title: Predictive factors and the effect of phenoxybenzamine on outcome in dogs undergoing adrenalectomy for pheochromocytoma.
abstract: BACKGROUND
  Some studies in dogs undergoing adrenalectomy for pheochromocytoma suggest that anesthetic complications and perioperative mortality are common. In humans, surgical outcome has improved with the use of phenoxybenzamine (PBZ) before adrenalectomy.
  
  
  OBJECTIVE
  Dogs treated with PBZ before adrenalectomy have increased survival compared with untreated dogs.
  
  
  METHODS
  Forty-eight dogs that underwent adrenalectomy for pheochromocytoma.
  
  
  METHODS
  A retrospective medical record review for dogs that underwent adrenalectomy for pheochromocytoma at a veterinary medical teaching hospital over the period from January 1986 through December 2005.
  
  
  RESULTS
  Twenty-three of 48 dogs were pretreated with PBZ (median dosage: 0.6 mg/kg PO q12h) for a median duration of 20 days before adrenalectomy. Duration of anesthesia and surgery, percentage of dogs with pheochromocytoma involving the right versus left adrenal gland, size of tumor, and presence of vascular invasion were similar for PBZ-treated and untreated dogs. Thirty-three (69%) of 48 dogs survived adrenalectomy in the perioperative period. PBZ-treated dogs had a significantly (P = .014) decreased mortality rate compared with untreated dogs (13 versus 48%, respectively). Additional significant prognostic factors for improved survival included younger age (P = .028), lack of intraoperative arrhythmias (P = .0075), and decreased surgical time (P = .0089).
  
  
  CONCLUSIONS
  Results from this retrospective study support treatment with PBZ before surgical removal of pheochromocytoma in dogs.
authors.affiliation: Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA. mherrera@vmth.ucdavis.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Herrera
authors.forename: M L
authors.initials: ML
authors.lastname: Mehl
authors.forename: P H
authors.initials: PH
authors.lastname: Kass
authors.forename: P J
authors.initials: PJ
authors.lastname: Pascoe
authors.forename: E C
authors.initials: EC
authors.lastname: Feldman
authors.forename: R W
authors.initials: RW
authors.lastname: Nelson
mesh_terms: D000315:Adrenalectomy / Q000009:adverse effects / Q000662:veterinary*; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000818:Animals; D004283:Dog Diseases / Q000188:drug therapy / Q000601:surgery*; D004285:Dogs; D005260:Female; D008297:Male; D010643:Phenoxybenzamine / Q000627:therapeutic use*; D010673:Pheochromocytoma / Q000601:surgery / Q000662:veterinary*; D011183:Postoperative Complications / Q000517:prevention & control / Q000662:veterinary; D012189:Retrospective Studies
chemical_list: D000317:Adrenergic alpha-Antagonists; D010643:Phenoxybenzamine