What is Trilostane for Dogs?
Cushing’s disease is a constellation of different symptoms that can occur with an elevation of cortisol levels for long periods. Luckily, Trilostane for dogs is a type of medication for Cushing’s disease in dogs.
Trilostane can assist in managing the disease and alleviating the symptoms, but what are the side effects of Trilostane for dogs, and is there anything else you should know? Keep reading to find out!
The Correct Dosage to Administer
When treating Cushing’s disease, your veterinarian will aim to minimize clinical signs associated with the condition while avoiding over-suppression of the adrenal axis, as over-suppression can have serious consequences.
Therefore it is also essential to never attempt to treat Cushing’s disease at home with Trilostane or other similar drugs. Always administer the medication as advised by your veterinary care provider.
When determining the Trilostane dose for dogs, clinical tests are necessary beforehand, for example, blood samples and ACTH stimulation tests. These help the veterinarian to determine the starting dose of Trilostane.
The starting dose is typically: 0.00007 to 0.0002oz/2.2lb (2 to 7mg/kg).
The starting dose is administered for roughly two weeks before a reexamination is required to assess whether adjusting the dose is necessary.
Once a stable dose is determined, regular monitoring is often necessary every third month. These checkups will likely include blood tests, urinalysis, and possibly ACTH stimulation tests.
Trilostane for Dogs – The Side Effects
The Trilostane for dogs side effects are often mild if administered in accordance with the veterinarian’s guidelines. Generally, most dogs tolerate Trilostane well, but there are some side effects associated with the medication.
- Lethargy (tiredness).
- Inappatience (lack of appetite).
These are often mild and stop by themselves or with gentle, supportive care, like easily digestible food or anti-nausea medication.
However, you cannot alone distinguish some of these clinical signs from the more severe condition, hypoadrenocorticism, which can occur in response to the administration of Trilostane. This drug treats HYPERadrenocorticism, also called Cushing’s disease, the opposite of hypoadrenocorticism.
Therefore you must contact your veterinarian if your animal is displaying any untoward reactions.
As always, administer the medication to animals allergic to it or any of the components or are pregnant or lactating.
What is the Cost Thereof?
The cost of Trilostane for dogs will vary between regions. But you should expect it to be in a range of $45 to $160, depending on the strength of the tablets.
However, you can argue that the high cost is not the medication but the diagnostic tests beforehand and the continued monitoring afterward.
After starting with the medication, regular checkups with your veterinarian will be necessary to avoid adverse effects, determine efficacy, and determine whether it is the correct dose for your dog. Even when reaching a stable dose, it will be necessary with checks now and then, as the condition can develop.
Insurance companies estimate that the cost of reaching an initial diagnosis can vary from $500 to $1500 depending on severity, region, and comorbidities.
How to Administer the Medication
Trilostane for dogs is available as capsules at either 0.0002oz, 0.0003oz, 0.001oz, 0.002oz, or 0.004oz (5mg, 10mg, 30mg, 60mg, or 120mg), available in aluminum foil blister cards.
Most dogs should receive the determined dose orally daily in the morning. In some cases, it may be necessary to administer it twice daily to ensure satisfactory management of symptoms.
The drug should be given with food to ensure the correct bioavailability within the body and to minimize the risk of adverse reactions. It is crucial that owners wash their hands after handling the medication, and they should not handle it if pregnant, nursing, or trying to get pregnant.
What to do if You Miss a Dose
Trilostane is a short-acting medication that typically stops working within 24 hours, which is why it is essential not to miss a dose. But sometimes accidents happen.
You can just give the regular dose if you miss a Trilostane dose and are close to the original administration time. If you are more than a few hours late, skip the missed dose and give the next one at the scheduled time.
You mustn’t stop using this medication without consulting your veterinarian.
Risk Factors Associated With Canine Trilostane
Although Trilostane for dogs can be considered relatively safe, it is important to avoid overdosing, as overdosing can be fatal. If you suspect your dog may have received an overdose of Trilostane, you should contact an emergency care veterinarian.
