Save at Walgreens Photo with 11 active coupons & promos verified by our experts. 745. Practices For Pet. Free photo books. The trilostane dose was decreased in two dogs;. Trilostane dosage was increased by 20–50% in those cases and rechecked at the next time-point programmed. Strengths: 67 strength combinations of Trilostane Oral Oil Suspension are available. Trilostane, sold under the brand name Vetoryl among others, is a medication which has been used in the treatment of Cushing's syndrome, Conn's syndrome, and postmenopausal breast cancer in humans. LEARN ABOUT RX DISCOUNT CARD. These include opioids, benzodiazepines, and alcohol. Nov. References. Purity: 0. Covetrus ® is a global animal-health company dedicated to empowering veterinary practices. Coupon valid day of pick-up only. org MSPCA-Angell West │293 Second Ave. 035 mgIn addition there was no rise in the levels of precursors immediately preceding the proposed site of action of trilostane. Existing customers will still be able to view the site for information regarding their pharmacy records and order history. Objectives: To compare the efficacy of twice daily (BID) versus once daily (SID) trilostane administration and to. Compared with mitotane, which destroys adrenocortical cells, trilostane. For a diabetic pet this means at mealtime the pet should get the Trilostane and insulin at the same time, when Fluffy is eating. Important safety information. C863R-US-12-018, 2014, Zoetis Inc. 57 for 1, 5ml of 0. Topics in Companion Animal Medicine. Grab up to 40% OFF with 33 active Black Friday Expressvet Coupon & Coupons at HotDeals. Prices start at $34. 3703. 2023-09-05. 1% to 99. , and cortisol concentrations was seen in both groups at 24 wk. 85%, respectively. This blockade is reversible and appears to be dose-related (). 0 µg/dL Please note: Optimal timing for administering ACTH (Cortrosyn) is 2-4 hours post administration of trilostane. GoodRx is not sponsored by or affiliated with any of the third-party brands identified. Oral suspensions and solutions can be administered directly into the mouth using a dosing syringe or mixed with a small amount of food. A method of determining Trilostane in a compound mixture comprising effecting a chromatographic separation of said mixture and analysing the eluate from the separation to determine Trilostane. All Drugs; Human Drugs; Animal Drugs. 47 Availability: Prescription Required (2) Spotlight! RX item Vetoryl 30 mg, 30 Capsules (Trilostane) Retail: $118. Danazol has a complex mechanism of. 0 mg/lb (2. Trilostane is a medication used as part of treatment for Cushing’s syndrome in canines. 2. Welcome to Dechra. : 14590510. e. Comment: Trilostane is a 3 β-hydroxysteroid dehydrogenase (gene symbol HSD3B1) inhibitor. Current Monitoring Options • Pre-trilostane resting cortisol concentration (attractive because inexpensive and convenient) • Post-trilostane ACTH stimulation test (remains most common monitoring protocol in US) VETORYL Capsules should be administered with food. Hair loss. As a franchise business, all promotional codes are location specific. Trilostane for Dogs – The Side Effects. Continue current do 1. , 1983), although responses may be variable. 11, announcing the approval of a new drug to treat Cushing’s disease and warning against continued importation or compounding of its active ingredient. Trilostane was evaluated for its efficacy in resolving clinical and clinicopathological abnormalities of equine Cushing's syndrome (ECS) and to assess its safety. This dog responded to trilostane discontinuation and supportive care. Once-daily Vetoryl Capsules (Trilostane) treats canine hyperadrenocorticism, or Cushing's disease, by regulating the cortisol hormone during times of stress. The manufacturer’s (Dechra) recommendation is a starting dose of 2. Trilostane is used to lower excess stress hormone levels released by the adrenal glands due to a condition known as hyperadrenocorticism (also known as Cushing’s disease) in dogs and sometimes in cats. Cushing’s disease is. VetOne Trilostane Capsules for Dogs. 69 Chewy Price. $79. Learn more. Trilostane [(4α, 5α, 17β) -3,17-dihydroxy-4,5-epoxyhydrost-2-en-2-carbonitrile ] is an inhibitor adrenocortical steroidogenesis. It is given by mouth as a capsule, given with food. Finding a reliable source for purchasing trilostane for your dog is crucial in ensuring successful treatment. Online pharmacies review: By being informed about the dangers of buying drugs on the Internet you can protect yourself and your family from the risks. Cortisol is normally released from the adrenal gland into. -. 