Dixie diagnosed 9/27/10 with Cushings (12-1/2 y/o chocolate lab)

[Dixie's Mom]

Hello everyone,

Dixie, my 12-1/2 yr. old chocolate lab was diagnosed with Cushings 3 weeks ago and has been on Trilostane. She has really become much more active and more interested in getting up and doing something - like going and watchin me feed our horses, cows, goats and everything else!! I hope she tolerates the Trilostane well. She just had her 1st blood work since she has been on her meds. No results yet.

I'm new to the forum and really need support on her diet, and other things I may be missing. She is now on Canadaie Senior Dog Food, as all of my dogs are on holistic NO GRAIN food. I lost Dixie's mom in March to Osteosarcoma and lost her dad in 2006 to Hemangiosarcoma. Lady, her mom, had a one year survival after we were referred to the University of Fla., where her lower jaw was partially removed. She did really great for one year. I don't want to lose my last lab to cancer. I am hoping we will do well with managing the Cushings.

I could really use advice as to where may be the cheapest and reputable pet pharmacy for the Trilostane. At present it is costing $160 per month to treat her. I'm hoping to find it for less. She is on 120 mg. every day.

I am open for suggestions and will appreciate all the response in getting her up and going as near to normal as possible. She weighs 94 lbs. at present and we are aiming for 80 lb. She is a shorter built lab.

Thanks in advance for any responses and I am very happy to be a part of this forum.

[lucygoo]

Hi,

The cheapest place to get Vetoryl is Center Pet Pharmacy. That's where I used to get mine, and noticed they're about $20.00 cheaper than everybody else. They are on-line and very nice people to deal with. Good luck:)

Gina

[Harley PoMMom]

Hi and welcome to you and Dixie from me and my boy Harley! So sorry for the circumstances that brought you here but glad you found this forum.

I was wondering if you could tell us more about Dixie's cushing's diagnosis. What test/s were done to confirm the cushing's diagnosis? Were other non-adrenal illnesses, like diabetes or hyperthyroidism, ruled out? What symptoms did Dixie display that led you or your vet to test for cushing's in the first place? Was a CBC/Chemistry blood panel done, and if so, could you post anything on there that is marked abnormal with the reference ranges and the units of measurements.

I am sorry for all the questions but the more we know the better our feedback will be, ok?

Re; price on Trilostane, take a look at this Thread: Buying Trilostane capsules http://www.k9cushings.com/forum/showthread.php?t=2600

We are here for you and Dixie so ask all the questions you want and we will answer them the best way we can.

Other Trilostane/Vetoryl links:

Trilostane/Vetoryl Information and Resources
http://www.k9cushings.com/forum/showthread.php?t=185

Dechra's U.S. Product Insert
http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

Love and hugs,
Lori

[labblab]

This is kind of a "wild card" suggestion, but I just thought I'd throw it out there, anyway. Prior to the FDA's approval of Vetoryl for sale here in the U.S. last year, some of our members imported Vetoryl from England via a U.K. internet pharmacy named "Masters Marketing." Now that 10 mg., 30 mg., and 60 mg. capsules are FDA approved and available here in the U.S., Masters will no longer export those capsule strengths to American residents. But it is possible that they may still be able to supply 120 mg. capsules. Here is a link to their webpage that previously listed Vetoryl capsules in all strengths:

http://www.masters-uk.com/veterinary/home.php?cat=102

If the prices on this page are still accurate, and if they will still supply 120 mg. capsules to U.S. residents -- you'll see that it represents quite a savings (approx. $101 for a 30-day supply). Quite a few "ifs" involved, however. Including the fact that you may or may not want to order 120 mg. capsules this early in Dixie's treatment, since she may require some tweaking both up or down before she is stabilized longer term (and therefore you'd prefer to have capsules in smaller dosage units in order to give you greater dosing flexibility).

But for future reference, you may want to give Masters a call at the U.S. "800" phone number listed on their webpage in order to see whether they are still able to supply Vetoryl in a 120 mg. dose to American residents. In the past, they would ship up to a 90-day supply of medication upon presentation of a valid Rx. I used them, myself, several years ago when I was treating my own Cushpup. I'm honestly not sure why there has been a delay in FDA approval of 120 mg. capsules here in the U.S. But until they are approved, it may still be possible for Masters to sell the product to you. And if Dixie remains on a 120 mg. dose or higher down the road, then you might want to consider ordering them from Masters.

