부신피질기능저히증은 부신에서 생산되는 글루코코르티코이드와 미네랄로코르티코이드의 결핍으로 발생한다. 개에서 부신피질기능저하증을 관리하기 위해 fludrocortisone이 사용되어왔다. 그러나 desoxycorticosterone pivalate의 경우 fludrocortisone과 대등한 효과와 보호자와 환자에게 적은 부담을 주기 때문에 최근 몇 년간 부신피질기능저하증 개의 관리를 위해 사용되었다. 임상증상, 전해질불균형, adrenocorticotropic hormone stimulation test를 통하여 부신피질 기능저하증으로 진단된 14마리의 개에서 DOCP의 효과를 분석하였다. DOCP의 초기용량은 2.2 mg/kg 으로 사용되었으며 25일 간격으로 근육 또는 피하로 주사되었다. DOCP의 효능을 보기 위해 25일 간격으로 임상증상, 혈청 전해질 수치, 혈청 요소질소, 크레아티닌 수치를 모니터링 하였다. Fludrocortisones은 개에서 효과적인 치료법이지만 부작용과 불충분한 반응으로 7마리의 개에서 DOCP로의 전환이 필요하였다. 7마리의 개는 처음부터 DOCP가 투약되어 총 14마리의 개가 DOCP로 관리 받았다. 12마리의 개에서 임상증상, 전해질 불균형이 완전히 해소되었으나 2마리의 개에서는 몸 떨림과 같은 약간의 임상증상이 여전히 남아있었다. 4마리의 개는 프레드니손의 정기적 투여가 필요하였다. 이러한 결과를 종합해 보면, fludrocortisone과 비교하여 DOCP가 임상증상과 전해질불균형의 개선에 훨씬 효과적이었으며 이 결과는 부신피질기능저하증 개에서 DOCP가 더 좋은 치료법임을 제시해준다.
부신피질기능저히증은 부신에서 생산되는 글루코코르티코이드와 미네랄로코르티코이드의 결핍으로 발생한다. 개에서 부신피질기능저하증을 관리하기 위해 fludrocortisone이 사용되어왔다. 그러나 desoxycorticosterone pivalate의 경우 fludrocortisone과 대등한 효과와 보호자와 환자에게 적은 부담을 주기 때문에 최근 몇 년간 부신피질기능저하증 개의 관리를 위해 사용되었다. 임상증상, 전해질불균형, adrenocorticotropic hormone stimulation test를 통하여 부신피질 기능저하증으로 진단된 14마리의 개에서 DOCP의 효과를 분석하였다. DOCP의 초기용량은 2.2 mg/kg 으로 사용되었으며 25일 간격으로 근육 또는 피하로 주사되었다. DOCP의 효능을 보기 위해 25일 간격으로 임상증상, 혈청 전해질 수치, 혈청 요소질소, 크레아티닌 수치를 모니터링 하였다. Fludrocortisones은 개에서 효과적인 치료법이지만 부작용과 불충분한 반응으로 7마리의 개에서 DOCP로의 전환이 필요하였다. 7마리의 개는 처음부터 DOCP가 투약되어 총 14마리의 개가 DOCP로 관리 받았다. 12마리의 개에서 임상증상, 전해질 불균형이 완전히 해소되었으나 2마리의 개에서는 몸 떨림과 같은 약간의 임상증상이 여전히 남아있었다. 4마리의 개는 프레드니손의 정기적 투여가 필요하였다. 이러한 결과를 종합해 보면, fludrocortisone과 비교하여 DOCP가 임상증상과 전해질불균형의 개선에 훨씬 효과적이었으며 이 결과는 부신피질기능저하증 개에서 DOCP가 더 좋은 치료법임을 제시해준다.
Hypoadrenocorticism results from the deficient adrenal gland production of glucocorticoids or mineralocorticoids. Fludrocortisone have been used for the management of hypoadrenocorticism in dogs. But desoxycorticosterone pivalate (DOCP) have been administered for management of hypoadrenocorticism in...
Hypoadrenocorticism results from the deficient adrenal gland production of glucocorticoids or mineralocorticoids. Fludrocortisone have been used for the management of hypoadrenocorticism in dogs. But desoxycorticosterone pivalate (DOCP) have been administered for management of hypoadrenocorticism in dogs since several years because of the equivalent effect of fludrocortisone, and lessening of owner and patient's effort. The therapy of DOCP was evaluated in 14 dogs diagnosed with hypoadrenocorticism based on clinical signs, an electrolyte imbalance, and the results of an adrenocorticotropic hormone stimulation test. DOCP was administered at 25-day intervals at an initial dose of 2.2 mg/kg. The dogs were monitored for clinical signs and serum electrolyte, blood urea nitrogen, and creatinine concentrations every 25 days. Fludrocortisone was an effective treatment in dogs overall; however, a change to DOCP was necessary in 7 dogs because of adverse effects or poor responses. Another 7 dogs were treated with DOCP from the first time. A total of 14 dogs were treated with DOCP. Clinical signs and electrolyte imbalance resolved completely in 12 dogs. However, mild clinical signs, such as shivering, remained in 2 dogs, and 4 dogs required regular supplementation with prednisone. Improvements in clinical signs and electrolyte imbalance were significantly better after treatment with DOCP than with fludrocortisone. The results suggest that DOCP may be a better choice than fludrocortisone for the management of hypoadrenocorticism in dogs.
