Treating Cushing's

Cushing's syndrome Treatment Options

Treatment of hyperadrenocorticism (HAC) may be achieved by surgery (adrenalectomy or trans-sphenoidal hypophysectomy), pituitary irradiation, or medical treatment. Surgery and radiotherapy are complicated procedures available only at a few specialty centers, therefore medical treatment is often the most practical and approachable treatment choice. VETORYL® Capsules (trilostane) are the only FDA approved treatment available for both pituitary-dependent hyperadrenocorticism (PDH) and adrenal-dependent hyperadrenocorticism (ADH) in the United States. Although the daily administration of VETORYL Capsules does not offer a medical cure for Cushing’s syndrome, it may allow the disease to be managed successfully, enhancing the dog’s vitality and quality of life.

A Few Facts about VETORYL Capsules:

  • VETORYL Capsules contain trilostane, which selectively, and reversibly, inhibits the enzyme 3βs-hydroxysteroid dehydrogenase, which is involved in the synthesis of several steroids including cortisol and aldosterone
  • At recommended dose rates, VETORYL Capsules tend to have a more selective effect on glucocorticoid production, however the potential inhibition of aldosterone must always be borne in mind by the attending clinician
  • VETORYL Capsules reduce circulating cortisol levels, leading to improvement in many of the clinical signs of HAC
  • VETORYL Capsules provide flexible and accurate dosing with five strengths, 5 mg, 10 mg, 30 mg, 60 mg and 120 mg capsules, allowing you to restore the dog’s vitality by reducing the clinical signs associated with HAC
  • Available in blister packs of 30 capsules for ease of dispensing.

Important VETORYL Capsules dosage and administration information

  • VETORYL Capsules should be administered orally, once daily, with food
  • The starting dose is 1-3 mg/lb (2.2-6.7 mg/kg) once a day for the treatment of hyperadrenocorticism in dogs
  • Start with the lowest possible dose based on body weight and available combinations of capsule sizes
  • Once treatment has started, the owner should be advised to monitor the dog’s demeanor, appetite and water intake
  • If the dog shows any signs of being unwell, advise the owner to stop treatment and contact a veterinarian immediately
  • The dose should be titrated according to individual response as determined by monitoring of clinical signs, physical examination and laboratory test results (ACTH stimulation test and serum biochemistry, including electrolytes)
  • Should symptoms not be adequately controlled for an entire 24 hour inter-dose period, consideration should be given to dosing with VETORYL Capsules twice daily

For further information please refer to the treatment and monitoring flowchart and the full prescribing information.

VETORYL Capsules give you the power to treat Pituitary Dependent Hyperadrenocorticism and Adrenal Dependent Hyperadrenocorticism in dogs. VETORYL Capsules have been approved by the FDA and are manufactured under current Good Manufacturing Practices (cGMP), assuring the quality and consistency of content and bioavailability, as established through the application process.

Some of the common dermatological complications of HAC may benefit from additional supportive measures. Dechra offers a complete line of products to support the restoration of a healthy skin and coat. Please visit our Dermatology page to learn more about these products. 

As with all drugs, side effects may occur. In field studies and post-approval experience, the most common side effects reported were: anorexia, lethargy/depression, vomiting, diarrhea, elevated liver enzymes, elevated potassium with or without decreased sodium, elevated BUN, decreased Na/K ratio, hypoadrenocorticism, weakness, elevated creatinine, shaking, and renal insufficiency. In some cases, death has been reported as an outcome of these adverse events. VETORYL Capsules are not for use in dogs with primary hepatic or renal disease, or in pregnant dogs. Refer to the prescribing information for complete details.

VETORYL Package Insert