Problems associated with medical therapy of canine hyperadrenocorticism.

The cause of hyperadrenocorticism determines treatment. Pituitary-dependent hyperadrenocorticism (PDH) can be treated surgically with bilateral adrenalectomy or hypophysectomy, or it can be managed medically with the adrenocorticolytic agent o,p'DDD or the cortisol synthesis inhibitor ketoconazole. Unilateral adrenocortical tumors should be surgically removed because of metastatic potential, although medical therapy has been used with some success. Regardless of the treatment method chosen, canine Cushing's syndrome cannot be treated easily, inexpensively, or without close monitoring and follow-up.