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Thread: question on first testing - Vetoryl or Lysodren?

  1. #41
    Join Date
    Jun 2012
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    Canada
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    16,150

    Default Re: question on first testing - Vetoryl or Lysodren?

    vetdxdirect.com, has lysodren at $6.49 per 500mg pill. which would be $194.70 for the first 10 days

    This is what I assume is the loading phase, after which you would give 3 pills per week instead of per day. So eventually approximately 12 pills per month at $77.88 per month (using online pricing vs vet pricing)

    With vetroyl, at 90lbs you'd start with a 60mg and a 30mg pills 1mg/1lb, which Dr.s Foster and Smith has
    60mg 74.70 (30 pills) and 30mg 59.70 (30 pills) $134.40 for a month. This would be the continuing price If you don't need to increase or decrease the dosage.

    We have had vets do the pred and lysodren. I don't know if this is a recommended way of loading though. I think Dr. Peterson has done this method. (one of our members on facebook page did this with Dr. Peterson). If I were to go this route I'd want a doctor like Dr. Peterson to be the one in charge of the case though.

    I am not the most familiar with lysodren use, but Glynda and others have used it successfully. I don't think they gave prednisone at the same time though. You do usually have prednisone on hand in case you go too low and need a rescue dose.

    Not sure how much that helps you, but it does give you a look at what kind of pricing you can get using an online pharmacy, not even using compounded but the name brand. I do think Walmart might carry lysodren.

    Sharlene and Molly Muffin
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  2. #42
    Join Date
    Apr 2009
    Location
    York, PA.
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    11,037

    Default Re: question on first testing - Vetoryl or Lysodren?

    I am always leery when a vet wants to start a dog on Lysodren with prednisone. It is too hard to tell when a dog is loaded on Lysodren because the prednisone will mask the side effects.

    Lysodren can be compounded (Mitotane) which is cheaper.

    Please don't give up, we are here to help and support you and your girl.

    Hugs, Lori

  3. #43
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    Jun 2012
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    Canada
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    Default Re: question on first testing - Vetoryl or Lysodren?

    That's my thoughts too Lori. The ACTH doesn't give you the Real result of what the adrenal glands are doing, and you can actually end up in Addisons crisis while your numbers are saying you are fine.

    Sharlene and Molly Muffin
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  4. #44
    Join Date
    Apr 2008
    Location
    Tennessee
    Posts
    6,593

    Default Re: question on first testing - Vetoryl or Lysodren?

    Your baby girl is a big girl at 90lbs and as I recall, she should be more like 65lbs. Her weight may be more advantageous if you choose to treat with Vetoryl. Researchers did a retrospective study with 70 dogs diagnosed with cushing's and the results indicate that dogs greater that 30kg may require smaller doses to control symptoms. Your girl's weight in pounds converts to 40.9kg so she definitely falls in the heavy weight category. Most specialist I follow recommend starting dose of 2mg/kg but Dr. Edward Feldman is even more conservative and prefers twice daily dosing at .5mg/kg. Since your girl is big and research shows that bigger dogs may need smaller doses, you might want to consider Dr. Feldman's preference. If so, your girl would get 20mg or 25mg twice daily. If you go with Dr. Mark Peterson's preference, you would start her on 40mg twice daily; however, again, with your girl being so large, you could drop that a bit to 30mg or 35mg twice daily and see how she does. Both of these specialist prefer twice daily dosing to achieve better control of cortisol throughout the day but you can achieve success with once daily dosing, which is what the manufacturer recommends.

    I treated two cushdogs on once daily dosing, another on twice daily dosing and all three were perfectly controlled. Oddly enough all were very small, 4.5lbs, 6.5lbs,10lbs, and all three stabilized on 30mg per day. However, hindsight is 20/20 and if I had it to do over, I would have had my tiny girl, Lulu, on twice daily dosing. She had severe osteoporosis from years of thyroid meds and cushing's. I suspect it was more the thyroid meds but I can't help but wonder if twice daily dosing to control her cortisol throughout the day would have made a difference. If I had a cushdog today, I would go with twice daily dosing. It's not as convenient but for me, it's called sleep insurance.

    As far as expense, compounded Trilostane, which is the active ingredient in Vetoryl, is the least costly but you need to only purchase through a trusted compounding pharmacy. My dogs had cushing's before Vetoryl was approved and their meds had to be compounded. I used Diamondback Drugs, as do many other members, and their prices are very good. Back then I paid about $87 for a three months supply of 30mg capsules. Once you and your vet decide on a dose, give them a call and get a price. Their contact information can be found at www.diamondbackdrugs.com.

    If you decide you want to use brand name Vetoryl, some of the better prices can be found at http://search.californiapetpharmacy....23671804106035 and
    http://www.valleyvet.com/ct_detail.h...e-562663425dfe

    Keep in mind that with Lysodren, the initial cost for daily loading is going to be expensive but once you achieve loading, you would go to a weekly maintenance dose, usually equal to the daily loading dose. Your expense would drop greatly once on maintenance. If loading at the recommended dose of 50mg/kg, your girl would be taking 2 pills twice daily. So it would cost a bit over $20 a day. Once on maintenance, the cost would be less than $100 a month.

