Quote Originally Posted by Squirt's Mom View Post
This is standard with Vetoryl/Trilostane. It is not a stable drug so it doesn't maintain control very well over time in most dogs. This is why it is so important 1) to know the signs of not only low cortisol but high and 2) to keep up the very sspecific testing schedule for this drug. The monitoring ACTHs are the only way to be sure the cortisol is once again elevated (and rule out other possibilities for the changes seen) so be sure to have that done before the vet increases the dose. Typically increases are no more than 25% of the current dose. Just a reminder....once the dose is increased the testing schedule starts all over at the 2 week mark.

I'm lazy today and haven't read back thru Kobe's thread so I apologize you have already given this info....has his skin been checked for Calcinosis cutis? This is usually diagnosed via a punch biopsy.

Let us know what the ACTH shows and how things are progressing for your sweet baby boy!

Hugs,
Leslie
It's now August 17. For the past few months I've been dealing with personal health issues and delayed Kobe's testing. This week he got his ACTH stim test and the results indicate his condition is stable, so he can remain on the 40mg dose for now (his weight is 33.6). Improvement seen in basic signs: drinking, eating OK. Pants in hot weather. Still has sensitive skin and scabby spots, interdigital infections are bad. Vet is giving a three-week regimen of antibiotic (previous episodes have been given two-weeks' worth), says it won't resolve the issue completely but can bring down the swelling and redness. Meanwhile, Kobe has a lump that appears to be a hematoma on lower abdomen about the size of a quarter. Doctor suspects some type of cancer, proposed removal and biopsy. Kobe is middle-aged (ten). No signs of problems right now from the lump; smaller lumps have formed and broken open, healed over. Vet discussed risks of cancer spreading, etc. etc.

So, there are more things to consider. Having decided to treat the Cushings, I'm presented with another problem, to treat or not to treat possible cancer. Kobe's age is middling. (I have the same situation with my health issues, being neither too old nor too young to sway me one way or another.) Now, does having Cushings make cancer treatment more problematic? For example, is his immune system compromised? I've heard Cushings can cause problems with regard to vaccinations. Overloading a dog's system can be fatal. An otherwise healthy dog might be treatable for cancer, but a dog with a serious condition??? And again there's the money factor. Just testing and screening with lump removal and biopsy is in the many hundreds, let's not even discuss treatment like chemo.

That's about where I'm at. Kobe's a good dog. Be well.