Declining need for Trilostane over time?

[Carin]

Re: Declining need for Trilostane over time?

Thanks, Glynda. Patti - don't worry about this, I'm just processing Duncan's experience after long treatment - but my vet is clearly somewhat concerned about the drop in Duncan's basal level over time. My impression was that he was worried that if his basal level was so low, he would be more prone to an Addisonian crash, and that the low basal number suggested we might be approaching a point where the adrenal gland wasn't functioning. But I will clarify that with him next time we talk.

Carin

[Lulusmom]

Re: Declining need for Trilostane over time?

Hi Carin,

You made a very good point about monitoring the basal number for purposes of determining possible Addison's Disease or Addisonian crisis. I failed to mention that. If resting/basal cortisol is low (less than 1) and the dog has no or a very low response to stimulation, then Addison's is a good bet.

Trilostane definitely affects aldosterone levels so it is very important that electrolytes are checked every time a stim is done. This is absolutely critical if acth stim results are too low for comfort.

Glynda

[zoesmom]

Re: Declining need for Trilostane over time?

Carin -

I'm jealous. I wish Zoe could be on a much lower dose. She's on the 180 bid. I think it's interesting what you describe has happened with Duncan. I had hopes last August when Zoe's consistently stubborn numbers took an unexpected plunge. Similar to Duncan's - a pre of .7 and a post of 1.6. She'd never had anything close to that before, always 5-ish to 10-ish, once even going back up to 13-something. So you can imagine my surprise. She WAS acting strange, but I never dreamed it was from too low cortisol. But it was.

So we did do a dose reduction.....all the way down to 150 mg. bid It was short-lived.....but it lasted a few months which is better than none. By Nov. she'd crept back up to 9. We didn't change her dose tho'. Then just about a month ago, we retested and her post was well over 10.....so this time we decided it was time for an increase and back to 180 mg. she went. So it's the usual roller coaster with the Zo.

The only thing we can say for sure is > All the dogs are so different. You just can't predict anything with any of them. But I'll keep my fingers crossed that Duncan is headed for a remission! Zoe has a long way to go, I think, to reach that point! Sue & Zo