when to do another blood test

[lindapalm]

My dog has been on Trilostane for Cushings disease for three weeks.  She has much more energy, can now walk, and is not panting.  She still pees and drinks excessively.   All my vet said is that he'd like me to monitor her water intake, which is impossible with nine animals, so I monitor her output, which is every one and a half to two hours. Is she due for another Cushings test by now, or do you wait longer?

[Justine Lee, D.V.M., DACVECC]

According to the company, you are supposed to test:  at 10 days, 4 weeks, 12 weeks after starting Vetoryl® treatment and then every 3 months. At these time points we recommend that you:

• ASSESS CLINICAL SIGNS
• ACTH stimulation test 4-6 hrs post-capsule – aim to always start the ACTHST (i.e. take the pre-ACTH blood) 4 hrs post-Vetoryl capsule.
• Routine haematology and biochemistry

Waiting till 2 months will be too far out.

[lindapalm]

Thank you very much.

[lindapalm]

I read the instructions in the pill box and they agree with what you said about testing at 3-4 weeks.  My vet wants to wait for two months.  I don't think he is too familiar with Trilostane, but I don't want to tell him what to do.  I assume that waiting the extra month won't hurt, or will it?  

[Justine Lee, D.V.M., DACVECC]

That's great that she's responding so well! As Dr. Coyner stated, the ACTH stimulation test should be done 4-6 hours after the dose (Ideally, 4 hours). It should be done at 4 weeks, 12 weeks, and then every 3 months thereafter. You can also have your vet call Dechra (the company that makes it) for more info. Hope that helps!

[Kimberly Coyner, D.V.M., DACVD]

Yes, three weeks is an appropriate time period to repeat an ACTH stimulation test to see if the Trilostane dose needs to be modified. The blood test should be done 4-6 hours after the Trilostane dose.
Kimberly Coyner, DVM DACVD