7-3. Blood Pressure/Heart Health Continued PROPRANOLOL 60MG TAB 3 60 180 SIMVASTATIN 40MG TAB 2 30 90 . When given orally to rats, trilostane inhibits corticosterone and aldosterone production and. Objectives: To assess the effect of trilostane and mitotane in dogs with pituitary-dependent hyperadrenocorticism on. 7 mg/kg) once a day. 5-year period. Please note your capsules may be either blue and opaque-white or blue and blue. Trilostane has become the treatment of choice for dogs with PDH in the last decade. pharmacies start at . 9% (18 packets) met acceptable stan-dards for trilostane strength and 59. Under section 573(c) of the act (21 U. 500 mg. The pre-trilostane cortisol was slightly better that the baseline cortisol and had the added benefit of being more useful at signaling potential oversuppression. In this article, I briefly review the diagnosis and treatment of. Target. Zerorez occasionally offers promotions in the form of discounts, room specials, coupons, promo codes, percentage off services, bundled room flat rates, free areas cleaned when you book other services, and so on off our standardpricing. 72–$63. Vetoryl is also effective for dogs with the pituitary form of Cushing’s Disease. "I wanted to say thanks to this website for providing a card such as this to the public for free! A few weeks ago I printed out one of your cards and used it on one of my medications because my co-pay went up and to my surprise instead of paying a $45. National Drug Code (NDC) number for Trilostane is 64918-0725. Morgan shares her insight here with blogs and videos. 05). Trilostane was administered the next morning, with food. , J. This is helpful for patients with Cushing’s disease, who suffer from excess amounts of cortisol being synthesized by the. The above coupon (printed on Mon May 08 12:46:53 UTC 2023) is good for the purchase of 1 jar of 100 % powder of trilostane. chews. C863R-US-12-018, 2014, Zoetis Inc. 49 Save: $11. 10 active coupon codes for Routine, Black Friday 2023. Trilostane inhibits synthesis of cortisol in dogs. Browse medications alphabetically. 001) than prior to treatment (115 fmol/L/s, range 15-1330 fmol/L/s). Trilostane, sold under the brand name Vetoryl among others, is a medication which has been used in the treatment of Cushing's syndrome, Conn's syndrome, and postmenopausal breast cancer in humans. 745. Bexagliflozin, marketed under the brand name Bexacat, is a medication used in the treatment of type 2 diabetes mellitus. 2, 3 The drug is a competitive inhibitor of. Cushing's Syndrome can be treated with a drug called Trilostane. 88. Vetoryl (Trilostane) is a competitive inhibitor of the enzyme 3-beta-hydroxysteroid dehydrogenase used in dogs for the treatment of pituitary dependent Cushing's Disease and Cushing's Disease due to adrenocortical tumors. 1% (26 packets) did not (Table S1). Rated 4. Procedures—47 dogs were treated orally with trilostane (0. Prices Medicare Drug Info Side. This is by far the most accurate, safe and effective method of diagnosing Cushing’s disease. Closure of Site. 5-2. Names depicted in photography are for illustrative purposes. Trilostane (from Vetoryl®) from 2 mg/ml to 140 mg/ml. 89%. VIEW MOREThe stability of a compounded trilostane suspension in cod liver oil stored at room temperature was investigated for 90 days. Methods: Trilostane (50 mg/kg) was administered subcutaneously once daily for up to six consecutive days, starting 10 min after intraperitoneal administration of kainic acid (15 mg/kg). The greater the dose needed, the greater the risk of side effects. The enzymatic action of 3β-HSD is thus essential for the synthesis of cortisol and all other steroids including. See full list on singlecare. Journal of. It is a steroidogenesis inhibitor, which means it works to block the production of glucocorticoids and mineralocorticoids. This is a generic drug. One of the dosage forms available for Trilostane is Oral Suspension. Background. This product was withdrawn from the U. Regarding excised tissue weights of pituitary and bilateral adrenal