Seein as it's informashon for da hoomans my muvva is gonna rite it all down, cus some hoomans can't understand wot us dogs is barkin about. *rolls eyes*
Please read the whole article, it is very important if your dog is to benefit from the medication and to have a good quality of life.
VETORYL (Trilostan) - For The Treatment Of Canine Cushings Disease
Why do I have to give Vetoryl® every day?
The active ingredient in Vetoryl® is a drug called trilostane. Trilostane is a short-acting drug which needs to be given every day to control the disease.
How do I give Vetoryl® to my dog?
Vetoryl® comes in a range of capsule sizes. Your veterinary surgeon will advise you of the right dose for your dog. We recommend that you give your dog Vetoryl® with a meal in the morning, as this will make it easier for your veterinary surgeon to perform monitoring tests 4-6 hours after dosing.
What should I do if I forget to give a capsule?
Speak to your veterinary surgeon. DO NOT give a double dose the next day.
How long will my dog require treatment?
Most dogs need to be given Vetoryl® every day for life.
How long will it take for my dog to improve on treatment?
The clinical signs of Cushing’s such as lethargy, increased drinking, eating and urination improve quickly - often within the first two weeks of treatment. Skin changes and hair loss take up to 3 to 6 months to improve.
Will I need to revisit my veterinary surgeon?
Yes. It is important that your dog revisits your veterinary surgeon for assessment and monitoring tests at 10 days, 4 weeks and 12 weeks after starting Vetoryl®, and thereafter every three months.
If your dog becomes unwell at any time whilst on Vetoryl®, stop treatment and consult your veterinary surgeon as soon as possible.
Does Vetoryl® have any side-effects?
Vetoryl® is well-tolerated by most dogs. If your dog develops any signs of illness while on Vetoryl® including lethargy, vomiting, diarrhoea and anorexia, stop treatment immediately and contact your veterinary surgeon as soon as possible.
Cushing’s syndrome cannot be cured but it can be successfully managed and controlled through medication. Vetoryl® is the only licensed treatment for Cushing’s in the UK. It contains trilostane which is a chemical substance that blocks the production of cortisol.
Cushing’s syndrome is not curable but with Vetoryl® it can be very effectively controlled; maintaining a good quality of life for your dog for years to come. Vetoryl®, which is the only licensed treatment for use in dogs, contains the active ingredient trilostane, a drug that rapidly reduces the production of cortisol by the adrenal glands.
Below is a quick reminder of the key things you need to remember about Vetoryl® treatment.
DO:
Give Vetoryl® capsules in the morning with food so that they can be easily absorbed. This also allows your veterinary surgeon to carry out monitoring tests at the appropriate time of day.
Take your dog back to your veterinary surgeon for regular monitoring.
Note your dog’s weight, water consumption, appetite and frequency of urination before treatment so you can monitor its improvement once treatment starts. Contact your veterinary surgeon if you have any concerns.
Contact your veterinary surgeon immediately if your dog stops eating, drinking or urinating or becomes unwell while on Vetoryl® treatment.
Wash hands after using Vetoryl®.
Book follow up appointments with your veterinary surgeon every three months so that progress can be assessed.
You might like to consider taking a photo before you start treatment - improvements such as hair regrowth, or the loss of a pot belly occur gradually so are less noticeable on a daily basis.
DO NOT:
DO NOT split capsules.
DO NOT handle if pregnant or trying to conceive.
DO NOT change your dog’s dose without advice from your veterinary surgeon.
First recheck at 2 weeks
Owners should have noticed that the dog is drinking less and urinating less
The ravenous appetite and excessive panting should have decreased
Lethargy is another clinical sign of Cushing’s syndrome that rapidly responds to treatment; even at the first 14-day check many owners have noticed their dogs are more active
Initial testing schedule (after initial diagnosis):
Examination (ACTH test) at 14 days after taking Vetoryl.
Re-examination at 4 weeks (ACTH test)
Re-examination at 12 weeks (ACTH test)
If results stable re-examination can be carried out at 3mth or 6mthly intervals. Should Cushings symptoms increase or there are any changes in the dogs sypmtoms, a re-examination (ACTH test) should be carried out, and if a higher dose is recommended then re-examination (ACTH test) after 14 days of new higher dose is recommended to check dose is not too high or still too low.
Unfortunately it is necessary to test frequently to ensure the dose is correct and to keep the symptoms at bay or at least reduced greatly to maintain a good quality of life for the dog and to avoid side effects.
At day 84 after starting treatment with VETORYL Capsules, 80% of dogs were considered treatment successes
At day 84, the percentage of dogs showing improvements in activity, appetite, thirst, urination, and panting ranged from 81% to 93%
In 93% of dogs, improvement in clinical assessments were noted at day 84
Below is a very important information you should be aware of when your dog is re-tested.
