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Mel-Tia
03-06-2013, 02:28 PM
From reading the new posts it is obvious to me that some of these vets do not know how to safely use vetoryl. I was wondering (like you have now realised I do a lot!) whether any actual clinical information has ever been provided to your vet from dechra when they order the initial pills

It seems to me like there should be something given as standard when the pills are ordered so our pups don't get in trouble!

As there is such a wide range of people from all areas on this forum I thought I would ask you all whether you knew?

Mel
Xxx

Roxee's Dad
03-06-2013, 02:57 PM
Good question Mel :)

I believe when ordering the brand name Vetoryl (Trilostane) an information or data sheet would come along with the prescription. Now how many people actually read the 2 pages of fine print? But when ordering the compounded version of Trilostane, I don't remember a data sheet being enclosed in the prescription.

Most of my research at the time revealed very little until I found this forum and the very knowledgeable members. The Information and resources section was very helpful and included links to studies, data sheets for the Vetoryl and many good links to learn more about Cushing's treatments, and I spent weeks just reading threads and post.

Not all vets are as informed as many of the members here. After joining this forum and learning so much, I interviewed a number of vets and mostly asked educated questions about cushings and the related treatments. The best I could find at the time was a vet that was treating 5 or 6 patients and only 4 of the 6 were doing well. I did hire him and through the information and links here in the forum, we learned together and yes we did have a few disagreements, but he was willing to work with me as a team, listen, and research the links I gave him and we always came to an agreement for what was best and safest for Roxee. I have fired a vet because of his lack of experience and knowledge of cushings. One vet who I loved dearly told me he accidentally killed his own dog because of his inexperience with the treatment of cushings.

molly muffin
03-07-2013, 12:35 AM
I was told vetroyl was completely safe, that 30 mgs to start my 19 lb dog on was absolutely a preferred dosage. I wasn't warned of any possible side affects to look out for or things to be aware of involved in cushings treatments. I didn't even know exactly how it was suppose to work other than, lower the cortisol. I am still told by my vet that she will not give me prednisone to have on hand.
I knew nothing until I found the forum and it still makes me angry if I think about it too much.
That said, I Did find this forum, and got a consult to an IMS and had an ultrasound and had an LDDS test to confirm the ACTH test (which by the way it did not do) and I still have that box of 30mgs vetroyl sitting in my desk drawer.
So what about those parents who never find us, who don't know what to look out for, who don't know what the proper dosage is, has the insert been updated with the current recommendations?
Getting clear, concise information out to people who don't necessarily understand a bunch of medical terminology would be nice to. This is warning signs, this is current dosage recommendations, this is when you might want to dose twice a day, etc. Keep it simple and straight forward.

I still have my vet, but I don't know if I'll ever let her treat Molly for cushings.

labblab
03-07-2013, 09:09 AM
One surely wishes that all medical providers -- physicians and veterinarians alike -- would make sure they are thoroughly familiar with the medications they prescribe, and pass that info on to their patients. However, in the case of brandname Vetoryl, the manufacturer (Dechra) does publish written product inserts to be included in the medication boxes (and also presents the same info and much more online for anyone to read). So owners who buy Vetoryl ought to have that information in their hands even if their vet has not properly conveyed it in the first place.

But herein lies a big catch. In defense of the vets, you would think that they ought to be able to rely on the dosing information that is printed on Dechra's written materials when they prescribe the drug to their patients. However, the printed dosing chart is now considered outdated and excessively high by many clinicians (and apparently even by Dechra themselves, per verbal contacts with their technical reps). Per Dechra's published chart, 30 mg. would indeed be the recommended dose for a dog of Molly's weight, for instance. So at least regarding dosing, I am willing to cut the vets some slack. Although, if they try to remain up-to-date with research and clinical findings for the drugs they are prescribing, they will quickly find that the trend is towards lower dosing for reasons of safety.

As far as treatment monitoring and medication side effects, I do think the Dechra publications do a good job as far as providing information and warnings. So for the benefit of any new readers, here's a link to our Trilostane/Vetoryl Resources thread that provides links to Dechra's printed info:

http://www.k9cushings.com/forum/showthread.php?t=185

I do fear that John is correct that, at least in the U.S., there is no uniform legal requirement that compounding pharmacies provide this same information to patients. So for any reader who has been prescribed compounded trilostane for his/her dog rather than brandname Vetoryl, please do familiarize yourself with the info contained in Dechra's links as the prescribing information will be identical.

Marianne

Katiesmum
06-06-2013, 09:02 AM
My vet has been good. Katie was a rescue dog supposedly in good health. I took her for her innoculations and the vet noticed her pot belly. I feel stupid as I thought she was just overweight. Blood test done and she has cushings. She was prescribed Vetroyl and I gave it her for five days but she developed symptoms pacing.crying,hiding and panting. Took her back to the vet and I have stopped the meds.I don't know where we go from here though