title: Adrenal necrosis in a dog receiving trilostane for the treatment of hyperadrenocorticism.
abstract: Clinical and biochemical changes suggestive of hypoadrenocorticism were observed in a 10-year-old male neutered Staffordshire bull terrier shortly after beginning therapy with trilostane for the treatment of hyperadrenocorticism. The dog's condition was stabilised with intravenous fluids, fludrocortisone and prednisolone. An exploratory laparotomy and excisional biopsy of the left adrenal gland were performed. Histopathological analysis showed adrenal cortical necrosis with reactive inflammation and fibrosis. Trilostane is a reversible inhibitor of steroid synthesis and this complication has not been reported previously. Clinicians should be aware that trilostane therapy may result in adrenal necrosis but that prompt treatment might correct a life-threatening situation.
authors.affiliation: Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Chapman
authors.forename: D F
authors.initials: DF
authors.lastname: Kelly
authors.forename: J
authors.initials: J
authors.lastname: Archer
authors.forename: D J
authors.initials: DJ
authors.lastname: Brockman
authors.forename: R
authors.initials: R
authors.lastname: Neiger
mesh_terms: D015096:3-Hydroxysteroid Dehydrogenases / Q000037:antagonists & inhibitors*; D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000662:veterinary*; D000308:Adrenocortical Hyperfunction / Q000188:drug therapy / Q000662:veterinary*; D000818:Animals; D003937:Diagnosis, Differential; D013196:Dihydrotestosterone / Q000009:adverse effects* / Q000031:analogs & derivatives*; D004283:Dog Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004285:Dogs; D004791:Enzyme Inhibitors / Q000009:adverse effects*; D008297:Male; D009336:Necrosis; D010086:Oxidative Phosphorylation Coupling Factors / Q000009:adverse effects*
chemical_list: D004791:Enzyme Inhibitors; D010086:Oxidative Phosphorylation Coupling Factors; D013196:Dihydrotestosterone; D015096:3-Hydroxysteroid Dehydrogenases; C009954:trilostane