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Thread: Wayne has crossed The Bridge / Wayne-Newly diagnosed 10-year-old pit mix

  1. #21
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    Dec 2017
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    I also meant to add that because she knows we are not high income people, she said that we could push off the next round of ACTH testing for 3 months rather than repeating it in 2 weeks. I consented to this but I hope this isn't a terrible idea... I know it's not standard practice, especially after a dose change. She did say to keep a very close eye on him and let her know of any changes in symptoms, in which case we would do the testing right away. I do trust this doctor but I feel a little nervous. I am just hoping we find the right dose soon - he has been doing so much better since starting the pills, so I was a little shocked that his results showed that maybe his cortisol was too low now. But again, I guess we really need the actual numbers, so I'm going to work on getting those tomorrow. You guys are a lifesaver - literally!

  2. #22
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    Hi again from me, and I’m so glad to hear that Wayne is doing better! As far as the testing, I’d normally be more worried about postponing testing if a dose was being increased as opposed to decreased. However, my reaction as it relates to Wayne will depend a lot on these actual ACTH results. So let’s wait and see what they were. A three-month testing interval is acceptable once a dog’s cortisol level has stabilized within the therapeutic range. But since you are still tinkering with dosing, there may be a compromise such as one more ACTH at six weeks. Or at least a basic blood chemistry to make sure that his electrolytes (mainly potassium and sodium levels) remain normal, along with a resting cortisol. A resting cortisol cannot really give you enough info to know if he needed a dosing increase, but it can provide some reassurance that cortisol is not dropping too low. So there are some options you can consider and discuss further with your vet as time goes on. In the meantime, though, let’s await those test numbers.

    Marianne

  3. #23
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    Jun 2012
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    Hi from me as well. Marianne has given you some options that you can discuss with your vet, especially t possible test at 6 weeks or a pre cortisol test to make sure he hasn't continued to drop too low.

    I think the most important thing is watch for symptoms of going too low. If he were to stop eating, developing diarrhea, become wobbly can't stand, etc. These things can be immediate indicators of a problem and you can get him into a vet.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  4. #24
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    Dec 2017
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    NYC
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    Thank you both for your replies.

    Now I need a different kind of advice. I am having serious problems with the online pharmacy, KV Supply, where I ordered his medication from. They have delayed and delayed, and I'm furious. This morning we gave him the last pill we had, and the pharmacy hasn't even shipped his order yet. I placed the original refill order on Dec 15th - it was revised to the lower dose as soon as the vet had more information, and we still don't have it. Have any of you had issues with this pharmacy? I can't see myself ordering from them again. I have made no less than 12 calls to them over the past week, and things are just dragging on their end. Any recommendations for other online vet pharmacies with competitive prices?

    Secondly, like I said, we are out of medication as of today. The vet said that if we missed one day of medication, it would probably be okay, but at this rate, I'm afraid he'll go without medication tomorrow morning AND the next day until the delivery, likely in the afternoon. I don't know what to do, as my vet doesn't routinely stock this drug, since it's pretty niche, and she's a small community practice. Is this likely to cause Wayne to have a major relapse or worsen his disease progression? Have any of you ever had luck with getting just a few tablets from a local pharmacy to tide you over until your full refill could be obtained? The only local vet pharmacy that carries the medication charges $185 for 30 pills, and I don't believe they will open a package to sell single pills, but of course I'll ask with the full expectation of being told no. I am so frustrated with this situation. We are not rich people, so we really feel the pain when we have to just thrown money away as I expect we'll have to do tomorrow at a local (very expensive) pharmacy. Ugh. Any advice? Should I cancel my order with this horrible online pharmacy and just bite the bullet and pay double tomorrow so that we don't miss a dose?

    Thanks as always for your advice. I feel like I'm doing a terrible job taking care of this pup's medical needs right now

  5. #25
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    Georgia
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    You are absolutely NOT doing a terrible job!!! You are working very hard to do the right thing for Wayne :-).

    Missing a couple of days of Vetoryl should not be a huge issue. So if you believe the order from KV will actually arrive shortly, I wouldn’t invest in a supplemental supply from the local pharmacy. You may see a temporary increase in symptoms during the interim. But once Wayne’s cortisol is reduced again, you should be back on track.