    If you are considering going with Lysodren, I personally would never give prednisone concurrently. While most specialists have migrated to Vetoryl, Dr. Edward Feldman still chooses Lysodren as he knows it like the back of his hand. He has been treating his patients with Lysodren for more than 40 years. I believe he is the consummate expert on Lysodren. He teaches his students at UC Davis, and his veterinary conference audiences, to never give prednisone and lysodren together. He says they are the antithesis of each other and you give one or the other but never both. Prednisone masks the signs of loading so no matter how vigilant you are about watching for signs, you may not see them because Prednisone will keep the dog hungry and drinking and peeing buckets. If you decide on Lysodren, you can get it at Costco today for $5.56 per pill. 30 count would cost $166.81. If you buy 100 pills, it $517.71 or $5.17 per pill. Walmart carries Lysodren, as does Target, so you can call these stores and ask for a price check. You can also check with Diamondback Drug on a price for compounded Mitotane, which is the active ingredient in Lysodren.

    Glynda

    P.S. Both of these medications are fat soluble drugs and must be given with food.

  5. #45
    Join Date
    Jan 2014
    Posts
    160

    Default Re: question on first testing - Vetoryl or Lysodren?

    Wow thanks again everyone!

    The amount of time given is so selfless especially since I'm sure you've written this out many times before.

    OK. No prednisone. Would i just take the script and not fill it.. or he must know she's not on it...?????

    A lot more work to do tomorrow. Unfortunately I don't have much tome today.

    I actually am looking forward to getting diamond treated! I want her as healthy as possible and hopefully somewhat back to herself.

    She will lose weight too right ... this pot belly will decrease? So her meds can be decreased then??

    Have a great day everyone!!!

    Michele

  6. #46
    Join Date
    Apr 2009
    Location
    Georgia
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    Default Re: question on first testing - Vetoryl or Lysodren?

    You should always be up-front with your vet re: which medications you are giving or not giving. Especially if an emergency arises, it is critical that all facts have been known by your vet. Keep in mind that we are not vets ourselves, and there may always be some reasoning behind your vet's various treatment recommendations to which we're not privy. So it is better to discuss those recommendations fully, especially if you disagree with them or have concerns such as is the case in this situation.

    As far as the prednisone, you will still want to have some on hand regardless of whether you treat with Lysodren or trilostane. In our opinion, not to be giving it alongside the other medication, but instead in the event that cortisol levels drop too far and the supplemental steroid is needed to at least temporarily offset the effects of overdosing.

    Marianne

  7. #47
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    Apr 2009
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    Nebraska
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    Default Re: question on first testing - Vetoryl or Lysodren?

    Michele

    I agree with everything posted, particularly about using prednisone and lysodren together. You would still need to get the rx filled because you MUST have it on hand to give in case of emergencies. You should also come clean with the vet and tell him/her you will NOT use them at the same time for all of the reasons we have cited. Kim

  8. #48
    Join Date
    Jan 2014
    Posts
    160

    Default Re: question on first testing - Vetoryl or Lysodren?

    OK.. I guess that was stupid to even consider...

    HOPEFULLY that's what he meant... not that she'd be on both but he was just prescribing to have on hand. So I WILL discuss that w him
    for sure and get it..

    Thankfully too this is a 24 hour office so God forbid something happen I have that option to run her over.

    It sounded like he said twice he:s had 4 years experience w this - even my bf heard that on speaker phone. I'm really assuming he said 40 cause 4 is not impressive and kind of scary . I read his profile and he has been in practice since the 70s though.

    Thanks

  9. #49

    Default Re: question on first testing - Vetoryl or Lysodren?

    Hi Michele,
    If you decide to go with Lysodren, please DO NOT use prednisone concurrently no matter what your vet tells you. I was pre k9cushings forum and totally uneducated and my vet's knowledge on Cushing's disease seems very questionable at this point. I have a pup who now is being treated for Addison's and it's becoming clearer each day that the concurrent use of prednisone was the culprit in this long and foggy road. I just read your entire thread and am worried for you and your baby because to me your vet seems lacking experience in this.

  10. #50
    Join Date
    Jan 2014
    Posts
    160

    Default Re: question on first testing - Vetoryl or Lysodren?

    I'm so sorry to hear that. All we want to do is help our pets and we assume these doctors "know everything" and its horrible especially when they suffer because of their mistakes

    I just lost an awesome cat.. was prepared for the worst but was told by another vet he'd be fine after a blood test ... just Ibd. Was so thrilled... then I took him 30 days later since he was losing weight to this doctor and was told cancer. I lost Max 9 days later. I'm still very upset for various reasons. He was only about 6.
    My neighbor and I both have been to every vet in our area... this place seems to be best.

    Sorry to change subjects so abruptly. But has anyone encountered chick peas in the dogs poop.... when they've never eaten anyikng even close?

    I asked several vets and no one has a clue and isn't too concerned. She can't get into anything that I wouldn't be aware of and has occurred now and then for a few months.

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