My 12yr.old mix-wired hair/pit was given insulin for biabetis for two months when vet said she suspected cushings because up to 40 units twice daily was not bringing blood sugar levels down. They did an ultrasound and said that it confirmed cushings.They did no blood tests for it. They want me to give her lysodren. Sadly the cost of the ultrasound broke me financially for a while.
They are keeping her on 40 units insulin twice a day for now. Until i can afford togo for treatment for the cushings i would be afraid to use lysodren from what i have learned about it. No one has told me what to expect, but I know in my heart to expect the worst because I cannot afford treatment for the cushings meaning her blood sugar will never come down. Somthing I foudn very interesting though, after giving her insulin for two months now she devolped a urinary infection and was given antibiotics. She is still on them. Since first starting the antibiotics all the symptoms of excessive thrist, hunger, panting, not walking very far, unable to walk up our steps, weakness -wel all those things have gone for now.Before she was panting and breathing hard day and night. Now she dosnt even do it anymore and sleeps and rests everday. What would the antibiotics have to do with all the symptoms of diabetis and cushings?

Any feedback on her situation would be very appreciated. Not giving up yet.
Thank you, Pam Shaw

Hi, Pam,
I cannot understand how an ultrasound exam can confirm Cushing's disease without blood tests : maybe I am out of date - very few vets had access to ultrasound when I was in practice.
It is very interesting that she responded so well to antibiotic treatment. Have you asked your own vet for an explanation? Maybe she had some sub-clinical infection that has been cleared up by the ABs.
W

If you still have the Vetoryl trilostane capsules please contact me as well as price requested. Thank You very much!

Hi Mike nearly a year has passed and I have just been reading your story re: Cushings and your dog jewels problems and wondered if there was any solutions in the end. my 9 year old standard Yorkie has Cushings and has been on Trilisane (Vetoryl) for 4 years now and I am lucky to say havn't had problems like yourself, however, whilst at work was giving her (Mitzie) 120ml every day in her food...........NObody told me anything different. I recently retired and had time to read the instructions properly on the leaflet and to my horror discovered that Vetorly capsules are to be administered at least 2 hours before any food. Since retiring in March I have been doing this two hours before her breakfast and believe me she has gone down from 120ml to 90ml and the last tinme she had her blood test they put her down to 60ml and her test results have come back saying she doesn't have cushings altho other results incline to a yes. She is currently on 60ml and has her next blood test in Dec 06. She is certainly a lot more energetic back legs a bit wobbly but that seems all. I wonder if she has been over prescribed Vetoryl as she is much more lively. If you would like I will keep you posted of the outcome in 2007 and hope your problems were at least sorted. You like me loves animals. I have two dogs both with med probs. But we love them just the same altho expensive to treat. Val

My Border Terrier, Branston, was diagnosed with Cushings approx 6 weeks ago. He is currently on 60mg Vetoryl per day. There are signs of improvement although I am concerned that he is still drinking excessively and his incontinence seems to be getting worse i.e. leaving small wet patches on the carpet or his bed even after he has just come back from a walk. Is this likely to improve?

Hi,
It will take time to get a complete response to the treatment, but by 6 weeks I would have expected the polydipsia and incontinence to have improved. Discuss with your vet a possible change in the dose of Vetoryl.
W

My cat, a stray we adopted at Xmas, is being treated for diabetes with caninsulin. He has put on some weight but there is a suspicion that he has concurrent Cushings disease.
I have read that Vetoryl (trilostane) can be used for cats with cushings but cannot find any indication of dosage. Non of the on line pet pharmacies seem to sell Vetoryl for canine use (I know it's a POM)
Any suggestions?

