Emming Christin, Geks Anna Karoline, Sajadihezaveh Sajedeh, Rieker Thomas, Brutsche Johannes, Volk Holger Andreas, Rieder Johanna
Department for Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
AniCura Small Animal Specialists Augsburg GmbH, Augsburg, Germany.
Front Vet Sci. 2025 Apr 14;12:1544750. doi: 10.3389/fvets.2025.1544750. eCollection 2025.
The aim of the study was to analyze glucocorticoid (GC) dosing protocols in dogs with hypoadrenocorticism (HA), and to identify predictors for optimal clinical outcomes during both the acute and chronic phases of the disease, as well as during long-term therapy.
This observational cross-sectional study utilized a case-based online questionnaire. Practicing veterinarians across Germany were invited to participate. The survey collected data in the disease course and follow-ups. Responses were analyzed using descriptive statistics, single and multiple comparisons, and a multivariable logistic regression model.
For 103 dogs the questionnaire was fully completed and analyzed. Of these, 85 dogs (82.5%) were hospitalized, and they received either prednisolone (52.9%), dexamethasone (31.8%) or hydrocortisone (11.8%). Hydrocortisone therapy was associated with a shorter hospitalization time and faster normalization of electrolytes compared to prednisolone. Follow-up data were available for 85 dogs, with 82.35% ( = 70/85) achieving an optimal or well-adjusted clinical outcome. Multivariable logistic regression analysis indicated that the eukalemic and eunatremic form was significantly less associated with the presence of azotemia and the occurrence of an acute adrenal crisis. Dividing the daily GC dosage was associated with poorer clinical outcomes and a reduced likelihood of achieving optimal medication adjustment.
Our findings provide new, relevant recommendations for the therapeutic management of HA in dogs. Hydrocortisone appears to be a promising treatment for managing HA during hospitalization, highlighting its potential use in clinical practice. Once-daily administration of prednisolone is advisable for long-term therapy. To achieve the best possible outcome, implementing an optimal treatment protocol is essential, which veterinarians should tailor based on the needs of both owners and animals. The main limitations of the study include its retrospective nature and the limited number of participants. Future studies, particularly prospective ones, could further validate the beneficial effects of hydrocortisone and evaluate long-term therapy in comparison to prednisolone.
本研究旨在分析患有肾上腺皮质功能减退症（HA）的犬只的糖皮质激素（GC）给药方案，并确定在疾病的急性期和慢性期以及长期治疗期间实现最佳临床结果的预测因素。
本观察性横断面研究采用基于病例的在线问卷。邀请了德国各地的执业兽医参与。该调查收集了疾病病程和随访的数据。使用描述性统计、单因素和多因素比较以及多变量逻辑回归模型对回复进行分析。
103只犬的问卷已完全填写并分析。其中，85只犬（82.5%）住院治疗，它们接受了泼尼松龙（52.9%）、地塞米松（31.8%）或氢化可的松（11.8%）治疗。与泼尼松龙相比，氢化可的松治疗与较短的住院时间和更快的电解质正常化相关。85只犬有随访数据，其中82.35%（=70/85）实现了最佳或良好调整的临床结果。多变量逻辑回归分析表明，正常血钾和正常血钠形式与氮质血症的存在和急性肾上腺危象的发生显著相关度较低。将每日GC剂量分开给药与较差的临床结果和实现最佳药物调整的可能性降低相关。
我们的研究结果为犬HA的治疗管理提供了新的相关建议。氢化可的松似乎是住院期间治疗HA的一种有前景的药物，突出了其在临床实践中的潜在用途。长期治疗建议每日一次给予泼尼松龙。为了获得最佳结果，实施最佳治疗方案至关重要，兽医应根据主人和动物的需求进行调整。本研究的主要局限性包括其回顾性性质和参与者数量有限。未来的研究，特别是前瞻性研究，可以进一步验证氢化可的松的有益效果，并与泼尼松龙比较评估长期治疗。
