Starting Cushing’s Treatment Tips

By Emily Hoppmann, DVM

• Once a diagnosis of Cushing’s Disease has been made your pet will be started on a   lifelong management protocol

• The first step is to reduced your pet’s food by 1/2 for 72 hours (at least) so that he is   eager to eat with his first dose of medication

• The medication used to treat Cushing’s Disease is Trilostane and its job is to lower the   level of steroids in the body to the correct level

• Trilostane must be given with food

• Trilostane is best given as a once a day medication, in the morning

• The major risk associated with treatment is that the steroid level will become too low,   so always have the prednisone prescribed at home in case of a sudden decrease in the   steroid level.

• Clinical signs to watch for if the steroid hormone is too low: vomiting, diarrhea, not   eating, not drinking, loss of energy/sluggishness, neurologic changes that can range   from just not seeming as alert to not being able to walk normally (often have a drunken   walk)

• If these signs are seen, stop the Trilostane and give one dose of the Prednisone   prescribed.

• If this occurs, please call right away so I can advise you have to restart the Trilostane at   a reduced dose in a few days.

• Once Trilostane therapy is started, the levels of steroids in the body will start to be   monitored and managed.

• This begins with the first test done 2 weeks after starting medication to be sure that the   dose is not too high.

• The next test needs to be done 4 weeks after initial test and is used to adjust dose.   This will be a total of 6 weeks after starting the medication.

Reminders For At Home Monitoring:

Monitor water consumption and appetite daily – as   the medication begins to work both of these levels should start to decrease. Remember   that a total lack of appetite or refusal to drink are signs that prednisone needs to be given.   Always remember the clinical signs that might indicate an issue with too little steroid in the   body. If seen, do not give the Trilostane, administer the prednisone as directed, and call your   veterinarian. These signs include vomiting, diarrhea, not eating, not drinking, loss of energy/  sluggishness, and/or neurologic changes (from not being as alert to walking as if drunk).