getting my dog tested monday how much will this cost long term

[marc4fishing]

Let me start by saying I love my dog Butter, he is a 6 year old yellow lab. We are getting his acth gell testing monday but from the looks of his symptoms be probably has cushing, he is ravenous for food, thirsty all the time and is ALWAYS panting. I have done a little research into cushings and to be totally honest I am scared to death of the cost this might be. At $200 a test and probably 6-9 dollars a day for meds I am not sure I can afford to treat him. How much does typical treatment cost per month for a dog weighing about 90 pounds.


I really love hime but I have 3 small children and their needs have to come first.

thanks in advance, I really don't want to sound like I am an SOB but I am not sure what to do

[StarDeb55]

Hi & welcome to both you & Butter! I only have a second to post. You may have notice a delay in your post appearing in the forum. Could you please check your e-mail, including your spam folder, for a message from the forum which is the last part of the approval process for membership. If you don't find the e-mail, please let us know.

Debbie

[labblab]

Hi and welcome from me, too!

I am pleased to tell you that your membership process is now complete, so everything that you post from this point onward should be immediately posted for public viewing.

As you can see from my avatar, I am a yellow Lab-lover, too! :)

Please do not despair. Although it is true that there can be significant testing costs at the beginning of Cushing's diagnosis and treatment, these costs should settle down dramatically once a dog is stabilized on treatment. And there is reason to hope that the costs of medication will not turn out to be as high as you are fearing. If Butter does turn out to be Cushinoid, your vet will undoubtedly be recommending one of two drugs to you: either Lysodren (chemical name, mitotane) or Vetoryl (chemical name, trilostane). Brandname versions of both these drugs are more expensive than compounded versions. But compounded versions of both are available, and it may be the case that your vet would prescribe a compounded version in order to help you cut down costs. Even if your vet prefers a brandname version, I'm hoping your medication estimate is still inflated. Both brandname drugs can be purchased through internet pharmacies with competitive pricing (you don't have to buy it directly from your vet). And I've just checked the cost of Vetoryl offered by a couple of internet pharmacies, for example, and at the starting dose that would be recommended by the manufacturer for a dog of Butter's weight, the cost could work out as low as approx. $4 per day (90 mg. a day). I believe a compounded version of trilostane could be much less expensive than that. I'm hoping some other folks will be by to also give you a ballpark estimate of Lysodren (mitotane) costs. In the long-run of treatment, it might even be less expensive.

So this is a long-winded way to tell you not to give up hope. Let's first find out more about Butter's history and testing. So please fill us in on all the details that you can think of, including actual test results when you have them.

I'm sorry that you have reason to need to be researching Cushing's, but so glad that you have found us so that we can help you along the way!

Marianne

[zoesmom]

Hi and welcome to you and Butter -

Here is our link to some financial resources for dog care:
http://www.k9cushings.com/forum/showthread.php?t=212

It's true that cushings can get expensive, but maybe one of these resources could be of help to you. As Marianne said, the biggest cost comes at the beginning, with diagnostic tests and early-on monitoring, to make sure the dog is on the correct dose. Lysodren is somewhat cheaper than trilostane as you would give it daily until the dog is 'loaded' (anywhere from 3 - 10 days, usually) and then you would only be giving medication on a weekly basis (usually the original daily dose is given, split up and spread out, over the course of a week, I think?) Once the dog is stable on the correct dose, the monitoring ACTH tests can be done only every 3 or 4 months - in time, possibly stretchng that out even longer, barring any problems. And some vets will allow you to skip the first part of that test, later on, if the dog is doing well on meds. That can save on costs, too. The ACTH costs vary widely depending on where you are located but I often did that (skipped the first part/blood draw)after Zoe settled in on her dose.

On trilostane costs (it's a newer drug for cush pups, but both work well), I can speak more specifically as my lab-mix Zoe took it for four years. I have some prices for compounded trilostane that I will go fetch and come back and post for you. Trilostane does not require a loading period; however, it has to be given daily; hence, it usually runs more overall. Marianne must have mistyped as that $4/month is way off for trilo. Maybe she meant lysodren as when Zoe was first dx'd, the prices I was quoted for lysodren were just under $4/tablet. Not sure how much that would calculate out for Butter per month but remember, he'd only be taking a few lysodren tabs/week, once he was loaded (I wanna say 2 - 3 tablets per week for a dog like Butter, but don't quote me on that).
Lysodren people can tell you more about that dosing and the costs.

