Peanut — possible effect of trilostane on growth of pre-existing tumors

Hi, my name is Norma. My dog, Peanut, a Dachsund mix, was diagnosed with Cushings just a few months ago. He was 15. He died 1 month after starting a Cushings drug called Trilostane. The vet said the reduction of his cortisol levels after being on the Trilostane may have allowed 2 small masses to grow rapidly that were formerly being controlled by the cortisol. The mass on his spleen grew a full 2cm in 1 week whereas it had been benign for 2 years before that. He also had bile vomiting and stopped eating completely after being on the Trilostane for 3 weeks. He was negative for Addisonian Crisis. I've combed over his records,blood tests, including 2 CAT scans taken over the last 2 weeks of his life and the Trilostane is the only factor that seems suspect in contributing to his rapid demise. I've been reading a lot of articles about treating vs not treating Cushings in dogs with medication. Many say treating with meds does not necessarily extend a dog's life. Had I know this I would not have approved the use of Trilostane for my dog, but would have just managed the pesky symptoms of frequent urination (we used doggie diapers and they worked great) and his drinking a lot of water. I hope this information helps other pet owners to make super well-informed decisions about whether to approve the use of Cushings drugs. Thanks.
Norma

Dear Norma,

You’ll see that I’ve moved the reply you posted elsewhere in order to create a new thread that is your very own. I took the liberty of giving it this specific title in the hope that we may be able to generate further discussion about the possible relationship between cortisol level and tumor growth.

First of all, I am so very sorry about your loss of Peanut. I can surely understand why his death has been made even more disturbing for you due to your suspicion that the trilostane treatment made things worse for him, rather than better. I wish I had a definitive answer for you in that regard, but I believe it will take more research to sort out the genuine effect of cortisol level and tumor growth. We have another new member whose dog suffers from a pre-existing liver tumor, and her specialist has told her that the Cornell Vet School is in the process of enrolling dogs in a study to research exactly that association: cortisol level and tumor growth. Unfortunately, we don’t yet know any specifics about this study, and I’ve been unable to uncover any details myself. But your posting today provides additional motivation to try to find out more. Prior to now, we’ve been aware that some research studies have linked trilostane treatment with the enlargement of Cushing’s-associated pituitary tumors in some dogs. However, I’d not known about any speculation regarding the effect of trilostane on other types of pre-existing tumors.

The decision as to whether or not to treat Cushing’s really does involve a number of factors that are specific to any individual dog: age, overall health history, severity of both internal abnormalities and outwardly observable symptoms, etc. Effective treatment can delay the progression of certain systemic issues, and can certainly allow many dogs to be more active and comfortable. However, as we’re starting to suspect, lowering the cortisol may create new problems or worsen certain issues for other dogs. So there’s definitely more to learn about both the disease and treatment pros-and-cons.

Returning back to Peanut’s own journey, though, I’m so sorry that things did not turn out well for him and especially for your loss of your boy. We have a special memorial thread here on our forum, and it would be our privilege to include Peanut if you’d like for us to do so. I’ll contact you later about specifics. In the meantime, please do feel free to continue posting here. And as I say, I’ll also try to update this thread with any additional research info that I can dig out.

Marianne

Thanks Marianne, I appreciate your feedback and information. Very interesting about the Cornell Study...there is always more to learn I've certainly found. Yes, I would love to include Peanut on the memorial thread. I will use the link you sent me earlier. Thanks again.

Norma