■多巴胺能激动剂被认为是最有效的治疗垂体中间部功能障碍的方法。然而,有些马对日常口服培高利特很难,推荐的注册治疗。卡麦角林缓释(ERC)注射可能提供替代方案。此回顾性病例系列的目的是描述对ERC的临床和内分泌反应。
■每周肌内注射ERC(5mg/mL,BOVAAus)0.01mg/kg(高剂量,HD)(n=10)或0.005mg/kg(低剂量,LD)(n=30)进行了综述。在5-8天使用Wilcoxon符号分级测试评估短期ACTH反应。使用广义估计方程评估长期ACTH反应(30至365天)。
■第一剂LDERC后5至8天,促肾上腺皮质激素(ACTH)浓度中位数较低(p=0.001),从153pg/mL(IQR:78,331)变为57pg/mL(IQR:30,102)。有了HDERC,ACTH中位浓度在治疗前也为153pg/mL(IQR:96,185),治疗后5~8天也为56pg/mL(IQR:29,86)(p=0.047).超过12个月的治疗,用LDERC治疗的马的ACTH浓度范围为14至>1,250pg/mL(中位数:51pg/mL),用HDERC治疗的马的ACTH浓度范围为20至472pg/mL(中位数:50pg/mL)。在接受LDERC和HDERC治疗的39.3%和52.3%的马匹中,测量值仍高于季节性参考范围,分别。78.3和100%接受LDERC和HDERC治疗的马匹的所有者报告了临床改善,分别。部分,在30.0%的LDERC和60%的HDERC病例中报告了自限性食欲不振。七匹马表现出嗜睡(5LDERC,2HDERC)。在ERC治疗后30天测量的胰岛素浓度与基线没有差异。
■临床和内分泌反应与以前口服培高利特治疗的报告结果一致。每周注射ERC可能是培高利特的有效替代品;0.005mg/kg剂量似乎同样有效,食欲不振的风险较小,比以前报道的0.01mg/kg剂量。
UNASSIGNED: Dopaminergic agonists are accepted as the most effective treatment for pituitary pars intermedia dysfunction. However, some horses are refractory to daily oral pergolide, the recommended registered treatment. Extended-release cabergoline (ERC) injection may offer an alternative. The objective of this retrospective case series was to describe clinical and endocrinological responses to ERC.
UNASSIGNED: Medical records of horses treated with weekly intramuscular injections of ERC (5 mg/mL, BOVA Aus) at either 0.01 mg/kg (high dose, HD) (n = 10) or 0.005 mg/kg (low dose, LD) (n = 30) were reviewed. Short-term
ACTH responses were assessed at 5-8 days using a Wilcoxon signed ranked test. Longer-term
ACTH responses (30 to 365 days) were assessed using generalised estimating equations.
UNASSIGNED: Five to eight days after the first dose of LDERC, median adrenocorticotropic hormone (
ACTH) concentration was lower (p = 0.001), changing from 153 pg/mL (IQR: 78, 331) to 57 pg/mL (IQR: 30, 102). With HDERC, median
ACTH concentration was also 153 pg/mL (IQR: 96, 185) before and then 56 pg/mL (IQR: 29, 86) after 5-8 days of treatment (p = 0.047). Over 12 months of treatment,
ACTH concentration ranged from 14 to >1,250 pg/mL (median: 51 pg/mL) in horses treated with LDERC and 20 to 472 pg/mL (median: 50 pg/mL) in horses treated with HDERC. Measurements remained above the seasonal reference range in 39.3 and 52.3% of horses treated with LDERC and HDERC, respectively. Clinical improvement was reported by owners in 78.3 and 100% of horses treated with LDERC and HDERC, respectively. Partial, self-limiting inappetence was reported in 30.0% of LDERC and 60% HDERC cases. Seven horses exhibited lethargy (5 LDERC, 2 HDERC). Insulin concentrations measured 30 days post-ERC treatment were no different from baseline.
UNASSIGNED: Clinical and endocrinological responses were consistent with results of previous reports of oral pergolide treatment. Weekly injection of ERC may be an effective alternative to pergolide; the 0.005 mg/kg dose appeared to be as effective, with less risk of inappetence, than the 0.01 mg/kg dose that has been reported previously.