Re: Please help - bad reaction with Trilo - don't know what to do next?
It would be very very important given the symptoms you see of Cushings to test Melly for Atypical Cushings, which is done with the University of Tennessee Panel.
Cortisol is not the only hormone that, when elevated, can cause Cushings symptoms. These other hormones are the cause of atypical Cushings. And as some have mentioned, Trilostane is contraindicated when some of these hormones are the cause of Cushings symptoms.
If it isn't truly cortisol that's elevated, then the Trilostane could be taking her cortisol too low AND increasing the hormone that is causing her symptoms so making the Cushings symptoms worse while also giving her Addison's disease (too low cortisol) which is far more miserable to live with than Cushings .
I can hear your frustration as I imagine you feel like finally you know what's going on with your dog and now we are telling you to hold off treating it.
The thing is... no damage will come to Melly from typical or atypical Cushings disease if you wait a week or two to do more testing so you're sure.
I know you love Melly deeply and want what's best for her - why not KNOW it's Cushings disease instead of being even 99% sure it is. And also KNOW what hormones are causing it so you know how best to treat it?
Is Melly still taking pred?
How is she doing?
If she's still on pred and she's doing well, almost certainly her own cortisol production remains suppressed - the opposite of Cushings.
If she's still on pred and she's starving and thirsty and panting worse than ever before, she most likely has normal or excess cortisol production of her own.
I'm sorry if we seem pushy or critical or skeptical of your vet or you... none of which is intentional. It's just that after you've been on a forum like this for a few years, you have seen a lot of misdiagnosed dogs who never ever had Cushings and who were sent into Addison's disease by being treated for something they didn't have.
Your vet should be more than happy to run the UTK panel to be sure about Melly.
Hope you have a very productive meeting and I hope you will forgive us if we are ranting a bit - it is only out of concern...
Natalie
It would be very very important given the symptoms you see of Cushings to test Melly for Atypical Cushings, which is done with the University of Tennessee Panel.
Cortisol is not the only hormone that, when elevated, can cause Cushings symptoms. These other hormones are the cause of atypical Cushings. And as some have mentioned, Trilostane is contraindicated when some of these hormones are the cause of Cushings symptoms.
If it isn't truly cortisol that's elevated, then the Trilostane could be taking her cortisol too low AND increasing the hormone that is causing her symptoms so making the Cushings symptoms worse while also giving her Addison's disease (too low cortisol) which is far more miserable to live with than Cushings .
I can hear your frustration as I imagine you feel like finally you know what's going on with your dog and now we are telling you to hold off treating it.
The thing is... no damage will come to Melly from typical or atypical Cushings disease if you wait a week or two to do more testing so you're sure.
I know you love Melly deeply and want what's best for her - why not KNOW it's Cushings disease instead of being even 99% sure it is. And also KNOW what hormones are causing it so you know how best to treat it?
Is Melly still taking pred?
How is she doing?
If she's still on pred and she's doing well, almost certainly her own cortisol production remains suppressed - the opposite of Cushings.
If she's still on pred and she's starving and thirsty and panting worse than ever before, she most likely has normal or excess cortisol production of her own.
I'm sorry if we seem pushy or critical or skeptical of your vet or you... none of which is intentional. It's just that after you've been on a forum like this for a few years, you have seen a lot of misdiagnosed dogs who never ever had Cushings and who were sent into Addison's disease by being treated for something they didn't have.
Your vet should be more than happy to run the UTK panel to be sure about Melly.
Hope you have a very productive meeting and I hope you will forgive us if we are ranting a bit - it is only out of concern...
Natalie
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