Academic literature on the topic 'Desoxycorticosterone pivalate'

In this article, the use of desoxycorticosterone pivalate is retrospectively reviewed in eight dogs with primary hypoadrenocorticism, presented at the Small Animal Department of Ghent University. The results showed that desoxycorticosterone pivalate provided adequate mineralocorticoid replacement in all cases, also in the dogs that had previously been treated with fludrocortisone acetate. A starting dosage of 1.5 – 2.2 mg/kg SC was used, with a fixed dosing interval of 28 days in most of the cases. Each time, prednisolone was added to the therapy as glucocorticoid supplementation. No side effects related to desoxycorticosterone pivalate therapy were noted and all owners were satisfied with the treatment consisting of desoxycorticosterone pivalate and prednisolone.

Twelve dogs with hypoadrenocorticism were treated with subcutaneous desoxycorticosterone pivalate (DOCP). Eight of these dogs were recently diagnosed and had not yet been treated. Four dogs previously had been diagnosed and treated (three with intramuscular DOCP, one with oral fludrocortisone acetate). History, physical examination, serum electrolytes, and blood urea nitrogen (BUN) were evaluated. Desoxycorticosterone pivalate (2.2 mg/kg body weight) was administered every 25 days. On day 0, recently diagnosed dogs had a median serum sodium concentration of 131.5 mEq/L, median serum potassium concentration of 6.6 mEq/L, and median BUN of 41.5 mg/dl. All subsequent median serum electrolyte and BUN concentrations were normal. All previously treated dogs had normal blood values which were maintained throughout the study.

Two cats were presented with lethargy and anorexia. Clinically, the cats showed hypothermia and dehydration. Blood examination in both cats showed hyponatraemia, hyperkalaemia and additionally azotaemia in case 1 and hypercalcaemia in case 2. In both cats, an adrenocorticotropic hormone (ACTH) stimulation test showed an insufficient stimulation of the adrenal glands. In case 1, markedly elevated endogenous ACTH was additionally measured. Both cats were successfully treated with a combination of desoxycorticosterone pivalate (DOCP) and prednisolone (0.15 mg/kg daily). Case 1 received a final concentration of 2.6 mg/kg DOCP every 30 days, while case 2 was successfully managed with 2.2 mg/kg every 28 days. These rare cases of feline hypoadrenocorticism demonstrate that DOCP can be used similarly as in dogs.

Two standard poodles were evaluated for painful, episodic muscle cramps affecting their thoracic and pelvic limbs. Both dogs had been diagnosed with hypoadrenocorticism and were being treated with fludrocortisone acetate and prednisone when evaluated for muscle cramps. However, the muscle cramping started approximately 1 month prior to the diagnosis of hypoadrenocorticism. Findings on general physical examination included lethargy and dehydration. Neurological examination was normal between episodes. Serum biochemical abnormalities included hyperalbuminemia, azotemia, hyponatremia, hypochloremia, and hyperkalemia. Altering treatment to desoxycorticosterone pivalate resolved the electrolyte abnormalities and the episodes of muscle cramping in both dogs. The authors conclude that hypoadrenocorticism can be associated with episodes of painful muscle cramping in standard poodles.

