Help help help

[Laci's Mom]

My dog has been on trilostane since the beginning of November and was doing well until the vet upped her dosage 10 days ago. She has started exhibiting some of the side effects and all I was told was to contact the vet if this happens. The vet is closed for the weekend and I'm no sure what to do at this point. Should I stop medication until Monday or try going back to original dosage?

[labblab]

Hello and welcome! Can you tell us specifically what side effects you are seeing? If there is any question at all about overdosing, the safest course of action is to stop the trilostane entirely until your dog can be evaluated by the vet. You can always resume the medication on Monday if all is OK, but you can't "take back" a dose after it has been given. Can you tell us more about what is going on?

Marianne

[Laci's Mom]

Mainly she is pooping constantly, does not want to eat (she will eat a little chicken but is not interested in anything else.). She sleeps in a crate and when she woke up this morning needing to go out (we made it from 12:30 am until 6:00 am without having to go out..the night before she was up needing to go out about every 3 hours) she just stood there and looked at me. I had to pick her up to take her out and, although she did poop twice, she would not walk back into the house.she came in and is just laying on the floor. She has also started panting a lot again.

[labblab]

I am not a vet, but if she were mine, I definitely would stop the trilostane right now. Were you given any prednisone to have on hand in an emergency situation? If cortisol levels drop too sharply, the prednisone will replace the missing cortisol.

Can you tell us about her weight and the trilo dose she has been taking? Especially if she is a small dog, dehydration from excessive diarrhea or vomiting can become a serious issue rather quickly.

The hope will be that if you stop the trilo, you will start to see some improvement in the coming hours as the effects of the drug wear off. But if the reverse happens, and she worsens, she may need emergency attention. Are there any ER vets available to you should you need them?

[Laci's Mom]

I asked about prednisone and was told they don't usually give that with trilostane to just bring her in if she exhibited severe side effects. Laci is a small yorki-poo (11 pounds) and was started on 0.25 ml of 20mg/ml twice a day. After a month (on December 9) she went in for her follow up test and the results showed that her 1st reading was good but 2nd reading was well above high end of acceptable so the vet increased dose to .35 ml. That was on Dec 10 so she's been on the higher dose about 2 weeks. There is an emergency vet here (to complicate matters, we are in the process of moving so we are currently in our new town and my vet is 1.5 hours away) so if she gets worse I can take her there. Laci is drinking ok right now and ate a little chicken a few minutes ago.

[labblab]

OK, that's good that she's drinking and eating a bit now. And the treatment and dosing regimen that your vet has been following sounds very reasonable. Given the circumstances, though, I would not start back on the trilo through the rest of the weekend.

When you have a chance, we'd love to hear more about her overall health history, including the onset/testing for her Cushing's. Keep us updated through the day as to how she is doing, OK? Otherwise, we will worry.

[Laci's Mom]

I can't thank you enough for your replies!!! I have been sooooo worried and, having read through all of the literature numerous times, the only info I could find regarding side effects was just to contact the vet. Of course, the vet has been closed so that was not an option! You have been a godsend. I will let you know how things go! Bless you, bless you, bless you!!!

[molly muffin]

Do you know what the actual number was for the post result?
One thing to keep in mind is that every dog is different and depending on what the number actually was, it could be that she will do a bit better at the higher end of the range?

I would definitely keep her off the trilostane too till you can find out what is going on.

[Laci's Mom]

UPDATE There is a vet near us that, it turns out, is opened every other Saturday and this was one of the days they were opened! (Laci had been in there for Bortadella nasal spray back in October) I called and was able to get her in today. Vet was wonderful and said she was definitely having side effects from the trilostan and that I did the right thing by not giving her the morning dose. He gave her fluids and something for her diarrhea as well as a B12 shot. He felt that it would be best to forego the trilostane today and start back on original 0.25 ml twice a day tomorrow.) His plan is to slowly get her back on the twice a day regime at the lower dose then re-evaluate after a couple of weeks. He said his goal is to treat his patient by getting her to a point that cushings symptoms are controlled and she is feeling good. (I think her high number was 17 or 18 which all I know is that that is above the highest number in the range they want to see). He also said if she started exhibiting side effects again tomorrow after morning dose to call and leave a message and he would return my call. Regardless, he will call on Monday morning to see how she is doing and will probably have her skip dosing on Tuesday and stet back twice a day on Wednesday. She is like a new dog tonight!! She has eaten and even got a toy out to play with. THANK YOU for your advice!

[molly muffin]

Oh I am so glad that you took her in and that this vet is very well versed in treating cushings from the sounds of it.

That is exactly the kind of plan that any of us would want for you or our furbabies in this situation. Do let us know how things are going. I'm very optimistic.