Diet

[bnorwood]

Hi, I have a 14 year old Chihuahua /Shih tzu mix. He was diagnosed about a year ago with Cushing's. He was pre- Cushings about 10 lbs, he gained weight and when diagnosed weighed about 14 lbs. When he started medication he would not eat and lost down to about 9 lbs. We switched medication to a compounded Trilastain and he started eating again. He has done pretty well for the last 6 months but recently hasn't had much of an appetite. He has lost down to 8.2 lbs. I am trying to find some food he will eat. I have tried chicken and rice and veggies. He eats this ok but is there something better that will put on the weight? Is it okay to feed him dark-meat chicken? Also, could an increase in medication (trilostane) help his appetite. Unfortunately, I can't afford the testing that goes with the medication. Thanks for the advice.

[labblab]

Hello and welcome to you and your little boy! It’ll be really helpful to us if we can find out more about his original diagnosis, and also any other abnormalities he may be exhibiting now aside from lack of appetite. Can you tell us what symptoms he was exhibiting prior to starting his medication, and also what testing was done that pointed towards Cushing’s being his problem? Also, can you tell us what dose of trilostane he is currently taking?

My big concern at the moment is that a lack of appetite and weight loss can be a sign that the dose of his trilostane is too *high* as opposed to being too low. We surely do understand that the cost of monitoring testing can become overwhelming. But the unfortunate reality is that continuing with the medication without regular testing of its effect on a dog’s adrenal function can result in life-threatening issues if cortisol levels are dropping too low.

That’s one reason why I’m especially wondering what symptoms led to the diagnostic testing in the first place. Given your boy’s age, if the symptoms were not all that troublesome, it may be safer to just discontinue the medication altogether. There is one way in which cortisol levels can be checked for dogs taking trilostane that is much less expensive than a traditional ACTH stimulation test. The alternative method is to take a single baseline cortisol level right before the morning dose of trilostane is given. So if you wish to continue giving the trilostane, I do urge you to at least have that much testing done, along with a check of your dog’s other basic blood chemistries.

But again, if even that much testing is out of your reach, than it’s likely much safer to just stop giving the trilostane altogether, at least for the time being. Hopefully that will lead to an improvement in his appetite, which at this point is likely a far more worrisome issue than a return of some of his earlier Cushing’s symptoms. But hopefully you can tell us more about those issues, too.

Thanks very much for any additional info you can give us. And once again, we’re really glad you’ve found us!

Marianne

[Squirt's Mom]

Hi and welcome to you and your baby boy!

I agree with Marianne 1010%. Just stop the treatment if testing is beyond your reach. While that sounds scary and maybe even irresponsible, Cushing's is not like some diseases like diabetes that MUST be treated or the dog won't make it. In the majority of cush pups this disease can be lived with....no comfortable for some dogs or parents but it can be done. Here's the deal...it is MUCH MORE DANGEROUS to keep treating without testing than it is to not treat or stop treating as is your case. These are very powerful drugs that must be monitored for the safely of the dog. So in your shoes...and I've been there....I would just stop the treatment and enjoy my sweet baby boy. At 14 that is getting to the age when I question continuing treatment anyway because it can be so very stressful on the older pups to go to the vet as often as most cush pups need to. I chose to stop treating my Squirt at age 15...she was 1/2 Cairn and 1/2 LH Chi. She lived another year and few months and passed WITH Cushing's not from it...she died from dementia and old age.

It is your choice and you know your baby boy and your situation better than anyone. Any decision you make will be made from a place of love...and you can't go wrong there. :) No matter what you decide, we will be here to walk this journey by your side.

Hugs,
Leslie