Wonderful news Sharon
I am so happy for you.
Happy hugs for you
((((((((((((((((((((((((((((((happy hugs))))))))))))))))))))))))))))))
Wonderful news Sharon
I am so happy for you.
Happy hugs for you
((((((((((((((((((((((((((((((happy hugs))))))))))))))))))))))))))))))
love,
addy, zoe and koko
My little dog - a heartbeat at my feet. ~Edith Wharton
Memory is the power to gather roses in the winter
First I want to say I am happy to hear that your daughter has good news.
But I do not want this to go unanswered in the wake of celebrations. Yes! Yes! Yes. You must be very careful of the drug, especially since I gather that you are splitting them, etc. If possible you should wear plastic/disposable gloves when doing this. Just remember that trilostane is/was a chemotherapy drug for breast cancer (I think). You should use a pill splitter dedicated to those pills - in other words, don't use the same one to split Norman's pill that you may use to split your pills or anyone else's pills. Don't be afraid of the pills, just use caution.
I hope Norman improves soon. It is a very frustrating road. So many ups and downs. But we do what we can for those we love.
Hugs ~ Mary Ann
Excellent news Sharon, hopefully just the start of a long good run now! It must Norman's turn for the good part next, so we're waiting with baited breath to hear it.
YAY!
Naomi, Oscar and Marcie.
RIP my beautiful Fraser - passed October 1 2013. Original diagnosis Cushing's, but taken from us with rapidly aggressive liver cancer.
I believe, here, Mary Ann is talking about Lysodren.
Lysodren/Mitotane is an oral chemotherapeutic agent. It is also known by o,p′-DDD.
Trilostane/Vetoryl is an enzyme inhibitor. It helps inhibit the enzyme 3-beta-hydroxysteroid dehydrogenase, which is involved in the production of cortisol.
I do think dedicating a pill splitter solely for the use of Trilostane/Vetoryl is a really good idea.
Such good news, now it's Norman's turn!
http://www.dechra-us.com/files//dech...l_Brochure.pdf
HUMAN WARNINGS:
Keep out of reach of children. Not for
human use.
Wash hands after use. Do not empty
capsule contents and do not attempt
to divide the capsules. Do not handle
the capsules if pregnant or if trying
to conceive. Trilostane is associated
with teratogenic effects and early
pregnancy loss in laboratory animals.
In the event of accidental ingestion/
overdose, seek medical advice
immediately and take the labeled
container with you.
"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.
congratulations on the good news for your daughter! I hope you can get something worked out for your Norman
Actually, Mary Ann is right that trilostane has been used as a breast cancer treatment. In fact, it was originally approved here in the US for that purpose two decades ago. But for reasons I don't recall, the FDA approval was withdrawn, perhaps just because the manufacturer did not pursue ongoing certification/marketing here. It is still approved and marketed for human use in the UK. The human brandname version of trilostane is marketed as "Modrenal," and that is the form of the drug that I first imported from the UK back when my Cushpup started treatment in 2003.
I just did a quick Google search, and it looks as though there may be renewed interest in using trilostane for breast cancer treatment. Here's the summary of a 2006 research study:
http://www.ncbi.nlm.nih.gov/pubmed/17109615Abstract
Antiestrogens, principally tamoxifen, and aromatase inhibitors have been used as the first- and second-line therapy in patients with advanced postmenopausal breast cancer for many years. However, some patients acquire resistance to these treatments and, at present, further endocrine treatment is achieved by merely substituting the current medication with a different antiestrogen or aromatase inhibitor. Trilostane offers an alternative endocrine treatment due to its unique mode of action. It is an allosteric modulator of the estrogen receptor and targets both the estrogen- and growth factor-dependent pathways through which estradiol stimulates cell proliferation. In clinical trials, trilostane has been shown to be an effective treatment for breast cancer in patients who have relapsed after receiving treatment with one or more forms of endocrine therapy. Ongoing and future clinical trials are examining the potential for the use of trilostane in premenopausal breast cancer, as well as in other malignancies such as prostate cancer.
So it is true that trilostane has been used in cancer treatment. This does not mean it is a toxic drug, however (it does not directly attack cancer cells) -- just one that needs to be handled with care due to its potential effects on hormones in humans as well as dogs.
Marianne
Last edited by labblab; 01-22-2013 at 11:27 AM. Reason: To reword.
Sharon, changing the subject , we staffers have been wracking our brains trying to think of ways to help you with Norman's treatment cost. One suggestion we've thought about is the possibility of sometimes performing baseline cortisol readings instead of full ACTH stimulation tests to assess the appropriateness of Norman's trilostane dosing. Baseline cortisols still require a blood draw and analysis, but you are spared the cost of the stimulating agent. I do not want to give you false hope that you will be able to totally discontinue ACTH testing. But you may be able to reduce the number of ACTH tests that are needed.
In the desire to ease the cost/demands of trilostane monitoring, Dr. Audrey Cook at Texas A & M University has been designing research to explore whether baseline cortisols, on their own, can reliably predict safe and appropriate trilostane treatment control. Her results are only preliminary, and she cautions that more research needs to be done. But her initial results suggest that as long as a dog's baseline cortisol falls within a specific optimal range and the dog is doing well clinically, a vet may be able to assume that the trilostane dose being given is safe and effective.
However (and this is a BIG "however"), she recommends that any dog with a baseline reading that falls outside a specific optimal range should still proceed to a complete ACTH stim test before making dosing changes. The ACTH would also be recommended any time a dog is not doing well clinically. Here's a link to the complete study:
http://www.2ndchance.info/cushings-m...tisollevel.pdf
Baseline cortisol monitoring may not be a good option for Norman right now since his clinical signs are still not under control and he is still so new to treatment. But a bit further down the road, baseline cortisol monitoring may give you some relief from ongoing ACTH costs. You may want to tell your vet about this study, and your vet may even wish to contact Dr. Cook directly to see whether there have been any recent updates to this research. After hearing about your specific situation, Dr. Cook might be able to give your vet some monitoring suggestions.
I know how anxious you are to see improvement with Norman. But I do encourage you to try to be patient and give him at least a couple more weeks to stabilize on this current dose of trilostane. At that point (and after maybe talking to Dr. Cook), your vet may feel that a baseline cortisol reading can be helpful in assessing how well he's doing on that dose. But I think he needs to have some time to adjust before you consider yet another dosing change. Even if this current dose is still too low, you won't know how much of an increase is appropriate until you can judge the maximal effect of the dose he's already taking. Does that make sense? I hope so!
Marianne