Management of functional adrenalectomy in dogs (I)
Everything you need to know prior to surgical intervention of a functional adrenalectomy (hypercortisolemia) in a dog
Hello! 😊
In this series of publications (two in total) we will review the key aspects surrounding functional adrenalectomy in dogs.
Following diagnosis
Our main objective in a dog with hypercortisolemia will be to normalise the cortisol concentration.
We will administer trilostane but…
Be careful! since these tumors are generally very sensitive to treatment and we can easily induce hypocortisolemia
Initial dose of trilostane (0.2 - 1 mg/kg q 12h)
WHAT are we pursuing with medical treatment prior to adrenalectomy associated with hypercortisolemia?
Resolve:
Clinical signs
Laboratory alterations
Reduce surgical complications
HOW LONG is it necessary to administer medical treatment prior to surgery in dogs with hypercortisolemia?
In general terms, a treatment of 1 to 2 months is necessary
After 10 - 14 days we will perform ACTH stimulation, what THERAPEUTIC RANGE are we pursuing?
Obtain a post-ACTH [cortisol] 1.5 - 5 ug/dL (4-6 hours post-stimulation)
What RISKS does prior treatment with trilostane MINIMIZE in dogs with hypercortisolemia?
Delayed wound healing.
Immunosuppression.
Arterial hypertension.
Hypercoagulability.
In the second part (for Premium subscribers) we will cover everything you need to know during the peri- and post-adrenalectomy period 🤓
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Thank you for being part of VETPILL 😊
- Carlos Martinez