5 yr old Boxer female. Being treated for Cushings with Trilostane 120MG per day. She weighs 71 pounds. Problem is she is very tired and lethargic. Has been on drug for 3 months. ACTH indicated all chemical levels are normal. Any idea's as to why she is lethargic and what I can do to increase energy levels?https://www.vetclickforum.co.uk/read.php?7,1387,1387#msg-1387Sat, 02 May 2026 09:07:22 +0000 Phorum 5.2.23 https://www.vetclickforum.co.uk/read.php?7,1387,15635#msg-15635 https://www.vetclickforum.co.uk/read.php?7,1387,15635#msg-15635
I wanted to say thank you to all have contributed to this discussion, reading from owner's of dogs with Cushings still have them alive and well four years on has heartened me at a time when I'm so unsure that I am doing the right thing for her.

Is anyone aware of a written book on Canine Cushing's Disease? I've done several searches and so far have not come up with anything.

Thanks,]]> Amanda Ask The VetSat, 16 Jan 2010 23:19:41 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,15433#msg-15433 https://www.vetclickforum.co.uk/read.php?7,1387,15433#msg-15433
The brochure mentioned administering the meds with food for better absorbtion but one of the posts here said they had better results giving the meds two hours before. Some of these posts are dated back to 2006 and 2007. Does anyone have any newer, more solid recommendations so that I can discuss that along with splitting the dosage with my vet? Now that vetoryl is FDA approved, is Marketing International still the cheapest place to purchase the meds?

Please keep posting your experiences and success stories. Thank you very much!!!!]]> Katherine Ask The VetMon, 28 Dec 2009 20:54:18 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,15082#msg-15082 https://www.vetclickforum.co.uk/read.php?7,1387,15082#msg-15082Kind Regards
Dave & Pat]]> Dave & Pat Ask The VetSat, 14 Nov 2009 11:14:08 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,14323#msg-14323 https://www.vetclickforum.co.uk/read.php?7,1387,14323#msg-14323
ALWAYS follow the makers' instructions. If you do not, and anything adverse happens, they will not accept responsibility.

W]]> Walter Beswick Ask The VetMon, 31 Aug 2009 07:24:11 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,14322#msg-14322 https://www.vetclickforum.co.uk/read.php?7,1387,14322#msg-14322 Joey N. Ask The VetMon, 31 Aug 2009 04:28:54 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,12142#msg-12142 https://www.vetclickforum.co.uk/read.php?7,1387,12142#msg-12142
If you Google 'Vetoryl for Dogs' and read 'Cushings Part Three' you will find a very useful account by the owner of a dog which was treated with Vetoryl for Cushings syndrome.
Skin problems do occasionally arise, but I am not aware of tremors being common when on Vetoryl treatment, though I am sure that if any other readers of these posts have encountered them, they will tell us!

W]]> Walter Beswick Ask The VetSat, 07 Mar 2009 21:02:13 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,12139#msg-12139 https://www.vetclickforum.co.uk/read.php?7,1387,12139#msg-12139Thank you very much CRichardson]]> c.richardson Ask The VetSat, 07 Mar 2009 15:02:54 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,9511#msg-9511 https://www.vetclickforum.co.uk/read.php?7,1387,9511#msg-9511my 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!.]]> christine Ask The VetWed, 06 Aug 2008 06:30:58 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,9180#msg-9180 https://www.vetclickforum.co.uk/read.php?7,1387,9180#msg-9180
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.]]> Walter Beswick Ask The VetMon, 07 Jul 2008 20:24:55 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,9176#msg-9176 https://www.vetclickforum.co.uk/read.php?7,1387,9176#msg-9176 David Birch Ask The VetMon, 07 Jul 2008 16:07:02 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8797#msg-8797 https://www.vetclickforum.co.uk/read.php?7,1387,8797#msg-8797
Thankyou for that very useful contribution. I am pleased that your dog is responding so well to treatment.

