Original Scientific Article Hyperadrenocorticism (HAC) in dogs is routinely treated with trilostane single-dose (CTG) which is reported to cause adverse reactions. The current retrospective study of several dogs with terminal stage of HAC aimed to compare the clinical, hematological, and biochemical effects of trilostane titration-dose treatment (TTG) with the single-dose treatment (CTG). All clinical cases (n=7) were confirmed on HAC by anamnestic, clinical, hematology, biochemistry, and low-dose dexamethasone suppression test findings, indicative for Cushing’s disease. Two cases were treated with CTG (2.2-6.7 mg/kg, single dose daily) and their treatment was discontinued on the second week due to adverse reactions. The TTG cases were treated for up to 12 weeks (0.5 mg/kg once daily for 7 days, and then with 0.5 mg/kg twice daily for 7 days). Blood samples and clinical checks were performed on 0., 4., and 12. weeks of the treatment. Hemoglobin was non-significantly higher in TTG at 12 weeks. Alanine transaminase was significantly lower in the TTG cases on the 12. week of the treatment (78.04±15.37 U/L) compared to the 0-week (137.81±24.03 U/L), and 4-week samples (131.92±23.36 U/L). No significant differences were observed with the CTG cases. Alkaline phosphatase was significantly lower on 12-week samples in TTG (251.02±93.06) compared to the 4-week (567.94±283.93 U/L), and 0-week samples (1,341.84 U/L). In conclusion, TTG has indicated to have significantly higher tendency to decrease alanine transaminase and alkaline phosphatase, alleviating the negative effects on the liver. The clinical findings were more adverse for the CTG. https://macvetrev.mk/LoadArticlePdf/383 2024-3-15 51 57 10.2478/macvetrev-2024-0016 Cushing’s disease dogs trilostane Irena Celeska iceleska@fvm.ukim.edu.mk false 1 Faculty of Veterinary Medicine-Skopje, Ss. Cyril and Methodius University in Skopje, Lazar Pop-Trajkov 5-7, 1000 Skopje, North Macedonia LEAD_AUTHOR Martin Nikolovski false 2 Faculty of Veterinary Medicine-Skopje, Ss. Cyril and Methodius University in Skopje, Lazar Pop-Trajkov 5-7, 1000 Skopje, North Macedonia AUTHOR Todor Novakov false 3 Faculty of Veterinary Medicine-Skopje, Ss. Cyril and Methodius University in Skopje, Lazar Pop-Trajkov 5-7, 1000 Skopje, North Macedonia AUTHOR Anastasija Angelovska false 4 Faculty of Veterinary Medicine-Skopje, Ss. Cyril and Methodius University in Skopje, Lazar Pop-Trajkov 5-7, 1000 Skopje, North Macedonia AUTHOR Ivica Gjurovski false 5 Faculty of Veterinary Medicine-Skopje, Ss. Cyril and Methodius University in Skopje, Lazar Pop-Trajkov 5-7, 1000 Skopje, North Macedonia AUTHOR Elena Atanaskova Petrov false 6 Faculty of Veterinary Medicine-Skopje, Ss. Cyril and Methodius University in Skopje, Lazar Pop-Trajkov 5-7, 1000 Skopje, North Macedonia AUTHOR Feldman, E.C., Nelson, R.W. (2004). Canine hyperadrenocorticism Cushings syndrome. In: Canine and Feline Endocrinology and Reproduction (p. 252). Elsevier Health Sciences. 1 Kritsepi-Konstantinou, M., Oikonomidis, I.L. (2016). The interpretation of leukogram in dog and cat. HJCAM 5(2): 63. 2 Ryad, N.M., Ramadan, E.S., Salem, N.Y., Saleh, I.A. (2021). Influence of dexamethasone administration on hematology, biochemistry, and thyroid hormones in dogs. Adv Anim Vet Sci. 9(1): 111-116. 3 https://doi.org/10.17582/journal.aavs/2021/9.1.111.116 Peterson, M.E. (2007). Diagnosis of hyperadrenocorticism in dogs. Clin Tech Small Anim Pract. 