Tambo who has cushings and diabetes (10 y/o chihuahua x Papillon)

[Angela]

Hi I'm Angela and my dog Tambo who is 10 years old is a female chihuahua crossed with a Papillon. She is being treated for Cushing since November last year (Trilostane) and she developed Diabetes in March of this year which is under control with the right amount of insulin twice a day. Here in Perth I do find the. Trilostane tablets quite expensive I'm pay $1.80 each at the moment, she has them am and pm. Would be good to hear from anyone Here in Perth to compare some of the costs of treating a cushings dog. Angela andTambo.

[Trish]

HI Angela
Welcome to you and Tambo! I am in NZ, but we do have a resident Perth expert!! Naomi aka SoggyDoggy. She has been treating her boy Fraser with cushings meds, but he recently stopped them with other health problems that have cropped up. She usually pops in most evenings so I am sure she will see your thread soon and pass on what she knows.

Welcome to the site!

Trish

[Deb101]

Hi Angela, I am very new to this site. We are still waiting for a firm diagnosis.
I thought I would say hello as I am in Australia too, but on the East Coast. Hope somebody has some information for you.

[goldengirl88]

Hi Angela:
Sorry to hear about your Tambo having problems. I know it is a shame these drugs are so darn expensive. Hope you have luck finding them cheaper, and that your baby does well going forward. Blessings
Patti

[Budsters Mom]

Hello and welcome to from me too :)
You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. Yes, Cushings is expensive to treat. Many of us struggle with that issue. :(So again welcome Angela and Tambo.

Hugs,
Kathy

[Harley PoMMom]

Hi Angela,

Welcome to you and Tambo, so glad you found your way here.

I was wondering if you would tell us more about Tambo, such as her weight, dosage of Trilostane she is on, and has she had any recent
ACTH tests that you could post for us?

We have a sister site that deals with canine diabetes, I strongly urge you to join there too, here is the link: http://www.k9diabetes.com/forum/ The very loving people there are extremely knowledgeable about canine diabetes and can answer any questions you might have.

Please know we will help in any way we can so donot hesitate to ask any and all questions.

Love and hugs,
Lori

[molly muffin]

Hello and welcome to the forum. What a little cutie.
Can you get compounded trilostane at a lower cost there in Perth? Cushings can be expensive that's for sure.
Hopefully some of our other members in your area will pop in and maybe have some ideas too.

Sharlene and Molly Muffin

[SoggyDoggy]

Hey Angela!

Ok, so you sent me a PM the other day, hope you got the reply, it had some of the trilo costs that I have paid. If you can let me know what strength Tambo is on too, that will help give a guide. As I said in the message, the 10mg capsules I paid $99.00 for a bottle of 100caps compounded, which obvioulsy works out to just over 1/2 of what you might be paying - depending on the strength obviously. Is Murdoch (our only teaching hospital for those not in the know ;)) giving you compounded caps or the actual Vetoryl caps? I know PVS (the only other specialist centre in Perth) gave me a choice, I just went compounded because the pharmacy that did them was still very close to me, I don't actually know what prices they charge for Vetoryl. Of course there are a number of compounding pharmacies around Perth, depends if you are north or south of river to find a close one.

As for the ACTH prices, I will find that receipt today and let you know too. It's still expensive, there are no ways around that, but there is a way that the agent can be stored and frozen to make it cheaper. I never went down that route, I may have eventually but then we only had 3 tests before Fraser came off the trilo. I have a feeling that the process is probably not known about heein perth, so not sure if murdoch would be willing to go there, though what better way to start spreading the news than through the place that trains all the vets? Anyway, if you want to have a look and show it to them, the article is here http://endocrinevet.blogspot.com.au/2011/03/how-to-extend-your-supply-of-cortrosyn.html It's worth a shot I guess, see what they think?

Also, Lori gave the link to the diabetes sister site. Again, worth looking at. I have found this place so amazingly helpful it's almost ridiculous, and having you hands full with both cushing's and diabetes is a lot. There are folks here who float between both boards too, so some names may become familiar, but as a cushing's resource network, this is by far the best out there.

Anyway, will find that receipt today and let you know more prices that I have paid, out of curiosity, what do you pay for the ACTH though?

Have a great Saturday, hope the sun emerges at some point :)

[Angela]

Having trouble navigating this site even though I have been reading the posts here for the last 6 months. Tambo was on 12mg of Trilostane which cost $1.81 per cap but now she is on20mg which cost $2.40 per cap. She has them am and pm along with her insulin injections. We were getting them from our local compounding pharmacy which were quite abit more expensive, now we get them from Murdoch Vet Hospital but the are componded from over east. They are not Vetorly.Acth test can be expensive but she usually has to have other tests done on the same day so I would have to look at an itemised bill to let you know of the cost at Murdoch.
I will keep in touch.