Will go get those trilo prices and be right back. Sue

[labblab]

Marianne must have mistyped as that $4/month is way off for trilo.
WHOOPS! As both Sue and Debbie have pointed out to me, I most definitely mistyped! I meant $4 per day for brandname Vetoryl, and NOT $4 per month. Here's two of the internet pharmacies with pricing that I was looking at: www.vetdepot.com (1 box of 60 mg. capsules + 1 box of 30 mg. capsules = $115 plus tax). Also, www.valleyvet.com (total of $124 plus tax). Sorry for the confusion! And I'll go back now and edit my original reply so as to clear it up...:o

And of course, there is no way of knowing what dose of Vetoryl/trilostane that Butter would ultimately end up on. It could be higher or lower. But Dechra, the manufacturers of Vetoryl, recommend that a dog be started out on a dose equalling 1 mg. per pound. So weighing 90 pounds, that's how I came up with this estimate for a starting dose and cost for Butter.

Marianne

[zoesmom]

Ok, back. Knowing how much trilostane Butter would need is a guessing game at this point. Over time, my Zo ended up on 180 mg twice a day. But while a few dogs likek Zo require an above average dose, MOST do not. Some even need far less than what is typical for their weight. Zoe, who weighed anywhere from 78 and 86 lbs during her cush journey, was on a dose that was exceptionally high. In fact, I can only think of one other BIG dog here that took anything close to what Zoe took and he was 110+ lbs. So don't base anything on Zoe and Big Mack. The most likely dose for a dog of Butter's size is probably going to wind up being 90 mg or 120 mg. They are usually started out on once a day dose, altho' some will end up on twice a day dosing at a slightly lower strength. (i.e. a dog taking 90 mg sid might require 60 mg bid., for instance.)

These prices were from pethealthpharmacy.com in AZ and are a couple years old: 120 mg. capsules of trilostane x 30 day supply is $48.90 and 60 mg capsules x 30 is $32.40. (Of course, you'd have to double that for a month’s supply if he ended up taking twice a day.) The price of 175mg x 30 capsules is $64.02. This last price is approximately the strength I ordered for Zoe. In Feb 2010, I paid just over $260 for a 120 caps compounded at 180 mg. So comparing that to the 175 mg. price x 4 (for 120 caps), that = $256. Based on that, you can see their prices haven’t increased much at all in the last couple years. (S & H was in the $5 range, regardless of qty ordered.)

So those are the facts I think you’re hoping to get. I’m not going to sugar coat it and say that it’s a breeze. But if you can find a way to work around the costs – possibly going with lysodren to save $$ - your Butter has a great chance to live out a normal life span. Sue

PS - Just reading back over Marianne's post . . . those are the prices for the brand name 'vetoryl' pills by Dechra. For the online places that make up a compounded version, you can get whatever specific strength of trilo capsule you need. For instance 45 or 75 or 150 mg or whatever. I'm not exactly sure what US Dechra is currently selling here in the States. Probably 10 mg, 30 mg and 60 mg. They used to sell 120 mg. (when we could only get it from the UK, before FDA approval here in US . . . but not sure if they still make those?) In any case, those prices for the 'official 'vetoryl caps will run considerably higher. I know!!!! I bought them from the UK for at least two years.) I hope somebody will stop by and give you some quotes on the lysodren costs.

[labblab]

I'm not exactly sure what US Dechra is currently selling here in the States. Probably 10 mg, 30 mg and 60 mg. They used to sell 120 mg. (when we could only get it from the UK, before FDA approval here in US . . . but not sure if they still make those?)
Sue, you're right that brandname Vetoryl is currently marketed in the U.S. in the form of 10 mg, 30 mg, and 60 mg capsules. Those three dosage strengths have already received FDA approval. Dechra continues to manufacture 120 mg capsules and markets them elsewhere in the world. It is undoubtedly only a matter of time before they are also FDA-approved and offered for sale here in the U.S., as well.

It MAY still be possible for folks to purchase 120 mg capsules from the U.K. internet pharmacy that Sue mentioned: Masters Marketing (http://www.masters-uk.com/veterinary/home.php). Their website implies that this is the case, and lists a price of approx. $100 for thirty 120 mg capsules (once you're on their homepage, do a product search for "Vetoryl"). However, when 120 mg capsules receive FDA-approval, I'm guessing that Masters will no longer be able to sell them to U.S. residents, either.

Marianne

[Casey's Mom]

Just so you know my Casey takes Lysodren 2x a week and the cost is about $30 per month for a 40 lb. dog.

It seems like a lot in the beginning with the loading and the testing but after the first month or so its not that bad at all!

Keep asking questions, there are lots of knowledgeable people on this site to answer all your questions.