Dissertação de Mestrado Integrado em Medicina Veterinária
A frequência de utilização do pivalato de desoxicorticosterona (DOCP), a dose inicialmente prescrita e as frequências de administração são variáveis entre a comunidade médico veterinária da Europa Ocidental (MVEO). Este estudo teve como objetivos averiguar a suplementação mineralocorticóide preferencial para maneio crónico do hipoadrenocorticismo (HA) e caraterizar a utilização de DOCP pela comunidade MVEO em cães diagnosticados com esta doença. Um questionário online em português, foi construído, validado e traduzido em 3 idiomas (Espanhol, Francês e Italiano), utilizando a plataforma eletrónica Google Forms. O questionário foi divulgado através de grupos exclusivos a Médicos Veterinários na rede social Facebook e via correio-eletrónico, incluindo questões sobre o regime inicial de tratamento, a dose inicial de DOCP, a monitorização clínica e eletrolítica em cães com doença de Addison. Obteve-se um total de 315 respostas em seis países (Portugal, Espanha, Itália, França, Bélgica e Luxemburgo). Dos que diagnosticaram HA recentemente, cerca de 84% utilizaram, pelos menos uma vez, DOCP e 80% preferem este fármaco ao acetato de fludrocortisona como primeira escolha para suplementação mineralocorticóide. Dos 154 que utilizaram DOCP, 63% indicaram que utilizam a dose inicial recomendada de 2,2mg/kg enquanto que, apenas 15% utilizam doses mais baixas. Após iniciarem tratamento com DOCP, cerca de 91% dos participantes monitorizam os eletrólitos duas vezes por mês e apenas 9% o fazem mensalmente até estabilização. Apenas 65% dos inquiridos se pronunciaram acerca do ajuste terapêutico. Destes, 53% privilegiam alterar a dose administrada enquanto 47% preferem aumentar o intervalo de administração. Após a primeira administração, 10% dos participantes apenas administram uma nova dose de DOCP quando o animal começa a descompensar. Em cães com valores eletrolíticos estáveis, 34% dos participantes fazem avaliações clínicas mensalmente, 44% trimestralmente, 17% duas vezes por ano e 5% anualmente. Este estudo confirma que, o DOCP é o fármaco de eleição para suplementação mineralocorticóide e que a maioria dos inquiridos segue as recomendações para a dose inicial e monitorização a curto prazo. Os ajustes terapêuticos de dose e frequência variam entre a amostra, evidenciando a necessidade de diretrizes específicas. Uma percentagem significativa dos inquiridos só administra DOCP novamente após descompensação clínica, o que pode aumentar o risco de crise addisoniana.
ABSTRACT- The use of desoxycorticosterone pivalate by veterinary surgeons: A Western European perspective - The frequency of use of desoxycorticosterone pivalate (DOCP), initial doses and treatment intervals are variable among Western European Veterinary Surgeons (WEVS). This study aimed to verify which is the preferable mineralocorticoid supplementation for chronic management of hypoadrenocorticism (HA) and characterize the use of DOCP by WEVS in dogs diagnosed with this disease. An online Portuguese survey translated into three different languages (Spanish, French and Italian) was developed and validated using the electronic platform Google Forms. The survey was shared through social network veterinary groups in Facebook and mailing lists including questions focused on initial treatment regimen, DOCP starting dosage, clinical and electrolytic monitoring schedule in dogs diagnosed with Addison’s disease. Overall, a total of 315 responses were obtained in six countries (Portugal, Spain, Italy, France, Belgium and Luxembourg). Of those who had recently diagnosed HA, about 84% used DOCP at least once and 80% indicated they preferred its use over fludrocortisone acetate as first-line choice for mineralocorticoid supplementation. Among 154 respondents who had used DOCP, 63% indicated using 2.2mg/kg as initial dosage while only 15% stated using lower dosages. Following initiation of DOCP treatment, about 91% of respondents indicated monitoring electrolytes twice a month and only 9% do it once a month until stabilization. Only 65% of the respondents indicated their therapeutic adjustment. Of these, 53% prefer changing the dosage while 47% stated increasing the administration interval. Following the initial administration, 10% of respondents indicated administering subsequent DOCP injections only in case of clinical relapse. In dogs with stable electrolytes concentrations, 34% of respondents reported reassessing dogs monthly, 44% quarterly, 17% twice yearly and 5% yearly. This study states DOCP is the preferred treatment for mineralocorticoid supplementation and the majority of WEVS follow the manufacturer’s recommendations for initial dosage and short term monitoring schedule. Subsequent preferred therapeutic adjustments regarding change in dosage or dosing intervals vary among sample, reflecting how relevant specific guidelines are. Of particular concern, a significant proportion of WEVS only administer DOCP in case of clinical relapse following the initial administration, which likely increases the risk of addisonian crisis.
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