Midge - Cushings + other problems - help please

[Mel B]

Re: Midge - Cushings + other problems - help please

Hi Glynda

Some more info:

Midge had the classic symptoms/appearance: excessive drinking and urination, voracious appetite, panting, pot bellied appearance (he'd always been 'rotund'). He had always been a nibbler of his legs too. He had the ACTH stim tests done around 4-5 hours after his dosing each time (as recommended). He didn't have an ultrasound performed, not sure about the Dex test ... At the time he was having loads of testing done he was an extremely unhappy chappy, in a lot of discomfort with his foot infection, so the vet kept it to the minimum to prevent stressing him out too much.

He was only tested for Cushings after many different types of antibiotic were tried to sort out the problem. Once he was diagnosed he was put on Vetoryl 30mg from the off and the dose was never altered as we were told the lab said it had 'excellent control' at that dosage.

Anaemia - The vet and I suspect the cause of this is due to his immune system being under strain with the infection and suspected liver failure, plus his lack of appetite which therefore meant he wasn't getting the nutrients he needed, it was a downward spiral which we had to stop, hence our current removal of the Vetoryl. I don't have any more test results info so I'll have to go back to the vet for that.

Midge is better than he was on the Vetoryl but obviously he's not 'cured'. He's eating normally, pottering a little more, and seems more content generally. His skin lesions are not as angry and are much much drier, his sweating has lessened, he's quite relaxed. He's not getting the horrible ear infections now which were pretty constant. He's happier and that is what matters, whether he's got a week, a month, or a year, so long as he's feeling better that it what is important, quality rather than quantity of life.

The question is - does anyone have any ideas on where we go from here/what to do? If he continues to get better should we consider putting him back on the Vetoryl?

[Mel B]

Re: Midge - Cushings + other problems - help please

Hi again

Midge is still doing well and feeling a lot better, he's drinking but not excessively now, and he's eating like it's going out of fashion! He's much more alert, his hearing has improved no-end and his feet are almost back to normal - his pads look like pads again, and his legs, despite still being very blotchy/black hardly have any yeasty stuff on them at all. His tummy is a lot better and gets very little yeasty stuff on now, even when he sweats. He does get warm though. He's happy to get up out of his bed without encouragement, pottering from room to room if he thinks there's a chance of a 'treat'. The problem is that I don't know if this renewed interest in food is a good or bad thing.

We're still in a quandary of what to do next ... has anyone got any experience of giving Vetoryl (Trilo.) once every couple of days, rather than daily? It would be great to hear if this has helped or caused problems. He weighs around 9kgs at the moment and was prescribed 30mg a day but after the way he was zonked out, lethargic and unwilling to eat I'm very reluctant to put him back on it daily in case he declines and/or gets anaemic again. I've partly got my 'little boy' back now and I don't want to 'lose; him again if I can help it.

[BestBuddy]

Re: Midge - Cushings + other problems - help please

Hi,

One of the last resort options for my Buddy when he was having problems with trilo was to consider dosing every two days. This is definitley not normal but I do believe there have been at least one of our members do it this way.

My specialist said that he had at least two dogs on strange trilo dosing, I think one was every 48hours and one was every 36hrs. I trusted the doc. and would have given this a try because the worst (in my mind) that could happen was that it wouldn't control the cortisol and the next ACTH would have told us so.

I do think that with trilo being newer that there is a lot to learn about but like all newish drugs it takes many years before we can truly understand how it works.

Jenny

[AlisonandMia]

Re: Midge - Cushings + other problems - help please

Sometimes we do see dogs on Trilostane being dosed on alternate days and similar arrangements but it isn't done very often and doesn't seem to be a successful regime long-term - and I've never seen it recommended or even discussed in any research or dosing information.

Vetoryl is available in 10mg capsules and these may be useful in allowing you to use a lower daily dose which would have to be preferable to giving what looks like a too-big dose every few days and hoping it works out ok. I've heard someone in the UK say that their vet didn't want to stock it (10mg size), possibly for commercial reasons. The 10mg dose hasn't been on the market that long and some vets may not be aware that it is available, either and thus believe they are stuck with trying to work something out using 30 mg caps. I don't know how the prescription/supply system for veterinary meds in the UK works but I'm pretty sure that even if your vet doesn't want to carry 10mg Vetoryl caps you should be able to obtain them somehow (with a script, of course.)

Here's a link to Dechra's info on the 10mg cap: http://www.dechra-eu.com/downloadfil...tDataSheet.pdf

And a link to the Vetoryl product info page on Dechra's site: http://www.dechra-eu.com/viewproductdetails.asp?ID=89

Alison