Hypoadrenocorticism results from the deficient adrenal gland production of glucocorticoids or mineralocorticoids. Fludrocortisone have been used for the management of hypoadrenocorticism in dogs. But desoxycorticosterone pivalate (DOCP) have been administered for management of hypoadrenocorticism in dogs since several years because of the equivalent effect of fludrocortisone, and lessening of owner and patient's effort. The therapy of DOCP was evaluated in 14 dogs diagnosed with hypoadrenocorticism based on clinical signs, an electrolyte imbalance, and the results of an adrenocorticotropic hormone stimulation test. DOCP was administered at 25-day intervals at an initial dose of 2.2 mg/kg. The dogs were monitored for clinical signs and serum electrolyte, blood urea nitrogen, and creatinine concentrations every 25 days. Fludrocortisone was an effective treatment in dogs overall; however, a change to DOCP was necessary in 7 dogs because of adverse effects or poor responses. Another 7 dogs were treated with DOCP from the first time. A total of 14 dogs were treated with DOCP. Clinical signs and electrolyte imbalance resolved completely in 12 dogs. However, mild clinical signs, such as shivering, remained in 2 dogs, and 4 dogs required regular supplementation with prednisone. Improvements in clinical signs and electrolyte imbalance were significantly better after treatment with DOCP than with fludrocortisone. The results suggest that DOCP may be a better choice than fludrocortisone for the management of hypoadrenocorticism in dogs.
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제안 방법
In the 7 dogs that were initially treated with DOCP, prednisone was prescribed when the dogs were faced with stressful situations. Electrolyte levels were evaluated 12 and 25 days after DOCP administration. Dose adjustments of DOCP and the interval of administration were determined on the basis of these results and the average injection interval of DOCP was 26.
2 ㎎/㎏) every 25 days intramuscularly or subcutaneously. Electrolyte levels were measured 12 days after DOCP administration to monitor the peak effect of this drug for dose adjustments and evaluation of therapeutic efficacy. If potassium level had increased (> 5.
22 mg/ kg of prednisone was prescribed only during illness with a nonadrenal related disease and stress. It was rechecked at 25 day intervals to determine the presence or absence of clinical signs, electrolyte imbalance and azotemia.
Five dogs were Maltese and 3 dogs were Cocker Spaniels. The diagnosis of hypoadrenocorticism was based on a medical history, a complete physical examination, serum biochemical analysis, complete blood counts, abdominal radiography, and ultrasonography. Depending on the test results, Hypoadrenocorticism was confirmed by ACTH stimulation test.
2 ㎎/㎏ of DOCP was injected intramuscularly because of a poor response to fludrocortisone. The remaining 7 dogs with hypoadrenocorticism were initially administrated with DOCP (2.2 ㎎/㎏) every 25 days intramuscularly or subcutaneously. Electrolyte levels were measured 12 days after DOCP administration to monitor the peak effect of this drug for dose adjustments and evaluation of therapeutic efficacy.
in domestic veterinary medicine. This study retrospectively evaluated the efficacy and adverse effects of long-term therapy with DOCP in 14 dogs with hypoadrenocorticism.
대상 데이터
This investigation was conducted in 14 dogs with hypoadrenocorticism at the Seoul National University Hospital for Animals from June 2004 to August 2010. The age of the 14 dogs ranged from 2 to 15 years (mean age: 7 y).
This work was supported by the Brain Korea 21 Program for Veterinary Science and the Research Institute for Veterinary Science, College of Veterinary Medicme, Seo니 1 National University.
성능/효과
All 14 dogs had symptoms of anorexia, 11 dogs experienced vomiting, 5 dogs experienced shivering, and 4 dogs experienced melena. Iatrogenic hypoadrenocorticism occurred in 1 of the 14 dogs diagnosed with hyperadrenocorticism that was being treated with mitotane (Table 1).
Electrolyte levels were evaluated 12 and 25 days after DOCP administration. Dose adjustments of DOCP and the interval of administration were determined on the basis of these results and the average injection interval of DOCP was 26.42 ± 0.41 days (range: 24~28 days).
(5-8%). On the basis of laboratory results, 13 of 14 dogs had both hyponatremia and hyperkalemia; the remaining 1 dog had hyperkalemia without hyponatremia. The average sodium: potassium ratio was [옹, 95 ± 1.
Consequently, the medication was switched to DOCP, after which the clinical signs related to uncontrolled hypoadrenocorticism and electrolyte imbalance disappeared. On the basis of the findings, DOCP seems to be more effective than fludrocortisone at resolving clinical signs and electrolyte imbalance in dogs with hypoadrenocorticism.
This study showed that the dose of fludrocortisone was continuously increased in some dogs because of a poor response. However, the effectiveness of such treatment was not sufficient to resolve the electrolyte imbalance and clinical signs.
참고문헌 (9)
John DB, David C. Twedt. Hypoadrenocorticism. In: Kirk's Current veterinary therapy XIV. St. Louis: WB Saunders. 2009; 231-235.
Kintzer PP. Peterson ME. Treatment and long term follow-up of 205 dogs with hypoadrenocorticism. J Vet Internal Med 1997; 11 (2) 43-49.
Klein SC, Peterson ME. Canine hypoadrenocorticism: Part I, Can Vet J 2010; 51: 63-69.
Lennon EM, Boyle TE, Hytchins RG, Friedenthal A, Correa MT, Bissett SA, Moses LS, Papich MG, Birkenheuer AJ. Use of basal serum or plasma cortisol concentrations to rule out a diagnosis of hypoadrenocorticism in dogs: 123 cases (2000- 20(5), J Am Vet Med Assoc 2007; 231: 413-416.
Sohn SY, Seo KW, Kim SU, Hwang CY and Youn HY, A Case of Treating with Desoxycorticosterone PivaIate (DOCP) against Canine Hypoadrenocorticism uncontrolled with Fludrocortisone, J Vet Clin 2009; 26(5) 472-475.
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