Chpt 10 Hormones and adrenal glands

What does Iatrogenic mean?

Caused by treatment (medication, surgery) 

What does atrophy mean?

without growth, wasting away, decreasing in size

What are thw two areas the adrenal glands are composed of?

Adrenal cortex, Arenal medulla

What hormones does the adrenal cortex (outer portion produce)?

Steroid hormones (glucocoticoids, Mineralocorticoids, sex hormones)

Whats the outer portion of the Adrenal gland?

Adrenal cortex

What drug is capable of destroying the adrenal cortex?

mitotane

Where is the adrenal cortex?

Outter portion of the adrenal gland

What hormones does the adrenal cortex produce?

Glucocorticoids, Mineralocortocoids, sex hormones

What is the general category of hormones produced by adrenal cortex?

Steroid hormones

What are adrenal glands controlled by?

Pituitary gland

What does the anterior pituitary gland produce to stimulate adrenal cortex to release its hormones?

ACTH

What is Hyperadrenocorticism?

Excess adrenal cortex hormones in the body

Who is Hyperadrenocorticism most common in?

Dogs, horses

What are causes of Hyperadrenocorticism?

Latrogenic, Adrenal gland tumors, pituitary gland tumors

What are the three P clinical signs in dogs with Hyperadrenocorticism?

PU/PD/PP, Pendulous abdomen, panting

What does this dog have?

Hyperadrenocorticism

What are clinical signs of Hyperadrenocorticism in horses?

Failure to shed, excessive sweating, loss of muscle mass, PU/PD

What are two drugs used to treat Hyperadrenocorticism?

Mitotane, Trilostane

How does Mitotane (Lysodren) work when treating Hyperadrenocorticism?

Destroys adrenal coretx to reduce production of excess hromone

Whats a caution when sending home Mitotane?

Wear glooves, can abosrb in skin

How does Trilostane (Vetoryl) work to treat Hyperadrenocorticism?

Works at adrenal gland to prevent production of steroid hormones

What is an FDA approved drug for dogs with Hyperadrenocorticism?

Tirlostane (Veroryl)

Rechecks are required frequently for patients being treated for Hyperadrenocorticism with Mitotane or Trilostane?

True

What is needed to monitor response to drug and to see how adrenal gland is functioning when treating for Hyperadrenocorticism?

Bloodwork

What is the unconventional way to treat Hyperadrenocorticism?

Ketoconazole - antifungal

Why might Ketoconazole be used over Mitotane with a dog with Hyperadrenocorticism?

Cheaper

What is the FDA approved treatment of choice for Hyperadrenocorticism in horses?

Pergolide (Prascend)

How does Pergolide work in horses to treat Hyperadrenocorticism?

Stimulates dopamine receptors which results in decrease ACTH secretion from pituitary

What does iatrogenic Cushing’s disease mean? (how was it caused?)

When its caused by us giving steroid medication to an animal at high doses for a longer amount of time

Regarding mitotane used as a treatment for Cushing’s disease - How does mitotane work to control disease?

Destroys the adrenal cortex

Regarding trilostane as a treatment for Cushing’s disease, how does it work to control the disease?

works on adrenal gland; Prevents production of steroid hormones

What is Hypoadrenocorticism – Addison’s Disease?

Adrenocortical insufficiency

What causes Hypoadrenocorticism – Addison’s Disease (Adrenocortical insufficency)?

Adrenal gland atrophy- not enough glucorticicoids and mineralcorticoids produced

What are clinical signs for Hypoadrenocorticism – Addison’s Disease?

Lethargy, vomiting/diarrhea, PU/PD, collapse, ELECTROLYTE IMBALANCE

What is Iatrogenic Hypoadrenocorticism?

Stopping a steroid medication to quickly, they need to be tapered off safely

What is the treatment for Hypoadrenocorticism – Addison’s Disease?

Supplement mineralocorticoids with DOCP and glucocorticoids with prednisone, prenidsolone

Whats an example of a Mineralcorticoid drug that would be used to treat Hypoadrenocorticism – Addison’s Disease?

Desoxycorticosterone (DOCP)

Whats an example of a glucocorticoid drug that would be used to treat Hypoadrenocorticism – Addison’s Disease?

Prednisolone

What is a human drug that contains both glucocorticoid and Mineralcorticoid to treat Hypoadrenocorticism – Addison’s Disease?

Fludrocortisone

Jake is a 3 yr old M/N Labrador retriever that presented for lethargy, vomiting and weakness since this weekend. Jake has had 2 episodes like this over the last 1 month, 1 requiring hospitalization at the E clinic with fluids. PE shows normal TPR. CBC shows mild normocytic, normochromic anemia, Chemistry panel shows hyperkalemia, Na:K ratio of 18:1, and low baseline cortisol.

Diagnosis?

Hypoadrenocorticism – Addison’s Disease

Jake is a 3 yr old M/N Labrador retriever that presented for lethargy, vomiting and weakness since this weekend. Jake has had 2 episodes like this over the last 1 month, 1 requiring hospitalization at the E clinic with fluids. PE shows normal TPR. CBC shows mild normocytic, normochromic anemia, Chemistry panel shows hyperkalemia, Na:K ratio of 18:1, and low baseline cortisol.

Treatment?

DOCP and Prednisolone or Fludrocortisone