Trilostane for dogs can be an effective medication for treating Cushing’s disease. It has the potential to greatly improve a dog’s quality of life. Integrative veterinarian Dr. Julie Buzby explains what Trilostane is, how it works, and what you need to know about giving it to your dog.
Trilostane is a medication used for treatment of Cushing’s disease in dogs. Diagnosis and treatment of this condition may seem confusing and arduous, but you and your veterinarian can work together to come up with a plan to make sure your dog is happy and healthy.
This was the case for one of my newer patients, Zoey.
How Trilostane helped a dog with Cushing’s
I recently met Zoey, an 8-year-old Standard Poodle. Her dog mom had just moved to town and made an appointment with me to get established as Zoey’s new vet.
In the exam room, I immediately noted a few things about my Poodle patient. She had a pot-belly, was mildly overweight, and she didn’t have the typical beautiful, curly Poodle hair. Instead, some patches of her coat looked thin and rough.
Zoey’s mom told me that her dog had been diagnosed with Cushing’s disease about six months prior. At that time, she’d opted to monitor her beloved dog instead of pursuing treatment. However, now Zoey’s mom was wondering if she’d made the right decision. Her dear dog was not as “glamorous” as she was even a few months ago, and she was spending a lot of time at her water bowl.
My client’s stress was evident. However, the worry turned to relief when I assured her that it wasn’t too late to consider treatment for her dog. Then I went on to explain that we could consider starting Zoey on a medication called Trilostane to help manage her Cushing’s.
Many of my Cushingoid patients have improved tremendously on Trilostane. Let’s take a closer look at what Trilostane is and how it can help dogs with Cushing’s disease.
What is Trilostane for dogs?
Veterinarians most commonly use the medication Trilostane to treat Cushing’s disease in dogs. You may also hear Trilostane referred to by its brand name, Vetoryl®. It is currently the only FDA approved medication for treatment of both pituitary dependent and adrenal dependent Cushing’s in dogs.
What is Cushing’s disease?
Let’s take a step back and talk about Cushing’s disease (also known as hyperadrenocorticism). Dogs with this condition have excess amounts of cortisol (a stress hormone) circulating in their bodies. This occurs for three main reasons:
- A tumor in the pituitary gland (in the brain) signals the adrenal glands (located near the kidneys) to produce excessive cortisol. This is called “pituitary dependent hyperadrenocorticism” or PDH.
- An adrenal gland tumor is producing too much cortisol. This is known as “adrenal dependent hyperadrenocorticism” or ADH.
- Taking steroids such as prednisone for dogs can induce a condition called “iatrogenic hyperadrenocorticism.”
Cushing’s disease often causes increased thirst in dogs and thus increased urination. Although this may initially raise concerns for other conditions, such as diabetes mellitus, there are a few notable distinctions. Cushingoid dogs may also have a poor haircoat, pot-bellied appearance, and pant excessively.
How does Trilostane help dogs with Cushing’s disease?
In dogs with Cushing’s disease, there are three main treatment options: medication, surgical removal of the adrenal gland, and radiation therapy. (To learn more about radiation therapy for Cushing’s, check out an article on the effects of radiation on large pituitary tumors which was published in The Canadian Veterinary Journal).
When it comes to medical therapy, Trilostane is the most common drug of choice for treatment of hyperadrenocorticism. This is partly because it has been shown to be effective for both pituitary-dependent (PDH) and adrenal-dependent hyperadrenocorticism (ADH).
Trilostane, a synthetic steroid, works by inhibiting enzymes in the adrenal gland. In turn, this decreases the amount of cortisol the adrenal glands produce (and therefore the amount of circulating cortisol).
What is the Trilostane dosage for dogs?
Most commonly, veterinarians will prescribe Trilostane capsules that you can give your dog by mouth. Vetoryl (brand name Trilostane) comes in different size capsules including 5 mg, 10 mg, 30 mg, 60 mg, and 120 mg. Your vet will select the capsule size that is right for your dog’s weight and symptoms.
Veterinarians may alternatively suggest Trilostane in compounded form. This means that a pharmacy makes the drug into a different form or dosage. In this case, the pharmacy would make it into a tablet or liquid, which the dog would take by mouth. Having a liquid option can be helpful for dogs who don’t take pills well.
(As a side note, if you are struggling to get pills into your pup, check out my article on what to do if your dog won’t take pills.)
Typically, your vet will recommend daily dosing of the Trilostane (i.e. every 24 hours). However, there are some cases where your dog may need it twice a day. Your vet will decide what is right for your dog.
Dogs need to take Trilostane every day in order for it to work properly. It is a short-acting drug, which means that the effects of each dose only last for a brief period of time. Additionally, you should give Trilostane with food. It can cause nausea if given on an empty stomach.
Each dog and case of Cushing’s disease is different. Therefore, it is very important to work closely with your veterinarian and follow his or her directions when giving Trilostane to your dog.
Is compounded Trilostane effective?
Before we go any further, I want to briefly talk about compounded Trilostane. While it is usually safe and effective, some may think it might not work as well as Vetoryl. During compounding, the pharmacy will break down the Vetoryl capsule to make the new form.
Historically, some compound medications have not always been reliable. The good news is that as veterinary medicine has continued to advance, so have compounding practices. The efficacy of compounded Trilostane is not as much of a concern as it used to be.
For dogs who can’t or won’t take capsules, the compounded Trilostane liquid might be the only option. Also, compounded Trilostane can sometimes be more cost effective than brand name Vetoryl. This can be a way for a dog parent to provide Trilostane to their dog that they otherwise would find more difficult to afford.
If you prefer or need to have your dog’s Trilostane compounded, please discuss it with your veterinarian and only use a trusted pharmacy.
What if I miss a dose of my dog’s Trilostane?
In order for Trilostane to be most effective, it is important to give it on a regular schedule. This means giving it every day at the same time of day (usually in the morning).
However, sometimes accidents happen and you might forget a dose of Trilostane. In that case, you can typically give it to your dog as soon as you remember. However, if it is close to the time that the next dose is due, skip the missed dose and give the next dose at the regular time.
If you are unsure whether to give a dose, contact your veterinarian for advice.
How quickly does Trilostane work?
One of the great things about Trilostane therapy is that most pet owners see a difference in their dog’s behavior within one to two days. They may notice that their dog’s thirst and urination have returned to normal. Some dog parents also notice that their dogs seem to pant less often than before.
Vetoryl studies have indicated that cortisol levels begin to lower and return to normal within 14 days of starting the Vetoryl. So if your dog is taking Trilostane regularly, hopefully the Cushing’s symptoms will continue to improve.
That being said, every dog will respond to Trilostane differently. This means sometimes the positive effects of Trilostane may take a bit longer to show up.
What are the side effects of Trilostane for dogs?
