Originally Posted by Oxer
"No adverse side effects were reported in any horse taking trilostane. In addition, trilostane therapy altered endocrine testing results to normal levels. Therefore, it appears that trilostane could be a useful, safe drug for treating ECS."
Susan Piscopo, DVM, PhD
Just read an article on Trilostane in Horses. It was a bit long but this was the last bit of the final paragraph of the study. (2004)
Yeah, 2004. It's a newer drug, these things always take time to show up after clinical trials and once it is more widely used in the population. There have been some reports since then and the efficacy also isn't as good as Pergolide as well as the mineralocorticoid effects. Ha, this thread happened to catch me the week I have a clinical pharmacology exam on cushings treatments. The literature is fresh in my mind!
As far as diagnosis- there is a test you can do (a few actually). Icelandics are prone to Equine Metabolic Syndrome. The best test for this is a combined glucose-insulin test. Your vet can run it and it is pretty cheap and easy to do. Ask them about it, but if they have been out of school for a while they may not know about EMS, it is a fairly recently characterized syndrome but has some very solid evidence behind it. I'd recommend staring with a search on thehorse.com to educate yourself a bit more on it. Good luck.