VERY IMPORTANT WHEN YOUR DOG IS ALREADY TAKING VETORYL & IS BEING MONITORED REGULARLY
Preparing for the ACTH stimulation test: Does the animal need to be fasted?
The dog or cat does not have to be fasted overnight, and lipemia does not appear to “clinically’ affect serum cortisol values. However, having a nonlipemic sample may be better in some situations, especially if serum cholesterol or triglycerides are being measuring on same sample.
Remember that the ACTH stimulation test is the most useful test for monitoring dogs being treated with trilostane (Vetoryl) or mitotane (Lysodren) see my blog entitled, Diagnosing Cushing's disease: Should the ACTH stimulation test ever be used? Both medications are fat-soluble drugs and must be given at time of meals, or the drugs will not be well absorbed.
With trilostane (Vetoryl), it’s extremely important to give the morning medication with food, and then start the ACTH stimulation test 3 to 4 hours later.
Fasting these dogs on the morning in which the ACTH stimulation test is scheduled should be avoided since it invalidates the test results.
When a dog ‘s food is withheld, the absorption of trilostane from the gastrointestinal tract is decreased. This leads to low circulating levels of trilostane, resulting in little to no inhibition of adrenocortical synthesis. Therefore, serum cortisol values will higher when the drug is given in a fasted state than when it is given with food.
The higher basal or ACTH-stimulated cortisol results could prompt one to unnecessarily increase the daily trilostane dose. That misjudgment may lead to drug overdosage, with the sequelae of hypoadrenocorticism and adrenal necrosis in some dogs.
written specifically to serve veterinarians and veterinary technicians.
Source link: Dr. Mark E. Peterson
I have put the whole article here, because if like me, you want to know as much as possible about Cushings Disease AND treatment and tests, you want as much information as you can get.
The only part of the above article which applies to us, owners of dogs with Cushings, is the section specifying not to starve your dog before his ACTH tests, as starving will affect the results and could mean your veterinary surgeon will dispence the wrong dose of Vetoryl for your dog.
And as we know Vetoryl is a powerful drug with some nasty side effects if the dose is even slightly too high. So it's important to make sure your dog has the best possible chance of being given the correct dose.
From personal experience I have found most vets are not 'up to speed' with the very latest things going on, they can't be. They have to deal with so many animals with so many different diseases, that they can't possibly know all there is about everything, and it's not fair of us to expect them to. But it is up to us to find out as much about the drugs and the diseases and latest findings as we can so we can advise our vets. They can then check for themselves to confirm what we are saying is correct and up to date, and treat our pets accordingly.
So in a nutshell, once your dog is taking Vetoryl (Trilostan)
Do not starve before the ACTH tests, and make sure the meal is given 4-6hrs BEFORE the ACTH test is carried out for an accurate result.
Here in the UK Vetoryl is manufactured and sold to veterinarians by:
DECHRA Veterinary Products
Sansaw Business Park
Hadnall
Shrewsbury
SY4 4AS
Telephone: 01939 211200
Company Registration No: 5385888
For further information please submit an electronic enquiry or contact our Customer Services Team on 01939 211200
I highly recommend Dechra's Customer Services Team, they are more than willing to give you any advice and answer any questions you may have regarding Vetoryl.
DECHRA's website link: DECHRA Veterinary Products
In the USA:
Dechra Veterinary Products
7015 College Blvd., Suite 525, Overland Park, KS 66211
Tel: + 913-327-0015 Fax: + 913-327-0016
Some vets will insist your dog is starved. Please please please tell them to contact DECHRA, because if they insist you starve your dog pre-testing, then your dog will be overdosed with Vetoryl (Trilostan) and this can be fatal. Many many vets insist on your dog being starved. You are within your rights to refuse this and inform them they are wrong! Don't be afraid to speak out, it's your beloved pet's welfare and wellbeing that is important.
One other thing, some vets state your dog is also hyperthyroid because of the T4 results.
It is most common for cushingoid dogs to have low T4 on blood chemistry and that doesn't mean the dog has primary hypothyroidism. It is much more likely that this abnormality is something called Sick Euthyroid Syndrome. This is a transient condition which corrects itself once the underlying cause has been addressed. In Cushing's, it is the excess cortisol that is causing the problem and once a dog is stabilized on treatment, the T4 usually returns to normal. If T4 continues to be low after a dog is stabilized, I would then pursue a primary hypothyroidism diagnosis via a full thyroid panel.
I hope this information has been useful. I'm sorry it's such a long article, but there was a lot to cover. And as I mentioned before, if you are like me, you want to know as much about the disease, the treatment and the drugs as you possibly can.
No comments:
Post a Comment