8 - Cushings Treatment Flashcards
(34 cards)
Goal of to for hyperadrenocorticism
Improve their quality of life
Most common cushings treatment
Trilostane
What does trilostane inhibit
3 - beta hydroxysteroid dehydrogenase
Does trilostane affect aldosterone
Not really
What si main function of trilostane
Inhibit steroids
Trilostane can sometimes do what to sex hormones
Raise
Do you follow does of trilostane
Start with lower!
Trilostane given
By mouth with food to enhance absorption
Why do you give trilostane 2x a day
It doesn’t last long enough
Trilostane monitoring
Appetite, vomiting,
First recheck with trilostane
10 - 14 days after starting
How to monitor acth with trilostane
4 - 6 hours post pill acth test, pre trilostane and 3 hours post pill cortisol
10 - 24% of dogs exerpeince what with trilostane
Overtreatment - iatrogenic Addison
Triolstane potiental side effects
GI signs, iatrogenic addition and maybe worsening cushings
What is the lowest cost treatment
Mitotane
Mitotane mechanism
Destroys the adrenal tissues
Treatment phases of Mitotane
Induction, maintenance, rein duct ion
What is the only test you can use for monitoring with Mitotane
ACTH
Induction phase of Mitotane
Works faster, and clinical signs are gone in few days, shouldn’t do it for more than 9 days
If you send home with Mitotane you should also send home
Prednisone
Induction dose turns into
Weekly dose
Maintence dose yo should monitor
ACTH stimulation test +/- electrolytes
Side effects of Mitotane
Permanent or reliable, GI signs, iatrogenic Addison
Ketoconazole inhibits
Cholesterol entry to the adrenal gland, cortisol production pathway, ACTH release to the pituitary
