (The out of hours vet is miles away). I started tablets again 4 days ago. Her panting has stopped and the excessive drinking/peeing has stopped. (her symptoms also included hair loss and ravenous appetite) But, her appetite has not come back. I can get her to eat a little by mixing in some wet food. She seems well in herself, but I am concerned about her appetite.

[labblab]

Hello and welcome to you and your girl! I’ve fully approved your membership, so if you should also receive an “automatic” email from the website asking you to confirm your membership request, you can now disregard it.

When you have the chance, we’d love to learn more specifics about your girl’s overall health history, and also the diagnostics that led to her adrenal Cushing’s diagnosis. In the meantime, I surely understand your worry over her loss of appetite. Speaking generally, her starting dose of Vetoryl seems appropriate for her weight. However, in recent years, some clinicians who treat Cushing’s dogs have found that larger dogs — for unknown reasons — may be more sensitive to the medication than are smaller dogs. Your girl is right at the weight level that has been identified as sort of a “cut-off” point in this regard. Meaning that she may be especially sensitive to the medication and would be at less risk of side effects if she started off with a smaller dose. However, it may also be the case that her loss of appetite may simply be a temporary reaction to her initial cortisol drop after beginning treatment. Did her appetite rebound at all during those days when you withheld the Vetory?

As long as she otherwise seems to be OK, if she were mine, I might wish to still continue with the Vetoryl for the moment but at a lower dose. But if she otherwise appears to be unwell at all, I’d definitely stop the medication altogether once again. As I’m sure you’re already doing, it’s also important to let your vet know of her continuing inappetance.

I’ll go ahead and close for now, but once again, we’ll look forward to learning more about your girl, and we surely welcome you both!

Marianne

[Squirt's Mom]

Hi Tanglewood,

I hope you're still here and read this. DO NOT give any more of the Vetoryl to your baby girl. That dose is too high. The maximum starting dose for a dog that size is 30mg per day. Loss of appetite is one of the hallmark signs of an overdose so please stop the Vetoryl and don't restart until you see signs of Cushing's again - excess peeing, excess drinking, ravenous appetite, panting, etc. THEN restart at lower dose - MAX of 30mg per day. I know of dogs that weigh more than your sweet girl who are doing excellent on 20mg a day. ;) Here are some links to share with the vet on this. And yes, Dechra, the manufacturer, knows about these studies, they know dogs are getting sick and worse by being given a starting dose that is too high but they do not care and flat refuse to change their literature. So good vets are operating on bad information and the dogs are paying for it. Here are the links (I hope the last two will open for you!):

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

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

https://drive.google.com/file/d/1pv52pVTBw4azQGEk1_T19Ez7IqNI1Mv1/view

https://drive.google.com/file/d/155aj2gOey6_fypWyihlhenygpCjmRdUz/view

I would love an update when you can to let us know how she's doing!

Hugs,
Leslie