An entirely different option is the consideration of compounded trilostane vs. brandname Vetoryl. Compounded trilostane is typically less expensive, but your vet may or may not wish to prescribe a compounded product. Here's the link to a recent thread in which this issue was discussed:

http://www.k9cushings.com/forum/showthread.php?t=2620

Marianne

[zoesmom]

Hi adn welcome -

I used the brandname vetoryl (imported from Master's in the UK that Marianne mentioned) and then, later, I switched to compounded trilostane which I bought online here in the states. I didn't notice any problems with the compounded vs the vetoryl brand. We used both for about 2 years each. I got my Zoe's compounded trilostane from pethealthpharmacy.com. They're in AZ and have a website but do not list prices. Their price for 120 mg x 30 is about $50. Sue

[Dixie's Mom]

I am so sorry for the delay in posting. I have been having a horrible time with an abcess tooth and root canal. Anyway, I will get copies of Dixie's lab work. I am almost positive the test was an ACTH. She was injected with Dex and the test took most of the day. Auburn University showed that her Cushings is coming from the pituitary. We have ruled out diabetes and she has been on thyroid meds for years. Soloxine .8mg. My vet called me yesterday to let me know her blood work after 2 weeks on Trilostane is good. I am here to tell you she has become a new dog in the past 3 weeks. A total CBC and chemistry has been done on her and a new thyroid was pulled. He says he will do all of these apx every 6 months esp. to watch renal and liver function.

The reason he tested for Cushings, was all of a sudden she started having urinary accidents. Dixie has never messed up anything, but I began noticing when she got up she was wet. I watched her for a few days and decided it was time to go to the vet. He did a urinalysis (after he finally got one from her) and it showed very diluted, and increased protein and other abnormalities. She had no energy (previous vet said it was old age), and she wouldn't slow down shedding - I know Labs shed lots, but I had never noticed her shedding like this. Her coat is getting very very shiny. She also has a very raspy breathing sound which is decreasing some.

I saw the pet health site where the Trilostane is compounded (in Az.) Has anyone every purchased from them? I guess it just concerns me that their prices are so cheap. I got a price from them of apx $100 for a 60 day supply of 120 mg. Trilostane. That is a very long way from $160 per month. Don't get me wrong, I love the price and will be glad to purchase in a moment notice but I want to make sure I'm getting an equal product.

I can't wait to hear from you all again. Just a note - Dixie has been laying on her bed beside the back door, but has not made too much of an effort getting up and going in the yard to check things out. She has really changed in the past 1-2 weeks. I raked pinestraw last Friday and she was with me rolling in the yard and playing around. I am so happy to see my old Dixie coming around.

[littleone1]

Hi and welcome from Corky and me.

The all day test was most likely the LDDS test. There are three blood draws which are 4 hours apart. The ACTH stim test is done in an hour. They take a blood draw, inject what they are going to use for the test, and then they take another blood draw an hour later. It all depends on the vet/IMS as to which one of the three things they use for the stim test. Corky can't have the gel. He is injected with Cortrosyn.

I have been purchasing Corky's Trilostane from Diamonback for over a year now, and he's never had any problems with it.

It would help if you would post the results of Dixie's tests when you get them. Most of us just post the blood work results that are not in the normal reference range. Please do post the results of the stim and LDDS tests.

I hope everything goes well with Dixie's treatment.

Terri

[Dixie's Mom]

Hi everyone,

I'm finally back. Dixie is doing wonderful on the Trilostane. Her coat is getting as shiny as a new penny, her energy level is drastically increased, she is now going with me to feed horses and cows, and above all greets me at the driveway when I come home. I have been missing this so much.

My vet gave me copies of the following test:
Dexametasone Suppression (Low Dose) - 9/20/10 Dog presented with diluted urine, inc. Alk. Phos. R/0 PDH as cause.
Results: Pre Dex 208 4 hr: 18 8hr.: 111 (Cortisol)
Impression: Slightly high pre value. Normal 4 hr post dex value, Elevated 8 hr. Post Dex Value. Result consistent with pituitary dependent cushings.

ACTH Response Test: 10/18/10 (Dixie has been on 120 mg Trilostane once a day since diagnosis)
Pre 26 2 hr post: 224 Cortisol
T4: 45
Impression: T4 in ideal range of 30-60
ACTH response slightly above normal range of 30-150. Values not far from ideal. May want to increase dosage 20% or may leave as is if good clinical response.

Hope this is helpful. We will be doing another ACTH in a few months, with chemical profile including liver and kidney function, and another thyroid profile.