mitotane/ lysodren 500mg tablets

RE: mitotane/ lysodren 500mg tablets

Sarah Keir — Mon, 28 May 2018 21:29:51 GMT

[quote user="Stephen Courtney"]

Ian Ramsey at Glasgow uses mitotane in animals that don't respond / respond adversely to vetoryl - if you email him he is very helpful, but can take a few days to get to you

[/quote]

If you join SAMSoc, he is very speedy at replying to post on the SAMSoc forum (which is also handily situated on part of the VetSurgeon.org website).

RE: mitotane/ lysodren 500mg tablets

Kate Richardson — Mon, 28 May 2018 21:25:10 GMT

Really good points re bid dosing, worth a chat to dechra, really helpful in cases like this. Requires a different testing time to determine if bid therapy is appropriate, but they can advise on the specifics. might explain the cortisol levels being ok on standard tests but the effect not lasting long enough hence clinical signs persisting

RE: mitotane/ lysodren 500mg tablets

Stephen Courtney — Mon, 28 May 2018 18:28:20 GMT

Ian Ramsey at Glasgow uses mitotane in animals that don't respond / respond adversely to vetoryl - if you email him he is very helpful, but can take a few days to get to you

RE: mitotane/ lysodren 500mg tablets

Thomas Johnson — Sat, 26 May 2018 12:59:09 GMT

[quote user="Edward Jones"]

From the datasheet: A small number of animals may require doses significantly in excess of 10 mg per kg body weight per day.

You could try 40mg TID, or 60mg BID.

I've have a dog that to get satisfactory clinical control I need doses that causes the ATCH stimulation to suggest overdosing, but any less and the dog is significantly pu/pd. It might be worth talking to Dechra about giving higher doses.

[/quote]

I treated an 11kg Mini Schnauzer that needed 90mg Vetoryl a day (60mg in the morning and 30mg in the evening) to control the clinical signs of Cushing's and his ACTH stim was on the borderline for over-control. Interestingly he was on that dose for about a year and then his cortisol levels started to drop further and over the next couple of years his Vetoryl dose was gradually reduced to 30mg sid.

RE: mitotane/ lysodren 500mg tablets

Edward Jones — Sat, 26 May 2018 10:34:36 GMT

[quote user="Richard Carter"]Have a little 12kg cairn terrier maxed out on vetoryl at 40mg bid[/quote]

From the datasheet: A small number of animals may require doses significantly in excess of 10 mg per kg body weight per day.

You could try 40mg TID, or 60mg BID.

RE: mitotane/ lysodren 500mg tablets

David Mills — Fri, 25 May 2018 20:49:48 GMT

[quote user="Richard Carter"]

[quote user="David Mills"]easier than a bitch spay apparently.[/quote]just finished reading up the BSAVA and Fossum guides to adrenalectomies - think I must be doing bitch spays different from you!!

Don't think I have even seen an adrenal gland in a dog that wasn't a post-mortem

[/quote]

Ha, I've never done an adrenalecromy, this was said at the David Church lecture, but he freely admitted he wasn't a surgeon!

I asked about it on here a while ago and people were generally positive about it. As a charity, the cost of trilostane is almost ruinous at times, and that's just treating those that need it.

RE: mitotane/ lysodren 500mg tablets

Jill Butterworth — Fri, 25 May 2018 19:28:59 GMT

I'm assuming it might be hypertrophic and easier to find...?

RE: mitotane/ lysodren 500mg tablets

Richard Carter — Fri, 25 May 2018 16:23:09 GMT

[quote user="David Mills"]easier than a bitch spay apparently.[/quote]just finished reading up the BSAVA and Fossum guides to adrenalectomies - think I must be doing bitch spays different from you!!

Don't think I have even seen an adrenal gland in a dog that wasn't a post-mortem

RE: mitotane/ lysodren 500mg tablets

Judith Archbold — Fri, 25 May 2018 12:57:16 GMT

A bit “ old fashioned” but could try Ketoconazole? (Aware of risk of dry eye).Although thought not to be as effective as Vetoryl but it just sprung to mind.

RE: mitotane/ lysodren 500mg tablets

David Mills — Fri, 25 May 2018 11:35:48 GMT

David Church gave a very good presentation on this at the BSAVA. I can't remember the exact figure but upto something like 40pc of dogs don't respond to trilostane.

He was also talking about adrenlectomies. They have done quite a few at the RVC, straightforward surgery, just need to supplement with preds after and perioperatively. Work for ADH and PDH. Bilateral flank approach, easier than a bitch spay apparently.

RE: mitotane/ lysodren 500mg tablets

Richard Carter — Fri, 25 May 2018 10:42:55 GMT

yes confirmed HAC but only time cortisol levels under control (i.e. into normal range) is on 40mg bid. However no change in clinical symptoms

So if pituitary tumour, the only other option really will be to see if lysodren more effective at reducing cortisol production

RE: mitotane/ lysodren 500mg tablets

Martin Atkinson — Fri, 25 May 2018 10:32:14 GMT

[quote user="Richard Carter"]

Have a little 12kg cairn terrier maxed out on vetoryl at 40mg bid and so far the only thing that has changed is the coat colour. According to pre-pill testing we should have achieved control, electrolytes all still in normal range as well but all the HAC signs completely out of control - p/phag; p/dips; weight gain, anxiety, panting etc. Anyone got some Lysodren tablets on a shelf - we had a look and not in the market of £700 +VAT for a course of tablets from our wholesaler

[/quote]Have you tested current cortisol levels? I would be thinking outside the box for other possible causes of these symptoms.