A known risk with using Trilostane, or similar drugs, is that it can induce the opposite of hyperadrenocorticism – hypoadrenocorticism, also known as Addison’s disease. It is not something owners should worry about constantly. Still, it is important to be aware of the risk, as an Addisonian crisis can occur at any dose and time during therapy with Trilostane.
An Addisonian crisis is when there are not enough corticosteroid hormones within the organism in a stressful situation, and it is a severe condition that needs immediate treatment. Symptoms can be difficult to detect, but some can include:
- Lethargy (tiredness).
- Decreased appetite.
- Vomiting and diarrhea.
Unfortunately, the main symptom of an Addisonian crisis is when the dog collapses in shock due to an inability to stabilize internal stressors within the body.
Hospitalization is almost always necessary as treatment focuses on intravenous fluid therapy and steroid injections. Luckily though, most dogs respond well to treatment and make a full recovery if they start adequate treatment early.
Are There Possible Drug Interactions?
As with all drugs, there are some drug interactions that you should be aware of before administering Trilostane. ACE inhibitors (Eg. Benazepril) and Ketoconazole can increase the risk of shifting the electrolyte balance within the body or increase the risk of hypoadrenocorticism.
It is, therefore, vital to always inform your veterinarian if your dog receives any medication, supplements, or vitamins, as all of these can affect the treatment plan of your unique dog.
How to Store Trilostane
Trilostane capsules for dogs should be stored at room temperature (77 degrees Fahrenheit/25 degrees Celcius) and away from children and other animals.
What to do in Case of an Emergency
The main worry when using Trilostane for dogs is the risk of suddenly developing an Addisonian crisis. If you suspect your dog is having an untoward reaction to the medication, seek immediate veterinary care and bring the medication.
The Latest Update on Trilostane for Dogs
Trilostane works by inhibiting cortisol secretion and thereby alleviating the symptoms; however, this effect is often less than 12 hours. This is why newer studies suggest that effective treatment should be every 12 hours rather than once daily to inhibit symptoms continuously.
However, some controversies concerning Trilostane still exist, meaning the continued study of the effects, efficacy, adverse effects, and even dosage timing is necessary to keep owners and professionals updated on the best way to help our furry friends.
How Does Trilostane Help With Cushing’s Disease?
Hyperadrenocorticism in dogs is the clinical term for Cushing’s disease and happens when the adrenal glands within the body stop responding to the usual negative feedback mechanism that regulates cortisol. The lack of a normal feedback response can lead to excessive production and hormone release, causing increased cortisol levels in dogs.
Even mild Cushing’s disease can be severe for your dog. Constantly increasing stress hormone levels can affect the whole body and put it at serious risk of developing conditions and illnesses, everything from kidney damage to diabetes. Symptoms of uncontrolled Cushing’s disease include:
- Polydipsia (increased drinking).
- Polyuria (increased urinating).
- Excessive hunger.
- Muscle weakness.
- Alopecia (hair loss).
- A potbellied appearance.
Some of these symptoms, especially in combination, are often enough to point your veterinarian in the right direction – although getting a definite diagnosis can take time.
However, once diagnosed, treatment options are often medical, surgical, or radiation therapy. Trilostane for dogs is the medical treatment option.
Trilostane is a synthetic steroid that inhibits an enzyme within the adrenal cortex, thereby inhibiting the production of glucocorticoids and, in some ways also, mineralocorticoids and even sex hormones. Minimizing the secretion of the hormones will then also alleviate some of the symptoms associated with Cushing’s disease.
It is, therefore, essential to remember that Trilostane is not a cure; it is a way to manage the disease and symptoms. Owners and veterinarians, therefore, need to be patient as changes in the condition tend to happen very gradually over long periods.
It is also worth remembering that although Trilostane is an excellent way to control most of the symptoms but some symptoms associated with Cushing’s disease, including raised blood pressure and increased urination, may persist.
Alternatives to Trilostane in Treating Canine Cushing’s
Some sometimes argue it is not “worth” treating Cushing’s disease in dogs as some studies suggest it does not increase the overall lifespan. But life is not just about the lifespan; it is much more about quality of life.
