[Treatment strategies for canine hypoadrenocorticism - a current overview]

Hypoadrenocorticism (HA) in dogs requires lifelong substitution therapy with glucocorticoids and, in most cases, also mineralocorticoids. For glucocorticoid replacement, prednisolone is administered at a maintenance dose of approximately 0.1 mg/kg/day. Alternative drugs such as hydrocortisone, dexamethasone, or methylprednisolone are used less frequently.

In veterinary medicine, desoxycorticosterone pivalate (DOCP) is the only parenteral preparation approved for the replacement of mineralocorticoid hormones in Europe.

The approved dosage is 2.2 mg/kg every 25-30 days (subcutaneously). One study demonstrated that a lower starting dose of 1.5 mg/kg may already achieve stable regulation.

Fludrocortisone acetate (FC) is a human drug possessing both mineralocorticoid and a certain degree of glucocorticoid activity. It was commonly used prior to the approval of DOCP and must be prescribed off-label for dogs. The usual dosage is 0.01-0.02 mg/kg/day, administered twice daily.

Studies indicate that DOCP is superior to FC, being associated with fewer adverse effects, better electrolyte control, improved clinical condition, and higher owner satisfaction. Close clinical and laboratory monitoring is essential to avoid over- or underdosage and to adjust therapy. With adequate treatment, the prognosis for dogs with HA is generally very good.