Monitoring Cushing's

Proper monitoring of Cushing’s syndrome patients is essential to ensuring optimal treatment results. Scheduling follow-up appointments and educating the pet owner on the importance of reporting any signs of change in their pet are vital to the treatment process.

The dose of trilostane should be titrated according to individual response as determined by monitoring of clinical signs, physical examination and laboratory test results (ACTH stimulation test and serum biochemistry, including electrolytes).

Once treatment has been initiated, samples should be taken for serum biochemistry (including electrolytes) and an ACTH stimulation test 10-14 days later, 30 days later, 90 days later and every 3 months thereafter.

After the administration of trilostane with food, cortisol levels are most significantly suppressed for 3 to 8 hours. Therefore, in order to obtain results at the peak time of effect, the ACTH stimulation test should be performed at 4-6 hours post-dosing. This will ensure you are assessing the dog’s cortisol levels when they will be at their lowest, thus uncovering any unintended over suppression of the adrenal glands that would indicate the need to decrease the dose.

A positive response to the administration of trilostane will manifest as an improvement in clinical signs and post-ACTH serum cortisol concentration between 1.45 - 9.1 μg/dL (4-6 hours after dosing with food).