犬垂体依赖性皮质醇增多症(PDH)与三罗司坦的管理通常需要终身治疗。需要的剂量越大,副作用的风险越大。先前已经描述了司来吉兰疗法,但不常用于PDH治疗。本研究旨在评估司来吉兰和三氯甾烷联合治疗犬PDH的疗效。招募了15只被诊断为自发性PDH的客户拥有的狗。患者接受曲洛司坦治疗(Tri组,n=8,初始剂量为0.5mg/kg,PO,q12h),或与三罗甾烷和司来吉兰(三+塞尔组,n=7,初始剂量为0.5mg/kg的三氯甾烷,PO,q12h和司来吉兰1mg/kg,PO,q24h)。狗接受了临床检查,血清生化分析,尿液分析,腹部超声,以及治疗第0天(D0)的eACTH和ACTH后皮质醇测量,30(D30),90(D90),180(D180)。由于联合治疗,缺乏不良反应。两组在研究结束时表现出相似的临床反应和较低的ACTH后皮质醇水平。在D180时,两组之间的三罗甾烷剂量没有显着差异。与Tri组患者相比,TriSel组的右或左肾上腺厚度没有增加。然而,在D0和D180时,两组之间的eACTH没有统计学差异。在研究结束时,Tri+Sel组的患者实现了更好的血清甘油三酯控制。司来吉兰与三氯甾烷的联合可能是犬PDH的可行疗法;然而,它的最终优势需要更大的研究。
Canine pituitary-dependent hypercortisolism (PDH) management with trilostane usually demands lifelong therapy. The greater the dose needed, the greater the risk of side effects. Selegiline therapy has been previously described but not commonly used for PDH treatment. The present work aimed to assess the efficacy of selegiline and trilostane combined therapy for canine PDH treatment. Fifteen client-owned dogs diagnosed with spontaneous PDH were enrolled. The patients were treated with trilostane (Tri group, n = 8, initial dose of 0.5 mg/kg, PO, q12h), or with trilostane and selegiline (Tri + Sel group, n = 7, initial trilostane dose of 0.5 mg/kg, PO, q12h and selegiline 1 mg/kg, PO, q24h). Dogs underwent clinical examination, serum biochemical analysis, urinalysis, abdominal ultrasound, and eACTH and post-ACTH cortisol measurements on treatment days zero (D0), 30 (D30), 90 (D90), and 180 (D180). There was a lack of adverse effects due to the combined therapy. Both groups showed a similar clinical response and lower post-ACTH cortisol levels at the
study\'s end. There was no significant difference in trilostane dosage at D180 between groups. There was no documented increase in either right or left adrenal gland thickness in the Tri + Sel group in contrast with patients in the Tri group. However, there was no statistical difference between the groups regarding eACTH at D0 and D180. Patients in the Tri + Sel group achieved better serum triglycerides control at the end of the
study. The association of selegiline with trilostane might be a feasible therapy for canine PDH; however, its eventual advantages need larger studies.