Most dogs tolerate Trilostane fairly well. It is a fairly safe medication, as long as the veterinarian’s directions are followed closely. The most common side effect of using Trilostane for dogs is nausea. You can minimize this issue by giving Trilostane with food. Other common side effects may include:
- Decreased appetite
- A lethargic dog (decreased energy)
- Vomiting
- Diarrhea
- Weakness
Typically, dogs only experience these minor side effects during the first day or two of starting the medication. However, if they persist or worsen, please contact your veterinarian immediately.
Some dogs can be allergic to Trilostane. Signs of an allergic reaction include swelling of the face, difficulty breathing, or itching. If this happens, please call your veterinarian immediately and do not give any more Trilostane.
Serious side effects
Rarely, a dog taking too much Trilostane may experience an Addisonian crisis. Essentially, Addison’s disease in dogs (hypoadrenocorticism) is the opposite of Cushing’s disease (hyperadrenocorticism). Low circulating levels of cortisol and other hormones produced by the adrenal glands can make dogs very sick.
In rare cases, an Addisonian crisis may occur if Trilostane decreases cortisol production too much. Worst case, this can lead to destruction or rupture of the adrenal gland. This damage could cause your dog to go into shock, which can be life threatening.
Signs of an Addisonian crisis include:
- Severe lethargy
- Vomiting
- Diarrhea, sometimes even bloody diarrhea
- Collapse
- Confusion
- Pale/white gums
If you have any suspicion that your dog is experiencing an Addisonian crisis, please call your veterinarian immediately or head to the nearest emergency hospital for an emergency vet visit.
Are there precautions or drug interactions for Trilostane?
While I mentioned earlier that Trilostane is generally considered to be safe, there are a few situations where it should be avoided. First, Trilostane should not be used in dogs who are pregnant or nursing. Since Trilostane affects hormones, this could cause serious side effects for mom and puppies.
Also, Trilostane should be used with caution in cases of liver disease in dogs. This is because the liver is responsible for metabolizing Trilostane. If liver function is impaired, the drug will not be metabolized appropriately. Finally, dogs who are allergic to Trilostane should not take it either.
There are also some medications that your dog should not take at the same time as Trilostane. The drugs listed below can interact with Trilostane and cause serious side effects.
- ACE inhibitors—medications like enalapril or benazepril that vets may use to treat heart disease in dogs, hypertension in dogs (i.e. high blood pressure), or some kidney problems
- Potassium sparing diuretics—drugs like spironolactone that are also useful in heart disease treatment
- Potassium supplements
- Ketoconazole—an anti-fungal medication
- Aminoglutethimide— a medication sometimes used in dogs with PDH Cushing’s
- Mitotane—another drug used to treat Cushing’s disease
If your dog has been on any of these medications before, or is currently on them, please let your veterinarian know prior to starting Trilostane. It is important to tell your veterinarian about any other drugs, vitamins, or supplements that you are giving your dog to avoid possible interactions any time your dog is starting a new medication.
Does my dog need any special monitoring after starting Trilostane?
Since Trilostane affects hormone levels, regular monitoring is important in order to ensure that it is working properly and that the dog isn’t taking too high of a dose. Especially when first starting this medication, your dog may need frequent blood tests to figure out what the best dose is for him or her.
Usually, within 10 to 14 days of starting Trilostane, your vet will want to re-examine your dog to evaluate clinical signs. He or she will also typically perform an adrenocorticotripic hormone (ACTH) stimulation test at this time.
An ACTH stimulation test is also one of the tests your veterinarian may have used to initially diagnose your dog with Cushing’s disease. Although it may seem frustrating to repeat the same test multiple times, it is very important to ensure your dog is on the right medication dose.
Based on these test results, and control of clinical signs, your veterinarian can determine if the Trilostane is keeping the cortisol at the appropriate level.
If your veterinarian adjusts your dog’s Trilostane dose, he or she may recommend running another ACTH stimulation test 10 to 14 days later. This will probably happen after every dose adjustment. The last thing we want is to cause an Addisonian crisis by giving an inappropriate amount of Trilostane for your dog.
Also, if your dog begins to show any side effects or abnormal behavior, your veterinarian may also recommend an examination, ACTH stimulation test, and/or other possible diagnostics.
Once your dog is regulated on Trilostane and has been at a constant dose, your vet may recommend re-examination and retesting 30 days later, then 90 days later. After that, your vet may want to see your dog every three to six months for further monitoring.
This is one possible monitoring plan, but it is important to realize that your veterinarian may suggest a different test or testing schedule based on your dog’s clinical signs and Trilostane dosage. It is important to follow your veterinarian’s recommendations closely in order to ensure the Trilostane reaches its full potential for your dog while also being as safe as possible.
A Poodle’s happy ending
After discussing how Trilostane works, the cost, and the monitoring required, Zoey’s mom decided to pursue Trilostane treatment. I started her on the medication that day. Ten days later, I saw my Poodle patient for her first recheck exam and ACTH stimulation test. She was drinking normal amounts of water and seemed more relaxed. Her mom was thrilled that she was back to her old self again!
Zoey’s recheck showed that her cortisol levels were improving already. Her mom could not believe the difference the Trilostane was making. We kept Zoey on the same dose and continued to monitor her. With each recheck, the gorgeous Poodle was improving and her bloodwork was closer to normal. Both Zoey and her mom seemed so relieved!
Ask your vet about Trilostane for dogs
I understand that it can feel overwhelming when your dog is first diagnosed with Cushing’s disease. Facing the potential of life-long medication and periodic monitoring can seem daunting. This probably isn’t what you pictured for your dog.
However, I am here to tell you that there is still a lot of room for hope. Trilostane might be just the ticket to improve your dog’s quality of life (and indirectly yours, too).
I won’t pretend everything is sunshine and rainbows. Like any drug it does have the potential for some side effects. You do need to be able to commit time and money to daily medications and monitoring. But the benefits of it can be amazing.
Treatment with Trilostane can potentially give your dog more good years with you, which means more memories, more smiles, and more joy. So, if your dog has Cushing’s disease and you are on the fence about starting a medication, please have an open conversation with your vet about whether Trilostane (or a different medication) could be right for your dog.
Has your dog been treated with Trilostane for Cushing’s disease?
Please share your experiences below.
I recently read this great informative article about Cushing’s disease in dogs, and I have a question regarding my dog, who was recently diagnosed with the condition…
She had been gaining weight, which prompted a visit to the vet. An ultrasound revealed an enlarged liver, and subsequent blood tests showed elevated cortisol levels, with an ALP level of 2000 (normal range: 23-212), an ALT level of 155 (normal: 10-125), and a GGT level of 40 (normal: 0-11). She then did the test which confirmed the disease.
