Emergency & Critical Care Specialist Service, VetsNow 24/7 Pet Emergency & Specialty Hospital, Glasgow, UK.
The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Midlothian, UK.
J Vet Intern Med. 2024 Mar-Apr;38(2):951-959. doi: 10.1111/jvim.17017. Epub 2024 Feb 14.
Evidence indicating the optimal treatment protocol for dogs in adrenal crisis is lacking.
Compare outcomes of dogs presented in adrenal crisis treated with either hydrocortisone (HC) continuous rate infusion (CRI) or intermittent dexamethasone (DEX) administration.
Thirty-nine client-owned dogs.
Multi-institutional retrospective observational study (July 2016-May 2022) including dogs diagnosed with adrenal crisis and with available sequential blood work during hospitalization. Dogs were excluded if already on treatment with exogenous corticosteroids. Outcomes assessed included duration of hospitalization, survival, number of repeat measurements of electrolyte concentrations, and time to normalization of electrolyte and acid-base status.
No significant difference was found between the groups for hospitalization time (P = .41; HC median [range] 48 h [19-105 h]; DEX 57 h [17-167 h]) nor case fatality rate 2/28 in the DEX group and 0/11 in the HC group (P = 1), nor in number of measurements of electrolyte concentrations (P = .90; HC 4 [2-10]; DEX 4.5 [2-15]). No significant differences were found between the 2 treatment groups in time to normalization of serum Na (P = .30; HC 33 h [7-66 h]; DEX 16 h [1.5-48 h]), K (P = .92; HC 17 h [4-48 h]; DEX 16 h [1.25-60 h]) or Na/K ratio (P = .08; HC 17 h [8-48 h]; DEX 26 h [1.5-60 h]).
This study detected no difference in outcomes for dogs in adrenal crisis treated with either DEX boluses or HC CRIs.
缺乏关于犬肾上腺危象最佳治疗方案的证据。
比较使用氢化可的松（HC）持续速率输注（CRI）或间断地塞米松（DEX）治疗的肾上腺危象犬的治疗结果。
39 只患犬。
多机构回顾性观察研究（2016 年 7 月至 2022 年 5 月），纳入诊断为肾上腺危象且住院期间有连续血液检查结果的犬。已接受外源性皮质类固醇治疗的犬被排除在外。评估的结果包括住院时间、存活率、电解质浓度重复测量次数以及电解质和酸碱状态正常化的时间。
两组在住院时间（P = .41；HC 中位数[范围]48 h[19-105 h]；DEX 57 h[17-167 h]）、病死率（DEX 组 2/28，HC 组 0/11，P = 1）或电解质浓度测量次数（P = .90；HC 4[2-10]；DEX 4.5[2-15]）方面均无显著差异。两组在血清钠正常化时间（P = .30；HC 33 h[7-66 h]；DEX 16 h[1.5-48 h]）、钾（P = .92；HC 17 h[4-48 h]；DEX 16 h[1.25-60 h]）或钠/钾比值（P = .08；HC 17 h[8-48 h]；DEX 26 h[1.5-60 h]）方面也无显著差异。
本研究未发现用 DEX 推注或 HC CRI 治疗的肾上腺危象犬的治疗结果有差异。
