Survival of dogs with pituitary‐dependent hyperadrenocorticism treated twice daily with low doses of trilostane

Abstract

Background Twice daily low trilostane doses have proven to be effective to manage canine Cushing's syndrome. However, survival and prognostic factors in dogs treated with this protocol have not been evaluated. The aim of the study was to evaluate survival and prognostic factors, including systolic blood pressure (SBP) at diagnosis, in dogs with pituitary‐dependent hypercortisolism (PDH) treated with low trilostane doses. Methods Medical records of 91 dogs newly diagnosed with PDH initially treated with 0.2–1.1 mg/kg of trilostane twice daily were retrospectively included. Survival times were calculated using the Kaplan–Meier estimator. Univariable and multivariable analysis were performed using the Cox proportional hazard regression analysis. Results Overall, median survival was 998 days (range 26–1832 days, 95% confidence interval = 755–1241 days). In the multivariable analysis, age (hazard ratio [HR] = 1.337, p < 0.001), presence of calcinosis cutis (HR = 5.271, p < 0.001), body condition score (BCS) ≤3/9 (HR = 8.100, p < 0.001) and higher platelet count (HR = 1.002, p = 0.022) were negatively correlated with survival. SBP was not associated with survival. Conclusions Low‐dose trilostane treatment twice daily provides slightly longer survival than previously reported for dogs with PDH treated once or twice daily at higher doses. Older age, presence of calcinosis cutis, low BCS and higher platelet count, but not systemic hypertension, are predictive of poorer prognosis in dogs with PDH.

Clinical features of muscle stiffness in 37 dogs with concurrent naturally occurring hypercortisolism

“…The median survival time for dogs with HC when treated with trilostane or mitotane has been reported to be 549 to 998 days. 55 , 56 , 57 , 58 Despite most dogs having persistent or worsening SMS, owners chose continued care. However, owners of 50% of the dogs in this study ultimately chose euthanasia because of persistent or worsening SMS, highlighting the impact that this condition can have on the dog's and owner's quality of life.…”

“…The median survival time from initial diagnosis of SMS in the dogs included in this study was 963 days (range, 8‐1188 days). The median survival time for dogs with HC when treated with trilostane or mitotane has been reported to be 549 to 998 days 55‐58 . Despite most dogs having persistent or worsening SMS, owners chose continued care.…”

Diagnostic Findings and Surgical Management of Three Dogs Affected by Osseous Metaplasia Secondary to a Salivary Mucocele

“…It is probable that the chronic inflammation caused by the saliva in contact with the soft tissues is the underlying cause of the sialocele calcification [21]. Calcifications have been widely reported in the veterinary literature and appear to be related to tumours, endocrinopathies and inflammatory lesions [33,34]. Tumours which can typically present calcification spots are pilomatricomas, benign follicular tumours located on the neck and trunk [33,35,36].…”

Evaluation of muscle mass and intramuscular fatty infiltration in dogs with hypercortisolism and their association with prognosis

“…In dogs, muscle atrophy leads to exercise intolerance and motor function impairment, which are clinically relevant problems that affect a dog's quality of life. Furthermore, previous studies of dogs with HC have shown that muscle weakness or low body condition score, which are speculated to result from muscle atrophy, were associated with worse prognosis 13,14 . However, the evaluation of muscle atrophy in these studies was subjective, and no quantitative evaluation of muscle mass was conducted.…”