22(1): 2-11. PMid:17542191 4 https://doi.org/10.1053/j.ctsap.2007.02.007 Behrend, E.N., Kooistra, H.S., Nelson, R., Reusch, C.E., Scott-Moncrieff, J.C. (2013). Diagnosis of spontaneous canine hyperadrenocorticism: 2012 ACVIM consensus statement (small animal). J Vet Intern Med. 27(6): 1292-1304. PMid:24112317 5 https://doi.org/10.1111/jvim.12192 Potts, G.O., Creange, J.E., Harding, H.R., Schane, H.P. (1978). Trilostane, an orally active inhibitor of steroid biosynthesis. Steroids 32(2): 257-267. PMid:715820 6 https://doi.org/10.1016/0039-128X(78)90010-7 Eastwood, J.M., Elwood, C.M., Hurley, K.J. (2003). Trilostane treatment of a dog with functional adrenocortical neoplasia. J Small Anim Pract. 44(3): 126-131. PMid:12653328 7 https://doi.org/10.1111/j.1748-5827.2003.tb00133.x Neiger, R., Hurley, K.J., Ramsey, I., O’Connor, J., Mooney, C.T. (2002). Trilostane treatment of 78 dogs with pituitary‐dependent hyperadrenocorticism. Vet Rec. 150(26): 799-804. PMid:12120922 8 https://doi.org/10.1136/vr.150.26.799 Lemetayer, J., Blois, S. (2018). Update on the use of trilostane in dogs. Can Vet J. 59(4): 397-407. 9 Bell, R., Neiger, R., McGrotty, Y., Ramsey, I.K. (2006). Study of the effects of once daily doses of trilostane on cortisol concentrations and responsiveness to adrenocorticotrophic hormone in hyperadrenocorticoid dogs. Vet Rec. 159(9): 277-281. PMid:16946310 10 https://doi.org/10.1136/vr.159.9.277 Vaughan, M.A., Feldman, E.C., Hoar, B.R., Nelson, R.W. (2008). Evaluation of twice-daily, low-dose trilostane treatment administered orally in dogs with naturally occurring hyperadrenocorticism. J Am Vet Med Assoc. 232(9): 1321-1328. PMid:18447776 11 https://doi.org/10.2460/javma.232.9.1321 Feldman, E.C. (2011). Evaluation of twice-daily lower-dose trilostane treatment administered orally in dogs with naturally occurring hyperadrenocorticism. J Am Vet Med Assoc. 238(11): 1441-1451. PMid:21627507 12 https://doi.org/10.2460/javma.238.11.1441 Teshima, T., Hara, Y., Takekoshi, S., Nezu, Y., Harada, Y., Yogo, T., Teramoto, A., Osaamura, R.Y., Tagawa, M. (2009). Trilostane-induced inhibition of cortisol secretion results in reduced negative feedback at the hypothalamic-pituitary axis. Domest Anim Endocrinol. 36(1): 32-44. PMid:19041802 13 https://doi.org/10.1016/j.domaniend.2008.10.002 Gilor, C., Graves, T.K. (2011). Interpretation of laboratory tests for canine Cushing’s syndrome. Top Companion Anim Med. 26(2): 98-108. PMid:21596349 14 https://doi.org/10.1053/j.tcam.2011.03.001 Fathman, L. (2005). Textbook of veterinary internal medicine. Elsevier Saunders 15 Jacoby, R.C., Owings, J.T., Ortega, T., Gosselin, R., Feldman, E.C. (2001). Biochemical basis for the hypercoagulable state seen in Cushing syndrome; discussion 1006-7. Arch Surg. 136(9): 1003-1006. PMid:11529821 16 https://doi.org/10.1001/archsurg.136.9.1003 Galac, S. (2010). Recent developments in canine Cushings syndrome. Utrecht University 17 Cho, K.D., Kang, J.H., Chang, D., Na, K.J., Yang, M.P. (2013). Efficacy of low‐ and high‐dose trilostane treatment in dogs (<5 kg) with pituitary‐dependent hyperadrenocorticism. J Vet Intern Med. 27(1): 91-98. PMid:23167780 18 https://doi.org/10.1111/jvim.12007 Ettinger, S.J., Feldman, E.C. (2010). Textbook of veterinary internal medicine. 7th edition, 2086-2088. 19 Alenza, D.P., Arenas, C., Lopez, M.L., Melian, C. (2006). Long-term efficacy of trilostane administered twice daily in dogs with pituitarydependent hyperadrenocorticism. J Am Anim Hosp Assoc. 42(4): 269-276. PMid:16822765 20 https://doi.org/10.5326/0420269