Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea.
Department of Veterinary Emergency and Critical Care Medicine and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University, Chuncheon-si, Republic of Korea.
Vet Med Sci. 2022 Nov;8(6):2292-2296. doi: 10.1002/vms3.954. Epub 2022 Sep 15.
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.
一只 13 岁已绝育的雌性雪纳瑞犬，患有慢性肾病（CKD；国际肾脏学会 2 期，非蛋白尿，血压正常）、糖尿病、皮质醇增多症和黏液样二尖瓣变性（美国兽医内科学会 B2 期），出现电解质失衡，进展为高钾血症和低钠血症，钠钾比值为 19.6。促肾上腺皮质激素刺激试验后的皮质醇水平在治疗范围内，但醛固酮水平低于参考范围；因此，诊断为孤立性醛固酮减少症。给予地塞米松戊酸酯（DOCP）后，电解质失衡得到改善，钠钾比值为 27.7。这是首例使用曲洛司坦和 DOCP 治疗 CKD 犬孤立性醛固酮减少症和皮质醇增多症的病例报告。该病例强调了在 CKD 犬长期使用曲洛司坦治疗后，识别孤立性醛固酮减少症的重要性。
