Can too much trilostane cause dark stool?

[tinybiny]

My min poodle is 15 years old and has been on Trilostane for over 2 years. It changed his life dramatically and has been great. He has other chronic health issues (gone blind due to glaucoma, diagnosed with melanoma 9 months ago). Recently, his symptoms have gotten worse - a lot more peeing and fussing for more food. He has been losing weight over time and I started giving him more food. He doesn't gain weight from the food, but I have noticed that he has dark stool off and on.

Other people I've talked to have said that when they had a dog with cushing's, the medicine kept the dog alive another year or two. I'm not sure what that means exactly. My dog has been alive longer than that. I am wondering can a build up of trilostane can cause dark stool. I have been googling if it is the melanoma or the trilostane or eating more. I am not finding anything that sounds like it is any of those. It also isn't constant.

He has really bad anxiety/panic when he goes to the vet. Believe it or not, in the 6 years I've had him (adopted him at age 9), no vet has ever had a good listen to his heart and lungs because of his panicking at the office. And, he has been to many different vets. So, with that in mind, I'm not too keen on having him go in for more tests if it isn't necessary. He's had a lot of tests in the last year because he had surgery to remove a melanoma tumor. I feel bad for him with all his health issues already to have to put him into a major panic attack if it isn't necessary. I do understand he is at the end of life point, but he still loves to eat. The only things he enjoys right now are eating and sleeping, but he still wags a lot when he thinks there is going to be food.

EDIT TO ADD: I live in California was told by the pharmacy that the base the trilostane was made in is no longer legal in my state. They had to change the base. He's been on the different mix of trilostane for about a month

[labblab]

Hello and welcome to you and your little boy. Is he taking any other medications in addition to trilostane? I'm especially wondering about any type of pain relief. This is because dark, tarry stools usually reflect bleeding from the stomach or upper GI tract. The "darkness" is actually blood that has been passing into the stool. Trilostane does not have a reputation for causing that type of GI inflammation, but painkillers often do -- especially NSAIDS such as Rimadyl, Deramaxx, etc. So that's why I'm wondering about any other medications.

A chronic GI ulceration accompanied by blood loss could definitely result in lack of energy and weight loss. You can probably easily take a stool sample in to your vet to have them check for blood. That may be the first place to start in this situation.

Marianne

[tinybiny]

Hi, he is also on Apoquel. He was diagnosed with unspecified allergies from chewing himself and the vet said Apoquel was the only medicine that wouldn't make his cushing's worse. He has been on that for over a year now. I will have to ask the vet if that is doing it and if it is, what to do because it's the only thing that keeps him from chewing himself up.

He recently had a series of Adequan shots for arthritis. Now that I typed that, I think the timing fits for the change in stool. I will look into that.

I have been giving him a lung treat every day since he always wants more food. I suppose it can be that. I will probably just bring in a stool sample like you suggested. He is considered current on his exam, so they should be able to just check it.

Since it seems like his cushing's is worse, I assume the vet will want to do another bloodtest to determine dosing. His symptoms have gotten a lot worse in the past couple months and I can't help but wonder if it has something to do with California law about how it is made. The drug worked wonders before the pharmacy had to change the base.

[molly muffin]

Hello and welcome to the forum I wasn't aware that California had changed the base. I assume that this is the basic filler that is in the trilostane medication though and not the trilostane itself. You could have the stool checked for any blood etc and if it isn't blood then it could be from the base, or something else in the diet.

I would think that with the weight loss, the vet might want to do an overall senior profile check to see how things are going over all with him and if anything shows up that could be an issue causing the weight loss. That is probably what I would request myself.

[tinybiny]

I just returned from travel. Tiny's stool stopped being dark a couple days before I left and my husband didn't think the stool was unusual while I was gone. Seems like whatever was happening has passed.

I'll be taking him in soon to get a medication check done. He is acting more and more like he has untreated cushings with the drinking, constant asking for food and urinating everywhere. I'm sure it's time to up his dose. The vet tends to not want to do lots of treatments at this point because of Tiny's age and chronic health concerns, but I'd like to see him be as comfortable as possible.

