Pozoukidou E. DVM, Medicine Unit, Companion Animals Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
Papadimas K. DVM, Medicine Unit, Companion Animals Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
Konstantinidis A.O. DVM, Medicine Unit, Companion Animals Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
Soumpasis N. DVM, Medicine Unit, Companion Animals Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
Introduction
Trilostane is currently the medical treatment of choice for hyperadrenocorticism in dogs. Iatrogenic hypoadrenocorticism is considered infrequent. Mineralocorticoid concentrations remain normal in most dogs, and the glucocorticoid deficiency is usually transient. This presentation describes a case of iatrogenic hypoaldosteronism in a dog on maintenance trilostane therapy for hyperadrenocorticism.
Clinical Case
A 6.5-year-old, female spayed Cocker Spaniel was presented due to anorexia. The dog had been treated with trilostane for the last 2.5 years since it was diagnosed with hyperadrenocorticism. Clinical examination revealed no abnormal findings. Serum biochemistry showed hyponatremia and normal potassium, with a reduced Na+/K+ ratio of 23. Basal and post-ACTH cortisol concentrations were within normal values for a dog with hyperadrenocorticism receiving trilostane. In contrast, serum basal and post-ACTH aldosterone concentrations were extremely low.
Results
Based on history, clinical and laboratory findings, including basal and post-ACTH cortisol and aldosterone concentrations, iatrogenic hypoaldosteronism was diagnosed. Trilostane was discontinued, desoxycorticosterone pivalate (DOCP) was prescribed and the dog responded well to therapy.
Conclusion
Aldosterone deficiency may occur in dogs receiving trilostane. This is the first case describing complete aldosterone deficiency without cortisol deficiency in a dog. Iatrogenic hypoaldosteronism should be considered as a differential in dogs receiving trilostane, especially when presented with diarrhea, anorexia and vomiting.
References
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- Wenger M, Sieber-Ruckstuhl NS, Müller C, Reusch CE (2004) Effect of trilostane on serum concentrations of aldosterone, cortisol, and potassium in dogs with pituitarydependent hyperadrenocorticism. Am J Vet Res 65(9).
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