W]]> Walter Beswick Ask The VetTue, 03 Jun 2008 20:37:53 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8795#msg-8795 https://www.vetclickforum.co.uk/read.php?7,1387,8795#msg-8795Our 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.]]> Ron Ask The VetTue, 03 Jun 2008 19:24:13 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8732#msg-8732 https://www.vetclickforum.co.uk/read.php?7,1387,8732#msg-8732
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]]> Walter Beswick Ask The VetWed, 28 May 2008 07:20:58 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8731#msg-8731 https://www.vetclickforum.co.uk/read.php?7,1387,8731#msg-8731My 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]]> Josephine Ask The VetTue, 27 May 2008 21:40:26 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8209#msg-8209 https://www.vetclickforum.co.uk/read.php?7,1387,8209#msg-8209I 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??????????]]> joy Ask The VetSat, 22 Mar 2008 20:55:36 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8190#msg-8190 https://www.vetclickforum.co.uk/read.php?7,1387,8190#msg-8190-------------------------------------------------------
> 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]]> anonymous Ask The VetWed, 19 Mar 2008 10:42:56 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8176#msg-8176 https://www.vetclickforum.co.uk/read.php?7,1387,8176#msg-8176
Your vet who is treating your dog is best placed to advise on the best treatment.

W]]> Walter Beswick Ask The VetMon, 17 Mar 2008 21:16:57 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8175#msg-8175 https://www.vetclickforum.co.uk/read.php?7,1387,8175#msg-8175Taco Smits]]> Taco Smits Ask The VetMon, 17 Mar 2008 20:31:56 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8079#msg-8079 https://www.vetclickforum.co.uk/read.php?7,1387,8079#msg-8079
Thank you for this very useful information, which should be of considerable help to others in the US whose pets have Cushings.

W]]> Walter Beswick Ask The VetThu, 06 Mar 2008 08:16:43 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,8075#msg-8075 https://www.vetclickforum.co.uk/read.php?7,1387,8075#msg-8075Exactly 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.]]> Ron Ask The VetWed, 05 Mar 2008 22:42:21 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,7800#msg-7800 https://www.vetclickforum.co.uk/read.php?7,1387,7800#msg-7800
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]]> Walter Beswick Ask The VetMon, 04 Feb 2008 09:53:08 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,7797#msg-7797 https://www.vetclickforum.co.uk/read.php?7,1387,7797#msg-7797 pauline Ask The VetSun, 03 Feb 2008 23:23:38 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,7661#msg-7661 https://www.vetclickforum.co.uk/read.php?7,1387,7661#msg-7661 Walter Beswick Ask The VetWed, 23 Jan 2008 08:22:37 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,7658#msg-7658 https://www.vetclickforum.co.uk/read.php?7,1387,7658#msg-7658
GB]]> Georgia Ask The VetWed, 23 Jan 2008 05:59:11 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,6149#msg-6149 https://www.vetclickforum.co.uk/read.php?7,1387,6149#msg-6149
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]]> Walter Beswick Ask The VetSun, 12 Aug 2007 12:03:26 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,6137#msg-6137 https://www.vetclickforum.co.uk/read.php?7,1387,6137#msg-6137I 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]]> Emma Lawford Ask The VetFri, 10 Aug 2007 18:59:50 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,6111#msg-6111 https://www.vetclickforum.co.uk/read.php?7,1387,6111#msg-6111
Sadly, in your dog's case I think it likely that Cushing's is only one of the problems of passing years!

Walter]]> Walter Beswick Ask The VetWed, 08 Aug 2007 11:52:02 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,6110#msg-6110 https://www.vetclickforum.co.uk/read.php?7,1387,6110#msg-6110
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.]]> Margo Ask The VetWed, 08 Aug 2007 09:22:03 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,5110#msg-5110 https://www.vetclickforum.co.uk/read.php?7,1387,5110#msg-5110
Thank you for your time.
Sincerely,
Cressida]]> cressida Ask The VetSun, 08 Apr 2007 19:47:50 +0000 https://www.vetclickforum.co.uk/read.php?7,1387,4644#msg-4644 https://www.vetclickforum.co.uk/read.php?7,1387,4644#msg-4644Any 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]]> Walter Beswick Ask The VetWed, 31 Jan 2007 13:27:51 +0000