Abstract：
Trilostane is the current treatment of choice for managing pituitary-dependent hypercortisolism (PDH) in dogs. While prescribing higher initial doses may elevate the risk of iatrogenic hypocortisolism, opting for more conservative approach could result in delayed disease control, since most individuals end up requiring dosage increases. The adrenocorticotrophin stimulation test (ACTHst), a widely recognized hormonal test for assessing adrenal function, is an essential tool for monitoring the pharmacological treatment of canine hypercortisolism (CH) that can also be used for diagnostic purposes. The aim of this study was to investigate the relationship between post-ACTH cortisol (cpACTH) at PDH diagnosis and the required trilostane dose for sign control and endogenous cortisol regulation in dogs, considering a hypothesis that higher serum cpACTH concentration would necessitate a higher trilostane dosage for disease management. Data for 43 dogs with PDH had their diagnostic cpACTH recorded and correlated to the trilostane dosage necessary to control clinical signs and achieve satisfactory cortisol levels (ideally 2-7 μg/dL). The odds ratio (p=0.042) suggests that dogs with cpACTH ≥ 27 μg/dL at diagnosis are 96% more likely to need a higher trilostane dosage for achieving satisfactory control of PDH. Thus, cpACTH was found to be associated with the final trilostane dose for controlling PDH in dogs.
摘要：
Trilostane是目前用于管理犬垂体依赖性皮质醇增多症（PDH）的首选治疗方法。虽然开更高的初始剂量可能会增加医源性皮质醇减少的风险，选择更保守的方法可能会导致疾病控制延迟，因为大多数人最终需要增加剂量。促肾上腺皮质激素刺激试验（ACTHst），广泛认可的评估肾上腺功能的荷尔蒙测试，是监测犬皮质醇增多症（CH）的药理治疗的重要工具，也可用于诊断目的。这项研究的目的是调查PDH诊断时ACTH后皮质醇（cpACTH）与犬中体征控制和内源性皮质醇调节所需的三氯甾烷剂量之间的关系，考虑一种假设，即更高的血清cpACTH浓度将需要更高的三罗甾烷剂量来进行疾病管理。记录了43只患有PDH的狗的诊断cpACTH的数据，并将其与控制临床症状和达到令人满意的皮质醇水平（理想情况下为2-7μg/dL）所需的三氯甾烷剂量相关联。比值比（p=0.042）表明，在诊断时cpACTH≥27μg/dL的狗需要更高的三氯甾烷剂量以实现对PDH的满意控制的可能性要高96％。因此，发现cpACTH与控制狗PDH的最终三罗司坦剂量相关。