However, my vet is hesitant to start her on Vetoryl, suggesting that her liver is significantly damaged. While I understand the seriousness of her condition, I’m concerned that not initiating treatment could worsen her symptoms and shorten her life. I’ve learned that untreated Cushing’s can lead to serious complications, including muscle weakness, kidney failure, and diabetes and my dog is only 8.
From my research, it seems that high ALP levels and liver enlargement are common in dogs with Cushing’s, as a response to the disease itself. Could it be that her liver issues are reversible with appropriate treatment? Given that Cushing’s is not well understood in Belgium, I wonder if my vet may not be fully aware of the latest research.
Thank you for taking the time to read this, best regards
Hi Elizabeth,
I am sorry you are facing this difficult situation with your pup. I understand why you are conflicted about how to proceed and think it is great you are searching for additional information. Unfortunately, without personally examining your girl, it is hard to make specific conclusions and recommendations. It is possible the liver enlargement and elevated enzyme levels are due to Cushing’s, but your vet is also correct that this could be signs of another underlying issue that would make treatment very risky. Is there a specialist in your area of Belgium? If not, it may be possible for your vet to schedule a video consultation with an internal medicine specialist in another area or country. Hoping you can get the answers you need to feel confident with the treatment plan moving forward. Wishing you both the best and praying for healing for your sweet girl.
Hello- We just lost our almost 14 year old beautiful llasa apso rescue, Sophie, to cushings. We believe her demise was tied to Adequan injections. In November, her liver tests were a little above normal on Rimadyl.
She stopped taking that and had back leg pain. We were happy to take her down the steps etc in our arms.
Then her new vet had all these posters for Adequan when we walked in and how it would give her her mobility back. She immediately started losing weight and not eating on the shot regime. They said it wasn’t related. She started the shots in February and barely made it to May. We had to make the terrible decision to put her down. We are still very upset. Wendy
Dear Wendy,
I am so sorry for your loss of Sophie. While any medication can have negative side effects, I would be surprised if the Adequan caused this dramatic decline in your girl’s health. You mentioned her liver tests were a little above normal back in November. Were they ever rechecked to see if they continued to increase? Ultimately the reason for her failing health may never be clearly understood. But I am certain Sophie knew how much she was loved and that she lived a happy life by your side. Wishing you comfort and peace as you continue life’s journey. Bless you.
Hello, My dog has cushing’s disease. He takes 60 mgs of vetoryl. He is also on .4 mg of thryo-tabs. His number are good. Unfortunately he continues to pee a lot and drink a lot. He needs to go out every 6 hours. It is a lot of pee. I thought maybe has to much thyroid medicine. The doctor suggested to only give him one pill in the morning only. He was tested for diabetes, but that was negative. The next move would be to increase the vetoryl. Any suggestions?
Hi Deborah,
I am sorry your boy is still dealing with these extreme symptoms despite all the medications he is taking. Without playing a personal role in his medical care, it is hard to offer specific recommendations. Although I cannot explain it, I have had several readers say they have seen improvement after giving Vetoryl twice daily instead of once daily. So, in your case, if you gave your boy 30mg in the AM and 30mg in the PM it might work better than just giving the whole 60mg in the AM. Before making any changes to your dog’s medication dosage or schedule it needs to be discussed with your vet. I wouldn’t want to cause unwanted negative effects if it could be avoided. Hoping you can partner with your vet to find the best way to offer your pup relief. Wishing you both the best and keep up the good work!
thank you for your article. I find myself in a very confusing point in my dog’s care. she was diagnosed with liver failure, with bilirubin of 8.5 and severe jaundice. this was discovered after an emergency room visit, because she was vomiting bile and even vomiting water. after the emergency vet she continued to decline which is when our vet discovered the full failure. she was placed on cerenia, and entice because she wouldn’t eat. they also thought she had a gallbladder obstruction. she finally started to improve a little bit, and the vet gave her clavamox twice a day for a few weeks. we had a detailed ultrasound done that revealed there was no gallbladder blockage but a lot of sludge and gallbladder infection. she was kept on clavamox which she will be on for a total of 4 weeks, she no longer needs cerenia or entyce, and she started urosidiol and denamarin. however, they discovered a tumor on her adrenal gland during the ultrasound that we had no idea was there. I was told it was cancer, ultrasound was done by a veterinarian who specializes in ultrasounds of difficult cases. it’s very close to her vena cava I believe they said. it just hasn’t metastasized. I find myself very confused because I don’t really know what steps to take after this. she’s too sick to do any testing right now to confirm the type of tumor it is, but I’m starting to see the symptoms of cushing’s. she’s eating six to seven times a day which is benefiting her with the liver failure, drinking a lot, begging for food, urinating and having accidents, she seems off. overall she doesn’t seem like herself which is really depressing because I thought she would start to get back to normal. I really don’t know what to do about medication because if she’s in liver failure I don’t know how I can give her trilostane or anything else. I don’t know if the liver failure will reverse because I don’t even know what caused it. she had a dental about 2 months ago and had perfect lab work. I really don’t know what to do. she also has stage 3 murmur and heart valves that leak and is also recovering from gastroenteritis. this all came on suddenly I really still have no idea what this came from. she is also on a low fat diet for the rest of her life. I don’t want to put her on medication that will cause her harm, and I don’t want to deny her if it can improve her life. horrible thing to be going through. I do find myself on your website a lot more because you have a lot of articles that I’m trying to learn about our conditions so thank you for that.
Dear Sissy,
I am so sorry you are facing this extremely difficult situation with your senior girl. I understand your concern and wish I had advice or guidance to offer. From what you describe, it sounds like you are already doing everything you can to ensure your pup is comfortable and pain free. You may reach a point where it is time to focus on palliative care until more emotional choices have to be made. Hoping you can find the best way forward. Wishing you and your sweet girl peace.
My little Tilly was diagnosed with Cushing 5 years ago. She was first on the tablets and then moved to the trilostane. She is now 14 and although obviously the effects of Cushing is going to take its toll over that many years and she is now becoming deaf and blind we credit trilostane to her still being with us today. Still going for little walks and looking for a play with her toy once a day.
Hi Kareena,
I am glad Tilly seems to be doing so well with the Trilostane. What a blessing you have spent 14 wonderful years together. Thank you for sharing your story with us. Wishing you and your sweet girl many happy days ahead.
My dog Teddy was eventually diagnosed with Cushings a few months ago and prescribed Vetoryl. It’s working but the side affects mean he’s lost over 2kg from his healthy 10.7 and is lethargic All the time. All he does is sleep and has no energy. Is there any alternative as this is no life for the next 5 to 10 years ? I love him but he’s better off dead than sleeping on the couch All day every day.
