Trilostane is an adrenal enzyme inhibitor that blocks 3-beta-hydroxysteroid dehydrogenase, a key enzyme in cortisol production. By slowing this process, the medication helps reduce excessive cortisol levels and manages the clinical signs of Cushing's disease.

It is considered a first-line treatment due to its effectiveness, safety profile, and ability to be adjusted to each dog's needs.

1. Accurate Diagnosis

 

Before a dog begins Trilostane, a full diagnostic evaluation is essential. This usually includes:

 

• Assessment of clinical signs
• Complete blood panel
• Urinalysis
• Hormone testing (ACTH stimulation test or low-dose dexamethasone suppression test)

 

A correct diagnosis ensures the dog gets the right treatment and eliminates other conditions that can mimic Cushing's disease.

2. Prescription and Correct Dosage

 

Trilostane is only given with a veterinarian's prescription. The dose depends on:

 

• The dog's body weight
• Severity of symptoms
• Adrenal test results
• Individual tolerance

 

Precise dosing is critical because both under-treatment and over-suppression of cortisol can cause complications.

3. Regular Monitoring and Check-ups

 

Continuous monitoring is the most important part of Trilostane therapy.

 

• Cortisol levels
• Electrolytes
• Liver function
• Kidney values
• Overall symptom improvement

 

Depending on the stage of treatment, testing is usually done every 2–4 weeks initially, then every 3–6 months long-term.

4. Dosage Adjustments

 

Because dogs respond differently, dose modifications are occasionally required.
The goal is to determine the lowest effective dose - one that reduces symptoms without reducing cortisol excessively.

 

• ACTH stimulation test results
• Physical examination findings
• Observed symptoms at home

5. Monitor for Low Cortisol (Adrenal Insufficiency)

 

While Trilostane reduces elevated cortisol levels, severe suppression might result in adrenal insufficiency, a serious illness.

 

Signs include:

 

• Weakness or Collapse
• Vomiting or diarrhea
• Lack of appetite
• Severe lethargy

 

This is why rigorous monitoring and prompt reporting of unexpected symptoms are required.

6. Managing Symptoms and Supporting the Dog's Health

 

When cortisol levels stabilize, the majority of clinical indications of Cushing's disease improve, including:

 

• Extreme thirst and urination
• Hair loss or a thin coat
• Skin Infections
• Muscle wasting
• Pot-bellied look

 

Some dogs may need additional supportive care, such as:

 

• Nutritional Management
• Treatment for secondary skin or urinary infections
• Supplements to promote liver and joint health

 

Many dogs gradually regain energy, strength, and increased coat condition.