Why are my dog's Cushing's symptoms getting worse on Vetoryl?

Hi there! Normally, if a dog being treated for Cushing's disease is still drinking and urinating excessively, this is an indication that her Vetoryl dose may need to be adjusted. We calculate a starting dose based on weight, but many dogs need further adjustments from there depending on how they respond to the medication. I would recommend calling your vet to discuss this. He/she will likely recommend bringing Ali back in for an ACTH stim test to check her cortisol levels, which will help guide the decision about whether to change her Vetoryl dose.

If Holly is not improving clinically, she might need to be tested again (ACTH stimulation test) to make sure the dose of Vetoryl is the correct one for her. Usually the blood test has to be done 10-14 days after the treatment has started, 4 to 6 hrs after Vetoryl administration. Please post again on the forum if you would like to discuss it further. I hope my answer was helpful.

I would not expect the signs you are describing to be secondary to the Vetoryl and I would not recommend stopping the medication without talking to your veterinarian first. Unfortunately there are not many safe alternative treatments for Cushing’s disease. I would be concerned that Boots might be showing signs of pain or potentially neurologic disease. It would be a good idea to have your vet examine him and to discuss these concerns.

Hello. For the most part, Vetoryl is used to control the symptoms of Cushing's by controlling the production of glucocorticoids. Overproduction of glucocorticoids is responsible for the symptoms of excessive drinking & urination but does nothing for the actual tumor growing on his pituitary gland. If Izzy's symptoms are manageable & tolerable then medication is not necessary. This would be your choice. But if his symptoms do get worse, at least consider once a day dosing. Most dogs do very well on twice daily dosing, but once a day can help in many pets. Thanks for using Petco Pet Education Center, formerly Petcoach.

My biggest concern is that your vet is talking about hyperadrenocorticism also known as Cushing's disease. This is what I think of when you discuss those symptoms, liver enzyme elevations and adrenal issues. Cushings is where they produce too much cortisol in their system. You can do a test to rule this in or out. You can have your vet do a low dose dexamethasone test OR a ACTH stimulation test. If it comes up positive then you can treat with the disease with a daily medicine called trilostane to help the symptoms. But you cannot cure cushings. I hope this helps and will help guide you in a conversation with your vet if this is actually what your vet thinks is going on.

Vetoryl (trilostane) is the best medication for managing Cushing's disease, but I'm sorry to hear that Lacy has not been tolerating it well. I have anecdotally heard of some vets using a variety of supplements for managing Cushing's disease signs, but these supplements will not ultimately decrease the cortisol production by the adrenal glands and generally seem ineffective. I don't know how long Lacy was receiving Vetoryl, but some dogs can initially become lethargic, vomit, have diarrhea, or a decreased appetite. Fortunately, these signs typically resolve after a few days to a few weeks on the medication. It may be worth discussing a temporary dose adjustment with Lacy's vet to see if she tolerates a lower dose better before gradually increasing to her 30mg dose. Some dogs also benefit from supportive measures (anti nausea medications, bland diets, etc.) in the first few days to weeks of treatment. I hope this helps and that all goes well!

Hi there! You are correct that Cushing's disease would be a common cause of the symptoms you are describing in an older dog (excessive panting, weight gain, and drinking/urinating more than normal) - however, there are also other illnesses that could cause this, so diagnostic testing would be needed as a first step to find out if Cushing's disease is even the problem or not. It would be EXTREMELY unsafe to start Vetoryl or any other medication for this condition without even knowing for sure if Tily has it, since these meds would be very dangerous for a dog to take if they weren't needed, and close monitoring of cortisol levels is needed for dogs who are on medication for Cushing's disease because if the dosing isn't right they can get very sick or even die. So this would be a problem that you would need to work closely with your veterinarian to diagnose and treat safely - it's not something you can do yourself at home, just based on guessing. If taking Tily to the vet is difficult for you, I would suggest calling around to some local clinics to see if there is anyone in your area who does house call visits. A mobile veterinarian could examine Tily and take the required lab samples (usually blood and urine testing, as a starting point), and then go from there depending on what is found.