There are no recommendations on the use of Trilostane in treating Cushing's Syndrome in cats on the manufacturere's data sheets.
Any use of it in cats would thus be 'off license' and the manufacturers would accept no responsibility for any adverse effects.
If your veterinary surgeon is happy to precribe it, he himself would be taking the responsibilty for any adverse effects.
I would suggest that you give Trilostane to your cat only if it is prescribed by a vaterinarian prepared to accept this responsibilty.
W

I just noticed your posting for trilostane dated April 2006. My dog was just diagnosed with cushing's. You were looking for a cheaper source and wondering if you found one. Also is your dog doing well?

Thank you for your time.
Sincerely,
Cressida

So there is one thing I don't really get. Since back leg/hind end weakness can be a symptom of Cushings (and a symptom my 14-year-old female Aussie-mostly Molly-dog has), and it is also an adverse effect of Trilostane, how does one know what is causing it once Trilostane has been given? To be fair, she has only been on the drug for two days, but she definitely has the reported adverse effects of lethargy and wobbly back legs, and she still drinks constantly, just as she did before starting the drug. She is not as wild about food, however. She is on 70 mgs once per day.

She was having a hard time getting up before, but today getting up without help was impossible. She could barely keep standing to relieve herself. She has also had vestibular problems in the last few years.

Thanks for any advice you have.

Hi, Margo,

Sadly, in your dog's case I think it likely that Cushing's is only one of the problems of passing years!

Walter

Hi
I have an 11 year old Llahsa Apso, Charlie who has had Cushings Disease for approx 4 years. His condition has been controlled well on Vetoryl (2 x 60mg a day) and he has had no problems since starting treatment, in fact hard to believe he ever had anything wrong with him. He has been monitored however with regular ACTH Stimulation tests during this time. However, in recent months he has had a cough and has been on Corvental, which was then changed to Frusemide in the past few weeks.

Approximately 3 weeks ago, Charlie was very unwell, lethargic, weak, shivering/shaking, diarhoea, sensitive abdomen and not eating. I had read about Addisons Disease and was immediately concerned so I took him to the vet and an ACTH Stimulation test was carried out. We were told that he had not experienced an Addisons Crisis and whilst we awaited the results his medication was reduced to 1 x 60mg a day. However, over the next few days he would not eat at all and had to be hospitalised with an intravenous drip. Then the results came back that he definitely did not have Addisons which I could not understand as he had all the symptons. To try and get Charlie to eat he was given an injection of steroids, which did seem to work, but only for a couple of days. The vet has now said that there is a possibility that Charlie could be suffering from side effects of the Vetoryl, which apparently can mimic Addisons symptons and so now he is no longer taking any Vetoryl.

It has been 4 days since the Vetoryl was withdrawn and although Charlie does seem more alert, he is still suffering from the shivering/shaking, and is still refusing to eat, (which is our greatest worry due to the weight he has already lost). I have contacted the vet again today, who has asked us to bring him in for another ACTH Test, but has also suggested a referral for a scan due to the problem maybe being due to a tumor.

How long can the side effects remain in the body and is there nothing that can be given to counteract these?

Your opinion and advice would be greatly appreciated at this worrying time.

Many thanks

Emma

Hi, Emma,

With long-term treatment using any powerful medication like Vetoryl one has to balance the beneficial effects of the treatment against possible undesirable side-effects.
This is especially the case when the medication is controlling, as opposed to curing, the condition.
Your vet who is monitoring Charlie almost on a day to day basis is best placed to advise you, but you must accept that without Vetoryl you would have lost Charlie long ago.

W

I read your note about your Yorkie. My Yorkie, Casey has been diagnosed with Cushings recently. In the meantime, while waiting for her diagnosis, whe has put on much weight, can no longer jump on sofa or go up and down steps. Her belly has gotten very large and she pants constantly. My vet put her on the Trilostane this week. I was just wondering how long it takes for the drug to kick in. My DMV said I should see almost immediate results but does that mean days, weeks or months. She has been on the meds for 3 days so far and I have not noticed any change in her. I feel so bad for her as she seems so uncomfortable and uneasy. Anyone have any feedback thanks.

GB

I would expect to see a response in the second or third weks of treatment.

