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I'm not sure what medication Simba has been on so far - Accutane is not used in veterinary medicine to treat Cushings disease.
Perhaps you mean trilostane?
If so, 2 mg/kg is a low dose. We can slowly increase the dose as needed to get control of his signs and improve his cortisol measurements on the ACTH Stim test.
Another option is a drug called Lysodren.
As far as retinoic acid goes, this has been used with some success for Cushing's disease as well.
The dose for this medication is 2 mg/kg/day as well.
We use the 9-cis isomer of retinoic acid to treat. I have not looked into this option recently, but in the past (several years ago) it was very expensive. It was probably several hundred dollars per week.
Most of my clients choose the Lysodren or trilostane route.
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