PDA

View Full Version : Tully, 9-yr-old SBT, and questions about trilostane



Sarah
03-31-2011, 06:49 PM
Hi, just joined this forum because of questions about my girl's treatment. Tully is a 9-yr-old Staffordshire Bull Terrier, she currently weighs about 27 pounds. (she weighed 30-32 pounds before, the primary symptom of her Cushings has been dramatic muscle wasting)

She was diagnosed with Cushings last week, and the vet (internal medicine specialist) put her on trilostane. 60 mg, 2x daily, which she had ordered for us from Wedgewood Pharmacy.

Now my concerns are first off, that I flat out can't afford to keep up that kind of treatment. 60 ct of the 60 mg trilostane from Wedgewood was $142 ($10 in shipping costs). I wish I could afford to spend $142 a month on medicine for my dog, I love her, but my budget isn't going to stretch that far for long.

My other big concern, though, is that the dosage seems really high to me for a dog this size, based on information I've found here, and on other sites on the internet. Of course, I'm not a vet, and mine may have had good reasons for her prescription. I tried calling yesterday (after the meds arrived and I had time to see what the dosage was, and look up what a usual dose was), the vet I've been seeing is off for a week, but the other internal medicine specialist said that this was on the high end of an appropriate dose and I could try using half that if I wanted. Which is what I'm doing, until I get a chance to talk to the vet I saw.

I'm just wondering what dosages other people have had, and been successful with, and if anyone else has used such a high dosage. Also, if anyone knows of a more affordable source for this medication. Or should I request that we use lysodren instead, would that be more affordable? I know my vet uses trilostane because she feels it is safer, but I would think using some medication is better than no medication.

Possibly also relevant... my dog has been a little unusual in her presentation of Cushings. The 3 vets at my usual practice, and the internal medicine specialist, didn't think she had it. She hasn't had the usual hair loss and was not pot bellied (possibly developing now). She was still enjoying her usual walks. She also didn't have elevated liver enzymes, which the specialist tells me 95% of Cushings dogs do. She has had a ravenous appetite, but that was a bit difficult to distinguish from her usual high interest in food. Pees a lot, but she's done that for years, and we had decided it was psychosomatic because she had no other symptoms of anything. She just started losing muscle mass last summer, and seeming not quite as enthusiastic about agility or her ball. The specialist vet did a urine test (creatinine/cortisol?) to rule out Cushings before pursuing an autoimmune disorder. She said a number over 13 would indicate there might be Cushings, Tully's was 258. So, we did an ultrasound and an ACTH stim, and determined that she has pituitary-based Cushings.

Harley PoMMom
03-31-2011, 07:49 PM
Hi Sarah,

Welcome to our family and we will help you and Tully in any way we can.

Although I am no vet, the starting dosage of 60 mg 2x daily, for Tully's weight of about 27 pounds seems pretty high to me. Vetoryl which is distributed by Dechra recommends a starting dose of 1.0-3.0 mg/lb, once a day. Please take a look at this link: Dechra's U.S. Product Insert. (http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf)

Could you please get copies of all tests, especially the Cushing's tests, that were done on Tully and post the results here. This will really help us with giving you meaningful feedback.

Love and hugs,
Lori

labblab
03-31-2011, 08:07 PM
Hi Sarah,

I'm afraid I only have a moment to post right now, but I want to "second" Lori's caution about the size of Tully's initial trilostane dose. In fact, I'll go one step further. Even though Dechra's published information cites an initial dosing range of 1-3 mg/lb, the technical representatives in their U.S. office have verbally advised us that their most current recommendation is to start dogs at a daily total of no more than 1 mg/lb. So this would translate into a daily total of approx. 30 mg. for Sarah -- even lower than the 60 mg. dosage that is listed on the chart in the Product Insert. And for a dog being dosed twice daily, this total amount (30 mg.) would be increased only incrementally and then split IN HALF for each dose, rather than doubled. So in summary, a daily total of 120 mg. would be a whopping high dose! A daily total of 60 mg. is even higher than the verbal recommendation that we have been hearing.

If you or your vets would care to contact the technical reps at Dechra's Kansas office about their most current dosing recommendations, our experience has been that they are happy to communicate either by phone or by email. Here's their contact info:

http://www.dechra-us.com/Default.aspx?ID=365

Marianne

Sarah
03-31-2011, 08:16 PM
Thanks, this is what I was thinking. I'll try to get copies of her tests. I'm also thinking of quitting with the specialist and going back to my regular vets, now we have the diagnosis, I would think they could monitor the Cushings.

littleone1
03-31-2011, 08:40 PM
Hi Sarah,

Corky and I also want to welcome you and Tully.

Corky has been treated with Trilostane for a little over 17 months. When he first started taking it, he was almost 24 pounds due to his cushings symptoms. His IMS started him at 20mg once a day. He's now, after all of this time, up to 60mg daily, but he's on 3x daily dosing. I agree with our other members that the starting dosage for Tully is high.

I get Corky's Trilo from Diamondback Pharmacy in AZ. I just got a 3 months supply and only paid around $90 for it, which included a $5 delivery charge. They do ship anywhere in the states, and they are not charging that much for shipping. They are a compounding pharmacy, and if Tully's dosage would be able to compounded, it would be much cheaper for you.

Terri

Sarah
04-02-2011, 02:12 AM
Thanks for the information. I will contact that pharmacy and see if I can get the prescription cheaper than the one my vet is using. I'm not really clear why, with compounding pharmacies all over, this practice chooses to use one in NJ. We are on the west coast.

Harley PoMMom
04-02-2011, 08:48 AM
Hi Sarah,

I am going to provide a link to another thread where members were discussing the pharmacies that they purchase their Trilostane from.

http://www.k9cushings.com/forum/showthread.php?t=2600 Buying Trilostane capsules

Love and hugs,
Lori

Eskimo'sMom
04-15-2011, 05:58 PM
wow your story sounds like mine..... She has little symptoms but does drink ALOT of water and her hind legs shake. Her vet insisted she did not have Cushings but after requesting of further testing! BOOM, Cushings, but it was the LDDS which determined this not blood panal, urinalysis, atch... not waiting for ultra sound appt.

ktzndgs
04-16-2011, 05:02 PM
I have a Newfoundland who was diagnosed last May 2010. She weighed 95 pounds at the time and was prescribed 120mg once a day. The dose of 60mg twice a day for a 27 pound dog frightens me. I'm not a vet but I have to suggest you get another opinion ASAP.

Macy was off Vetoryl (trilostane) for over 3 weeks due to being consistently given to much medication. We've restarted her now and the IMS would have liked to start her on 40 mg twice a day. Having done a ton of homework I'm restarting her on 40mg/day total. Will divide the dose and do 20mg twice a day to begin.

You can always add more meds later if needed but I'd rather start low and go up. Vetoryl can make them pretty sick (or worse) if they get too much of it.

Kathy

Keiko's Mom
04-16-2011, 08:58 PM
Hi. I'm new to cushings and this forum, too. My dog weighs 73 pounds and is on 30mg. Vetoryl twice a day. It's been two weeks since I started treatment and second ACTH shows that it's working fine. I buy from Drs. Foster and Smith....you can buy per each capsule and free shipping. I had bought alot of pet items over the years from them and it's a good company. 60 each of 30mg costs $111.00 with free shipping. I started a new thread on Keiko this morning (might have more info for you).