Have a look on the web. My vet quoted £1.50 per capsule (30-60 mgs) and I've bought a month's supply to get the tretament started but can buy it on the web for about 85p per capsule. My chap only eats 4-6 ozs 'meat' a day so it's not a huge burden. Incidentally I've stopped feeding him proprietary food (kibble) believing that it's full of things that can do him a great deal of harm.

Hi,

OK for shopping around for the cheapest, but remember two important things:

1. There are 'fake' medicines on the market, with little or none of the action of the real thing

2. You must have a prescription for you to legally order and the internet pharmacist to legally supply Vetoryl.

W

For the benefit of anyone in the US who needs information about Trilostane, I just want to share my own experiences with it thus far. First, I got it very easily from an outfit called Masters International in the UK. Since we were buying directly for personal use, no FDA waiver was required. My vet simply faxed a prescription to them and I placed my order online. I ordered a 90-day supply based on the initial 60 mg. a day dosage. In order to have flexibility, we ordered the 30 mg. capsules (it comes in 10, 30, 60 and 120 mg. capsules). A 90-day supply, or 180 of the 30 mg. capsules, cost us $231 with shipping adding another $15.50 to the price. That worked out to about $1.37 per capsule, including shipping.
Exactly a week after I placed my order, the medicine, known by its brand name of Vetoryl, arrived. That was much quicker than they estimate but I'm told it isn't really all that rare.
The service at Masters International is truly excellent. If you ever have to call them (but be mindful of time differences) they answer promptly and are unfailingly polite and informative. They also are good about answering email.
Our vet opted to begin with two separate 30 mg. dosages each day, which seems to be gaining favor among vets who use Vetoryl. At first we spaced them 12 hours apart, but we quickly decided to simply give them at each feeding, which means the second comes only nine yours after the first. It seemed to us that the later evening dosing was putting our dog in a bit of stress at her 11 p.m. bed time, perhaps because the earlier dose had worn off and the later one had not yet kicked in. Anyway, the change of schedule seemed to solve the problem and our dog began sleeping much better at night.
After an initial blood test one week into the treatment, our vet raised the dose to 90 mg. a day--60 in the morning and 30 in the evening. Ten days later, we had her blood checked again and this time her cortisol levels were normal, having dropped from 17 to 5. We are maintaining the 90 mg dosage and will re-test in two weeks.
Be advised that our dog, a 10-year-old Boston Terrier, weighs 28 pounds. We think we caught her Cushing's quite early, thanks to an alert vet who spotted oddities in her annual check up and began monitoring her closely. Our dog eventually developed all the classic Cushing's symptoms--panting, excessive drinking, etc. Almost immediately after we starting giving her the Veotryl, her panting and excessive thirst began to subside and her energy perked up. Today, only 17 days later, the only remaining symptom is her "pot belly." But it has quit expanding and at some times of the day it shows shrinkage (don't ask me why it varies).
I am at this early point extremely impressed by Trilostane (Vetoryl) and believe it should be the drug of first choice for almost all cases of Canine Cushing's. After all, its effects, with very few exceptions, are totally reversible because, unlike Lysodren, it doesn't kill any tissue. It simply regulates the production of Cortison by the adrenal glands. It seems to me that if it doesn't work, you could always switch to the more toxic, but equally effective, Lysodren. Doing the reverse would appear to be more problematic since Lysodren's effects tend to be permanent.
My vet, who is new to Vetoryl but has taken a keen interest in it, is equally impressed and says the drug is almost certain to become the standard for Cushing's treatment in the US just as it is in Europe.
I hope this is helpful to some of you. I think it is sad that this very good medicine is often overlooked by people seeking to treat their animals' Cushing's Syndrome. Hopefully the FDA will soon give it final approval here and our veterinarians will begin gaining familiarity with it. I believe the FDA has already approved its safety and that efficacy determinations are in the final stages.
Good luck to all of you.

