Shiba Inu on Trilostane w elevated liver enzymes

[Frannie'sfather]

Hi...12 year old Shiba on thyroxine, trilostane, and Atopica. Knew Atopica was too toxic for her, but vet insisted. Today after elevated liver enzymes found, told to drop Atopica. Any suggestions? Getting an ultrasound on Tuesday. Miss having my rambunctious Shiba; sad she is so depressed and sick w vomiting. She has lost a lot of hair as well.

[Junior's Mom]

Welcome to the forum. First thing, never give vetoryl/trilostane to a sick dog. Please stop the medication.
Many questions will be asked of you, so members can better help you. Such as tests run so far, and what abnormal results came from them.
This is a great place to help your fur baby.
Tracey

[labblab]

Hello and welcome, but I am so sorry your dog is not doing well right now. It's true that we tend to ask a lot of questions, but I think most importantly right now, when you saw the vet yesterday, was testing done to make sure that the vomiting and lethargy are not being caused by oversuppression of cortisol by the trilostane? Apparently blood chemistries were drawn, but how about any check of the cortisol level (ideally an ACTH stim test, but at least a resting cortisol level)? This testing would be extremely important, because low cortisol can become life-threatening very quickly.

Also, can you tell us why the Atopica was prescribed? Cushing's itself elevates liver enzymes, so I am not sure whether you are meaning that the liver numbers are now even higher? Regardless, what was the purpose of taking the drug?

We will be grateful for any additional info you can supply regarding your dog's overall health history, the symptoms and testing that led to the Cushing's diagnosis, any other medications she's taking, her weight, her dose of trilostane, and results of any treatment monitoring tests of cortisol. Whew!!! I know that's a lot of questions, but your answers will be really helpful to us. And once more, I think the most important question right now relates to the possibility that her cortisol has dropped too low. If so, as Tracey says, the trilostane needs to be stopped immediately, and your dog may also need some supplemental steroid to offset the oversuppression.

Marianne