Hi Barry,
I am sorry Teddy’s health is declining and I understand your concern. I wish I had some great advice but, without playing a personal role in his medical care, it is hard to make specific recommendations. Some dogs just don’t respond well to treatment or face these negative side effects. You know Teddy better than anyone and if you think saying goodbye is the most loving option, then I would encourage you to trust your intuition. I will attach links to other articles with more information and great advice from other readers. Hoping you can find the answers you need to navigate this difficult situation. Bless you and your sweet boy.
1. Using a Quality of Life Scale for Dogs
2. When To Euthanize A Dog With Cushing’s Disease: A Vet’s Advice
3. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
Dr. Buzby,
My 13 year old Crixus was diagnosed with PDH Cushing’s through clinical signs, ultrasound, and LDDS test just over a month ago. He was prescribed Vetoryl 60mg (His weight was 90lbs) and on day 5 of taking the medication he collapsed and died as soon as he hit the ground. My vet contacted Dechra who said it happens but they aren’t sure why. They surmise inability to regulate electrolytes and potassium goes sky high, stopping the heart. They offered a refund and said his case would be added to their database.
It was the most traumatic experience of my life as it happened in front of me. He walked 2 miles a day, ate food like normal, and was happy. Even the morning of his death, he was his normal self. He just was very thirsty and panted all the time. Also when he got nervous or scared, he would shake uncontrollably. Other than that, we did regular bloodwork and he was a happy healthy pup with lots of life left.
I am worried that this happens more than we think. I have been doing deep dives into forums online, and it is scary. I also have a video of his case circulating on socials and many people have sent me messages about the adverse reactions. My question is, in your experience, have you seen this happen before? Especially when he was only at 60% of the lowest recommended dose? Any insight is helpful as I would not wish this pain on anyone and and don’t want to see more pets lost because of this medication. Thank you.
Dear Rachael,
I am so sorry for your tragic and sudden loss of Crixus. I have never seen this before and was unaware this was a possibility! It kills me to know that companies are aware of potential issues like this and don’t disclose information upfront. I know there is nothing that can replace having your boy by your side, but knowing good can come from this tragedy offers a bit of hope. I am sure you telling others about Crixus’ story will have a big impact. Thank you for sharing your experience with us. May his memory be with you always and be a blessing in your life.
Wow! All these stories. We are certainly not alone but our story is at a very young age compared to most. Our little girl of only 1 1/2 years old was just diagnosed w/Cushings. We begin Vetoryl tomorrow morning. Certainly hoping for a good outcome. These success stories give us hope for this young
companion.
Hi Justin,
I hope the Vetoryl will help restore your pup’s quality of life and improve her health. Feel free to leave an update and let us know how things are going. Best wishes to you and your sweet girl.
Hello. My dog was just diagnosed with Cushings and she has been on 5 mg of Vetoryl for about 2 weeks. She is still drinking a lot water and not eating her meals, only treats. Our vet raised the dose to 10 mgs but then lowered it back to 5 mg because she that it was causing nausea. My dog also has diabetes and gets insulin twice a day. She is a 13 year old miniature schnauzer.
I’m so nervous about all of this. Do you have any suggestions? Thank you
Dear Lisa,
I understand your concern for your pup. Battling Cushing’s and diabetes at the same time is so difficult. My best advice is to consider a consultation with an internal medicine specialist. They have lots of experience dealing with complicated cases and can offer a wealth of knowledge on possible treatments and therapies to pursue. Hoping you can get the answers you need to ensure your girl remains happy and healthy. Bless you both.
My dog was diagnosed with Cushing’s because he was insulin resistant so he has diabetes as well. He is on a low dose 10mg twice a day rather than a higher once a day dose. That is what is recommended for diabetic dogs.
Hi Dr. Buzby,
Our 12-year old family pittie, Huckabee, was on prednisone and appeared to have developed Cushing’s disease after presenting with symptoms (excessive thirst and peeing) and confirmed Cushing’s by testing cortisol levels at the vet. He (60-lb dog) was put on 60 mg of Trilosten compounded and about 5 days later completely stopped showing interest in food. He has been off the Trilosten for about a week now but his appetite does not appear to have returned (he’ll just turn away from food, when he normally was excited to eat and loved treats etc.). We’ve been feeding him small amounts of liquid food through a syringe. Tomorrow, he is going to get a sonogram to see if he has any issues in his stomach and we’re also getting a surgery for a feeding tube for him.
I’m curious if there are any questions we should bring up with our vet to try and figure out how to help our sweet Huck. I’m not sure what caused him to lose his appetite (and he appears to be very weak and lethargic from not eating) but I would appreciate being able to get some ideas on how to help him. He is in otherwise great shape and typically has the energy of a puppy, loves walks and of course normally any and all meals.
Thank you so much!
Meg
Dear Meg,
My heart goes out to you as you face this emotional situation with Huckabee. I am so sorry he is experiencing these severe symptoms. I can only imagine how worried you must be. Without playing a personal role in his medical care it is hard to make specific recommendations. My best advice is to make sure you get a specialist involved if you are not already consulting with someone from internal medicine. They have tons of experience when it comes to managing complicated cases and may have ideas about testing or treatment that is not readily available in general practice. Hoping your sweet boy has been able to turn things around and is on the road to recovery. Feel free to leave an update if you have a chance.
My Lucy was diagnosed with Cushings in January 2023. She never had the pot belly or hair loss, but I noticed she was drinking a lot more. Prior vet said she was “totally surprised” that Lucy was ultimately diagnosed with Cushings. Lucy has been on Vetoryl (10 mg bid) since then. She had a couple of ACTH stim tests during that time, but then a new vet switched to a cortisol baseline test instead so her last stim test was in April 2023. The new vet also said she didn’t need to check it as often as the previous one wanted to. She now says it is fine to switch her to Trilostane (same 10 mg bid). I am a bit concerned about these two changes. Trilostane is WAY less expensive than Vetoryl and that would be a welcome change, but I don’t want to compromise Lucy’s care. Thank you for any words of advice!
Hi Diane,
I understand your concern for Lucy and think it is great you are being proactive with advocating for her health and well-being. Both of the changes you mention seem to be within the standard of care and are what I would do for my own patients. Vetoryl is Trilostane, it is just the name brand. Think of it like your doctor advising you to quit buying name brand Tylenol and just use the pharmacy brand acetaminophen to save money. They should work the same way because they are the same active ingredient and dosage. An ACTH stim test is needed to get a diagnosis of Cushing’s so you can see how the body reacts (or doesn’t) to the stimulation. Since we already know that Lucy has Cushing’s then it is ok to utilize baseline cortisol levels to monitor for changes in her condition. I hope this gives you some peace of mind but please don’t hesitate to discuss these concerns with your vet. Wishing you and your sweet girl all the best and keep up the good work.