Hi, Ronm,

Thank you for this very useful information, which should be of considerable help to others in the US whose pets have Cushings.

W

How is your Border terrier now. Our Border of 7 years is diagnosed Cushing. We have been offered three treatment options. Vetoryl, Lysodren or operation. Can you give us some advice?
Taco Smits

Hi,

Your vet who is treating your dog is best placed to advise on the best treatment.

W

Anonymous User Wrote:
-------------------------------------------------------
> My cat, a stray we adopted at Xmas, is being
> treated for diabetes with caninsulin. He has put
> on some weight but there is a suspicion that he
> has concurrent Cushings disease.
> I have read that Vetoryl (trilostane) can be used
> for cats with cushings but cannot find any
> indication of dosage. Non of the on line pet
> pharmacies seem to sell Vetoryl for canine use (I
> know it's a POM)
> Any suggestions?
my cat has cushings and is on 10mg twice a day of vetoryl, which is easily available from online pet pharmacies, for dogs, in fact i haven't seen it for anything else so find it strange you can't find it. get it direct from the makers, mastersmarketing.com they are the cheapest and you need a prescription. good luck

Hi here,
I hope all is well with your pet now, I have been finding out about cushings myself recently for my own dog had this awhile ago and the vet did ultra sound then bloods, and decided after asking me a few q's that it was c'shings and it was irreversable. as you can imagine I was distraught for my little friend. Then I stopped going to pick up the meds after 8 months, due to cost and 5 months later after a scrape and clean the vet did bloods, at their insistants to find out how poorly I had made my dog because I hadn't been back for meds and to the astonishment of the vet the cushings had gone???
I had stopped feeding my friend peanuts which will by way of content,as I found out recently mimick cushings properties, but ofcourse now after having been on vetoryl which she did not need my dog now has grown with the help of vetoryl a nasty tumor that needs surgery where do I go now??????????

Hi,
My 11 year old border terrier has been on insulin for about a year now for diabetes. I had just got the symptoms under control when he was also diagnosed with cushings. He has been on Vetoryl for about two weeks now and is wobbly on his legs, not eating at all ( which makes blood sugar control impossible) and is incontinent again.
He is an old dog and the thought of making him suffer more than he was bm giving him these drugs is not something I want to do.
Any advice?
many thanks
Jos

Hi. Josephine,

There comes a time when we have to ask ourselves why we are trying to prolong a pet's life in the face of serious and illness which is destroying tha animal's 'quality of life'. Is it because we cannot bear the thought of being without a much loved pet? Is it
because we actually enjoy the martyrdom of all the expense and worry?

As pet owners we have the responsibility of sparing our pets unnecessary suffering, and the ability, legally, to do something about it.

Ask yourself why you are keeping him going in these sad circumstances.

I am sure that you will come up with the right answer since you have managed to ask the question.

