A little late on posting this but after two weeks of 40mg trilostane/day, he was slightly less ravenous and not getting up in the middle of the night to pee, but still drinking a lot and acting pretty hungry. Energy levels seem somewhat better and his skin and fur seem less dry. Post-trilostane ACTH stimulation test two weeks in came back 2.8 ug/dL pre, 8.6 post, while the internist said her targets for a dog being treated for Cushings were 1.5-3 pre, 4-6 post, so still a little high. We decided to up it to 60 mg/day, no signs whatsoever of cortisol dropping too low since then, maybe a minor further improvement in the eating and peeing but still not where I'd like it to be.

We're doing a pre-trilostane resting cortisol test two weeks out from the dosage change, so toward the end of this week. I'm thinking we may want to split the dosage and go twice a day. His drinking and appetite seem worst first thing in the morning.