    As far as future orders, I’m not familiar with KV. In checking their website, it looks as though their prescription meds are filled through Pets Choice Pharmacy, which in turn is an arm of Lambert Vet Supply. We do have other members who have used Lambert, and perhaps you’d receive more satisfactory service if you ordered directly from Lambert. If you’d like to search for other alternatives and/or compare pricing, here’s a link to a listing of “safe” internet pharmacies that has been compiled by the National Association of Pharmacy Boards. The NAPB is a professional association that has been working to enhance a credentialing process for internet providers. After clicking on the link, just scroll down to the veterinary provider section.

    https://www.safe.pharmacy/buying-safely/

    Hopefully, this will offer you additional options for obtaining Wayne’s Vetoryl in the future. Longterm, if the cost of his medication becomes prohibitive to you, another possible option is to switch from brandname Vetoryl to a compounded version of trilostane that is individually prepared for Wayne. There are pros and cons to compounded products that we can discuss further. But for right now, hopefully you can find a provider on this list that is more reliable than KV has been for you.

    Marianne
    Last edited by labblab; 01-15-2018 at 10:27 PM. Reason: To add.

  6. #26
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    Also talk to Diamondback Drugs out of Arizona. That is who many of us here use, including me. They have always been very prompt with both new meds and refills from my experience. Like Marianne said, you are NOT doing a bad job. You have no control of KV or the postal system but have done your part in getting these meds in. So do not let guilt get a foot hold - it is very hard to get rid of and you do not deserve to feel that way at all.

    Hugs.
    Leslie
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  7. #27
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    If you were to end up shifting to a compounded version of trilostane, then as Leslie says, Diamondback Drugs is definitely recommended and used by a number of members here. However, they do not sell brandname Vetoryl. So I’m afraid you will need to look elsewhere for the time being.

    Marianne

  8. #28
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    Jun 2012
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    Canada
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    Did you get any resolution with KV Supply? Did they agree to either, send immediately or refund money? If they will refund your money, you could try calling lambert directly. We have had others use them successfully.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  9. #29
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    Dec 2017
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    NYC
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    I have talked to them by phone at least 3 times a day for the last week, and still no answer as to what is going on. It is maddening. I do need to demand a refund, but then they keep saying Oh we're shipping today. They've done this at least 5 times now. In the meantime, I have to spend about 3x as much to get the stuff locally tomorrow because it has now been two days since we've run out of medication. I have actually cried about it - maybe it's pregnancy hormones but I think it's mainly the frustration and feeling like I'm letting my big boy down. Ugh.

    Since I'm going to need to switch pharmacies anyway, do you guys mind sharing what the drawback would be of getting compounded medicine? For myself, I am more than satisfied with generics, so I'm totally okay with using them for my dog family too. Diamondback got back to me with a quote and it is about half as expensive as the brand name vetoryl - I couldn't believe it! My experience with KV Supply has been incredibly frustrating, and I am sure I will never use them again. I am open to other pharmacy recommendations too if you have any other favorites and don't recommend compounds at this time for us.

  10. #30
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    York, PA.
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    Default Re: Wayne-Newly diagnosed 10-year-old pit mix, horrible reactions to Vetoryl/Trilosta

    I like this post by Marianne to another member regarding compounding Trilostane:

    Quote Originally Posted by labblab View Post
    You are correct that there is no generic version of Vetoryl available. When we discuss "compounded trilostane," we are talking about custom doses of medication containing that active chemical that are prepared by individual pharmacies (as opposed to pharmaceutical companies). Here's an excerpt from a related reply that I posted some time ago to another member.

    Trilostane is the active ingredient in Vetoryl, and for dogs who need doses or forms of trilostane that are not available in Vetoryl, there are veterinary compounding pharmacies that will custom-make individual prescriptions. Compounded trilostane is generally much less expense than Vetoryl which is a definite "plus." There are also some "minuses" as well, in that a recent research study has shown that the products obtained from some (unnamed) compounding pharmacies are more variable in both actual dose and efficiency than brandname Vetoryl. For this reason, some vets do not feel comfortable prescribing compounded versions of the drug unless a dog truly does not have another option due to the size of the dose needed. However, we realize that for dogs needing big doses like Chloe, or doses that require the combination of multiple Vetoryl capsules, the expense of Vetoryl can be overwhelming, and compounded trilostane may offer the only affordable option for continuing with treatment.

    Marianne
    When deciding to compound, one has to make sure they are getting their medication from a reputable compounding pharmacy, many of our members use Diamondback as their online pharmacy agent.

    Lori

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