[Angela]

Hi Tambo is a female who weighs 4.7 kg. She has been taking Trilostane since November of last year when she was diagosed with cushings. She was originally on 12mg once a day. She had about 3 Acth Test done between Nov and the end of January and the results were good. At the beginning of March she developed diabetes and went through Ketoacidosis. She was treated at the Mudoch Emergency Vet Hospital where they done several test and found that she also had mild Pancreatis. a suspected blood clot in her lungs, a uniary tract infection and some sort of growth near her heart. This came as a shock to us because she seemed happy and only a bit lethargic at the time. She recieved excellent treatment and care for 5 days at Murdoch. Myself and my partner between us took 7 weeks off work to look after her. She has improved greatly so now its just the diabetes and cushings we are treating. The heart growth we are not going to deal with it may have been there for years and may not be growing.The vet doesnt think it is cancer but more test would be need to find out about it and we arent going there.
She had her last Acth test about a week and a half ago and now her dose has increased to 20 mg (just upped it today) which she has twice a day. She is due for her next test in 10 days time. From November until she developed diabetes she was only having the Trilo once a day. From March she has been taking Trilo am and pm along with her insulin injections.

[SoggyDoggy]

Hey again,

Sounds to me like the trilostane is costing more than it should if compounded. I just went through my bank statements to look and found the 5mg cost for 100 caps was $68.00 and as said before the 10mg was $99.00. While I don't have an accurate recollection, and no evidence of the cost of the 60mg caps, I think they were about $190? They were definitely under $200, that much I know for sure, but that was for 3x the strength you are using. I know also they charge more for getting them in quantity's of 60 than in 100, but I would think that you should be paying somewhere around $1.20-$1.50 per cap. Mine came from Main Street Pharmacy in Osborne Park if that helps you out at all. If Murdoch are happy to write you a script, it might be worth shopping around a bit more. There are certain places that are better at the compounding than others, but I know Main street is highly thought of by a large number of vets. Just depends where you are or if you're up for the drive.

Found the ACTH receipt too. Synacthen 250mcg vial, $118.50, Endocrine cortisol assay x2 (pre and post) $158.00 plus consult fee $92.50. Total bill for the day was $405.90 incl GST (quoted prices excl gst) Local vet total bill was slightly cheaper, but they didnt charge a consult fee, the actual acth test at pvs was about $85 less than local.

Hope this helps a bit? It's a pricey disease, and struggling with diabetes too! Don't envy you at all :(

[Angela]

Hi, thanks for the info. I do hope Fraser is still happy, it must be a hard time for you right now, our pets are a big part of our lives.
Tambo is doing ok but with the diabetes I worry a bit, especially when she goes off her food as she has to eat before we can inject her with her insulin. The sister site of this which covers diabetes in dogs is just as good.
Sometimes I get into the habit of searching on the net for too much info on Cushings and Diabetes and after awhile it seems that's all that you focus on.
I will eventually post a photo of Tambo as we think she is such a pretty dog, as most dog owners would agree of their own dogs.

[Angela]

Could someone tell me if it is it usual for a dog to have its dose of Trilostane increased by much over its life span? Tambo was on 12 mg and is now on 20mg
So in a years time is there a chance that she could end up needing a hefty dose?

[Harley PoMMom]

Could someone tell me if it is it usual for a dog to have its dose of Trilostane increased by much over its life span? Tambo was on 12 mg and is now on 20mg
So in a years time is there a chance that she could end up needing a hefty dose?

Tweaking the dose of Trilostane, I'm afraid, is a lifetime task for the pet, and the tweaking can go either way, meaning one might have to decrease than in few months, years, etc. have to increase. :eek:;)

[Angela]

Hi hopefully someone can advise me. Tambo has been treated for cushings with Trilostane since November. She has had to have her dose adjusted a few times so far and it's always been a gradual increase. We have noticed that she seems more arthritic now that she is on a higher dose. How important is it to get the dose spot on? Would it be best to under dose her so she still has some of that feel good cortisone in her body to mask the arthritis?

[mytil]

Hi and welcome to our site! I am sorry your girl is having these troubles.

Controlled cortisol does unmasked arthritic problems as you can see. What were the results of the last ACTH test? What is the dosage amount of the Trilo?

I know others will chime in shortly as to any types of medicine they use for arthritis pain. IMO I do not think it would be a good idea to under dose to control any kind of arthritic problems simply because the excess cortisol can affect internal organs and ability to handle infections.

Terry

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about arthritis and Vetoryl (Trilostane) dosing into Tambo’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thanks!

[Budsters Mom]

Hi Angela,
High cortisol levels help to mask symptoms because it performs similar to a steroid. Symptomatic conditions such as arthritis and allergies often worsen once the cortisol starts to lower. Buddy's allergies went haywire when that occurred. As far as under dosing to help Tambo's arthritis symptoms, that will be something you will need to discuss with your vet. Others may come along with some suggestions. Xxxxxxxx

[frijole]

I chose adequan injections and they worked well for my Haley. She lived to be 16 1/2. I also gave her fish oil and glucosamine chondrointin. She did very well on them. Kim