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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16316
Experience:  Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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I am caring for a friend's approx. 15 lb. Frenchton who just

Customer Question

I am caring for a friend's approx. 15 lb. Frenchton who just ingested a dose of my dog's Trilostane, 28 mg. The Frenchton does not have Cushings disease, is this an emergency for which I need to take her to a pet ER, or will a dose this low have negligible consequences for her?
Submitted: 3 months ago.
Category: Dog Veterinary
Expert:  Dr. B. replied 3 months ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

How long ago did she get this?

How is she just now?

Customer: replied 3 months ago.
It has been almost an hour now. She is seems okay, laying down but only because we all are and she is easily arousable. What are the physiologic effects of Trilostane in a dog without Cushings? Our vet told us there was a risk of adrenal gland necrosis if a dog is not truly Cushings positive, but can one low dose begin that process?
Expert:  Dr. B. replied 3 months ago.

Thank you,

Now this is a moderate (4mg/kg) dose that she has had. The problem is that this is a drug that blocks the adrenal gland's over activity in Cushing's dogs. For a non-Cushinoid dog to have this runs the risk of gut upset (vomiting, diarrhea, appetite loss) but there is also a concern of a possible Addisonian crisis (from the drug dropping those adrenal gland hormones dangerously low --which can cause collapse). And your vet is right that we can see death of the adrenal tissue at this dose, but that is quite rare. Still, we need to tread with care.

If she has had this that recently, then our ideal option would be to induce vomiting now. We do have a 2hr post ingestion window to do this, but the sooner we do the more we are likely to get our before she absorbs it. To do so at home, you can administer 3% hydrogen peroxide orally at a dose of 1ml per pound. (2 teaspoons per 10 pounds of body weight). You can give it via dropper, syringe, turkey baster – we just want to get it in. After giving this orally, move the abdomen around or get your wee one walking about to get things mixing. This should usually lead to vomiting. If it is unsuccessful after 10 minutes then it can be repeated twice more. And if we still have no vomiting, then you'd need to consider seeing your local vet (or ER vet) so that apomorphine (a very strong injectable emetic) can be administered just get this out of the stomach and avoid any adverse issues.

As well or alternatively, you can also consider administering activated charcoal at this stage. This is available over the counter from the pharmacy (ask for the high strength version, not the one for gas) and works by binding any remaining material in the stomach. For activated charcoal, we tend to give 1-4 grams per pound every 8 hrs. This can be mixed with food to be fed or with water to syringe feed (do note that it stains, so keep it away from white carpets/clothes). This will just limit how much is absorbed and reduce the intoxication risk here.

Finally, after the above, we do want to try to address any potential GI upset here for the next 24-48 hours. To do so, you can consider offering a light diet option for a few days. Examples of an easily digestible diet include cooked white rice with boiled chicken, boiled white fish, scrambled egg, or meat baby food (as long as its free from garlic or onion powder). Ideally, we want to offer this as small frequent meals to keep the stomach settled.

Further to this, we can also treat with an antacid. There are a number of antacids that are available over the counter and pet friendly. Ones we can use here include Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid) or Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac). Whichever you use, we'd give this 20 minutes before food to allow absorption and of course double check with your vet before use if your wee one has any known health issues or is on any medications you haven't mentioned.

In this situation, just in case you do wish to see an ER vet, you can check @ http://www.vetlocator.com/ or

www.veccs.org/index.php?option=com_hospitals&nationid=1&Itemid=193

Please take care,

Dr. B.

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Expert:  Dr. B. replied 3 months ago.
Hi,

I'm just following up on our conversation about your pet. How is everything going?

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