My dog on Trilostane for Cushing's is lethargic. How to boost energy?

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.

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!

The most common adverse reactions of Vetoryl reported are poor/reduced appetite, vomiting, lethargy/dullness, diarrhea, and weakness. Occasionally, more serious reactions, including severe depression, hemorrhagic diarrhea, collapse, hypoadrenocortical crisis or adrenal necrosis/rupture may occur, and may result in death. Weakness of the hind limbs, yes but paralysis I would say, no. If he has paralysis he needs to see the vet right away. There is no treatment for those side effects other than adjusting the Vetoryl dosage but I cannot advise you on that. You need to work with your vet regarding this issue. He may need to be switched to a different medication all together (like Lysodren). There is no natural treatment to treat Cushing's disease in dogs but there are a couple products to help support dogs with Cushing's disease. This does not take the place of the actual treatment: Cushex drops: http://petalive.nativeremedies.com/search?w=cushex Energy Tonic: http://www.nativeremedies.com/petalive/energy-tonic-supports-vitality-dogs-cats.html Hope this helps. Best wishes!

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.

If Holly is not improving clinically, she might need to be tested again (ACTH stimulation test) to make sure the dose of Vetoryl is the correct one for her. Usually the blood test has to be done 10-14 days after the treatment has started, 4 to 6 hrs after Vetoryl administration. Please post again on the forum if you would like to discuss it further. I hope my answer was helpful.

I would not expect the signs you are describing to be secondary to the Vetoryl and I would not recommend stopping the medication without talking to your veterinarian first. Unfortunately there are not many safe alternative treatments for Cushing’s disease. I would be concerned that Boots might be showing signs of pain or potentially neurologic disease. It would be a good idea to have your vet examine him and to discuss these concerns.

Poor Nemesis. Sometimes pets will need the medication adjusted. I recommend to call your veterinarian and ask if another test is needed to evaluate the blood levels in his body. The test is called an ACTH stimulation test. It has been found that 50% of dogs with Cushing’s disease will also have a urinary tract infection that can only be detected with a urine culture. I recommend to have this test done as well as this will cause constant drinking and urination. Other conditions such as thyroid disease, diabetes or kidney disease can also cause these signs. You must start ruling them out. Best of luck.