Case file: 5 questions veterinarians ask the Dechra Veterinary Products Technical Services Team
Diagnosing canine hyperadrenocorticism can be fairly straightforward, based on history and clinical signs, along with the
results of diagnostic tests that are readily available to practitioners. Once a diagnosis of pituitary- or adrenal-dependent
hyperadrenocorticism is made, VETORYL® (trilostane) Capsules are the only FDA-approved drug indicated for medical treatment
of either condition. VETORYL Capsules are backed by a company with a veterinary technical services team ready to answer your
In this case file, the Dechra Veterinary Products Technical Services Team answers five questions they are frequently asked
about canine hyperadrenocorticism and VETORYL Capsules. When you identify canine Cushing's cases and you have questions about
this treatment, contact the team who wants to help you successfully manage your patients.
Q: What sizes of VETORYL Capsules are available, and is an exact dose required when starting treatment for canine hyperadrenocorticism?
A: VETORYL Capsules are available in 10, 30, 60, and 120 mg sizes. The starting dose for the treatment of hyperadrenocorticism
in dogs is 1.0 to 3.0 mg/lb (2.2 to 6.7 mg/kg) once a day, based on body weight and capsule size. VETORYL Capsules should
always be administered with food to ensure maximum serum levels and, thus, efficacy. Dechra Veterinary Products recommends
using the lowest effective dose consistent with individual response; round the dose down if the calculated amount is between
available capsule sizes and assess the patient's response to that dose in 10 to 14 days.
Q: What is the recommended monitoring protocol, and what information should be obtained from the owner at each recheck appointment?
A: Ten to 14 days after starting VETORYL Capsules, re-examine the dog and perform an adrenocorticotropic hormone (ACTH) stimulation
test four to six hours after VETORYL Capsules have been administered with food. Re-examine the dog at 30 days and 90 days
after beginning VETORYL Capsules, and every three months thereafter. At a minimum, this monitoring should include a thorough
history and physical examination, ACTH stimulation test (conducted four to six hours after VETORYL Capsules administration,
with food), and serum biochemical tests (with particular attention paid to electrolytes and renal and hepatic function). Before
each ACTH stimulation test is performed, be sure to confirm that the owner gave the VETORYL Capsules that morning, and that
the drug was given with a small amount of food.
We cannot overemphasize the importance of talking with the owner at each recheck appointment about how the dog is doing at
home. Specifically, ask:
- Are the clinical signs of hyperadrenocorticism well controlled in your dog?
- Does your dog exhibit any new signs or conditions of concern to you?
This information is critical when interpreting the results of the ACTH stimulation and other biochemical tests. Dechra Veterinary
Products encourages veterinarians to contact the Veterinary Technical Services Team if assistance is needed in interpreting