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Vetoryl Capsules for Dogs


Vetoryl Capsules


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Vetoryl Capsules

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  • Trilostane
  • Adrenocortical suppressant
  • Treats Cushing’s syndrome in dogs
  • For oral use in dogs only
Options:
10mg (30 capsules) - 
30mg (30 capsules) - 
60mg (30 capsules) - 
120mg (30 capsules) - 
SKU: 300710-RX
Price: $42.95

Quantity:
RX required for this item.
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Why VETORYL Capsules?

  • Contain the active ingredient trilostane.
  • Trilostane blocks the excessive production of cortisol by reversibly inhibiting the action of the enzyme 3-ß hydroxysteroid dehydrogenase.
  • While treatment with trilostane significantly reduces serum cortisol concentrations, it has not been found to reduce aldosterone significantly.†

Adrenocortical suppressant for oral use in dogs only.

DESCRIPTION:

VETORYL Capsules are available in 3 sizes (10, 30 and 60 mg) for oral administration based on body weight. Trilostane (4α, 5α-epoxy-17β-hydroxy-3-oxoandrostane-2α-carbonitrile) is an orally active synthetic steroid analogue that selectively inhibits 3 β-hydroxysteroid dehydrogenase in the adrenal cortex, thereby inhibiting the conversion of pregnenolone to progesterone. This inhibition blocks production of glucocorticoids and to a lesser extent, mineralocorticoids and sex hormones while steroid precursor levels increase.

INDICATIONS:

  • VETORYL Capsules are indicated for the treatment of pituitary-dependent hyperadrenocorticism in dogs.
  • VETORYL Capsules are indicated for the treatment of hyperadrenocorticism due to adrenocortical tumor in dogs.

DOSAGE AND ADMINISTRATION:

Always provide the Client Information Sheet with prescription. The starting dose for the treatment of hyperadrenocorticism in dogs is 1.0-3.0 mg/lb (2.2-6.7 mg/kg) once a day based on body weight and capsule size (see Table 1). VETORYL Capsules should be administered with food.

by Dechra
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Showing comments 1-2 of 2
1. Melissa on 8/28/2013, said:

Our senior Lab mix was just diagnosed with Cushing's. Heartland has the very best price out there on the medication VETORYL used to treat this. Shipping is fast.
Was this comment helpful? yes no   (2 people found this comment helpful, 0 did not)
2. Katherine on 2/16/2013, said:

Vetoryl has been very effective in treating my beagle's pituitary dependent Cushing's syndrome. He is now 15 years old and his Cushing's was diagnosed two years ago.
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Showing comments 1-2 of 2

Table 1: Starting dose

Weight range (pounds)

Weight range (kg)

Starting dose (mg) ONCE DAILY

≥3.8 to <10

≥1.7 to <4.5

10

≥10 to <22

≥4.5 to <10

30

≥22 to <44

≥10 to <20

60

≥ 4 to <88

≥20 to <40

120 (2 x 60 mg)

≥88 to <132*

≥40 to <60*

180 (3 x 60 mg)

*Dogs over 132 pounds (60 kg) should be administered the appropriate combination of capsules.

After approximately 10-14 days at this dose, re-examine the dog and conduct a 4-6 hour post-dosing ACTH stimulation test. If physical examination is acceptable, take action according to Table 2.

Table 2: Action at 10-14 day evaluation

Post-ACTH serum cortisol

Action

µg/dL

nmol/L

<1.45

<40

Stop treatment. Re-start at a decreased dose

1.45 to 5.4

40 to 150

Continue on same dose

>5.4 to 9.1

>150 to 250

EITHER: Continue on current dose if clinical signs are well controlled

OR: Increase dose if clinical signs of hyperadrenocorticism are still evident*

>9.1

>250

Increase initial dose

*Combinations of capsule sizes should be used to slowly increase the once daily dose.

Individual dose adjustments and close monitoring are essential. Re-examine and conduct an ACTH stimulation test 10-14 days after every dose alteration. Care must be taken during dose increases to monitor the dog’s clinical signs and serum electrolyte concentrations. Once daily administration is recommended. However, if clinical signs are not controlled for the full day, twice daily dosing may be needed. To switch from once daily to twice daily dosing, increase the total daily dose by 1/3 to 1/2 and divide the total amount into two doses given 12 hours apart.

Long-Term Monitoring

Once an optimum dose of VETORYL Capsules has been reached, re-examine the dog at 30 days, 90 days and every 3 months thereafter. At a minimum, this monitoring should include a thorough history and physical examination, ACTH stimulation test

(conducted 4-6 hours after VETORYL Capsule administration), and serum biochemical tests (with particular attention to electrolytes, renal and hepatic function). A post-ACTH stimulation test resulting in a cortisol of <1.45 µg/dL (<40 nmol/L), with or without electrolyte abnormalities, may precede the development of clinical signs of hypoadrenocorticism. Good control is indicated by favorable clinical signs as well as post-ACTH serum cortisol of 1.45-9.1 µg/dL (40-250 nmol/L).

If the ACTH stimulation test is <1.45 µg/dL (<40 nmol/L) and/or if electrolyte imbalances characteristic of hypoadrenocorticism (hyperkalemia and hyponatremia) are found, VETORYL Capsules should be temporarily discontinued until recurrence of clinical signs consistent with hyperadrenocorticism and test results return to normal (1.45-9.1 µg/dL or 40-250 nmol/L). VETORYL Capsules may then be re-introduced at a lower dose.

Owners should be instructed to stop therapy and contact their veterinarian immediately in the event of adverse reactions or unusual developments.

CONTRAINDICATIONS:

The use of VETORYL Capsules is contraindicated in dogs that have demonstrated hypersensitivity to trilostane.

