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Your pet has been diagnosed with Cushing’s
Syndrome (Hyperadrenocorticism), which arises from an excess of cortisol
being produced by the adrenal gland (see additional handout, Cushing’s
Syndrome). We are going to use a drug called Lysodren to help control
the production of cortisol in <Animal>’s body. Lysodren works in the
adrenal gland by destroying the cells that produce cortisol. Since the
body needs cortisol , as well as the other hormones produced in the
adrenal gland to survive, treatment with this drug can have serious side
effects
How do we use Lysodren?
There are two stages to the use of this drug. Initially, we are going to
have an “induction” phase during which you will give Lysodren twice
daily for 4 to 10 days. During this time, we are allowing the Lysodren
to destroy all of the excess adrenal tissue that has built up in
response to the continued stimulation by ACTH hormone. We know that as
the Lysodren destroys enough of the adrenal tissue, <animal> will
probably start to lose <his> appetite. We will use this fact to help us
determine when we have completed the induction phase. Therefore, we want
you to follow these rules:
- Feed <animal> <his> normal feeding in the
morning and afternoon before giving the lysodren.
- If <he> eats the whole meal, give <him>
the pill(s).
- As soon as <he> leaves 50% of his food,
doesn’t eat, or takes much longer than normal to finish his meal, do
not give the drug and call us. Most likely we will have you bring
<him> in for an ACTH stimulation test to see if we have reduced the
cortisol sufficiently to begin phase two of our treatment which is
called maintenance.
Once we have brought down the cortisol level to
the normal range, we will give Lysodren only once a week at a different
dose which we will inform you of.
What are the side effects of Lysodren administration?
Lysodren can cause a variety of side effects
ranging from lack of appetite, to weakness, vomiting and diarrhea. Most
of the side effects are actually due to the loss of cortisol caused by
the lysodren. Therefore, we are going to dispense a bottle of Prednisone
(a variety of cortisone) for you to have on hand as an antidote for
these symptoms.
If your pet exhibits any of the symptoms above:
- Do not give the next scheduled dose of
lysodren.
- Give ____ Mg of Prednisone. Wait 1 hour,
if the symptoms are not improving, call us
What type of monitoring is needed while
<Animal> is taking Lysodren?
We will need to perform an ACTH stimulation
test at the end of the induction phase (5-10 days after starting the
drug). Then again at 6 weeks, 3 months, 6 months and 1 year.
Because of the many potential problems arising from uncontrolled
Cushing’s syndrome (diabetes, hypertension, strokes, skin problems,
infections etc), we require a physical examination twice yearly, an ACTH
Stimulation test and a general blood profile be run once yearly while
your pet is taking Lysodren.
Please note that refills of this drug will not be provided without this
monitoring for the sake of your pet’s medical safety.
What is the prognosis for treatment?
Lysodren has been used for years to
successfully treat Cushing’s syndrome. The prognosis for treatment is
quite good once we get <animal> onto the maintenance dose. In most pets,
the symptoms of Cushing’s syndrome will reduce within the first 4 to 6
weeks of treatment. Chronic skin problems should improve over the course
of 3 to 6 months provided appropriate supportive care is given.
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