Effects of trilostane on the pituitary-adrenocortical and renin–aldosterone axis in dogs with pituitary-dependent hypercortisolism

Galac, Sara; Buijtels, J.J.C.W.M.; Mol, Jan A.; Kooistra, Hans S.

doi:10.1016/j.tvjl.2008.10.007

Cited by 37 publications

(69 citation statements)

References 30 publications

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“…Veterinarians are instructed, in the literature, to begin ACTHst testing 2–24 hours after trilostane is administered to dogs with NOH 8, 9, 10, 11, 12, 13, 14, 15, 16. As demonstrated in an earlier study, ACTHst begun 3–4 hours after trilostane administration yielded significantly lower results when compared with tests begun 8–9 hours after 9.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Adrenocorticotropic Hormone Stimulation Test Results Started 2 versus 4 Hours after Trilostane Administration in Dogs with Naturally Occurring Hyperadrenocorticism

Bonadio

Feldman

Cohen

et al. 2014

Veterinary Internal Medicne

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BackgroundTrilostane medical treatment of naturally occurring hyperadrenocorticism (NOH) in dogs is common, as is use of the adrenocorticotropic hormone (ACTH) stimulation test (ACTHst) in monitoring response to treatment. There is uncertainty regarding when the ACTHst should be started relative to time of trilostane administration.ObjectiveTo compare ACTHst results in dogs being treated for NOH with trilostane when the test is begun 2 versus 4 hours after trilostane administration.AnimalsTwenty‐one privately owned dogs with NOH, each treated with trilostane for at least 30 days.MethodsEach dog had 2 ACTHst completed, 1 started 2 hours and the other 4 hours after trilostane administration. The second test was started no sooner than 46 hours and no later than 74 hours after the first.ResultsFor all 21 dogs, the mean post‐ACTH serum cortisol concentration from tests started 2 hours after trilostane administration (5.4 ± 3.7 μg/dL) was significantly lower (P = .03) as compared with results from the tests started 4 hours after administration (6.5 ± 4.5 μg/dL).ConclusionsResults of ACTHst started at different times yield significantly different results. Dogs with NOH, treated with trilostane, and monitored with ACTHst results should have all of their subsequent ACTHst tests begun at or about the same time after trilostane administration.

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Section: Discussionmentioning

confidence: 99%

Comparison of Adrenocorticotropic Hormone Stimulation Test Results Started 2 versus 4 Hours after Trilostane Administration in Dogs with Naturally Occurring Hyperadrenocorticism

Bonadio

Feldman

Cohen

et al. 2014

Veterinary Internal Medicne

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“…However in the earlier studies many dogs did not have their cortisol levels reduced to the authors stated target range [18][19][20][21]. Later studies, which tended to be more precise on the timing of the ACTH stimulation test, achieved a higher rate of success in this respect [22,23].…”

Section: Monitoringmentioning

confidence: 99%

“…The clinical use of trilostane in canine HAC, and in particular PDH, has now been evaluated in several published clinical studies from centres across the world [18][19][20][21][22][23]. In addition unpublished studies have been conducted for regulatory purposes (Dechra Veterinary Products; data on file).…”

Section: Use In Canine Pituitary Dependent Hyperadrenocorticismmentioning

confidence: 99%

“…Most clinical studies to date have used the clinical signs and the ACTH stimulation test as the primary methods of assessing control [18][19][20][21][22][23]. In these studies trilostane caused significant reductions in both the mean basal and post-ACTH stimulation cortisol concentrations in dogs with HAC in the first month of treatment.…”

Section: Monitoringmentioning

confidence: 99%

“…However equally many dogs that have a target level post ACTH stimulation test serum cortisol will exhibit signs of HAC [20,24]. Various different timings and cortisol target levels for the ACTH stimulation test when used to monitor trilostane therapy have been used [18][19][20][21][22][23]. The lower the target range the greater the chance of hypoadrenocorticism.…”

Section: Monitoringmentioning

confidence: 99%

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Trilostane in Dogs

Ramsey

2010

Veterinary Clinics of North America: Small Animal Practice

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SynopsisOver the last 10 years trilostane, a competitive inhibitor of steroid synthesis, has become widely used for the treatment of canine hyperadrenocorticism. Trilostane causes a significant but reversible decrease in cortisol production and a concomitant improvement in clinical signs in most dogs with this common condition. Side effects, though infrequent, can be serious: dogs treated with this drug require regular monitoring. This review summarises current knowledge of the use of this drug with particular emphasis on its efficacy, safety, adverse reactions and effects on endocrine parameters. Brief mention is made of its other uses in dogs and other species.

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Isolated hypoaldosteronism managed by DOCP in a dog with chronic kidney disease and hypercortisolism

Park

Kim

et al. 2022

Veterinary Medicine & Sci

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A 13-year-old spayed female Schnauzer dog with chronic kidney disease (CKD; International Renal Interest Society stage 2, non-proteinuric, normotensive), diabetes mellitus, hypercortisolism and myxomatous mitral valve degeneration (American College of Veterinary Internal Medicine stage B2) presented with electrolyte imbalance that had progressed to hyperkalaemia and hyponatremia, with a sodium to potassium (Na:K) ratio of 19.6. Cortisol levels after the adrenocorticotropic hormone stimulation test were within the therapeutic range, but aldosterone levels were below the reference range; hence, isolated hypoaldosteronism was diagnosed. After administration of deoxycorticosterone pivalate (DOCP), the electrolyte imbalance improved with a Na:K ratio of 27.7. This is the first report of the management of isolated hypoaldosteronism and hypercortisolism using trilostane and DOCP in a dog. This case highlights the importance of recognizing isolated hypoaldosteronism after long-term treatment with trilostane in a canine patient with CKD.

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Effects of trilostane on the pituitary-adrenocortical and renin–aldosterone axis in dogs with pituitary-dependent hypercortisolism

Cited by 37 publications

References 30 publications

Comparison of Adrenocorticotropic Hormone Stimulation Test Results Started 2 versus 4 Hours after Trilostane Administration in Dogs with Naturally Occurring Hyperadrenocorticism

Comparison of Adrenocorticotropic Hormone Stimulation Test Results Started 2 versus 4 Hours after Trilostane Administration in Dogs with Naturally Occurring Hyperadrenocorticism

Trilostane in Dogs

Isolated hypoaldosteronism managed by DOCP in a dog with chronic kidney disease and hypercortisolism

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