Re: New cushings diagnosis
So 8.5 is the consistent post ACTH result and the vet wants to double from 45mg twice a day to 90mg twice a day. I don't think I would want to go up that high and wait 3 months for a retest, especially if the calicinosis cutis (the sores on his back) are clearing up nicely. However, since the urinating accidents is still an issue, he isn't considered to be under control. You are looking for a post result of the ACTH between 1.5 and 5ug. So he doesn't have much to come down, and it can be a post results up to 9mg if the symptoms are controlled. He isn't quite controlled yet so I would look at a smaller increase.
Perhaps something like 50mg twice a day or 55mg twice a day would do the trick.
There is another option and that is to try name brand vetroyl, although it can be more expensive. Another good pharmacy to get trilostane from is there in Arizona and is called Diamondback, but I don't think they do chewable tablets.
They haven't been able to determine either a cause for cushings or a proof of hereditary in cushings.
I'd just keep an eye on Venus and make sure to get blood work regularly to make sure she is okay and then perhaps if you are very concerned you could do a cortisol urine test. If no cortisol (or within acceptable range) then there shouldn't be a concern of cushings. Due to the family history though I think it would be worth keeping an eye with the urine testing, as that could give you an early warning if things start to develop.
Sharlene and the late great diva - Molly muffin (always missed and never forgotten)