15 year old poodle on trilostane - frequent dosing increases not helping

[frijole]

I hate to alarm you but the diarrhea is a sign of overdose. Since you just started it ,it could be something else but you shouldn't give vet oryx to a sick dog......so you need to cease giving it til diarrhea is gone. Also call the vet. Should you continue giving the meds you will have no way of knowing if the dog is overdosing or sick. Kim

[mitsua]

Well, I did call the vet yesterday and report the diarehha but she didn't call back so I thought it was just an ajustment to the medication. She is on the lowest dose 10mg. THis vet will not use a compounding pharmacy and told me she will not write a script for me to give to them. She said she sticks with the name brand pharmaceutical companies. So this will be a problem for me if we have to go lower. I will keep an eye on her today to see if she has diarehha today. She hasn't stopped drinking, panting or eating yet so am not sure what to do at the present. The vet said it takes a few weeks before you see results. I have an ACTH stim test scheduled in 14 days.

ANyone else have input?

[goldengirl88]

If the next dose is too much for your dog and the vet won't write a script go to someone else. You can't overdose your dog for the sake of this vet using only name brands- which I do understand. I feel your dog is overdosed if it has the diarrhea. Stop the Vetoryl until the dog is checked. You need to get it to a vet as you need to get electrolytes checked. Did this vet give you prednisone? If not you need to get some of that too. It will all be ok as soon as you get this dose straightened out. We are here to help you so don't worry we are all in the same boat. Blessings
Patti

[lulusmom]

The vet said it takes a few weeks before you see results.

This is absolutely not true. Dogs are very sensitive to the drug initially and cortisol can drop like rock in a day or two. For this reason, some dogs may feel really crappy initially due to cortisol withdrawal and sometimes it's difficult to determine the difference between withdrawal, cortisol that has dropped too low or even an intolerance to the drug. If your dog is not eating, has diarrhea or vomiting, you should discontinue dosing until her appetite returns and diarrhea clears up. If she continues to vomit, have diarrhea and become more listless, I would recommend that you get her to an er clinic.

Glynda

[frijole]

I was out all day so am glad the others chimed in. I know you aren't familiar with us and we are just internet folks but please trust me we have been welcoming people in your situation for decades and nothing is harder than to watch a dog get into trouble when you see it coming and there is nothing you can do about it.... The drug works very fast and my concern is that the dog could have been misdiagnosed and therefore the instant diarrhea. This happens frequently. Simple solution is to cease the med until diarrhea clears up then start again and if it happens again you know the meds are the culprit and will have to start doubting the diagnosis.

Is the diarrhea gone or still here today? Thanks! Kim

[mitsua]

Thanks, everyone. Diarhea gone today but today she was very lethargic and barely could keep up on her walk. Didn't want to have anything to do with the other dogs in the park. Folks asked me if she was sick? She slept most of the day and now about 10 hours later is back to her perky self. Tomorrow will be day 3 on meds. Panting has diminshed tremendously but still was panting a bit on her walk and when she thinks she;s getting food. Still very hungry and drinking water but maybe not so frequently as before as she's sleeping a lot. I was wondering if she needs to adjust to the meds. I thought pregnisone was only used when the dog was on Lysodren. For vetoryl, I thought you just stop giving the meds. She weighs 15.2 pounds and is taking 10mg of Trilostane 1x a day.

[mitsua]

Can someone get back to me with their thoughts on the LDDS test results which I posted.

The last # was 1.5 which was above the range of 1.4. The vet said it was this # which gives the diagnosis of cushings. I don't recall the other #s. She said the clinical sgns of overeating, panting, excessive urination and no UTI, no high blood pressure is sufficient to diagnose cushings.

Any thoughts from anyone?

[molly muffin]

With the LDDS you need to look at the over all picture. What was her initial cortisol level, then did she suppress at all at 4 hour and 8 hour, with the LDDS being just out of range, you'd need to include that with symptoms which she does have but most vets would have done an ACTH to verify that indeed it is cushings and not something else. It's hard to say without seeing the entire LDDS test and make any kind of determination.

A dog can go into crisis on either of the medications, and with vetroyl as long as you don't go too low, you can stop it and they will usually perk back up, but if they don't, then you could need to administer prednisone to help them out. If she gets wobbly where she can't stand, stop the vetroyl immediately. It could be that she might not do well on 10 even, but you don't know until the ACTH test, unless she crashes.

No dog is exactly the same, and they react in their own way to the medication, sometimes they are very sensitive to it. Sometimes, when the cortisol comes down fast, they just don't feel too good. So many things have to be taken into consideration with the whole.

Sharlene and Molly Muffin

[mitsua]

Vet wants to continue on Trilostane until day 11 when she will do ACTH test. Said she isn't worried about diarrehea as it subsides.

Day 6 of treatment -- still has diarrahea in am walks but not lethargic anymore -- in fact she is back to panting (not as much, though or for as long) and drinking lots of water. when I told vet, she thought my dog might be candidate for 2x a day dosing. BUT isn't 20 mg too much for a 15 pound dog? Last night she panted so bad you would have thought I never gave her medicine.

Urine culture came back negative. Blood pressure was fine.

[goldengirl88]

I really hate to say this, but a vet that is not worried about diarrhea while the dog is taking trilostane worries me sick!!! Blessings
Patti