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How Trilostane Works
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According to a 2009 thesis by Abra M. Wright, D.M.V., "trilostane blocks cortisol synthesis by the adrenal cortex." In other words, trilostane stops the adrenal gland from creating cortisol, a hormone. Horses receive trilostane in tablet form.
The Good News About Trilostane
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In a U.K. study of 20 horses and ponies with Cushing's Disease, Catherine McGowan, Ph.D. reported good results with trilostane. Trilostane reduced lethargy in the 19 previously sluggish horses, and 13 of 16 horses with Cushing's-related laminitis, a disease of the hoof, improved as well. Perhaps most important, all the horses' endocrine levels returned to normal. McGowan reported no adverse side effects.
The Bad News About Trilostane
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With positive results and no known side effects, trilostane has only two downsides: The FDA has approved its use for dogs but not horses, and in the United Kingdom, where trilostane has the stamp of approval, it comes with a prohibitive price.
Alternative Cushing's Disease Treatments
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Veterinarians treated most Cushing's horses with cyproheptadine until the more effective pergolide hit the market, according to Janice Posnikoff, D.M.V. Pergolide remains the most common drug prescribed for horses with Cushing's Disease.
Diet also plays a role in controlling and possibly even preventing Cushing's. Limiting a horse's sugar intake and increasing vitamins helps keep Cushing's horses stable.
The Future of Trilostane
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With trilostane testing ongoing, it is currently available for horses in the United States only through veterinarians and in limited circumstances.
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Trilostane Equine Cushing's Disease
Afflicting horses and ponies usually in their late teens and 20s, Cushing's disease "is the medical condition of hyperadrenocorticism," according to Kim Christie in her article "Equine Cushing's Disease" on Penn State University's website. The drug trilostane slows the overproduction of hormones in the afflicted horse's adrenal gland.