Trilostane therapy for canine hyperadrenocorticism requires careful dose titration and monitoring to prevent potentially fatal adrenal suppression while adequately controlling disease symptoms.
Trilostane monitoring represents a welfare balancing act: insufficient dosing leaves dogs experiencing the metabolic consequences of excess cortisol, while excessive dosing risks life-threatening adrenal insufficiency. The monitoring protocol - ACTH stimulation tests at 4-6 hours post-pill, initially monthly then every 3-6 months - is designed to find the individual therapeutic window. Owners who skip monitoring tests to save costs inadvertently accept welfare risks at both ends of the dosing spectrum. Understanding the purpose of monitoring motivates compliance.