He has been on his current dose for close to 2 1/2 years. How often do dogs need their dose changed?

[judymaggie]

Hi! I am glad that Tiny's stool has returned to normal. With regard to your question about how often does a dose need to be changed, there is no set answer. Some dogs never have to have their dose changed; others do periodically, either up or down. Be sure not to make any changes without an ACTH done. I also agree with Sharlene that a senior panel should be done as well -- however, it is best not to do both the ACTH and panel on the same day as fasting is preferable with the panel in order to get the most accurate results.

[tinybiny]

I actually ended up taking Tiny in to see a new vet because it is much closer (5 min drive vs. 20 min) and less expensive. Tiny has full blown panic attacks when he goes to the vet riding in the car beforehand makes it worse.

The new vet drew his blood/urine and updated his glaucoma test. He said Cushing's can create several new issues like diabetes, kidney disease and something else that I cannot remember that he thinks can be the cause of the increased urination. He wanted to check all that before doing the ACTH test. He might not even do the ACTH test if something else gets diagnosed and the treatment for whatever it is helps with the increased urination. Tiny was actually calm enough at this vet that the vet was able to clearly hear his heart and hear a murmur. In the 6 years I've had Tiny, no vet has ever been able to hear his heart clearly because of the panic attacks he has when he goes to the vet.

I'm just waiting for the results of those tests at this point. Perhaps I'll start reading up on the diabetes, too, since that's what the vet seemed to think was going on.

[Harley PoMMom]

I'm glad to read that you have a vet that Tiny feels a lot calmer to be around. When you get those test results could you post them here for us? You need only to post the abnormal values and please include the normal reference ranges...Thanks!

If Tiny would have diabetes we have a sister site that deals with canine diabetes, they are a wonderful group and are very knowledgeable, here's their link: http://www.k9diabetes.com/forum/

Hugs, Lori

[tinybiny]

The vet called yesterday and it was actually what I consider to be very good news. Tiny likely has a UTI, which would account for the increase urination and sleepiness. Everything else in his blood/urine looked good. Only abnormality was a bunch of rods, which the vet said was bacteria. Today, I'll start him on his antibiotics and his urine will be tested again at the end of treatment.

He actually showed no signs of diabetes or Cushing's in the normal blood /urine panels. So, the vet doesn't want him to take the ACTH test or adjust his Trilostane at this time because it seems to be under control. I don't have the lab results, but will ask for copies when I pick up his antibiotics today.

It was such a relief to hear that it is something easily treatable like a UTI. He already has so many chronic health issues, I don't think he could take on anything else.

[molly muffin]

This is really good news as it is easy to treat.

Go Tiny :)

[tinybiny]

Tiny's antibiotic is making his vomit every day. I have been spreading out his food and medications to try to get the medication to stay down, but now he won't eat. He did have some breakfast yesterday, but no dinner or bed time snack. He refuses to eat today, too. The vet said to cut the antibiotic dosage in half, but to make sure Tiny has a significant meal before I give the next dose. Not sure how that is going to work out if I can't get him to eat.

He has never refused food. He always asks for more food no matter what he is sick with. I am very distraught about this. I'm supposed to call the vet again tomorrow. I am also squirting water into his mouth since he doesn't seem to be drinking anymore, either.

EDIT: As soon as I walked away from my post, he went and drank some water on his own.

[Joan2517]

If he is still on the Trilostane, please don't give him anymore until you have his cortisol checked...it may have dropped too low.

[molly muffin]

As Joan said, you don't want to give him trilostane when he isn't eating or drinking. It won't hurt to stop the trilostane, get him through the antibiotic, and rid of the UTI (verified with a culture that it is gone as many come back right away or within a month otherwise) and then when he is drinking and eating normally again, you can restart the trilostane.

[Harley PoMMom]

Joan and Sharlene are right, the Trilostane has to be stopped since Tiny's not eating. I know how worried you must be about your sweet boy and when they refuse to eat it triples the worrying. When my Harley got picky I tried a whole bunch of things; baby food (no onions), deli meats, canned cat food, tuna, fast food...what they eat is not as important as getting them to eat.

Hugs, Lori