Dogs with Cushing’s disease need treatment to manage the symptoms. Some mild symptoms may not affect the quality of life a lot, including increased urinating and drinking, but some are more severe and debilitating, like severe tiredness.
Choosing not to treat Cushing’s disease is also likely to develop comorbidities, including diabetes, high blood pressure, pancreatitis, and infections. All conditions can be debilitating and even fatal for your dog.
Therefore treating Cushing’s disease is essential, and luckily there are options, Trilostane, and others, available to improve your dog’s quality of life and reduce the risk of other conditions. Alternatives to Trilostane, a medical therapy, include surgical and radiation therapy.
Surgical therapy has the benefit of actually curing the condition; if tumors cause Cushing’s disease. In humans, surgery is the treatment of choice in many places.
Surgical therapy commonly involves either an abdominal surgical incision where the surgeon removes the affected adrenal gland or the removal of the pituitary gland.
The surgery is, however, technically challenging, with increased risks, which is why it is not an option everywhere.
Radiation therapy is rarely an option but is sometimes an option for individuals suffering from only a pituitary gland tumor. In these cases, radiation may be able to reduce the size of the mass and therefore limit the symptoms.
There is one other type of drug that is FDA-approved to treat Cushing’s disease in dogs. However, it is only approved to treat uncomplicated, pituitary-dependent Cushing’s, which may not be the correct option for every animal.
FAQ on Trilostane and Cushing’s Disease
What’s the Difference Between Hypo- and Hyperadrenocorticism?
Hypoadrenocorticism is the clinical term for the condition more commonly called Addison’s disease – where the dog is not producing enough hormones. Hyperadrenocorticism is the clinical term for Cushing’s disease, where too many hormones are present.
What Causes Cushing’s Disease?
Cushing’s can, in rare cases, occur due to prolonged therapy with other drugs; however, in the vast majority of cases, it occurs naturally due to a tumor in either the pituitary gland or the adrenal gland.
Can Cushing’s Disease Be Cured?
If surgery is an option, Cushing’s disease is curable, although in most cases, medical management of symptoms with medication like Trilostane is opted for. The medication carries fewer risks and a high level of treatment success, which is why it is often the treatment of choice.
Can I Give My Dog Trilostane Bought Online?
Trilostane requires a veterinary prescription, and you should not buy it without one. Determining the correct dose may also prove tricky, so owners should never attempt to use the drug without consulting a veterinarian.
Do I Need to Go for Regular Checkups?
Cushing’s disease is dynamic, meaning it can be necessary to adjust the dose of Trilostane depending on the symptoms the animal is displaying. Using Trilostane can also, in some cases, have untoward effects on the body, making regular checkups necessary with continuous treatment.
Can Trilostane be Helpful With Other Conditions?
A dog may sometimes suffer from alopecia (hair loss) as the only symptom. In these cases, some studies suggest that Trilostane can be an effective way of combating hair loss.
Can I Give My Cat Trilostane?
Trilostane currently appears to be well-tolerated by cats as a viable way to treat hyperadrenocorticism (Cushing’s) in cats as well. Cushing’s disease is, however, an uncommon condition in cats.
We all want our furry friends to stay happy and healthy for as long as possible. Therefore it can be challenging to watch them fall ill due to a disease with such apparent symptoms as with Cushing’s disease, where the fur may fall out, the skin becomes thin, and our best friend is suddenly tired all the time.
To many owners, it can seem like their beloved dog has become old in a matter of minutes, which can be a very uncomfortable situation to be in.
Do not despair, though; some great treatment options are available if the cause of the changes is Cushing’s disease, Trilostane being one of the most widely available. Trilostane will most likely be able to get your dog back on his feet, inhibiting the symptoms, and help your best friend continue leading a happy and healthy life!
Catharina is a Veterinary Medicine student from Uni of Copenhagen. When she isn’t making camp in the library, stuck to the books, she’s also a writer and avid photographer. Capturing everything from buildings to dogs – especially her poodle Bailey is a frequent subject.