Trilostane treatment for canines, as discussed by veterinary expert Elizabeth Racine, DVM, reviewed by Emily Oliver, CVT, and last updated on June 28, 2022. Optional: Share on Facebook, Twitter, email, or print.
Trilostane, marketed as Vetoryl, is a medication primarily used to treat Cushing's disease in dogs. It also finds off-label use in managing Alopecia X, a form of hair loss[1][3][5].
Treating Cushing's Disease
For canine Cushing's disease, which involves excess cortisol production, Trilostane is the standard FDA-approved treatment. It controls symptoms by blocking cortisol production[1][3][5]. The typical starting dose is between 2.2 to 6.7 mg per kilogram of body weight, administered once daily with food to enhance absorption. Dosage may be adjusted over time based on response and monitoring[1].
Managing Alopecia X
While not as extensively documented, trilostane is sometimes used off-label to address hormonal imbalances contributing to hair loss seen in Alopecia X. This use is less standardized compared to Cushing's treatment[1][3].
Common Side Effects
The medication is generally well tolerated but can cause gastrointestinal issues such as vomiting, diarrhea, and appetite changes. It may also lead to weakness or lethargy. A serious risk is adrenal insufficiency, a drop in cortisol, especially if dosing is too high or improperly managed[1][3]. Owners and veterinarians should watch for signs like weakness, vomiting, or appetite changes and seek immediate veterinary advice if they occur[1][3].
Monitoring
Dogs on trilostane require regular veterinary check-ups including blood work to monitor cortisol levels and overall health due to the risk of side effects and to ensure effective dose management[1][3].
Considerations for Alopecia X
If considering trilostane for Alopecia X, close consultation with a veterinarian is essential due to the lack of well-established protocols compared to its established use in Cushing's disease. Annual or semi-annual blood work is recommended to ensure liver and kidney function are adequate. An ACTH stimulation test is required one to two weeks after starting trilostane to assess the correct dosage.
Storage and Cost
Trilostane oral capsules from the brand name Vetoryl can be stored at room temperature for up to 3 years. Compounded trilostane products have unique storage requirements, so it's important to ask the compounding pharmacy for specific instructions. Trilostane can be quite expensive, with a monthly supply costing anywhere from $50-$150 depending on the dog's dosage.
Cautions and Precautions
Trilostane should be used with caution in dogs with other medical conditions, such as liver and kidney disease. Monitoring symptoms like increased water intake, urination, appetite, and energy level is important to check if the medication is working. Dogs who have recently been treated with mitotane should wait at least one month after discontinuing mitotane before starting trilostane therapy. The dosage may be adjusted based on the test results. Trilostane should be used with caution in dogs receiving ACE inhibitors, potassium-sparing diuretics, ketoconazole, or mitotane.
[1] Veterinary Medicine: Drug Monographs for Trilostane [3] Merck Veterinary Manual [5] Cornell University College of Veterinary Medicine
- In addition to treating Cushing's disease, Trilostane, the active ingredient in Vetoryl, shows off-label use in managing certain medical conditions, such as Alopecia X, a form of hair loss.
- Chronic diseases like Alopecia X involve hormonal imbalances that can potentially be addressed with Trilostane, though its use in such cases is not as extensively documented as its use in Cushing's disease treatment.
- Respiratory conditions, digestive health, eye health, hearing, and skin conditions are examples of other health and wellness areas that may require various therapies and treatments.
- Fitness and exercise are crucial for maintaining cardiovascular health and overall well-being, while proper nutrition and weight management are essential components of a healthy lifestyle.
- Autoimmune disorders and mental health disorders are complex conditions that may require specialized therapies and treatments to manage effectively.
- Skin care is a vital aspect of pet care, as skin conditions can affect the pet's overall health and comfort.
- In some cases, alternative treatments such as CBD may be considered for managing certain neurological disorders or pain in pets.
- Lifestyle changes, such as dietary modifications and increased exercise, are often recommended for managing many chronic diseases and maintaining overall health and well-being.
- When caring for pets with medical conditions, regular veterinary check-ups, monitoring symptoms, and understanding potential side effects and interactions with other medications are crucial.
- Managing chronic diseases, such as Cushing's disease or Alopecia X, requires close collaboration between dog owners and veterinarians, as dosage adjustments and monitoring are essential to ensure effective treatment and minimize side effects.
- Trilostane oral capsules are costly, with a monthly supply costing anywhere from $50 to $150 depending on the dog's dosage, making affordability an important consideration for pet owners dealing with chronic diseases.
