Adverse effects to Trilostane. How common? (Sweet Lily has passed)

[Lilypily]

Thanks. She has her appetite back and is drinking. She is still lethargic though and still has diaroeah.

It's her tummy that is my biggest concern at the moment. I'm aware of the 'pot belly' and she has that for a while, but it's getting bigger and it's firm. Is a really big misshaped belly common?

[Squirt's Mom]

I think if it were me, I would be asking for an abdominal ultrasound asap to get a look at the internal organs. This test saved my Squirt's life by finding a tumor on her spleen. You want this performed on a high resolution machine by someone skilled in this test and in reading what they see. Rarely is a GP vet qualified so you will probably need a referral to an IMS.

I'm really glad she is feeling well enough to eat again and hope the trend continues.
Hugs,
Leslie and the gang

[goldengirl88]

You are still not giving the trilostane right? As long as she has diarrhea you should not be giving it. Hopefully she will turn around in the next couple days. I would go for the ultra sound also. Blessings
Patti

[molly muffin]

Hi, how is Lily doing? Is she still lethargic? Is the diarrhea gone? Just want to make sure that things are going okay.

Sharlene and Molly Muffin

[Lilypily]

Hi guys, sorry for the very late reply.

After a second opinion we have chosen not to try the Trilostane again, it's just to risky for her.

Lil had a ultrasound and all her organs are perfect Her Gall Bladder is enlarged and sludgy, the vet said this is completely normal for her age. Her right Adrenal Gland is cystic, but the vet said if the Cushings was Adrenal based the glands would show up huge on the ultrasound.

So we are loving and enjoying every minute with her. She currently has a urinary infection which she's on antibiotics for. Her abdomen is HUGE. If she wasn't desexed i'd be sure she's just about to drop a litter, lol.

[Lilypily]

Hi guys. My Lil is being untreated for her cushings. She is suffering from constant UTI's. It seems we just finish a course of antibiotics, and off we go again

Does anyone know of a natural product/drink that is safe to give to dogs, that might help put things in balance a bit for her?

TIA

Also what is a good product for dry skin? I'm thinking of trying Sorbaline????

[goldengirl88]

I believe the way you started out with the Trilostane too high is what caused most of the problems. You dog will continue to get UTI's. If it were me, and the dog was feeling better, and the electrolytes are all in balance, I would start on a low dose of Trilostane 10mg. It will lower some of the cortisol in your dog's system and maybe start the UTI situation getting better. I am sure you read the consequences of not treating your dog? As long as you understand that and still choose not to treat that is your decision, and we will respect it. I just wish you had not started the dog off so high. I hope it all works out for you. Blessings
Patti

[Squirt's Mom]

So is the vet thinking the Cushing's diagnosis was in error from the beginning?

Or is the vet thinking she really does have Cushing's, that Trilostane is the only choice to treat and since she didn't handle that HUGE dose well, you just don't do anything even tho there is another drug out there that she might handle better?

If I were in your shoes, I would be seeking a second opinion asap if at all possible. I would let the new vet with fresh eyes, and hopefully more experience and understanding of Cushing's, look at her. I would want an in depth explanation of what a "cystic" adrenal gland means. Your vet is right in a small way in that with the pituitary form of Cushing's BOTH adrenals are typically enlarged - but not always. In the adrenal based form, one gland is typically large while the other is very small, or even atrophied. So what does it mean that one is "cystic"? Would that effect the cortisol level possibly causing a false-positive on the LDDS? Is that indicative of some other disease / condition?

I hope she is feeling alright today and you, too!
Hugs,
Leslie and the gang

[Harley PoMMom]

Was an urine culture and sensitivity test performed? This is the only reliable way to determine the bacteria that is causing the UTI, and to know which antibiotic will be effective against that particular bacteria.

Hugs, Lori

[Jan W.]

I was reading this run and one thing I thought about was the LDDS was run when she had a urinary infection - this might have given a false positive as some else mentioned. I just went through all this am just started my girl on trilostane today but I had lots of tests done and waited to make sure her bowel infection was clear before I had the last tests done on Thursday.
Someone mentioned getting a urine culture and being a nurse, I know that it can be difficult to determine the bacteria that is the causative agent without a culture and sensitivity. If you have continual infections, get a culture urine sent. If you are feeding your dog kibble (dry) this can increase your dogs pH which in turn helps along bacteria. If you changed to less processed food like canned for awhile or maybe give a little Vitamin C with the kibble and see if the UTI's settle down. The urine culture in the meantime can tell you what antibiotic will be best. The antibiotic you were given is a very common one currently given for UTI's and covers E Coli well. Sometimes a takes more than one round also.
Listen to what these people have to say as I (with this forum's friends) have been working on this whole cushings thing for a few months and impatiently wanting to get started, but just started today. And I'm hoping my dog's tests were not false positives, but we can find no infections at present and tests (note that I said tests)are still positive and my dog has a lot more cushings symptoms than your dog seems to have.
I agree with holding back on the trilostane until you have more ammunition. Someone on this site made me take a deep breath and slow down - the Cushings is slow going. A urinary tract infection is not.
I also am worried about the higher dose and made my vet start us on a very low dose and I still am apprehensive. Here again - being a nurse, I always felt that I could increase something if it was not enough, but it is hard to take it back. I realize this will cost me more money in the beginning for tests, but at least any adverse reactions should be lessened I HOPE!!
Give you little critter a big hug. Jan W.