Hi. My 7 year old Boston Terrier was diagnosed with Cushing’s about two months ago following the 4 and 8 hour dexo(?) test. However, she never had symptoms and still doesn’t. I just today finally got the nerve to give her the first dose of 20 mg of Trilostane because my vet said if I don’t I’m waiting on a “train wreck”. I’m scared to death because she is perfectly fine….never drinking much water, never over-peeing and not ravenous. What if I hurt her by giving her this pill today? Can someone help me?
Dear Debbie,
I understand your concern for your dog and think it is good you are reaching out for advice. Cushing’s is usually only treated to help control symptoms. If your dog is not experiencing any worrisome symptoms from this disease, I am not sure you will see much of a benefit from the treatment. I am curious though… if your dog is acting normally and has no symptoms then why did your vet pursue Cushing’s testing? What made them suspicious your dog had this disease? It sounds like you may need to reach out to your vet and ask some questions. They might be able to clear up some of the confusion and offer guidance on why treatment was recommended. Best wishes and good luck!
Thank you for your response. I’m really puzzled as to why he started Cushings treatment. He treated her all summer for a skin condition, took blood, and never mentioned Cushings. Four weeks ago she went in for another skin check and he said he drew blood and it was abnormal so the next week he did the four and eight hour test and it came back positive. Other than that, nothing that I’ve noticed at home. I told him just last week there were still no symptoms and he said I couldn’t just wait until she got bad. That’s why I never started the meds until today. He’s been my vet for 30 years and I have always trusted him completely so I gave her the Trilostane today. I’m now considering not giving her another one. I’m so confused.
Hi Debbie,
I wish I could be more help, but without playing a personal role in your dog’s medical care it is hard to make specific recommendations. If you are not comfortable with how things are being treated, it is always ok to seek a second opinion. You can even ask your vet for a referral or consultation with an internal medicine specialist. Most local specialists welcome phone calls from general practice veterinarians and will offer guidance with complicated cases. I saw your other three posts where you were asking why your comment was not visible on the website. The comments are not published until they are reviewed and answered. We get hundreds of comments each month and it can take a while to work through them. Luckily your comment from yesterday just happened to pop up while I was logged in and reviewing those that had been recently submitted. We do have some comments that are backlogged for a couple months, and it is quite a task to work through them all. That is also the reason for the disclaimer that this is not a telemedicine website and if a reader is needing prompt answers or medical advice, they should call their veterinarian. This forum is geared toward sharing experiences and offering support and empathy to others, but we do our best to address questions. Hoping you can find the answers you need to feel confident with how your dog’s case is being handled. Take care and give your sweet girl a hug for me. ♥
Hi, My nearly 13 year old dog was just diagnosed with Cushing’s. They also just found a large mass in her liver as well as her adrenal gland after conducting an ultrasound because her liver enzymes were all high. She has been presenting with many of the symptoms for cushings for a couple of months. Excessive drinking, ALWAYS looking for food, muscle and hair loss. She has, however lost quite a bit of weight as well. Her energy is still normal. The vet wants to put her on Trilostane (60mg). She is 53lbs. My fear is that I keep reading with liver problems – it isn’t good for them. Will this exacerbate her liver issues? Is there another Cushings medication that is not metabolized in the liver?
Hi Jennifer,
I am sorry your dog has received this difficult diagnosis and understand why you are concerned. Unfortunately, trilostane is the best treatment for this disease. It is important to note that Cushing’s alone can lead to liver issues due to the high levels of cortisol/steroids circulating in the body. So, it is hard to say how much of your dog’s liver problems are secondary to the Cushing’s and what is truly related to just liver dysfunction. It is possible that once Cushing’s treatment is started you will see an improvement in your dog’s liver function. Hoping your vet can find the best way to keep your girl happy and healthy for as long as possible. Best wishes to you both!
hi, my dog has the same problem, I wanted to know if her liver got better after starting the treatment?
hi Jennifer, I wanted to know if you ended up giving him vetoryl as I find myself in the same problem. An ultrasound revealed an enlarged liver, and blood tests showedn ALP level of 2000 (normal range: 23-212), an ALT level of 155 (normal: 10-125), and a GGT level of 40 (normal: 0-11). I wanted to know if you dog shared those 3 increased levels as well?
I have a 13 lb Maltese named Trinket. He got diagnosed this past summer with Cushing’s, and he is so young, only 6. He was having a lot of trouble with the medication, either it wasn’t helping at all or too strong. I.e. Addison’s symptoms. We started him back on the Vetoryl this past month. Well initially we started him on 6 mg 2x day (so 12 mg) compounded generic, then the vet changed it to 10 mg Vetoryl (5 mg 2x day) and he seems to have gotten worse. He was having what I call episodes, where he got restless, pacing with his back legs low, shakey and ravenously hungry. He had them a few times a week. Since changing the dose to 2 mg lower, it seems like this is happening every single night now. I’m wondering if that’s a sign that the medication dose is too low or if I should be patient to see if it works and wait til my next test which is in 10 days. I just hate seeing him this way. He’s also on melatonin. It feels so helpless right now like he’s never going to get better and he is so young. I feel stuck and I’m not sure what direction to go
Hi Lauren,
I am so sorry your boy is struggling, and I understand why you are concerned. I wish I could tell you what was best but without examining Trinket myself, it is hard to make specific recommendations. Please reach out to your vet and make sure they are aware of these worrisome symptoms you have noticed. They can let you know if they need to see your pup sooner or if waiting till the scheduled recheck is ok. Hoping you can get some answers and find the best way forward. Wishing you all the best and praying for a positive outcome.
Hi…my Poodle/Bichon mix Mr. B has been a tough case to diagnose. 1 ATCH test confirmed Cushings. I then took him to a top internist and that Stem test was negative. So a few weeks later she did a low dex test and Cushings was confirmed. I started him on 10mg of Trilostane yesterday. She wants to do another ATCH stem cell test in 2 weeks. Of course I will do it..but my question is if the ATCH tests disagrees. The most recent was normal…how will I know what numbers to look for in the next test? The low dex test was definitive…I am confused an Mr. B is too. lol. I am monitoring him closlely…panting..excessive water consumption and frequent urination…( I recommend a belly band with a feminine pad inside) saves the mess AND the stress. Look forward to your answer and to all of you…best of luck with your pups!
Hi Robert,
I understand your concern for Mr. B and can see why you are looking for additional information. Unfortunately, without playing a personal role in your dog’s medical care it is hard for me to make specific conclusions. My intuition tells me the specialist is probably just looking to see how the levels have changed since starting treatment. Sometimes it is more helpful to monitor trends than it is to focus on specific numbers. Not all dogs follow the textbooks and Mr. B’s “normal” may not actually fall into the normal reference range that is reported for dogs. Also, please make sure you mention these questions to the specialist. They would be able to give you better answers and explain why they are making these decisions. It is always ok to be honest and voice any concerns. Sometimes they don’t explain in detail because they don’t realize there is any confusion taking place with the communication. I am hopeful that together, you and the internist, will be able to get things straightened out and ensure Mr. B is living his best life. Best wishes and keep up the good work!