glands,. Trestolone acetate is a synthetic and injected anabolic–androgenic steroid (AAS) and a derivative of nandrolone (19-nortestosterone) which was never marketed. Save at TriLASTIN with 2 active coupons & promos verified by our experts. CushAway is a nutritional supplement designed to aid in the. com Important safety information. com will no longer accept new orders. Trilostane Coupon Use this FREE Trilostane pharmacy coupon to get the lowest price on your pet's Trilostane prescription. $411. $131. Barker EN, Campbell S, Tebb AJ, et al. 5725. Fluconazole is commonly used to treat yeast infections of the mouth or throat (thrush). Many articles published in the past few years have contributed to a better understanding of the use of trilostane in dogs. This coupon entitles residents of all US States including Guam and Puerto Rico to save up to and sometimes over 80% on TRILOSTANE and all FDA approved prescription. Do. Your Discount Pricing for TRILOSTANE at Fry's Food & Drug 1 jar of 100 % powder To find our lowest prices at different pharmacies in your area take a look at our other trilostane coupons Trilostane Compounded is used to treat dogs with hyperadrenocorticism, also known as Cushing's disease. Penny, our 7 yr old chihuahua, has Cushings. com will shut down permanently. Vetoryl. One study evaluated compounded trilostane products from 8 compounding pharmacies, as well as capsules compounded from the licensed product. There was a wide variability in drug content among the compounded trilostane batches-39% to 152. Trilostane (Vetoryl®) dosing and monitoring* Treatment of Cushing’s syndrome Day 1 Start trilostane treatment. Medications that dogs in this population were receiving concurrently included trilostane, levothyroxine, bezafibrate, cyanocobalamin, and 14 dogs were receiving a fatty acid supplement. However, drug potency fell >10% below the labeled value when stored in. 2023, Manufacturer printable Vetoryl coupon is not available at present, but you can still get savings with this Vetoryl discount card. 2 Place The Order Order online or over the phone: 1 (800) 738-7209. 525, Overland Park, KS, 66211. If the adrenal gland was the cause, the life expectancy tends to be about three years. 2004. Skin & Coat, All Dog, Liver, 60 Soft Chews, 5. S. Trilostane and epostane also competitively inhibit purified human 3β-HSD1 with 12–16-fold lower K i values compared to the noncompetitive K i values measured for human 3β-HSD2. Adrenal-dependent prognosis Surgery has a 10-25% risk of mortality, and with the surgical removal of the adrenal tumor, patients’ average survival time. 9% (18 packets) met acceptable standards for trilostane strength and 59. Alternative products. 96 Off Trilostane. 48 Chewy Price. In the treatment of hyperadrenocorticism, trilostane. Common side effects include lethargy, vomiting, diarrhea, and anorexia. "I wanted to say thanks to this website for providing a card such as this to the public for free! A few weeks ago I printed out one of your cards and used it on one of my medications because my co-pay went up and to my surprise instead of paying a $45. 4–5. Vetoryl – FDA prescribing information, side effects and uses; Trilostane Prices and Trilostane Coupons – GoodRx; Low-Dose, Twice-Daily Trilostane Treatment for Dogs with. Mise à jour sur l’utilisation du trilostane chez les chiens. Before treatment is started, your veterinarian will perform routine blood. Reusch CE, Sieber-Ruckstuhl N, Wenger M, Lutz H, Perren A, Pospischil A. Trilostane should always be given with food to improve absorption. 3 Verify Script We will contact your veterinarian and confirm the prescription directly with them. Rated 4. of Clin. With this Vetoryl Rebate Card, Price for 1 package (30 capsules) of Vetoryl 30mg (brand) is from $52. Le Trilostane n'est pas un médicament bon marché et, à titre d'information, u ne plaquette de 30 gélules de Trilostane coûte entre 55 et 60 euros. Min. Browse Harbor Freight Tools coupons and promo codes for big savings on tools for your next project or adventure. 