W

In response to a posted question, I, as a layman whose dog has Cushing's, believe the best way to treat a Cushing's dog is to start with the least toxic and advance if it doesn't work. In our case, we started with Anipryl (which we knew was a long shot) and when it failed to work switched to Vetoryl, which has worked quickly and spectacularly. Contrary to common belief, you do not need an FDA waiver to buy Vetoryl from its UK distributor but you DO need a prescription from your veterinarian. Our dog, a 10-year-old, 28-pound Boston, takes 90 mg. a day with 60 given in the morning and 30 given 9 hours later. She is now free of all clinical signs of Cushing's and her energy level, coat, appetite and urination frequency have returned to normal. Even her pot belly has begun shrinking back to normal. She has been taking Vetoryl four months. The improvement in symptoms began almost immediately with an abrupt end to her constant panting. However, we did later have to increase her dosage (by 30 mg., to its present level) to get the cortisol down to the desired level.
Our Vetoryl costs just over $95 a month, including shipping. We buy it online from Masters International in the UK. Our last order arrived at our home in NC six days after we placed it. Our earlier orders took exactly a week.
I prefer Vetoryl to Lysodren purely because it is less toxic, has fewer side effects and its effects are fully reversible simply by discontinuing the drug. With Lysodren, a DDT derivative, some adrenal tissue is killed and though it is possible regrow tissue after discontinuing the drug, it takes time in most cases. Therefore, if you start with Lysodren and want to switch to Vetoryl it would be a bit trickier than the reverse approach would be. If and when Vetoryl ever ceases to work for our dog, we are fully prepared to try Lysodren. However, we don't expect that to be necessary.
Another advantage of Vetoryl/Trilostane is that there is no tricky loading period. You just start the medication and test your animal to see how it is working and tweak the dosge accordingly. You may have to test frequently at first, and those tests are a bit pricey, but one the cortisol levels are normalized the testing is needed only every 4 months or so. The key is to find a US vet who either has experience with the drug or is willing to expend the time and effort to use it properly and in partnership with the owner.
A couple of points about Vetoryl. First, the twice-a-day dosing, though contrary to the manufacturer's recommended once-daily approach, appears to be gaining favor among US vets who have used Vetoryl. In our case, we found that we also had to tweak the spacing between the morning dosing and the evening dosing. We deduced that the morning dosage was wearing off before the evening dosage kicked in and as a result our dog was getting slightly stressed for a couple of hours at bedtime. We reduced the spacing to 9 hours from 12 hours and that problem disappeared. Establishing the correct dosage and the correct dosing schedule is key to success with Vetoryl.
Incidentally, when last we had our dog's cortisol levels checked by our vet, which was a month ago, they were down to 1.5. That's one POINT five, not fifteen!! Before treatment began, the level was measured at twenty-eight (28). Needless to say, we are very pleased.
Finally, I personally would not recommend buying Trilostane (the chemical name for Vetoryl) from a compounding pharmacy. Although I am sure there are many very good compounding pharmacies who do fine work, the truth is that since Trilostane has not yet received final FDA approval for use in this country, those pharmacies are operating in murky area of law when they sell the drug here. Furthermore, it is my understanding that since compounders work from raw chemicals, the quality can vary or be inconsistent, especially with regulatory oversight lacking. To me, buying the drug in its legally manufactured form is a wiser course even if it may cost a bit more. Hopefully, final FDA approval will come this year and the purchasing process will be much easier. In the meantime, Masters International is very efficient, has great customer service and is entirely satisfactory. You can check out the company's website if you like simply by Googling it. We place our orders online, by the way.
The good news about Cushing's is that it is very treatable and once treated the animal can lead a long, high-quality life.

Hi, Ron,

Thankyou for that very useful contribution. I am pleased that your dog is responding so well to treatment.

W

My 9 year old minature Yorkie has had Cushings for about 4 years and has been on 30mg of vetoryl daily. She has been on the whole quite well except for a bout of pancreatitis about 3 years ago. Some 10 weeks ago she started to show a weekness in her back legs and then lost feeling in one front leg causing complete dissability within 5 weeks. We had an MRI scan which showed nothing deffinate and as a last resort she was put on a course of steroids 5mg per day for a dog of 3Kg. Within a week she stood on her own and a week later was walking with a distinct wobble. Last week we had an ADHT to check her cushings and were astounded that the vet told us to discontinue the Vetoryl for the time being but keep the steroids going for a further month before repeating the test. Is it possible that she is cured? or is it possible that vetoryl can be overdosed to a point where it causes an Addisons type problems. I'm just after answers.

Hi,

It seems that your vet has the situation well under control, go on his advice. Clinical pictures do change, and the dosage requirements alter as the condition progresses. I cannot explain the connection between the Vetoryl dosage, the Cushings and the walking problems, nor why it responded so well to steroids

W.

Hi Pam,
my dashound mix "Harry" 10yrs old has got "cushings" he had "special" blood tests and then an ultra sound confirmed it!! he is now on "vetoryl". this is his 3rd month on the medication!.