My 15 1/2 year old female Teacup Puddle started showing symptoms of Cushings. A through exam and testing confirmed Cushings. My vet recommended Vetoryl so we started with 5mg 2x daily (my girl weighed 9 1/2 lbs). She quickly improved but then started showing signs of too high a dose (lethargic, poor balance, staggering gait, vomiting). I stopped administering and discussed with my vet and we agreed to lower dose to 5mg 1x daily. Much better response but still some adverse effects so I dropped dose to 5mg every other day. My girl has had a good response to that; ie: hair shinier, better appetite, better urination, minimal gulping water, better sleep, more aware and engaging with me,. My question though: she hates getting the capsule. I wrapped it in cheese or a chunk of meat. She spit it out. I try to place it down her throat and she gags it up and spits it out or hides it in her cheek and spits out later. Can I open the capsule and mix the powder with her food?
Hi Rusty,
I am glad you were able to lower the dose of your dog’s medication and resolve most of the side effects she was experiencing. Trilostane usually has a warning on the label that says the capsule is not to be opened or split. It is my understanding that this is to prevent you (the human) from being exposed to the medication since it could affect how your body functions. Also, most medications are in capsules to prevent them from having an overtly bitter taste. My worry is mixing the powder into your dog’s food would probably result in her refusing to eat or causing food aversion. Here is a link to another article that may offer some new tricks to try: Your Dog Won’t Take Pills? 5 Easy Solutions for Uncooperative Pooches
Please make sure your vet is aware of the difficulty you are having with giving your pup her medicine. They may have some other ideas or options to try as well. Best wishes and good luck!
I adopted Harley, a malti-poo at 10 1/2 years old just over a year ago, found a “cyst” on his hip a day later. Long story short, it was sarcoma, he had surgery and ECT over several months and the cancer seems to be cured. During a recheck his vet said he appeared to have Cushing’s. After testing, we found out it was pituitary type. We finally got Trilostane, oil based suspension and he got two 10 mg. doses over 2 days and he stopped eating altogether, sleeps all the time and acts miserable. He’s also on Amlodipine for hypertension. our vet said to hold Trilosane for 2 days and call him, That’s tomorrow. No change, but he’s weaker. As far as I know, there’s no other med that will help and he’s so sweet…and he’s my last dog! Can you suggest anything?!
Hi Sally,
I understand your concern for Harley and think it is good you are reaching out for advice. Without playing a personal role in his medical care it is hard to make specific recommendations. Since Harley’s case seems to be more complicated, it may be a good idea to schedule a consultation with an internal medicine specialist. They can offer suggestions that might be a good fit for your boy and help you navigate this difficult situation. Hoping you can get some answers quickly. Wishing you both nothing but the best.
My dog started showing early signs of “something” in early 2020. It looked like ascites to me, vague activity intolerance, just a lot of nonspecific “this isn’t right.” I asked to have liver and cardiac tests done. Nothing wrong. A year later, the vet started suspecting Cushing’s, and did an abdominal ultrasound and a round of tests. Came back negative. A year later same thing. It wasn’t until this year, 2023, that we were absolutely certain that her clinical presentation was Cushing’s, and the tests finally came back positive. So my poor sweet dog has been developing this for 3 years with negative tests, and it was only once it became severe that we were able to do anything for her.
She was so far advanced, that every symptom in the book was at the severe stage. Could hardly walk a mile, drinking constantly, stealing food, hair falling out, confused, sleeping 23 hours a day, belly like a piglet.
She started trilostane 2 months ago, and now she’s like a 12 year old puppy. Runs, plays, solicits attention. Not only doesn’t have food obsession, but sometimes she doesn’t even finish her bowl! No more confusion, lethargy normal to a 12-year-old dog.
I know that this is palliative, not curative, and she is 12 years old after all. But holy cow, this is giving her a new lease on life.
If anyone is hesitant, please don’t be. Any medication can be dangerous – and your vet will watch this one closely with you.
Hi Donna,
What a blessing to have your sweet girl back to her normal happy self! Thank you for sharing your story with our readers. It is great to hear the positive outcomes and offer hope to others in a similar situation. Take care and keep up the good work!
Great success story! Thank you for sharing. My dog just got a Cushing’s diagnosis.. Can you tell me how many mg were prescribed and if you administered it once or twice a day? How much does your dog weigh? I know that informs dosage. Thank you so much
Hi
My dog is having Liver disease from last 2.5 years. His liver condition is stable. But in routine 6 months ultrasound they found out his both adrenal glands are little enlarged with no mass. He is absolutely fine with no symptoms. They are going to test his urine next week to check if he has Cushing.
I am scared to death thinking medicine will work for him. Or there will be no medicine available for him.vet is telling me he will be fine as there is a medication for him. But still I am so scared.
Hi Shru,
I understand why you are worried, but it sounds like your dog is doing pretty well. Even if the testing shows your dog has Cushing’s disease your vet may hold off on medications for now. The standard recommendation is only to use medication to control symptoms. Since your pup is symptom free and this was only found by coincidence, there may be no need in treatment at this time. I hope you find the answers you need to ensure your boy is well taken care of. Wishing you both the best of luck.
Hi Dr. Buzby,
My dog PaoPao, a 9-year-old bischon/poodle mix, was recently diagnosed with Cushing’s disease. In fact, he’s getting his LDDS test done right now while I worriedly pace about the house, as we’re still working to figure out if it’s pituitary or adrenal based.
PaoPao doesn’t present most of the typical signs of Cushing’s; no pot belly, no excessive thirst, no panting, no real hair loss, but he has lost considerable muscle mass, is ravenously hungry, had high liver enzyme levels, and his hair has thinned a bit in certain areas. In fact, it was only because of an article I read by you that I urged my veterinarian to test for Cushing’s, as the vet had been treating him for hypothyroidism, which I suspect was really Cushing’s in disguise.
Our vet’s plan is to start a 10mg dose of Trilostane, while I’ll be using the alternative treatments of lignan, melatonin and Si Miao San under the vet’s routine testing to assure we’re not overly aggressive and turn Cushing’s into Addison’s.
Everything I’ve read seems to indicate that Cushing’s dogs only live 2-3 years after diagnosis. My question for you may be a bit complicated to answer, but if the treatment successfully lowers the cortisol levels, shouldn’t the dog be able to live a long life? What an I missing here? PaoPao is only 9, and I imagined we’d have so many more wonderful years together. Presuming his treatment is effective, the idea that our time together could still be cut so short, so soon, is absolutely devastating to me.
