Printable View
Dr. Plunkett talked to the Internal Medicine specialist, Dr. Sue Kimmel. She said to stop the Vetoryl and she wants to see him. The earliest appointment available is May 9, but they will call me if she has a cancellation. Plunkett is supposed to send her all his test results. They are located at the Emergency Clinic where Lee died...I hate going there.
Given that low baseline cortisol reading, I really can’t argue with another vacation from the Vetoryl. How about the thyroid medication — are you leaving that at the same level until you see Dr. Kimmel?
I’m really sorry that things have gotten so confusing, Joan. I can imagine how upsetting it is to see Gable continuing to be bothered by these symptoms when the answers are not obvious. I also totally understand your feelings about returning to the specialty clinic. It has to bring back a lot of painful memories :-(((. But it sounds as though it’s time to let a specialist directly eyeball Gable in order to get a better handle on things. So I’ll be hoping maybe the visit can be moved up so you don’t have to stay in limbo for so long.
Hang in there, girl. I know it’s hard, so you’ve got us walking right there alongside you...
Hi Joan Oh man I'm really sorry that Gable is going through all these problems.
I always think it is so much trickier when trying to deal with two issues like with Gables thyroid and cushings. You really are doing a great job you know.
Hugs
Thank you, Sharlene...
I am hoping that we just started him back on the Vetoryl too soon after the over suppression of Thyroid meds. He'll be off for a month now, so maybe things will settle down. He was doing so well and looking so awesome, I just can't believe how he just crashed. So far his fur still looks amazing, but he's drinking so much and panting so much that I just want to scream.
But I am so happy to see you!
what dose of vertroyl is he on? I thought it was a pretty low one but maybe it needs to be an even lower dose with the thyroid meds in his system too
10mg a day, but he was still so symptomatic. He was doing so well on 40, then BOOM! I noticed an increase in drinking and then saw something that Glynda put on about the pre pill testing that I was doing with Gable, not noting the reserved cortisol, just the resting. So I had them do an ACTH test and it was way low. We stopped the Vetoryl for a few weeks, tested again and it was rising, so put him on the 10mg a day. They said to give him one thyroid pill in the morning and one at night, but I was so freaked out about it that I only gave him one a day.
I have noticed that the lump in his neck, that Plunkett took a sample of last year, I think and said was just a cyst, is now about the size of a tangerine. I don't know if that has to do with anything, but I agree with Marianne that it's time to see a specialist. It's weird...it's the same one I had made an appointment to see the day that Lena died. I just wish we didn't have to wait so long.
I'm back to watching, waiting, not sleeping at night because I'm listening to see if he has to go out. I was so happy that he was doing so good. We all noticed around Xmas how good he looked and seemed. he had a waist, had lost about 10 pounds and was playing again. He doesn't have anymore bare patches, his fur came back so beautiful, and his tail is like a fan. We never noticed it before...and he's got so much fur that we can't see the skin on his belly! He's not shedding either.
I just don't get it, Sharlene...I really thought it would be a different outcome this time. I hate to leave him and commute to the city and I know he feels better when I'm home.
I miss Lena every single day and I don't want to lose him, too. it will be a year in May since he started on the Vetoryl. I was resistant to treat, but Marianne was right that his case was different than Lena's, and I do believe that putting him on meds was the right thing to do.
But now I'm afraid again...
Hi Joan,
I wanted to help you not be so concerned about the ACTH test results. You say they were "way low" but that is not true. The ranges these labs use when performing the ACTH do NOT take into consideration whether the dog is on treatment or not. SO their ranges are always for untreated cush pups/dogs who do not have Cushing's or Addisons. So these results -
[quote]Sample 1 is 0.5 (LOW) ref range 1.0 - 5.0
Sample 2 is 3.5 (LOW) ref range 8.0 - 17.0[quote]
are not bad OTHER than the pre - which is too low. The post of 3.5 ug/dl is PERFECT for a dog on Trilostane. Remember, the normal range for a pup on Vetoryl (Trilostane) is 1.45- 9.1 ug/dl....that 9.1 is ONLY if all signs are good however. IF the dog is still showing signs at 9.1 then the dose needs to be increased a little bit to get it down to around 5.4ug/dl. Not all dogs respond the same therefore Dechra has provided a little leeway with that post. But Gable's POST is perfect...the PRE is not so I also agree with stopping the med for a bit. Here is a quote from Dechra about the ACTH results -
https://www.dechra-us.com/therapy-ar...oring-cushingsQuote:
A positive response to the administration of VETORYL Capsules will manifest as an improvement in clinical signs and post-ACTH serum cortisol concentration between 1.45 - 9.1 μg/dL (4-6 hours after dosing with food).
Hang in there!
Hugs,
Leslie
Thanks, Leslie...Marianne said the same thing, but his return of symptoms is making me nuts!
Joan, does it seem that his thirst/urination increase towards the evening? If so, an option could be to split the 10 mg Vetoryl dose into 5 mg twice a day to get an even control of that cortisol.
He's off the Vetoryl until he sees the specialist, Lori...May 9.