Bates J A, Shott S, Schall W D
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
Aust Vet J. 2013 Mar;91(3):77-82; discussion 81-2. doi: 10.1111/avj.12019.
To evaluate the efficacy of initial doses of desoxycorticosterone pivalate (DOCP) that are lower and less expensive than the presently recommended initial dose of 2.2 mg/kg for treating dogs with primary hypoadrenocorticism.
A retrospective study was performed on 49 dogs with primary hypoadrenocorticism, including 36 with initial DOCP doses less than 2.2 mg/kg. Medical records were reviewed for clinical data. All study dogs were followed up with telephone calls to owners or veterinarians to determine the date of death or last follow-up. Data were analysed to investigate relationships between initial DOCP dose and survival and serum Na, K and their ratio.
Regardless of their initial DOCP dose, none of the dogs developed uncontrolled hypoadrenocorticism or severe electrolyte abnormalities or clinical problems that would have made an increase in the DOCP dose necessary. Over time, most dogs had a decrease in their DOCP dose in mg/kg, because of weight gain during treatment. No statistically significant relationships were found between initial DOCP dose and survival or post-treatment serum Na, K or Na : K, with the exception of one statistically significant result that suggested lower efficacy for higher doses.
Initial DOCP doses less than 2.2 mg/kg may be effective in controlling serum electrolyte concentrations in dogs with primary hypoadrenocorticism without adversely affecting survival. If confirmed by additional research, these findings would enable practitioners to reduce the cost of DOCP treatment by using lower initial doses, potentially saving the lives of dogs that would otherwise be euthanased because of treatment expense.
评估初剂量的特戊酸去氧皮质酮(DOCP)在治疗患有原发性肾上腺皮质功能减退症的犬类时的疗效,该剂量低于目前推荐的2.2mg/kg初剂量且成本更低。
对49只患有原发性肾上腺皮质功能减退症的犬进行回顾性研究,其中36只犬的初始DOCP剂量低于2.2mg/kg。查阅病历以获取临床数据。通过给犬主或兽医打电话进行随访,以确定犬的死亡日期或最后一次随访日期。分析数据以研究初始DOCP剂量与生存率以及血清钠、钾及其比值之间的关系。
无论初始DOCP剂量如何,这些犬均未出现无法控制的肾上腺皮质功能减退症、严重电解质异常或需要增加DOCP剂量的临床问题。随着时间推移,由于治疗期间体重增加,大多数犬每千克体重的DOCP剂量有所降低。除了一个表明较高剂量疗效较低的具有统计学意义的结果外,未发现初始DOCP剂量与生存率或治疗后血清钠、钾或钠钾比值之间存在统计学显著关系。
低于2.2mg/kg的初始DOCP剂量可能有效控制患有原发性肾上腺皮质功能减退症犬的血清电解质浓度,且不会对生存率产生不利影响。如果进一步研究证实这些发现,将使从业者能够通过使用较低的初始剂量降低DOCP治疗成本,可能挽救那些因治疗费用而可能被安乐死的犬的生命。