Hi Michael,
I am so sorry PaoPao is suspected to have this terrible disease. I think it is great you have been actively working to find answers and are such a strong advocate for your dog’s health and well-being. Unfortunately, I don’t have clear answers as to why Cushing’s treatment does not restore the normal lifespan of a dog. My educated guess is that while some medications can decrease the production of cortisol in the body, the effects of a pituitary tumor or adrenal issue are still causing problems behind the scenes. I think of it like a diabetic who is taking insulin. The insulin may have the blood sugar at an optimal level, but the diabetes has not gone away and is still causing problems for the body. How are things with PaoPao today? Were you able to get a definitive answer with the LDDS testing? Hoping you can find the best way to offer your sweet boy happiness and peace. Bless you both.
Hi again,
After a lot of testing, PaoPao started treatment with Vetoryl in October. At the time, prior to treatment with Vetoryl, he was getting pretty bad. His thirst had increased, his hair thinned more and more, and he no longer wanted to go on walks, his favorite part of any day.
Vetoryl turned much of his issues around almost immediately. He’s doing much better today, with all his tests showing values in the normal range. His hair is still thinning and he’s still ravenously hungry, but that’s just made it easier to spoil him, because even something as simple as a sliced cucumber gets him excited. There’s not much I can do now but continue our treatment plan, monitor his health, and love him.
If we really only have a few years left together, I’ve determined that we’ll make the most of it together. We’re going on lots of fun walks to new places, snuggling extra long in the evening, and enjoying our time together. My wife and I usually travel abroad for a few weeks during the holidays and leave Pao with house sitters, but we’re doing a staycation and taking him to the mountains this year instead. If our time really is so short, we want to spend as much of it as we can together.
Thanks for taking the time to think of us, Dr. Buzby. My heart and best wishes go out to everyone dealing with this disease. Just remember that for all it takes from us, at least it gives us the presence of mind to cherish what time we may have together with our dearest friends.
Hi Michael,
I am so glad to hear from you again! Thank you for the update on PaoPao. What a blessing the Vetoryl has improved your boy’s quality of life and given him some relief from the severe symptoms he was experiencing. Enjoy your upcoming vacation to the mountains and I wish you and Pao all the best. ♥
hi, my dog has the same issues, high liver enzyme levels. ALP level of 2000 (normal range: 23-212), an ALT level of 155 (normal: 10-125), and a GGT level of 40 (normal: 0-11). I wanted to know if you dogs had also high values in those three levels, and if his liver is now back to normal with vetroyl?
What (if any) supplements can be taken with Vetroyl that might help my Lucy?
Hi Arvilla,
Most supplements are safe with Vetoryl but you should always consult your vet before adding anything to your dog’s treatment regimen. What issue is Lucy dealing with that you are trying to find a supplement for?
My dog has been on Vetoryl for about 2 1/2 months. He isnt excessively drinki g, urinating or panting. His skin and hair are looking so much better. He has responded very well. I do wish there was some coupons or discounts for Vetoryl as it is expensive especially while we are being monitored with the ACTH Tests
Hi Michelle,
I am glad your dog is doing so well on Vetoryl and you are noticing a vast improvement in his Cushing’s symptoms. I understand that veterinary care is not cheap and can be a burden when treating and monitoring a chronic disease. Hoping things will begin to stabilize and the vet visits will start to become less frequent. Wishing you and your pup the best of luck. Keep up the good work!
I started my yorkie-poo on V (t0 mg) a week ago under vet supervision. No changes yet but came across this forum accidently and feel so much better – appreciate people and the Dr taking time for such thoughtful responses and feedback!!! I took him to the vet for the sudden appearance of a rat tail (lost much of the fat and hair on his tail seemingly overnight). He had also developed cystic lumps over the years. Dr suspected cushings but said since the dog appeared fine otherwise to just monitor him. He maintained the testing and treatment are expensive and many times inconclusive. Well, within a few months he went from a happy energetic dog to an old one – shaking, panting, excessive drinking, insatiable appetite (almost food aggressive), confused, having accidents in the house, pot belly, thin scaly skin and dull patchy coat. I took him in as soon as I could get an appt. The dr didn’t prescribe until all the testing was complete which took another few weeks. Anyway I wanted to provide some details so others could benefit if they are suspicious and hopefully start the process of testing sooner rather than later. I had zero idea the disease would progress so rapidly:(. Praying my little love recovers as nicely as some of the dogs described here!
J
Hi JG,
I am glad you were able to get a diagnosis and have started treatment with your little pup. How are things going? Are you noticing an improvement in your boy’s symptoms? Hoping he is feeling better, and his quality of life has been restored. Feel free to leave an update if you have a chance. Wishing you both the best for many happy days ahead.
Dear Dr. Buzby, My 12 year old beagle (42 lbs.) was just diagnosed (pituitary). Compounded Vetoryl has been ordered, 40 mg. I am scared to death to give this to him! He suffers now with loss of appetite and diarrhea and I fear I am going to make him sicker. I have heard that he needs to be on an initial lower dose to begin and I don’t know what to do. Have also heard that if his symptoms are not severe we don’t need meds at all. I am at a loss.
Hi Andrea,
I know you are worried and want to do what is best for your senior boy. While any medication can have unwanted side effects, Trailstone can be nothing short of a miracle for dog’s suffering with Cushing’s disease. It is very possible this will help your sweet boy feel better and improve his quality of life. Your vet will advise you on what dose is appropriate and will help you adjust things as needed based on routine blood monitoring. Try not to focus on all the “what ifs”. I am hopeful you will be pleased with the results.
My Chinese Crested is 14.5 yes and has been on Vetoryl for 2 years. This week he suddenly got very shaky, unstable and disoriented. I honestly thought we were going to lose him. He then slept for about 30 hours, we woke him up only to pee.
Now he seems better but isn’t eating. We saw the vet today. We were told to keep him on the Vetoryl, gave him some pills to increase his appetite and keep him on a sub cu drip twice a day. I now read Vetoryl can affect appetite. Should we be concerned? He’s already significantly underweight, if he refuses to eat I doubt he’ll last a week.
Hi Gillian,
What a scary few days you had with your pup. I’m so glad you were able to get him to the vet for an evaluation, and I hope that he continued to improve and started eating again. Since I haven’t personally examined him and looked at his bloodwork, I can’t say with any certainty if the lack of appetite was from the Vetoryl or from whatever made him so sick to begin with. Lack of appetite is definitely concerning, especially for dogs who are already underweight, so I usually ask my clients to give me a call in a few days (or less) if their dogs haven’t started eating better again or don’t seem to be improving. Hope your little guy is feeling better!
What about atypical cushings, can that be treated with melatonin and lignans?
Hi J,
That would be a great question for your vet! Each case is different, and it is hard to make specific recommendations without having personal knowledge of all the details.