2 Because human 3β-HSD (type 1) is a critical enzyme in theCushing’s Disease and Compounded Trilostane. The mean duration of trilostane treatment for 21 PDH dogs studied was 8. Trilostane is an inhibitor of the 3β-HSDs: 3β-HSD1 and 3β-HSD2 with K i values of 0. The. Food and Drug Administration (FDA) sent an open letter to veterinarians Sept. chews. Before the study, to define the number of patients needed to document at least 50% mitigation of the eACTH increase at D180 in comparison with D0 in the intervention group (Tri + Sel), the statistical calculator. 50. Inhibition of cortisol is dose dependent and reversible. 26). Dechra Veterinary Products. Blood samples were taken −30, 0 (within x minutes of administration), 15, 30, 60, and 90 minutes, and 2, 3, 4, 6, 8, 12, 16, 20, and 24 hours, after administration of trilostane. Prednisone (Generic) Tablets, 5-mg, 60 tablets. After approximately 10-14 days at this dose, re-examine the dog and conduct a 4-6 hour post-dosing ACTH stimulation test and serum. Trilostane inhibits synthesis of cortisol in dogs. Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. We partner with tens of thousand of veterinarians to help pets like yours take the medications they’re prescribed. Original coupon must be presented. The present work aimed to assess. Get selegiline for as low as $34. As with all drugs, side effects may occur. 00. 1 Caution should. Dr. If an Addisonian crisis or any other negative reactions occur, call your veterinary. 1–30 kg body weight group; and 0 of the 19 dogs in the >30 kg body weight group. cabergoline. Trestolone acetate. Additionally, only 6 dogs in this population were being fed a commercial renal diet. 4 Refill On File If your order had one or more refill on it. 4–5. MFCD00199295. 29 Philo codes & coupons verified for November 2023: redeem 50% off or $10 off 1 month with code. It may be necessary to wait at least one month. Up to $100 off streaming + free month trial offer. In healthy dogs, mean maximal plasma concentrations occur 1. 1G -Glass Bottle with Plastic Insert (View image) CAS RN. , Ste. 00 / 1KG. Abstract Objective—To evaluate the effect of trilostane on serum concentrations of aldosterone, cortisol, and potassium in dogs with pituitary-dependent hyperadrenocorticism (PDH), compare the degree of reduction of aldosterone with that of cortisol, and compare aldosterone concentrations of healthy dogs with those. as VetorylTM from Dechra Veterinary Products. Select your medications. Trilostane ( (4α,5α,17β)-3,17-dihydroxy-4,5-epoxyandrost-2-ene-2-carbonitrile); >= 98% HPLC; Trilostane has been used to evaluate its capability to regulate the sex-dependent differences in the lipopolysaccharide (LPS)-induced inflammatory responses of astrocytes; Trilostane inhibits the production. 9% (18 packets) had acceptable strength of trilostane. No significant difference in accurac y results were found between packets prepared by hand and those prepared using a packing device. TRILOSTANE - National Center for Advancing Translational Sciences. With VistaCreate, you can quickly design your own coupon and start your online promo right away. Optical. Prix du Trilostane. Due to advertising restrictions and GDPR, Bova UK cannot advertise its formulations and can only discuss formulations with registered. The cost for Lysodren oral tablet 500 mg is around $1,359 for a supply of 100 tablets, depending on the pharmacy you visit. Sildenafil. *If your pet is in need of urgent or emergency care, contact your pet's veterinarian immediately. dopamine agonist. 2-6. 99. 6174 out of 5 stars. 99 $107. 2. (9) Most of these side effects go away after the drug is stopped, but in rare instances, dogs may experience permanent adrenal gland damage and die. Trilostane, as an allosteric modulator of the estrogen receptor that targets both the estrogen and growth factor–dependent pathways, offers an alternative approach. 5 years for dogs with Cushing’s disease due to an ACTH-producing pituitary tumor (i. Out of scope information includes radiopharmaceuticals, contrast media, herbals, homeopathics, and food. Vetoryl (brand name Trilostane) comes in different size capsules including 5 mg, 10 mg, 30 mg, 60 mg, and 120 mg. It is contraindicated in liver or kidney disease and pregnant animals. Pharmacy: 855. Pink Modern Love Coupons. FREE delivery on first-time orders. pituitary-dependent Cushing’s disease). This Item – Vetoryl (trilostane) Capsules for Dogs, 5-mg, 30 capsules. 26. These could be symptoms of a serious liver problem. 30-ct. $1,908. market in April 1994. 