Vicki, my heart sank when I read that your vet is concerned that Scoop's ACTH result is too low. After his having been on trilostane treatment for these months, I would have hoped that she would know what the desired testing range is for a dog taking the drug. Per the manufacturer of brandname Vetoryl, the post-ACTH result should be between 1.45 ug/dl and 5.4 ug/dl, with it going as high as 9.1 ug/dl as long as a dog's symptoms are well-controlled. Scoop's test result was good, and no decrease is warranted. Since Scoop is diabetic, I've also been bothered that she hasn't pursued the twice daily dosing since it is recommended by so many experts. All in all, it seems as though she is kind of stumbling through the process. It would really be nice if you could get some direct input from a vet who has more experience with all of this, especially since Scoop still sounds unwell. Have you ever spoken directly with the IMS yourself? Would you want to try to arrange a consultation now? I am worried for Scoop and sure wish an expert could take a look at him.

As far as compounded trilostane vs. brandname Vetoryl, Sharlene is right that the effective ingredient should be the same chemical in both. But just so you'll know, compounded trilostane is not the same thing as a generic version of a brandname drug. Both brandname drugs and their generic counterparts are manufactured by pharmaceutical companies under FDA oversight of testing and inspection. However, there are currently no generic versions of Vetoryl for sale anywhere in the world, so brandname Vetoryl is the only version of the drug that is FDA-approved. Compounded drugs are instead prepared onsite by individual pharmacies and fall outside of FDA approval. Some recent studies have shown that there may be less consistency or effectiveness from batch to batch of drugs compounded by some pharmacies. And any inconsistency in the product could lead to less consistent dosing control. It is for this reason that some vets prefer that their patients use brandname Vetoryl and not a compounded substitute. Compounded trilostane is usually much less expensive, however, and we do have many members who have been very satisfied with their compounded product.

You are right in assuming that compounded products legally cannot be sold in the exact same dose as brandname Vetoryl. But you can buy either one online as long as you have a valid prescription from your vet. I'll try to come back later today and give you a link to a thread that lists sources with the best pricing for both types of the drug.

Marianne