Pet Lovers

[goldensrbest]

Have you checked walmart?

[m0rgan]

I have had two dogs with addisons and give them fludrocortisone that I buy from Walgreens for about $60.00 for 180 tablets.  Percorten wasn't available when my first dog was diagnosed so we did the fludro.  When my second dog was diagnosed, by me since I knew the signs, the vet recommended percorten but I decided I wanted to stay with fludro and he agreed that I could.  I give her two 0.1 mg pills, one at breakfast and one at dinner and she has been fine.  No relapses which my neighbor had with her dog.  When you think about a once a month shot which starts to wear off at some period in that month and 1 pill twice a day which keeps everything even all month long, no spikes or dips.  I know vets like percorten but is that because of $$$ or best for the dog?  My dog is between 17-18 lbs. so depending on your dog's size you may need more or less than mine.  I wouldn't begin to tell someone else what to do but here's my experience with not one but two dogs with addisons.  Good luck.

[CamilleP]

Morgan, it's quite possible that both your dogs are doing well on fludrocortisone, but there is one common drawback to the drug.  Since it acts as both an aldosterone substitute and a cortisol substitute, it can take, essentially, an overdose of the cortisol function to provide an adequate aldosterone substitute level.  Overdosing cortisol-like compounds for a very long term, as is needed in treating Addison's, can damage the dog's liver and muscle tone.  For some dogs, though, Fludrocortisone works better than Percorten, and if a vet cannot titrate a good dose of Percorten that keeps the electrolytes balanced for a full 28 day cycle, then Fludrocortisone is certainly worth a shot. 

As an aside, the way Percorten is administered, intra-muscularly, and the form in which it comes, a suspension of crystals in a carrier liquid, allows the drug to slowly migrate into the bloodstream over time, as the crystals dissolve, bit by bit, into the bloodstream.  That is why it is absolutely critical that Percorten be stored properly, at the correct temperature, and be thoroughly mixed in the vial before the dose is drawn up into the syringe, so that the dose is actually correct.  A fair percentage of Percorten "failures" are probably due to improper storage (NEVER in a refrigerator or freezer) or inadequate shaking of the drug, so that the suspension of the crystals is as homogenous as humanly possible.

[m0rgan]

@CamilleP 

What you described is way over my head but all I know is it works so far for my dogs.  My last one died at one week before he would be 15 from a spleenatic tumor.  My other dog which I still have now is 14 1/2 and doing well.  I realize, just like in humans, one medicine does not work for all.  My point was that there are alternatives and @ellaphant should check with her vet.  I do appreciate your message because if fludro stops working for my dog I will definitely check out percorten with my vet.  He wanted me to give prednisone but we don't have to.  Your message makes me think I am lucky to have a simple solution that others may not.  Thank you.

[CamilleP]

Morgan, you were totally correct to refuse prednisone, that would have been a definite overdose of cortisol replacement hormone.  You are indeed lucky that your dogs both did or are doing well on Fludrocortisone, it is not normally the ideal drug, since you can't seperate out the two different hormone replacement drugs to dose them individually.  Some dogs, however, seem to need far more cortisol replacement than others, and for them, Fludrocortisone can be the perfect drug. 

[lynbeechwood]

My beloved dog passed away 2 years ago from Addisons complications. I wish I knew about the pill (possible) option. To this day I struggle with the memory of watching my favorite boy decline- going to the vet repeatedly-- doing the percorten every 25-30 days- its such a difficult disease to manage.

 Its not that I didn't trust the vet because they were the ones who put the symptoms together and diagnosed the Addisons- but I just felt that the Percorten was less and less effective over time. Also so expensive. I was able to have a vial last about 2-3 treatments due to the fact that my poodle was small. But Geez- your dogs life depends on getting this drug. Prayers to all that are going thru this difficult diagnosis--I currently have a little female poodle with Cushings Disease and hope that I am able to keep her quality of life stable.

[m0rgan]

What is the treatment for Cushings?  I thank God every day that Casey is managed with fludrocortisone especially since @CamilleP wrote what she did.  I know I am very fortunate and hope all remains the same.  I am really very curious about Cushings treatment.

[CamilleP]

Odds are that most Cushing's cases are managed with Trilostane these days, it is an oral drug that interrupts the cortisol synthesis cycle in the adrenal glands.  That presumes that the dog has Typical Cushing's.  If it's Iatrogenic Cushing's, then the treatment would be to gradually wean the dog off of the prescribed prednisone and hope the damage was not so severe that the dog's liver could not recover from it.  If it was Atypical Cushing's, then the treatment would be a couple of different compounds, usually melatonin and lignans.  My dog was made Addisonian by the adminstration of an older compound, Lysodren, that was the normal drug before Trilostane was approved for use in the USA by the FDA.  Lysodren was a much more dangerous drug because it worked by literally destroying adrenal tissue, and different dogs reacted differently to the same dose.  For my dog, the doses of Lysodren the endocrinologist from the vet school gave her were far too high, and her adrenal glands were completely destroyed.