Skippy has passed; 12 y/o Yorkie with likely pituitary tumor (Trilostane)

Not too long at all, you've really learned so much that needs to be shared. Very interesting and informative.
I'm with you at the matter of the next medical crisis:mad::(. Such a sad reality for us but you're doing such a great job & leaving no stone unturned for your Skippy.
Sniff that ball and fly out the door little guy-every day! Make your mamma smile! We're rooting for you!

I don't know where exactly to post information so I will stick it here:
Cabergoline, a dopamine agonist which might or might not help shrink a pituitary tumor and lower cortisol seemed rare and exotic last week when Purdue provided it to me, 8 pills cut in half equals 16 doses for $263.00. More reading and a little checking and I've learned, not so much.

Using Blink Health an online drug buying service where you pay them and take your script to the pharmacy, I can buy Cabergoline at the local Kroger, in stock, same quantity and strength for $101.00. Typically Purdue was cheaper for Vetoryl, for this drug NO. Now I'm wondering if all the other drugs they keep prescribing for Skippy can be purchased for cheaper at the pharmacy, if they are for human use as well. It's not enough that we and our dogs have to experience Cushing's and the damage it does to them. We have to be gouged too? Nah!

WestcoastFlea1, as far as I can find retinonic acid, pasireotide and lanreotide are either unavailable commercially or extraordinary expensive, i.e., thousands of dollars a dose. Have you learned anything differently? Thanks

Yes, this is the perfect place to post that information. Thank you.:)

I typed a very long post explaining Buddy's (also a yorkie) experience with a probable enlarging macro tumor. I choose to delete it because this is Skippy's and your jouney, not ours.

Know that you are not alone. Many of us have been through this. It is still hell, but you will get through. There will be some bumps, bruises and tears along the way, but you will get through this.

Hugs,
Kathy

Kathy, thank you and thanks for your kind post earlier. Intellectually, I know you are right but I appreciate you repeating it. I will read your thread, should have done so earlier. Skippy is a yorkie mix but since he came from a puppy mill, the owners gave the pet store where he was sold, AKC papers verifying his heritage. Only when his legs began to grow very long did his owners dump him when he was a year old. Puppy mills, don't get me started.

Good RX is another option, one of our members brought it to our attention: https://www.goodrx.com/?utm_source=g...FZmCswodfQwFYQ

After typing in Cabergoline in their search engine it came back with Walmart selling "8 tablets of cabergoline 0.5mg" for $77.24

In case it hasn't already been posted, here is the original text of Castillo's study on Retinoic Acid. I know others have explored the availability of this drug without success. I saw a few studies suggesting it may have efficacy with humans as well.

https://academic.oup.com/endo/articl...0/en.2006-0414


Here is an overview of drugs that are being tested.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840568/

One more study on retinoic acid which is also called Isotretinoin and is available commercially for approximately $280.00 a month or less depending on strength. This study mentions the Castillo study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789464/

I wish I had medical education or this stuff was less technical!

"All at Purdue agreed that clients should be apprised of the possibility of a macro and an MRI should be recommended at the outset of treatment, especially if the dog is displaying even subtle neurological symptoms. But the reality is that many of us can barely afford the diagnostic tests and treat the Cushing’s symptoms, let alone secure an MRI or further treatment if their dog has a macro. After talking with them I felt as if I was an odd or challenging client in raising so many issues. They did say that knowing of the macro in November would likely have made little difference in Skippy’s treatment options as the tumor is so slow growing."

Thanks so much for the detailed information Carole. It's all very good to know but I wanted to comment particularly on what you said in the quote above. I wish more vets knew the importance of determining whether or not the tumor is a macro once the dog is diagnosed with pituitary cushings. Not once were we told that trilostane would actually make the tumor worse and never did the vets tell us that the tremoring she was experiencing could be signs of a macro. Why didn't they know this? Charlotte was being treated at UC Davis for heavens sake! Only after she almost died from the Vetoryl did they suggest we see a neurologist and have a MRI. I had no idea we were speeding up her death by giving her those drugs! And in the end I look back and see I spent more money on the drugs and continued diagnostics than I would have paid to have a CT Scan or MRI to determine what the proper course of action should be. I'm very angry.

It's still hard to come here regularly as the loss of Charlotte is still so fresh but I will keep checking in on you and Skippy and please know you are in my thoughts and prayers.

Hugs,
Laurie

Laurie, I share your anger but I am trying to let go of it as I know it generates a lot of negative energy and doesn't help me accept what is. But, I do understand the difference, Charlotte is gone and Skippy is still alive.
Speaking of Skippy, he is holding his own as far as I can observe. Still eating & drinking buckets; he sleeps a lot but is now willing to walk a few blocks. No increase in macro related behaviors, but still stares & still fast walks back home. It's all pretty subtle & most would think he is just an old dog. Back tomorrow for BP& eye check. Does anyone know if I should take in a couple of urine samples to test cortisol in his urine? I am going to ask Dr. Scott- Moncrieff about increasing the dosage since he is tolerating the Cabergoline well. I'll post again when I know more.

Thanks for the update Carole, I hope that the cabergoline is working. And I totally agree with you about letting the anger go, that isn't going to help you or Skippy. Dogs feel what we are feeling and you need to be as positive around him as possible. I guess the anger keeps me wanting to make a difference now that Charlotte is gone. But wasn't productive while she was still here with me.

Hugs,
Laurie