Long-term survival of dogs with adrenal-dependent hyperadrenocorticism: a comparison between mitotane and twice daily trilostane treatment.
BACKGROUND
Treatment of adrenal-dependent hyperadrenocorticism (ADH) involves either surgical resection of the adrenal tumor or medical therapy. For many years, mitotane has been considered the medical treatment of choice for dogs with ADH.


OBJECTIVE
The aim of this study was to determine survival and prognostic factors for dogs with ADH treated with mitotane and trilostane.


METHODS
Twenty-six dogs with ADH were included in the study.


METHODS
Fourteen dogs were treated with mitotane and 12 dogs were treated with trilostane. Medical records were reviewed. Epidemiologic factors, signalment, clinicopathologic abnormalities, endocrine test results, and treatment protocols were evaluated to identify potential predictive factors of overall survival time.


RESULTS
Survival times of dogs treated with mitotane (median, 15.6 months) or trilostane (median, 14.0 months) were not significantly different. Using univariate analysis, age and postadrenocorticotropic hormone cortisol concentrations were inversely correlated with survival time. The multivariate model also identified weakness at presentation as a negative prognostic indicator.


CONCLUSIONS
The type of medical treatment (mitotane versus trilostane) does not influence survival time in dogs with ADH; therefore, trilostane, a drug with less frequent and milder adverse effects, might be used as the primary medical treatment when adrenalectomy cannot be performed.
Department of Small Animal Medicine, School of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain.
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Arenas
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Melián
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MD
Pérez-Alenza
D000308:Adrenocortical Hyperfunction / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000662:veterinary*; D000818:Animals; D013196:Dihydrotestosterone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004283:Dog Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D004285:Dogs; D005260:Female; D053208:Kaplan-Meier Estimate; D008297:Male; D008939:Mitotane / Q000008:administration & dosage / Q000627:therapeutic use*; D011379:Prognosis; D016019:Survival Analysis
D013196:Dihydrotestosterone; D008939:Mitotane; C009954:trilostane
Cushing; Endocrine; Internal medicine