9-year-old Dachshund with pituitary Cushings on 40mg Trilostane

[Larysa]

My Zirka is a 9-year-old dachshund who was diagnosed with Cushing's last month. She's been on Trilostane for 5 weeks now - initially 30mg and now 40mg. The vet says her levels are perfect and we have to check in a month from now and keep going with 40mg per day. I have noticed that the excessive thirst has gotten better and she actually leaves food in her bowl (occasionally) instead of ravenously gulping it all down. But she still have the distended pot belly and that doesn't seen to be getting much better. Her hair on her back is also still really thin. I thought I would see results sooner. Any thoughts/advice would be greatly appreciated. Should I just be patient or is the dose potentially too low? Thank you!!

[Harley PoMMom]

Hi and welcome to you and Zirka,

We would be able to provide you with better feedback if you could tell us more about your girl. Such as, how much does she weigh? Is she taking any other herbs/supplements/medications? Does she have any other health issues? What symptoms did Zirka display that led you or your vet to test for Cushing's in the first place?

If you could get your hands on all tests that were done on Zirka and post any abnormalities that are listed that would be great! Also, if you would post the results from any monitoring and/or diagnostic tests for Cushing's that would help us too.

Clinical symptoms such as the increased drinking/urinating and ravenous appetite usually ease up with in two weeks of starting treatment with Trilostane. Any hair or coat problems do take much more time.

More information regarding Trilostane/Vetoryl can be found here: Trilostane/Vetoryl Information and Resources. (http://www.k9cushings.com/forum/showthread.php?t=185
)

Please do not hesitate to ask all the questions you want, and know we will help in any way we can.

Hugs, Lori

[goldengirl88]

Hello and welcome to the forum. I am not sure how much your baby weighs, but 40mg for a dashound seems high to start them on. Please tell us the weight and how many days has she been on the trilostane? Do you have prednisone on hand if she goes too low? If not please ask your vet for some. Blessings
Patti

[Larysa]

She weighs about 14.5 lbs but ideally should weigh about 10. She's always been a bit on the heavy side and has had thinning hair on her back but in the last few months we noticed that she was drinking a drastically increased amount of water and was overly ravenous at meals. She and her sister used to graze on food and we would leave it out but once she started eating everything in sight, we starting restricting food and feeding them measured amounts twice a day. Her weight seemed to shift drastically into a pot belly instead of being generally spread out and the hair thinning got worse. We took her in and she was diagnosed with pituitary Cushings. The vet put her on 30mg for ten days and then upped it to 40mg and she's been on that for a few weeks now. I was told to watch for lethargy and weakness and anything else alarming like vomiting or diarrhea but she's been totally fine. Now we are supposed to keep her on the 40mg per day until our scheduled checkup next month. I will call the vet and ask them to send me her numbers and test results so I can post them. Thank you so much for your help! I have been relying solely on the vet and after reading things on this discussion board am worrying that I might be missing something.

[Larysa]

Ok, so I called the vet and here are the results of her costisol tests:

The first test was on Sept 3rd after she was on 30mg of trilostane for 10 days: first test was 7.4, second was 5.1 and third was 6.7.

The second test was on Sept 16th after she was on 40mg of trilostane for 12 days: first test was 2.2, second was 5.7 and third was 7.6.

[frijole]

I'm not following the info you posted. The test that is supposed to be done is called an acth test and there should only be 2 numbers. Can you physically stop by vets and get copies just to make sure the right test is being done? I want to make sure it isn't the low dose dex suppression test which is done to diagnose cushings.

I agree - 40 mgs is very high for a dog that is so small. Also you were only on the dose a short while. We find the results tend to improve with time so switching too early can lead to overdosing. Please get the copies just so we can feel better about what is going on. Thanks. Kim

[Squirt's Mom]

The first test was on Sept 3rd after she was on 30mg of trilostane for 10 days: first test was 7.4, second was 5.1 and third was 6.7.

The second test was on Sept 16th after she was on 40mg of trilostane for 12 days: first test was 2.2, second was 5.7 and third was 7.6.

Oh, dear, it looks like your vet may be running the wrong test for monitoring. The test that is needed once treatment starts is called an ACTH - it only has 2 numbers, a pre and a post. The test results above look like they are from either a LDDS or HDDS, neither of which should be used to monitor and ONLY for diagnosing before treatment starts.

[Harley PoMMom]

I'm pretty sure that in Canada and the U.K. that 3 blood draws are performed for the ACTH stimulation tests

[Larysa]

I am going to have them fax all of her results to me. They are terrible at explaining things to be in detail and I was trusting them to know what they were doing until I started reading up on it. I will get back to you guys with all the specifics of her diagnostic tests and the 2 tests they have done since she started on the meds. Thank you!!

[frijole]

I'm pretty sure that in Canada and the U.K. that 3 blood draws are performed for the ACTH stimulation tests

That is why I asked her to check and actually see the test results because I thought I had seen 3 numbers before. Frankly I like to see the times of the draws to make sure the test is being done correctly anyway so having the hard copy is really a best practice. Thanks Lori! Kim

[molly muffin]

Hello and welcome to the forum.

I don't want to confuse anything further from what Lori and Kim are talking about. It is important that the test being done is the ACTH test, not the LDDS. If you are in Canada, then they do 3 draws for ACTH, but we'd need to know what the hours next to each test say.

Sharlene and Molly Muffin