I have a 12yr male neutered Siberian Husky. Last year, we had to start him on Galliprant for arthritis. In this year’s spring, took him to vet for lethargy, and some hair/fur loss. He was diagnosed with Hypothyroidism and is now on Levothyroxine (0.5mg/day). The hair/fur loss did not improve so we requested he be tested for Cushings. ACTH test came back “equivocal”, but due to symptoms, decided to put him on lowest dose Vetoryl (30mg/2x day) Was just re-tested and his levels are now where they should be. Definite improvement on happier & a little more like his old self, water intake/output, panting has improved, has gained some weight (possibly muscle gain as no difference in food). Possibly slight improvement in fur regrowth and hope this will continue-but for the winter, my Husky will wear a warm jacket. Even though Vetoryl is expensive, we thought we’d make changes to our lifestyle to provide him with the best quality of life!
Hi Diane,
Thank you for sharing your experience with our readers! It is so nice to read a success story and I am sure it will be a beacon of hope to others in a similar situation. I am glad your sweet boy is showing some improvements since starting the Vetoryl. I am hopeful he will continue to improve and have many happy days ahead. Best wishes and bless you both!
Thank you for your reply.
Update after 50+days on Vetoryl: My fur-baby is still doing well. I have him playing/running a little bit each day. I have seen what I believe is “blowing coat”, so I presume this is due to the fact that his system is now getting adjusted to levels and re-starting the “blowing coat” process. Hopefully, the “bald” spot on his neck (the worst spot) will come back over time.
I wanted to let others know that not every day will be a home run. I am so grateful that his quality of life has improved and appreciate every day with him! Seeing his daily smiles/kisses, reassure me that I did the right thing with treatment.
Also, in regards to price – if others have access to Costo pet pharmacy, they were 1/2 the price of other places!
Thanks, Diane
Hi Diane,
This is such good news! Thank you for the update and for the pharmacy advice. I am sure this will be helpful for others needing to find cost saving solutions for their dog’s medical care. Best wishes!
Hi, we have a 11 year old Pomeranian that was diagnosed with Cushing last week. The Dr. Has ordered Trilostane 10 mg we are waiting on delivery. The price is really high for a limited income any recommendations?
Thank you
Valerie
Hi Valerie,
I understand that medications can be expensive and cause a burden on the family. Unfortunately, for Cushing’s disease there are very limited treatment options. Like the article mentioned, if your veterinarian can order the generic or have the medication compounded it may be slightly less expensive. I am sorry you are dealing with this issue in your senior pup. I hope your dog will respond favorably to the treatment and have many happy days ahead.
My puggle was diagnosed almost 5 years ago and has done great on this medication.
From what I’ve read she has out lived the expectation and I’m thankful ❤️
Hi Kathy,
What a blessing! Thanks for sharing. ♥
Hi Dr. Buzby my 10 lb dog was diagnosed with Cushings in April 2021. We have been trying to get his cushings under control with Vetoryl thus whole past year. He’s now on 100mg and hes peeing alot overnight, every hour to hour and a half. This has been a few months. Any idea how I can reduce the peeing? Im 65 and need jy sleep badly. We’ve checked his urine a few times, done bloodwork. Any insight? Thank you
Hi Shelley,
I can only imagine how frustrated you and your vet must be. You have done everything right and still don’t have the answers you need. Unfortunately, some dogs are just very complicated cases, and it sounds like your little guy is one of those. I am suspicious that something else may be going on that just hasn’t been diagnosed yet. It can be very difficult to unravel these issues especially if there is more than one thing happening at a time. It is not uncommon for dogs with Cushing’s to also develop diabetes. I think that is one of the things your vet was looking for with testing the urine and checking blood work. My best advice is to schedule a consult with a veterinary internal medicine specialist. They deal with extreme cases like this every day and may have recommendations on next steps to take with testing and treatment. I hope you can find the answers you need to get these severe side effects under control. Praying your sweet boy finds some relief soon. I wish you both the best.
I have a 25 lb doxi, age 13. He has been on 25 mg of trilistone for about a year now. I feel his peeing has been better when I cut the pill in half, giving him half in the morning and half at night with food.
Can a dog with iatrogenic hyperadrenocorticism from taking Prednisone daily for an immune mediated disease, also take the Trilostane? Thanks!
Hi Jenny,
I would think the prednisone and trilostane would be fighting against each other. Ideally, if prednisone has caused iatrogenic Cushing’s, the prednisone would be discontinued. I understand there may be cases where this isn’t an option. I recommend you talk with a veterinary internal medicine specialist. They can let you know if there are other medications that are good options to help suppress the immune system and would allow you to avoid the prednisone. Once the steroids are discontinued, the iatrogenic Cushing’s should resolve as well. I hope you can find the answers you are looking for and make the best decision for you and your dog. Good luck!
My sweet Yorkie Abby is 10.5 yrs old and has been on Vetoryl since 2017. She has done fantastic on it! Her pot belly has gotten better as well as her beautiful hair. Her thirst is also better. We can’t tell about anything else because unfortunately she was diagnosed with Congestive Heart Failure last year and is on a ton of meds for that including Lasix, which makes her urinate constantly. But I have been extremely happy with how her Cushings is going. She gets tested every 6 mths and her dosage has stayed contant. It’s very easy for a dog, with the proper mediation and veterinarian care, to live with Cushings.
Hi Vicki,
I am happy to hear Abby is doing so well with her Cushing’s treatment! Thank you for sharing your experience with our readers. Praying the CHF can be managed with medications and allow your sweet girl to have many more days ahead. Wishing you both the best. ♥
Thanks Vicki. Hearing your story gives me hope that we’ll have more time too.
Wishing you and Abby well,
Michael
My sweet 11 year old Rottweiler, Koda, was diagnosed with Cushing’s disease about three weeks ago. She only had increased thirst and urination so the vet thought she was in the beginning stages of the disease after some blood tests. She weight 115 pounds and was put on 120mg of Vetoryl daily and after 10 days was like a zombie and lost most of her vision. I took her back in for more labs which showed her cortisol level to be less than 1 so the vet immediately stopped the Vetoryl. After a week she had another lab completed still showing her cortisol level less than 1. Oddly enough, Koda has had some of her Cushing’s symptoms return but no change in her labs. She has absolutely no energy and recently started bleeding from her gums. The vet wants to wait one more week to do more labs before treating her for Addison’s disease. I was so hopeful when Koda was started on Vetoryl, however, she seems to have had the worst adverse side effect to the medication and I am just so worried about her.
Hi Karin,
My heart goes out to you as you face this difficult situation with Koda. I am sorry she had these severe side effects and is now facing these new worrisome symptoms. I understand your concern and wish I had some great advice. If you are not already working with an internal medicine specialist, I would highly recommend you ask for a consultation and get Koda established as a patient. Hoping you can find a way to get her stabilized and restore her quality of life. Wishing you both nothing but the best and praying for a positive outcome.