Trilostane Side Effect - Worry or wait?

[AdoAnnie]

Hello, I'm new here. I've been following this site since our 12 yr old dachshund/jack russell mix, Annie, was diagnosed a couple of months ago. She started on Trilostane, 10mg twice per day and responded well. We had one set back where she lost her appetite. Our vet stopped the meds for a few days and restarted again and we only give it to her with a full meal (which includes chicken mixed with her food). She's been doing okay and is scheduled for another STIM test on Tuesday morning.

Annie is prone to GI upset and has had several episodes of HGE over the years. Yesterday, she had a lot of digestive noise (also not uncommon). This morning she had diarrhea. The vet is closed today, and this doesn't seem like an emergency-worthy visit. I'm inclined to skip her evening dose of Trilostane and call the vet first thing in the morning. I'm guessing this will throw off the results of the STIM test or we may need to reschedule. I'm just looking for advice.

I'm also curious is anyone has had good results from compounding Trilostane. Our vet had said that we may need to get Annie on a smaller dose to avoid the GI upset.

Thanks!

[lulusmom]

Hi and welcome to you and Annie.

I'm glad that you came out of the shadows and started your own thread for your precious Annie. Rule of thumb is that you never give Trilostane to a sick dog and diarrhea qualifies as being sick. If either of my two cushdogs acted off in any way, I took them off Trilostane for a few days. Do not continue to dose Annie until she has completely recovered and yes, you should reschedule the acth stimulation test.

You mention that you now give Annie her Trilostane with a full meal. Trilostane should ALWAYS be given with a meal. Were you not giving with food prior to her her losing her appetite? It is imperative that the acth stimulation tests are done within 3 to 6 hours after dosing with a meal. Was this done correctly for Annie? If not, the results of the acth stim tests that have been done so far, are unreliable. Can you please post the results of all acth stimulations that have been done after starting treatment?

What symptoms did Annie have that lead you to and your vet to pursue a cushing's diagnosis. What tests were done to diagnose Annie and can you please post the results of those tests? Does Annie have pituitary or adrenal dependent disease?

Finding a trustworthy compounding pharmacy is very important. A lot of us use Diamondback Drugs for our compounded meds. My two cushdogs were on compounded Trilostane for two years with excellent control. They deliver nationwide and have rave reviews from most members who deal with them. You can find there contact info at www.diamondbackdrugs.com.

We're here to help you and Annie in any way we can. You can help us provide more meaningful feedback by posting as much information as you can about Annie's diagnostic and treatment monitoring testing.

Glynda

[molly muffin]

Hello and welcome to you and Annie.

I'm with Glynda, it doesn't hurt to withhold Trilostane, but you will want to reschedule the ACTH test, as it needs to be done during dosing phase. Once things have cleared back up, and she is not having any diarrhea, then after about 4 days of medication, you can do the ACTH and it should be accurate. As Glynda mentioned, make sure the medicine is given with a full meal and tests are done 4 - 6 hours after medicating.

I'd withhold today, call your vet tomorrow and have a chat, let him know what is going on, and cancel tomorrows ACTH.

Welcome again! We look forward to getting to know you and Annie.

Sharlene and molly muffin

[goldengirl88]

Welcome from me too. Just wanted to chime in and say I believe what Glynda and Sharlene said. Always withhold Trilostane if you have any doubt your dog is acting different, it does not hurt as you can go right back on when the episode is over, I hope all goes well for you and your baby. Blessings
Patti