EKREM ÇAĞATAY ÇOLAKOĞLU, ALİ EVREN HAYDARDEDEOĞLU, Hadi ALİHOSSEİNİ, ARİF KURTDEDE

Mitotane-induced hypoadrenocorticism in a dog with hyperadrenocorticism

5 yaşlı Terrier ırkı köpek, anöstrus, poliüri, polidipsi ve alopesi şikayetleriyle küçük hayvan hastanesine getirildi. Klinik ve paraklinik değerlendirmeler hipofiz kaynaklı hiperadrenokortisizmi doğruladı ve hastaya Mitotan (25 mg/kg BID 5 gün) reçete edildi. İki hafta sonra hasta; kusma, ataksi ve güçsüzlük şikayetleriyle getirildi. Hasta sahibi; herhangi bir dozaj azaltımı yapmaksızın, önerim dışı olarak Mitotan tedavisine 14 gün boyunca devam ettiğini belirtti. Rutin kan analizleri ve bazal kortizol ölçümlerinde şiddetli hipoglisemi ve hipokortisolemi belirlendi. Metilprednisolon asetat ve destekleyici sağaltıma başlandı. 3 hafta sonra hasta sahibinden köpeğin öldüğü bilgisi alındı. Bu olgu sunumu ile Mitotan tedavisinin olası komplikasyonunun hipoadrenokortisizm olabileceği vurgulanmıştır.

Hiperadrenokortisizmli bir köpekte Mitotan kullanımına bağlı gelişen hipoadrenokortisizm

A 5-year-old, Terrier breed dog having the complaints of anestrus, polyuria, polydipsia and alopecia referred to Small Animal Veterinary Teaching Hospital. Paraclinical and clinical assessments confirmed the diagnosis of pituitary-dependent hyperadrenocorticism and Mitotane (25 mg/kg BID 5 days) prescribed. The dog was presented to clinic with the signs of vomiting, ataxia and weakness after two weeks. The owner reported that Mitotane therapy continued for 14 days without decreasing the dosage contrary to what is describe. Routin blood work and basal cortisol concentration revealed severe hypoglycemia and hypocortisolemia. Methylprednisolone acetate and supportive therapy were initiated. The dog died after three weeks according to owners information. This case report emphasized that one of the possible complication of Mitotane therapy is hypoadrenocorticism.

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1. Kaufman J: Diseases of the adrenal cortex of dogs and cats. Mod Vet Pract, 65 (6): 429-434,1984.
2. Kooistra HS , Galac S : Recent advances in the diagnosis of C ushings syndrome in dogs. Vet Clin North Am: Small Anim Pract, 40 (2): 259-267, 2010.
3. Melian C: Hyperadrenocorticism in dogs. In, Ettinger SJ, Feldman EC (Eds): Textbook of V eterinary I nternal Medicine. 7 th ed., 1816-1840, Saunders, Philadelphia, 2010.
4. Peterson ME: Diagnosis of hyperadrenocorticism in dogs. Clin Tech Small Anim Pract, 22 (1 ): 2-11, 2007.
5. Brown CG, Graves TK: Hyperadrenocorticism:treating dogs. Compendium, 132-145, 2007.
6. Sande A, Lanen KV: Canine hypoadrenocorticism: Pathogenesis, diagnosis, and treatment. Topics Comp Anim Med, 29 (2): 1-7, 2014.
7. Baumstark ME, Sieber-Ruckstuhl NS, Müller C, Wenger M, Boretti FS, Reusch CE: Evaluation of aldosterone concentrations in dogs with hypoadrenocorticism. J Vet Intern Med, 28, 154-159, 2014.
8. Kaneko JJ, Harvey JW, Bruss ML: Clinical Biochemistry of Domestic Animals. 8th ed., 889-895, Academic Press, 2008.
9. Feldman EC, Nelson RW: Canine and F eline E ndocrinology and R eproduction. 3 rd ed., 252-353, St. Louis, WB Saunders, 2004.
10. Kintzer PP, Peterson ME: Mitotane (o, p-DDD) treatment of 200 dogs with pituitary-dependent hyperadrenocorticism. J Vet Intern Med. , 5 (3): 182-190, 1991.