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I have a maltese who was diagnosed with Cushings Syndrome in…

I have a maltese...

I have a maltese who was diagnosed with Cushings Syndrome in 2016 and has been taking vetroyl 90mg since. He has been over weight but recently started losing weight. I stopped the med for 3 days but when the vet repeated the acth they said it was normal and revommend that i but him back on the meds. I am concerned because now he has stopped eating, shovers and barely drinking fluids. I

Veterinarian's Assistant: I'm sorry to hear that. Is there anything else important you think the Veterinarian should know about the dog?

He was given a med to increase his appetite but I don't know how long I can wait. I feel like I'm watching him die one day at a time. His labs in May and Sept were both normal. The doctor is recommening xrays and IV therapy which is costing me hundreds. I don't mind if i know he will live.

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Answered in 2 minutes by:
11/21/2017
Dr B
Dr B, Veterinarian
Category: Dog
Satisfied Customers: 2,352
Experience: DVM
Verified

HI this is DRB and I would be happy to help you with this.....

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If your dog is not eating, then the vetoryl should be stopped until the appetite comes back and then talk with your vet about a lower dose....cushings will not kill your dog but vetoryl sure can if over supplemented....

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I am standing by for questions...

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Just so you know this question will stay open for several days and you can come back for several days and ask me other questions without additional charges. I will be retiring soon because I have a very early surgery, but feel free to leave any questions you may have here and I will get back to you by tomorrow night. Sincerely, DRB

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Customer reply replied 6 months ago
I dropped his dose from 90 to 30 mg. I was tsking a 60mg pill in the am snd 30 mg in the pm but most days only got 60mg. In oct the stim test was norm and i went back to just 30mg daily even though the vet recommend that i restart his full dose. I did mention that i was not consistent with the 90 mg. But i feel like it is the med that has made him worse and now i can't even get him to eat table food which he loves. Hes also barely drinking water and shivers.
Customer reply replied 6 months ago
He last ate well early last week. Hes eaten one or two crackers but i can't get him to eat any protein.

As I said, I would stop the vetoryl for now....did your vet do complete blood work with the stim test?

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Customer reply replied 6 months ago
in Oct. She said it was normal

your vet should have you stop the vetoryl and give your dog some appetite stimulant and worry about restarting vetroyl later...if that does not work then I would do abdominal ultrasound....

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Hold on a sec....

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Most common side effects of Trilostane include: (vetoryl)

  • Reduced appetite.
  • Vomiting.
  • Diarrhea or loose stool.
  • Lethargy/dullness.
  • Weakness.
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it sounds like your dog's adrenal glands are too suppressed right now...like I said Cushings disease will not kill your dog overnight but adrenal suppression can....

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If he were my patient I would stop veteroyl and give a little prednisone for a little bit....

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vetoryl can always be restarted at lower dose when he is feeling better......

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Just so you know this question will stay open for several days and you can come back for several days and ask me other questions without additional charges. I will be retiring soon because I have a very early surgery, but feel free to leave any questions you may have here and I will get back to you by tomorrow night. Sincerely, DRB

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Your dog probably will not eat until vetoryl totally out of his system.....take care and let me know if you need additional help..I will check my computer tomorrow...

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Customer reply replied 6 months ago
Ok. I will hold off on thevetroyl. I gave him one dose today and yesterday. How long can he go without eating? Ivr been trying to get him to drink water or Gatorade. The vet prescribed mortazapine 7.5mg to help increase his appetite. Should i take him in for Iv hydration?
Customer reply replied 6 months ago
His cortisol baseline was2.4 and post acth was 1.9ug/dl

I would definitely take your dog in for IV fluid therapy, yes....and you need to have a talk with your vet.....your vet should have recommended stopping the vetoryl until your dogs appetite came back......

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Customer reply replied 6 months ago
His amylse, calcium and Alkp were rlevsted. Urine pos - uti

It does not matter what your dogs stim test was...if he is not eating we have to figure out why and we cannot until vetoryl is stopped....then if his appetite does not come back that means something else is wrong..I hope that makes sense...

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We have an anorectic patient and that takes precedence over all else...

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We have to treat the patient, not the lab results...

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Can I answer any other questions?

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I am retiring now, but feel free to leave any additional thoughts or questions here....DRB

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Customer reply replied 6 months ago
that makes since. Any do you jave any other remedies or recommendations for increasing his appetite?
Customer reply replied 6 months ago
I thank you for your communication.

Personally I would ask your vet for a low low dose of pred for a few days...

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That works best when anorexia associated with vetoryl...

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I sincerely ***** ***** I have helped you, and that I have earned my 5 star rating today! Please remember to rate my service by selecting the 5 stars at the top of the screen (rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know.

Please remember my answers do not replace or supersede the advice of your veterinarian as my answers do not create a valid client patient relationship as I am unable to examine your pet. Thank you very much! DrB

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I am back online tomorrow night.....and even if you rate me this question will not close for several days.....DRB

Dr B
Dr B, Veterinarian
Category: Dog
Satisfied Customers: 2,352
Experience: DVM
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Customer reply replied 6 months ago
Ok, much appreciated! Good night
Customer reply replied 6 months ago
Hello Dr B. My dog had xrays today that were normal. He does have an ear infection but still not eating. Dr. Has provided another med to increase his appetite. Cortisol test was normal so he doesn't have Addisons.

Even if he does not have addison's it does not mean that vetoryl is not lowering his appetite.....there is something that is being missed.....

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Customer reply replied 6 months ago
I agree. I havent restarted the med. Just praying his appetite will improve at this point if not he will probably die.

If he is that sick get your vet to put him on IV fluids and do an abdominal ultrasound....

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Customer reply replied 6 months ago
that may be the next steps. I will see how he does over the next two days. Thank you for your responses and recommendation

sure. let me know if you need additional help...DRB

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Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr B
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Customer reply replied 5 months ago
Hello Dr. B. Sorry but i am just receiving your message. My maltese had dental cleaning and five extractions on monday. I am praying this was the reason for him not eating but he's still not eating. Its been over two weeks. Im conerned. He seems a bit stronger. No longer shivering. Hes on doxycycline and med to increase his appetite. I has resorted to force feeding him puppy milk since he wont eat. He has been tolerating ok. Hes only drinking water in limited amounts. If he doesnt start eating the doctor is recommending and internist and ultrasound.
Customer reply replied 5 months ago
He did receive iv fluids before and after his dental work. His HR dropped to 20 during the procedure and they had to give epinephrine
Customer reply replied 5 months ago
Hes still not himself. Not barking or eating. Stays in one spot for most of the day unless i pick him up or take him outside to urinate

Has anyone run a cortisol level on him?

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Customer reply replied 5 months ago
Hello Dr. B, He's had two levels drawn. One on Oct 18th was 2.4. Post ACTH was 1.9 and the other on Nov 21st was 2.9.
The doc said it was normal so no prednisone.

ok, good I am glad they did that....have they figured out anything else yet?

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Customer reply replied 5 months ago
Hello Dr. B. Thanks for your support over the past two
weeks. My dog transitioned last night at 9:30 peacefully. Im very sad but glad that he's no longer suffering.

You are certainly welcome and I am very sorry for your loss......let me know if you need anything else....

DRB

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Customer reply replied 5 months ago
Thank you!

sure thing...take care....

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Dr B
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