5mg/kg, q 12 hours) and one dog was treated with ketoconazole (12 mg/kg, q 12 hours) for the. Toll-Free: 866-933-2472. $69. 6 months (range, 1‐25) and dosages at the time of the studies ranged from 0. 3. In 3 easy steps you can have your pet’s Rx filled and delivered right to your doorstep. In field studies and post‐approval experience, the most common side effects reported were: polyuria, polydipsia, depression/lethargy, pain on injection, weight gain, inappropriate urination, alopecia, decreased appetite/anorexia, panting, vomiting, diarrhea, shaking/trembling, polyphagia, urinary tract infection. Monoisotopic mass 329. 55. Trilostane is a competitive inhibitor of 3β-HSD. pharmacies start at . Supply Ability: 10 tons. Fluconazole dosage for esophageal and oropharyngeal candidiasis. Hyperadrenocorticism (also known as Cushing’s disease) is a condition in which excess levels of the hormone cortisol are produced. 0833 out of 5 stars. Details. Advance consultation with your physician is particularly important if you are under eighteen (18) years old, pregnant, nursing or have health problems. 5% of trilostane down-regulated genes and 9. No significant difference in accuracy results were found between packets prepared by hand and those prepared using a packing device. com by. Trilostane is a bulk ingredient labeled by 'Sterling Spa'. $58. Compare prescription drug prices and find coupons at more than 60,000 US pharmacies. Trilostane: Capsule Trilostane may be prescribed for: Canine Cushing's; About Capsule: One of the dosage forms available for Trilostane is Capsule. ChemicalPuddefoot et al. 10 and 1. required. 2 to 6. 97. Save with. The average life expectancy for dogs with Cushing's disease depends on where the issue originated. Prescription Item. S. 5981. Trilostane produces suppression of the adrenal cortex by inhibiting enzymatic conversion of steroids by 3-beta-hydroxysteroid dehydrogenase/delta 5,4 ketosteroid isomerase, thus blocking synthesis of adrenal steroids. Our discount coupons are pre-activated and can be used at over 68,000 pharmacies nationwide to save up to 75% off your prescription medication. financial limitations), the pre-trilostane cortisol concentration will likely provide the most clinically useful information. 6% of label claim-compared with the variance for the controls, which was 96. Trilostane is an adrenal steroid synthesis inhibitor that may be prescribed for hyperadrenocorticism (Cushing's Disease) or other adrenal imbalances. Dr. JAAHA. 95. Altogether. Results of in vitro steroid production experiments with trilostane. 6174 out of 5 stars. Veterinary Pharmacy for Compounded Pet Medications. Trilostane has an extensive dose range, and the starting doses can vary significantly. Details. 50. Data on file, Apoquel ® /Cytopoint ® Pet Tracker, Wave 10, 2021, Zoetis Inc. This product was withdrawn from the U. Each box contains 30 capsules. Description. See drug prices. 31 Autoship Price. Due to the medical condition, some dogs may require lifelong medication and regular checkups with a vet. Vet Rec. High pressure liquid chromatographic (HPLC) analysis of plasma taken over 8 h from ten normal male subjects medicated with 120 mg of trilostane revealed that the drug is rapidly metabolised into at least one metabolite, 17-keto trilostane. 9, 10 Adrenocortical necrosis has been reported in dogs on trilostane treatment 11, 12 and in 1 dog hyperkalemia and. Clinical and biochemical changes suggestive of hypoadrenocorticism were observed in a 10-year-old male neutered Staffordshire bull terrier shortly after beginning therapy with trilostane for the treatment of hyperadrenocorts, and this complication has not been reported previously. 2012;27(1):25-30. 70. Trilostane Compounded capsule is a blue and white elongated capsule made specifically for your pet. Sildenafil. Trilostane is supplied in 10-, 30-, 60-, and 120-mg capsules. This prescription discount coupon can be redeemed at participating pharmacies such as CVS Pharmacy. 0-3. 1 Trilsotane has been approved for use in the treatment of Cushing’s syndrome in dogs to reduce cortisol, aldosterone, and corticosterone levels. Packaging and Container. com. trilostane administered twice daily in dogs with pituitary-depen - dent hyperadrenocorticism. Stop wasting time and money — PayPal Honey helps you find coupon codes on 30,000+ sites. My Price $19. 3. $26. 