All About Trilostane - Understanding Cushing's Disease through Zayn's Journey

By: Katherine Vuong, Lenape H.S. 2025

Recently, I became increasingly concerned about the troubling changes in my 10-year-old dog, Zayn. He developed a pronounced, unpleasant odor, oily skin, significant fur loss, and began excessively licking himself. Given these symptoms, I conducted a detailed investigation and found that he might be suffering from Cushing's disease. Cushing's disease is an endocrine disorder, marked by the overproduction of cortisol by the adrenal glands. It can lead to a variety of health complications, including increased thirst, frequent urination, and noticeable changes in skin health. All the symptoms that Zayn was displaying. I wanted to help him as much as possible, it became crucial to gain insight into Cushing's disease and its potential impact on his well-being.

Cushing's disease, also referred to as hyperadrenocorticism, is most often caused by tumors in either the adrenal or pituitary glands, which are responsible for regulating cortisol production. Cortisol plays an essential role in many functions, including metabolism, immune response, and the body's ability to manage stress. However, when there is an over production, cortisol can have harmful effects. Common clinical signs of Cushing's disease include polydipsia (excessive thirst), polyuria (increased urination), a pot-bellied appearance, and skin issues such as thinning fur and increased oiliness. Due to the complexity and range of symptoms, diagnosing Cushing's disease often requires a comprehensive veterinary evaluation, including laboratory tests and imaging to assess adrenal gland function.

We promptly scheduled a veterinary appointment, and after the initial bloodwork, Zayn was diagnosed with Cushing's syndrome. The veterinarian prescribed Vetoryl (Trilostane), an FDA-approved medication specifically designed to treat Cushing's disease in dogs. This medication works as a steroidogenesis inhibitor, reducing cortisol production by blocking the enzyme 3β-hydroxysteroid dehydrogenase, which is necessary for cortisol synthesis. By lowering cortisol levels, Trilostane helps alleviate symptoms such as skin irritation and abnormal behavior. In addition, Zyrtec, an antihistamine, was prescribed to help address Zayn's skin condition and ease the discomfort associated with the disease.

Giving the Vetoryl capsules proved challenging, as Zayn resisted taking his medication. After researching further, I discovered that many pet owners face similar difficulties. Thankfully, I learned about compounding pharmacies, such as CareFirst Specialty Pharmacy, which could formulate a custom chewable tablet that Zayn found palatable. This made giving him his medication much easier and significantly reduced the stress associated with treatment.

After a few more blood works, we found a perfect dose of Trilostane for Zayn. Combining Trilostane with Zyrtec has proven to be an effective treatment regimen. Over the course of several weeks, I observed marked improvements in his overall health. Balding spots began to regrow, his fur regained its shine, and the odor subsided. While these treatments do not offer a permanent cure, Zayn began to show signs of his old self again. This experience deepened my appreciation for veterinary medicine and the scientific advancements that make such treatments possible.

Though Trilostane does not work in every case of Cushing's syndrome, I am incredibly grateful for the significant improvement in Zayn's quality of life.

References

1. American Kennel Club. "Cushing's Disease in Dogs." AKC
2. McCarthy, A. "Cushing's Disease in Dogs." PetMD
3. U.S. Food & Drug Administration. "FDA Approves Trilostane for Cushing's Disease in Dogs." FDA
4. Hsu, H. "Cushing's Disease: Treatment Options for Dogs." VCA Animal Hospitals
5. Hirst, N. "The Role of Supplements in Treating Cushing's Disease in Dogs." Veterinary Medicine
6. VanCleave, K. "Cushing's Disease: An Overview." Vetstreet