Calcinosis Cutis and Trilostane

Karen, you may be new to cushing's but you've learned much and are asking very good questions.

Every dog responds differently to Vetoryl and no matter what the dose, if it's too high, cortisol will drop too low and the dog will get sick. If you have had an opportunity to read some of the studies on this drug, you will note that there was a huge disparity in the ultimate dose that eventually achieved stabilization.

It is more likely that a dog with pituitary depending cushing's will experience calcinosis for two reasons; 1) most dogs (approximately 85%) of dogs diagnosed with cushing's have a pituitary tumor and 2) adrenal tumors have random secretion patterns and don't always over secrete cortisol.

You are correct that Vetoryl has a short half life so yes, it's enzyme inhibiting abilities starts to wane after several hours, which is why some dogs won't see resolution of symptoms even if the pre and post stimulated cortisol levels are within the therapeutic levels set by Dechra, the manufacturer of Vetoryl. For this reason, many vets feel that dogs with diabetes will benefit from twice daily dosing as cortisol is more evenly controlled throughout the day and night. It stands to reason that if cortisol is the adrenal steroid responsible for calinosis cutis, twice daily dosing would probably be beneficial for these dogs.

Glynda

Oh boy! For a minute my heart sank!
As of right now, Daisy does not have CC and she's been on Trilostane since May off and on.

Now that she's acclimated well and I'm seeing improvement in her Cushings symptoms, it would be a shame for something else to crop up.

I'll be anxiously waiting for input from those of you who are more experienced Cushmoms. Thanks Marianne for your assessment and I sure hope that the two are unrelated.