Study suggests most single-dose trilostane ingestions stay mild

A new retrospective study of 403 ASPCA Animal Poison Control Center cases suggests that most dogs who ingest a single unintended dose of trilostane have mild, self-limiting signs and rarely need intensive treatment. The paper, published in the Journal of Veterinary Emergency and Critical Care, reviewed cases from 2008 through 2023 and focused on accidental one-time exposures, a common real-world scenario for dogs taking trilostane for hyperadrenocorticism. That matters because trilostane can suppress cortisol synthesis, and its approved labeling warns that overdose may require treatment for hypoadrenocorticism with corticosteroids, mineralocorticoids, and IV fluids in more serious cases. (pmc.ncbi.nlm.nih.gov)

Why it matters: For veterinary teams, the study adds a larger evidence base for triaging accidental extra-dose calls. The topline takeaway appears reassuring: most single-dose exposures did not progress to severe illness. Still, clinicians should keep the drug’s known risk profile in mind, especially because trilostane labeling and review literature note potential adverse effects including vomiting, diarrhea, lethargy, weakness, electrolyte abnormalities, hypoadrenocorticism, and, rarely, adrenal necrosis. In practice, that supports a measured approach: assess dose, timing, body weight, concurrent illness, and clinical signs, rather than assuming every accidental ingestion needs aggressive intervention. (todaysveterinarypractice.com)

What to watch: Watch for the full paper’s dose-stratified details, which could further refine when outpatient monitoring is enough and when endocrine testing, decontamination, or hospital care is warranted. (todaysveterinarypractice.com)