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Old 04-24-2009, 08:27 PM
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zoesmom zoesmom is offline
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Hi and welcome -

What the others have said is right on target. Once we see the test results, it will be easier to tell if it's just too much trilo or a matter of a wrong dx, although her symptoms sure sound like they fit the bill. But those test results are crucial.

I can tell you that my Zoe had the same problems when she first started trilostane - in fact, she got to the point of vomiting and diarrhea, after only two days, even though her dose was in the range for a dog her size. (She also was/is on PPA for incontinence so I don't think that's the problem. PPA is not a heart med, but in humans I know it can affect the heartbeat/heartrate. It's a stimulant.)

Two or three times, we had to stop Zoe's trilostane and after a few days wait each time, we reintroduced at a lower dose. The first couple of reductions weren't enough and within 2 days, she'd start getting sick again. She was started on 180 mg sid, and ended up taking only 45 mg bid, before she could tolerate it. (She weighed 80lbs at the time) It took about 2 or 3 mos. to gradually increase her dose back up to 120 mg. sid because I wanted to be extra cautious, after the rough start. Luckily, I had 15 and 45 mg. tablets at the time so was able to make several different adjustments. (Did you know you can order the exact dosage needed from compounding pharmacies?? I get Zoe's from pethealthpharmacy.com in AZ and it's a great price, compared to what I initially paid 3 years ago.)

Anyway, Zoe did fine, once we took that slower approach. But it's impt. to take several days off before restarting at a lower dose (Dechra recommends 7 - we did 4 or 5, I think.) We have seen some big dogs who needed a much lower dose than normal, and some little guys who wind up on a much higher than standard dose. Each dog is different, so there can be a lot of dose tweaking in the beginning. Zoe is past 3 years on trilostane now, and takes twice the dose that originally made her so sick (she gets 180 mg bid at the present, although she's taken even higher single doses - having been all over the board with trying to find what works best for her.)

So for now, the pred, then when she comes off of that, I'd wait 5 - 7 days before trying a lower dose. Maybe 30 mg would work for her. Even if you have to order some new trilo, hang onto those 60 mg. capsules because you never know if she may end up taking that eventually. Actually, until you can post those original test results, I wouldn't restart the trilo at all, just in case it's a case of misdiagnosis. Sue/Zoe

Last edited by zoesmom; 04-24-2009 at 08:34 PM.