Vetoryl vs Compounded Trilostane side effects?

[IWALY]

Hello,
I was wondering if anyone has experienced side effects with compounded trilostane? The long story short, my Peanut (13 year old, 18lb dachshund with diabetes and cushings and chronic pancreatitis) is being treated with 20mg of trilostane twice a day and he seems to have diarrhea as a side effect. When we put him on Vetoryl 20mg twice a day he does not have diarrhea, we have only tested this once so far and unfortunately has a lot of medical issues and has a lot going on so while it appears that the diarrhea happens when on the compounded med, we are not 100% sure. I think we would need to switch between the two a few times to be more certain. So I was wondering if anyone else out there experienced this or found any difference when they have used compounded vs Vetoryl? The compounding company has been in business for 50 years and is suppose to be very reliable, but I know so many who use Diamondback that I'm thinking of buying more compounded from them to see how he does on it from them. It's just so expensive to keep buying meds just to test so to speak... Thank you in advance for your input!

[labblab]

Hello, and welcome back to you. I see you were last here with us back in 2013 with your dog, Waly. And now you have yet another Cushpup, little Peanut! I’m so sorry that you are again dealing with Cushing’s, but very glad you’ve returned to us.

My first observation about Peanut is that this is a rather high dose of trilostane for a dog of his weight. So my first worry is that the diarrhea is simply a result of his cortisol dropping too low. Can you tell us more about the exact process that led to the Cushing’s diagnosis, including actual diagnostic monitoring and testing results? What worries me is that other illnesses such as diabetes and acute pancreatitis can skew the diagnostic testing, so it will help us to learn more about the development of all these problems. It will also help us to know his dosing history. How long has he been taking the 20 mg. twice daily, and how recently has his cortisol bern tested (along with the actual results)?

To return to your original question, yes, it’s possible that there is something about the compounded product that is creating an issue. It might be the binder that the the pharmacy is using, or it might be that the dosage is inaccurate and the pills/capsules may actually be stronger than 20 mg. If so, that could explain why Peanut does better on the Vetoryl. But it’ll help us a lot if we can find out more specifics about Peanut’s overall situation.

Thanks in advance for any additional information. And also, we’d really welcome learning about how things turned out for your sweet Waly, as well.

Once again, welcome back!
Marianne