Standard Poodle - Poor response to trilostane

[THC]

I was considering those two herbal treatments for my Standard Poodle who has Cushing's. He is presently on 28mg of Trilostane every three days reduced from every day after loss of appetite and energy, and weight. He is eating better and has more energy but has yet to gain back his weight. He has lost 30 pounds! I was conidering the herbal treatments because the Trilostane is causing diarrhea the day after he takes. I have a prescription for Flagyl but don't want him constantly taking that either. Any input will be appreciated.

[labblab]

Hello and welcome to you and your boy. You’ll see that I have made a copy of your reply posted elsewhere, and I am using it to also start a thread that is your very own. This way, it will be much easier for our members to reply to you directly.

First of all, 30 pounds is an enormous amount of weight to lose and certainly is indeed worrisome! Did weight loss precede the trilostane treatment, or has it all resulted since starting the medication? There are several aspects of your boy’s situation that are troubling. Weight loss is not characteristic of uncontrolled Cushing’s — in fact, weight gain is the norm. So if the weight loss preceded the trilostane, I would be worrying that there is instead something else going on in place of, or in addition to, Cushing’s.

Secondly, even if trilostane treatment is appropriate, the more reasonable approach would seem to be to give a smaller dose daily, rather than a larger dose every three days. The medication remains active in the body for less than 24 hours, so by dosing every third day, he is getting a big effect (perhaps even too-big) on one day and then probably receiving no effect on the other two days. So he is on kind of a rollercoaster instead of getting a steady, consistent daily treatment effect. This may help account for the diarrhea on treatment days. Has he had monitoring ACTH testing to indicate the effect the trilostane is having on his cortisol?

Actually, in terms of testing, can you tell us more about the symptoms and also the original testing that led to the Cushing’s diagnosis in the first place? Unfortunately, there is no single blood test that can definitively diagnose Cushing’s all by itself. Other illnesses can produce “false positives” if enough stress is being placed on the body. This is why I am wondering about the weight loss, and also any other pre-existing symptoms. The entire picture of test results and symptoms have to be taken into account when arriving at a Cushing’s diagnosis.

I apologize for asking so many questions! But as you can see, it will help us a great deal if we can find out more specifics about your boy’s situation. In the meantime, we’re really glad you’ve found us!

Marianne

[THC]

Thank you for your reply. His weigh lost started in May right after he was diagnosed. He also has hypothyroidism. The Vet recommended the every third day regime. I was not giving him the medication with food. Now I do and the diarrhea has stopped. He has had ACTH monitoring and I will share those. Apologies for my delayed reply.