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  #11  
Old 04-25-2009, 07:34 AM
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Carin Carin is offline
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Default Re: Declining need for Trilostane over time?

Patti - others here will be much more informed about interpreting test results than I am, but my understanding is that the goal is to get the second result in the range of 1.45-5.4, so that result is very high. The flow chart in the Vetoryl pdf in the forum's files makes things fairly clear: http://www.dechra-us.com/File/vetory..._Flowchart.pdf

Carin
  #12  
Old 04-25-2009, 07:47 AM
frijole frijole is offline
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Default Re: Declining need for Trilostane over time?

Hi Carin. You are right that those numbers are high because Jesse hasn't started treatment and is still being diagnosed. "Normal" dogs cortisol levels are 22 or below so that number is high but not "way high". The 1 to 5 numbers that we talk about are the goals for decreasing cortisol in cush dogs.

Cush dogs need way lower cortisol levels than others dogs since their poor bodies want to keep producing it. Hope this makes sense. Kim
  #13  
Old 04-25-2009, 07:50 AM
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Carin Carin is offline
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Default Re: Declining need for Trilostane over time?

Hi Kim. I replied to Patti's question on this thread without catching up on Patti and Jesse's story in their own thread. Going over to read that now...

Carin
  #14  
Old 04-25-2009, 09:05 AM
Patricia ann Wh Patricia ann Wh is offline
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Default Re: Declining need for Trilostane over time?

Hi,

So should the lower number be from 1 - 5 ??

I'm sorry I looked at that flow chart, and I'm confused, I'll look at it again.

Oh My Lord, I can't believe you guys understand all of this.

Two vets said (no three) that they would start Jesse on low dose trilostane. (Not that any of them have used it) Oh BOY

Thank you all
  #15  
Old 04-25-2009, 09:24 AM
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Lulusmom Lulusmom is offline
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Default Re: Declining need for Trilostane over time?

To answer Patti's question, the basal or pre draw number is of little value when interpreting the acth stim test for monitoring of treatment. The normal resting or basal range is usually 1 to 6 (depending on the lab) and anything above that can usually be attributed to the stress of being at the vet's office. It is the post draw that you want to be within the 1 to 5 range, ideally anywhere between 1.5 to 4.5.

Glynda
  #16  
Old 04-25-2009, 10:23 AM
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Carin Carin is offline
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Default 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
  #17  
Old 04-25-2009, 11:06 AM
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Default 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
  #18  
Old 04-26-2009, 10:22 PM
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zoesmom zoesmom is offline
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Default 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

Last edited by zoesmom; 04-26-2009 at 10:24 PM.
 

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