Isolated hypoaldosteronism managed by DOCP in a dog with chronic kidney disease and hypercortisolism,Veterinary Medicine and Science

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Isolated hypoaldosteronism managed by DOCP in a dog with chronic kidney disease and hypercortisolism
Veterinary Medicine and Science ( IF 1.8 ) Pub Date : 2022-09-15 , DOI: 10.1002/vms3.954
Su-Min Park ₁ , Ju-Hyun An ₂ , Na-Hyeong Kim ₁ , Ye-In Oh ₃ , Kyoung-Won Seo ₁ , Hwa-Young Youn ₁

Affiliation

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.

中文翻译：

DOCP 治疗慢性肾病和皮质醇增多症犬的孤立性醛固酮增多症

一只 13 岁绝育雌性雪纳瑞犬，患有慢性肾病（CKD；国际肾脏病协会 2 期，无蛋白尿，血压正常）、糖尿病、皮质醇增多症和粘液瘤性二尖瓣变性（美国兽医内科学院 B2 期）出现电解质失衡，并发展为高钾血症和低钠血症，钠钾 (Na:K) 比为 19.6。促肾上腺皮质激素刺激试验后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增多症。给予新戊酸脱氧皮质酮 (DOCP) 后，电解质失衡得到改善，Na:K 比值为 27.7。这是在犬中使用曲洛司坦和 DOCP 治疗孤立性醛固酮增多症和皮质醇增多症的第一份报告。该病例强调了在患有 CKD 的犬类患者中长期使用曲洛司坦治疗后识别孤立性醛固酮增多症的重要性。

更新日期：2022-09-15

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