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Hyperadrenocorticism: Trilostane Therapy 1427

Hyperadrenocorticism: Trilostane Therapy
VetBooks.ir

Trilostane
1 mg/kg q 12h or 2 mg/kg q 24h

Decreased appetite, vomiting, diarrhea,
listlessness, or water intake <60 mL/kg/d
OR
10-14 days

ACTH stimulation test
(4–6 hr post-pill;
use consistent timing
for subsequent rechecks)

Response below ideal Response ideal Response above ideal

• If this is first recheck and
• Discontinue 2–3 days clinical signs are improved,
• Restart at 25% lower Clinical signs controlled Clinical signs present continue therapy and repeat
dose, then recheck ACTH ACTH stim on day 30
stim in 7 days • If clinical signs are
unimproved at first or
subsequent recheck,
• Continue therapy. Increase dose frequency increase dose by 25% and
• Recheck ACTH stim on days (e.g., from once to twice recheck ACTH stim in 7 days
30 and 90, then q 90-120 days daily), then recheck ACTH
• Recheck ACTH stim if signs stim in 10 days
of hyperadrenocorticism recur
• Recheck ACTH stim if signs
of hypoadrenocorticism
recognized

Note: Idealrange is 30–150nmol/Lpre-and post-ACTH; normal resting range is 10–160 nmol/L.
ACTH stim, ACTH stimulation test.
(From Rand J, Behrend E, Gunn-Moore D, Campbell-Ward M, editors: Clinical endocrinology of companion animals. New York: Wiley-Blackwell, 2013.)
Clinical Algorithms
AUTHOR & EDITOR: Ellen N. Behrend, VMD, PhD, DACVIM

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