Jojo - 10 y/o American Bulldog (Trilostane)

[rhondaboyce]

I am a mom to 6 dogs. I did Pitbull rescue for a number of years but am no longer able to take anymore in. I do still do Education and Awareness.
Jojo is my American Bulldog. Shes about 100 lbs. I rescued her off the streets in 2003 and she is approx 10 years old. She has a wonderful story. I took her in 6 months or so ago because of exccessive water intake and hair loss and after numerous test (which I have at home-at work) she was diagnosed with Cushings. I would like any advice anyone has for me. Her script has run out and before I spend another fortune taking her back in I have a couple of questions. yes she is worth it and I will do anything for her but after losing my job of ten years and my home (im now renting) my income is very low. On her bottle it says Trilostane 250mg/ml suspension and her dose is 30ml once a day. It is liquid form and it cost me about 200 per month.I have researched some and want to know if there is anything I can do to cut cost? Can you tell me about the pills and if they are comparable? I know she will need this the rest of her life and she suffers without it. The vet told me that this was cheap for the liquid form. Is there anything other things I can do to help her? I appreciate any advice and look forward to getting to know everyone. I am in nashville TN. I did apply for Brown Dog but they do not have funds. I love her so much. This girl dont leave my side often and has always looked at me with those big ol brown eyes. I love her so much..Thanks
Rhonda, Jazz, Jojo, Gracie, Ombre, Theo, and Lila

[labblab]

Hi Rhonda,

Welcome to you and Jojo! I'm afraid I have only a few moments to post right now, but I do want to ask you to try to clarify with your vet what Jojo's prescription would be if she were to take her trilostane in pill or capsule form. Perhaps another member who has personal experience with liquid trilo can make sense of the liquid-to-pill conversion. But the numbers on Jojo's bottle are puzzling to me. Are you certain that you've copied down the numbers correctly, especially the "zeros" in the numbers?

Here is why I am confused...According to the written guidelines of the manufacturers of Vetoryl (brandname capsule form of trilostane), a dog of Jojo's size should be started at a beginning dose of approx. 180 mg. once a day, and their most recent revised verbal recommendations are for an even lower dose (they are verbally recommending an initial dosing formula of no more than 1 mg. per pound of a dog's weight). The numbers on Jojo's bottle of liquid trilostane seem to imply a massively huge dose that just cannot be right. So either I am misinterpreting the directions on the bottle or the numbers are somehow incorrect. If you could double-check Jojo's daily dose, in milograms, that would be great.

Also, has Jojo's trilostane dose changed (either up or down) after first starting treatment six months ago? Dosing changes are not uncommon, especially during the first few weeks and months or treatment. So that is perhaps the reason why your vet recommended a liquid version of the drug -- so as to make it easier to alter the dose as needed. However, in order to judge whether or not you can buy trilostane in a cheaper form, we will need to know more about her dosing history and whether or not she has now been stable for a while on her current dose.

In that vein, any and all testing results will be a big help to us -- especially any ACTH monitoring tests that have performed since starting the trilostane.

Once again, welcome to you both!
Marianne

[lulusmom]

Hi Rhonda and welcome to the forum.

I have a cushdog named Jojo too but he is quite a bit smaller (6.5 lbs) than your Jojo. :D I'm also a rescuer and am currently looking for a rescue or a home for a beautiful, 8 month old, blue and white Pitty. Know anybody who might be interested? :D

I've used liquid Trilostane and if I'm right, I think your Jojo is getting 75mg once a day. If one ml (whole syringe) equals 250mg, then .30 ml would be approximately 75mg. Does that sound right?

If Jojo has stabilized on 75mg once daily, you have the choice of continuing to use the 250mg compounded liquid or you can have 75mg capsules compounded. If you are in the U.S., try calling the veterinary compounding pharmacies some of us use to check pricing. I use Diamondback Drugs in Scottsdale, AZ. They will give you the price for both.

www.diamondbackdrugs.com

There are a few others with competitive pricing but I can't remember their names off the top of my head. I'm sure others will be by to share.

Glynda

[rhondaboyce]

Hey Marianne and Glynda! Thank you so much for your responses. And yes you were right I was reading it wrong! its 1 ml per day. Yes Im a dork. Trying to be so careful reading it and I still get it wrong!. I see light at the end of the tunnel with an option for a less expensive medicine. Thank you again. id love to talk about other experiences. Do you guys or have you ever known of this didease casing breathing issues without the medication? I try to get online and read but its so overwelming im really glad to be here. Im at work but will check again at home. And Glynda I wish I could take your guy in but I just cant. Have you been on Pitbull Crusaders? Its a yahoo group with lots of people to help and ask for help.Thank you again.

Rhonda

[rhondaboyce]

Sorry for my spelling. Trying to hurry.
Rhonda

[lulusmom]

Hey Rhonda, I was just kidding about the Pitty. I do need to find him a place but his current owners are willing to keep him until I do. Yes, I am familiar with Pitbull Crusaders and I think a good deal of the members are also my friends on facebook.

So Jojo is getting a full syringe of the liquid trilostane once a day? When you say breathing problems, are you talking about heavy panting or is Jojo having true difficulty in breathing?

[labblab]

Hi again, Rhonda.

If Jojo is getting a full syringe daily, then it sounds as though her dose is 250 mg. That is a big dose, and I'm afraid it may still turn out to be fairly costly in a solid form. But I agree with Glynda that Diamondback would be a good start as far as checking out pricing.

Has Jojo always been on this same dosage, or has it changed? Have her symptoms improved, and is she generally looking well? Or as Glynda has asked, is she currently having problems?

Marianne

[rhondaboyce]

Its 1 ml once a day. It hasnt changed and when she has it her symtoms seem much better.She gets out of breath really easy and I just wondered if that is a symtom of the disease?I will check out Diamondback thanks guys.

[labblab]

Rhonda, has Jojo's cortisol level been checked during this time that she has been taking the trilostane? The gold standard for monitoring trilostane treatment is the ACTH stim test during which two cortisol readings are taken: a baseline or resting level, and then a second level 1-2 hours after a stimulating agent has been injected. At the very least, you would want to at least be checking Jojo's resting cortisol level. The testing is to insure that her cortisol is not dropping too low on the trilostane. Her current dose is relatively high for a dog of her weight, and shortness of breath may be an indication that she is being overdosed. Have any monitoring tests been done to make sure she is taking the right dose? Here is a link to a Vetoryl Product Insert that will tell you a lot more about treatment and monitoring, as well as the dangers of overdosing:

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

Marianne