Dog with Cushing's on Trilostane has seizures. Is Adrenal Harmony better?

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Oh no! Poor Charlie! I have not heard of strokes being a side effect of Vetoryl (trilostane). It is very well tolerated and has significantly decreased the side effects for treating cushings compared to the older drug choice. Untreated cushings can cause clots though. I wonder if the stroke is unrelated and maybe he is experiencing a Vestibular event. Look at his eyes and see if they are moving abnormally. Dogs with Vestibular disease have abnormal eye movements, a head tilt, fall to one side, walk drunk, pant and drool because they are very dizzy. Vestibular disease is rarely fatal and can be managed. They tend to get better. I would encourage you to take Charlie to an emergency hospital to be evaluated. I wish you the best!

The concern is often more linked to a tumour of the pituitary gland, which is located at the base of the brain. The tumour can be benign or malignant and what it does it is stimulating the adrenal glands to produce cortisol. If the pituitary tumour grows, it can cause neurological signs and therefore seizures too. The masses can be quite large , over 1 cm , and cause symptoms related to pressure to the brain structures nearby. If the seizures are not very frequent, it means the tumour rate of growth is not that fast, and this is a good sign in itself. However an MRI would be able to provide more information and allow monitoring, if possible.

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. I will strongly discourage you from giving Sophia Trilostan without knowing for sure that she has Cushing disease. She may have, for example ascites, diabetes or internal organ enlargement, which makes the belly look potted. In that case, giving Trilostan can lead to a life-threatening hypoadrenal crisis. Please, take your dog to your local vets to confirm the diagnosis and then start the treatment, if necessary.

It's never a good idea to stop or make any dosing changes in a prescription medication without your vet's input, so I would definitely recommend giving him/her a call to discuss your concerns before you change anything. In general, I can tell you that if your dog has symptoms like lethargy, vomiting or diarrhea, or not wanting to eat, this may be a sign that the trilostane dose needs to be reduced. So this is definitely cause for concern - I would call your vet today to let them know. They may recommend having Max come in for blood work to check his cortisol levels - this will help determine what needs to be done regarding his medication.

Thank you for submitting your question regarding Bruno. I base quality of life decisions on several factors. Is the patient eating and drinking on his own? How is his mobility? Can he navigate stairs safely, move freely around the house and get outside to go potty? This tends to be a significant problem in large breed dogs. Any time a pet has a chronic illness, there will be good and bad days. Are the good days still outnumbering the bad days? Finally, does he still seem happy? I would recommend carefully thinking about these questions and seeing what his blood work shows. Cushing's can be managed most cases. The seizures are worrisome though. They are unpredictable. He might never have another one, but they could go on to become a frequent occurrence. His blood work will determine if he is healthy enough for anti-seizure medications. I hope this information helps.

Some common symptoms of Cushings's are panting, increased thirst/urination, but these are also common symptoms of many diseases. Bloodwork and endocrine testing can help to ferret that out. Neurologic symptoms can sometimes be present with Cushing's if there is a larger tumor in the pituitary gland but seizures can also be caused by other things as well so an MRI is typically required. CT can sometimes be used if a pituitary mass is strongly suspected. Itchy feet is typically caused by allergies which may also be associated with secondary infection. Next steps are to see your vet for an exam, bloodwork, and endocrine testing. Abdominal ultrasound and blood pressure measurement are also typical next steps. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Vetoryl (trilostane) is the best medication for managing Cushing's disease, but I'm sorry to hear that Lacy has not been tolerating it well. I have anecdotally heard of some vets using a variety of supplements for managing Cushing's disease signs, but these supplements will not ultimately decrease the cortisol production by the adrenal glands and generally seem ineffective. I don't know how long Lacy was receiving Vetoryl, but some dogs can initially become lethargic, vomit, have diarrhea, or a decreased appetite. Fortunately, these signs typically resolve after a few days to a few weeks on the medication. It may be worth discussing a temporary dose adjustment with Lacy's vet to see if she tolerates a lower dose better before gradually increasing to her 30mg dose. Some dogs also benefit from supportive measures (anti nausea medications, bland diets, etc.) in the first few days to weeks of treatment. I hope this helps and that all goes well!