Do not use VETORYL Capsules in animals with primary hepatic disease or renal insufficiency.

Do not use in pregnant dogs. Studies conducted with trilostane in laboratory animals have shown teratogenic effects and early pregnancy loss.

WARNINGS:

In case of overdosage, symptomatic treatment of hypoadrenocorticism with corticosteroids, mineralocorticoids and intravenous fluids may be required.

Angiotensin-converting enzyme (ACE) inhibitors should be used with caution with VETORYL Capsules, as both drugs have aldosterone-lowering effects which may be additive, impairing the patient’s ability to maintain normal electrolytes, blood volume and renal perfusion. Potassium sparing diuretics (e.g. spironolactone) should not be used with VETORYL Capsules, as both drugs have the potential to inhibit aldosterone, increasing the likelihood of hyperkalemia.

HUMAN WARNINGS:

Keep out of reach of children. Not for human use.

Wash hands after use. Do not empty capsule contents and do not attempt to divide the capsules. Do not handle the capsules if pregnant or if trying to conceive. Trilostane is associated with teratogenic effects and early pregnancy loss in laboratory animals. In the event of accidental ingestion/overdose, seek medical advice immediately and take the labeled container with you.

PRECAUTIONS:

Hypoadrenocorticism can develop at any dose of VETORYL Capsules. In some cases, it may take months for adrenal function to return and some dogs never regain adequate adrenal function.

A small percentage of dogs may develop corticosteroid withdrawal syndrome within 10 days of starting treatment. This phenomenon results from acute withdrawal of circulating glucocorticoids; clinical signs include weakness, lethargy, anorexia, and weight loss1. These clinical signs should be differentiated from an early hypoadrenocortical crisis by measurement of serum electrolyte concentrations and performance of an ACTH stimulation test. Corticosteroid withdrawal syndrome should respond to cessation of VETORYL Capsules (duration of discontinuation based on the severity of the clinical signs) and restarting at a lower dose.

Mitotane (o,p’-DDD) treatment will reduce adrenal function. Experience in foreign markets suggests that when mitotane therapy is stopped, an interval of at least one month should elapse before the introduction of VETORYL Capsules. It is important to wait for both the recurrence of clinical signs consistent with hyperadrenocorticism, and a post-ACTH cortisol level of >9.1 µg/dL (>250 nmol/L) before treatment with VETORYL Capsules is initiated. Close monitoring of adrenal function is advised, as dogs previously treated with mitotane may be more responsive to the effects of VETORYL Capsules.

The use of VETORYL Capsules will not affect the adrenal tumor itself. Adrenalectomy should be considered as an option for cases that are good surgical candidates.

The safe use of this drug has not been evaluated in lactating dogs and males intended for breeding.


For a copy of the Material Safety Data Sheet (MSDS), or to report adverse reactions, call Dechra Veterinary Products at (866) 933-2472.

INFORMATION FOR DOG OWNERS:

Owners should be aware that the most common adverse reactions may include: an unexpected decrease in appetite, vomiting, diarrhea, or lethargy and should receive the Client Information Sheet with the prescription. Owners should be informed that control of hyperadrenocorticism should result in resolution of polyphagia, polyuria and polydipsia. Serious adverse reactions associated with this drug can occur without warning and in rare situations result in death (see ADVERSE REACTIONS). Owners should be advised to discontinue VETORYL Capsules and contact their veterinarian immediately if signs of intolerance are observed. Owners should be advised of the importance of periodic follow-up for all dogs during administration of VETORYL Capsules.


EFFECTIVENESS:

Eighty-three dogs with hyperadrenocorticism were enrolled in a multi-center US field study. Additionally, 30 dogs with hyperadrenocorticism were enrolled in two UK field studies. Results from these studies demonstrated that treatment with VETORYL Capsules resulted in an improvement in clinical signs (decreased thirst, decreased frequency of urination, decreased panting, and improvement of appetite and activity). Improvement in post-ACTH cortisol levels occurred in most cases within 14 days of starting VETORYL Capsules therapy.

In these three studies, there were a total of 10 dogs diagnosed with hyperadrenocorticism due to an adrenal tumor or due to concurrent pituitary and adrenal tumors. Evaluation of these cases failed to demonstrate a difference in clinical, endocrine, or biochemical response when compared to cases of pituitary-dependent hyperadrenocorticism.

ANIMAL SAFETY:

In a laboratory study, VETORYL Capsules were administered to 8 healthy 6 month old Beagles per group at 0X (empty capsules), 1X, 3X, and 5X the maximum starting dose of 6.7 mg/kg twice daily for 90 days. Three animals in the 3X group (receiving 20.1 mg/kg twice daily) and five animals in the 5X group (receiving 33.5 mg/kg twice daily) died between Days 23 and 46. They showed one or more of the following clinical signs: decreased appetite, decreased activity, weight loss, dehydration, soft stool, slight muscle tremors, diarrhea, lateral recumbency, and staggering gait. Bloodwork showed hyponatremia, hyperkalemia, and azotemia, consistent with hypoadrenocortical crisis. Post-mortem findings included epithelial necrosis or cystic dilation of duodenal mucosal crypts, gastric mucosal or thymic hemorrhage, atrial thrombosis, pyelitis and cystitis, and inflammation of the lungs.

ACTH stimulated cortisol release was reduced in all dogs treated with VETORYL Capsules. The dogs in the 3X and 5X groups had decreased activity. The 5X dogs had less weight gain than the other groups. The 3X and 5X dogs had lower sodium, albumin, total protein, and cholesterol compared to the control dogs. The 5X dogs had lower mean corpuscular volume than the controls. There was a dose dependent increase in amylase. Post-mortem findings included dose dependent adrenal cortical hypertrophy.


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