21 to 1. They can be anything from 20% off your purchase to $10 off $49 to Buy One, Get One Free promotions. Online Pharmacies Reviews Ratings Scam Reports. The production of cortisone is complex and some of the pathways are common to sex-hormone production. com will no longer accept new orders. The commercially available product for dogs is called Vetoryl ® and comes in 5mg, 10mg, 30mg, 60mg and 120mg strengths. 452. >. Medical management of pituitary-dependent hyperadrenocorticism: mitotane versus trilostane. Vetoryl 120 mg hard capsules for dogs: Do not use in dogs weighing less than 20 kg. Trilostane, also known as 4α,5-epoxy-3,17β-dihydroxy-5α-androst-2-ene-2-carbonitrile, is a synthetic androstane steroid and a derivative of 5α-reduced androstane derivatives like. $111. Contact your regular veterinarian if you notice any side effects. Oncol. After approximately 10-14 days at this dose, re-examine the dog and conduct a 4-6 hour post-dosing ACTH stimulation test and serum. Of the 44 packets containing trilostane, 40. 91 mg/kg PO q12h). 78%. Trilostane is a small molecule drug that targets ERβ and is primarily used in the field of endocrinology and metabolic disease. . Surgical techniques to remove pituitary tumors in dogs. Rated 4. BENAZEPRIL 40MG TABDesired pre- and post-ACTH cortisol for dogs on trilostane* (or Lysodren) therapy: Both pre and post samples between 1. Treat hyperdrenocorticism in dogs with Vetoryl. Details. 0 mg/lb (2. Buy Vetoryl (Trilostane) online from a safe and certified Canadian pharmacy. See moreThe average cost for 1 Bottle, 1000GM of 1 Bottles each, is $248,038. INTRODUCTION. , Boston, MA 02130│617-522-7282│fax: 617-989-1635│angell. Treating Cushing's disease in dogs. 候群藥物治療之第一線用藥，因其價格便. 2. Amazon Pharmacy Home Delivery 4500 S Pleasant Valley Road, Suite 201 Austin, TX 78744-2911. 1, 2023 – Jan. Save with Routine discount codes. Welding & Machinery. , 2006, Trilostane in advanced breast cancer. Ketoconazole 200 mg Tablet Pet Wellbeing Adrenal Harmony Gold for Dogs and Cats Anipryl Tablets 30 Ct. Dogs, Cats, Horses. Compounded trilostane retained stability, defined as maintaining 90–105% labeled value, for 60 days when stored in amber glass bottles. Veterinary drugs should only be compounded based on a licensed veterinarian's prescription, and to meet the medical needs of a specific patient. In field studies and post-approval experience, the most common side effects reported were: anorexia, lethargy/depression, vomiting, diarrhea, elevated liver enzymes, elevated potassium with or without decreased sodium, elevated BUN, decreased Na/K ratio, hypoadrenocorticism, weakness, elevated creatinine, shaking, and. Cytopoint has been shown to be effective for the treatment of dogs against allergic dermatitis and atopic dermatitis. $38. S. Trilostane Coupon; Trimethoprim Sulfate Coupon; Tritop Coupon; Tumil-K Coupon; Uroeze Coupon; Ursodiol Coupon; Vincristine Coupon; Virbantel Coupon; Zantac Coupon;Vetoryl Description. Your patient will be able to obtain an Advancing Access co-pay coupon card in real time. com will no longer accept new orders. VETORYL Capsules should be administered with food. 2 Place The Order Order online or over the phone: 1 (800) 738-7209. customerservice@petcarerx. It provides valuable insights into the current market trends, along with. 0-3. 9 Its administration effectively blocks cortisol secretion and, to a lesser extent, that of aldosterone. Biol. Method: A trilostane assay was developed for analysis. This is because animal studies showed that the medication could be harmful to an unborn baby. A drug used for the treatment of Cushing's disease (hyperandrenocorticism) mainly in dogs but also in cats and horses. 824. Amazon Pharmacy for prescribers ›. The molecule inhibits the enzyme progesterone reductase, which is necessary for the production of glycorticoids and mineralocorticoids, competitively and reversibly blocking the conversion of D5-3b. As a sought after speaker, Dr. It may have value in veterinary practice for treating equine (McGowan and Neiger, 2003) and canine (Neiger et al. FREE shipping on $49+ orders!Vetoryl Capsules are used to treat dogs with pituitary-dependent and adrenocortical tumor-dependent hyperadrenocorticism. Trilostane decreases the production of excessive cortisol hormone by the adrenal gland.