Prophylactic Efficacy of Desmopressin Acetate for Diabetes Insipidus after Hypophysectomy in the Dog.

Abstract

ABSTRACT. The prophylactic efficacy of desmopressin acetate (DDAVP) on diabetes insipidus (DI) after hypophysectomy was investigated in the dog. In the control group, hypernatremia with a plasma level of 155 mEq/l or higher persisted for 12 hr from the 4th to the 16th hour after hypophysectomy, and symptoms of DI developed within five days after surgery. In the DDAVP treatment group, these changes were not observed, showing that administration of DDAVP (4 µg, instillation, twice daily) effectively prevented hypernatremia that develops immediately after surgery and DI-like symptoms that persists for about one week after surgery. KEY WORDS: canine, desmopressin acetate, hypophysectomy.J. Vet. Med. Sci. 65(1): 17-22, 2003 As modern imaging procedures such as magnetic resonance imaging and computed tomography have become widely used in the field of veterinary medicine, the precision of antemortem diagnosis of pituitary tumor has increased in recent years [3,7]. In veterinary neurosurgery, transsphenoidal hypophysectomy is recognized as useful for pituitary adenoma of the anterior and intermediate lobes accompanied by Cushing's syndrome in dogs and cats, and these surgical procedures and results of such surgery in clinical cases have been reported [6,7,9,12]. However, total resection of pituitary tissue, which plays a central role in endocrine function, induces endocrinological abnormalities after surgery such as diabetes insipidus (DI), hypoadrenocorticism, and hypothyroidism, requiring careful postoperative management mainly by hormone supplementation therapy. Among these pituitary hormone deficiencies, DI due to antidiuretic hormone (ADH) deficiency is an important clinical problem encountered soon after surgery because it causes the loss of a large volume of hypotonic fluid into urine, hypernatremia, and an acute decrease in the circulating blood volume, which may induce hypovolemic shock [18]. In the field of veterinary medicine, a V2-receptor selective agonist, desmopressin acetate (generic name: 1-deamino-8-D-argininevasopressin acetate trihydrate, DDAVP), is used to treat spontaneous central DI [1,21]. The use of DDAVP for management of postoperative DI after hypophysectomy in the dog with pituitary tumor was reported [7]. In that report, however, the dogs had endocrinological abnormalities before surgery caused by pituitary tumor, and surgery was followed by hormone supplement therapy using glucocorticoids, mineralcorticoids, and thyroid hormones. Therefore, it was difficult to evaluate the efficacy of DDAVP alone for postoperative DI after hypophysectomy. In this study, we evaluated fluid and electrolyte abnormalites due to antidiuretic hormone deficiency after surgery and investigated the prophylactic efficacy of DDAVP on DI in the dog after hypophysectomy. MATERIALS AND METHODSExperimental animals: Clinically healthy beagles, seven males and three females (mean age 3.6 years, mean body weight 12.5 kg), were used. No abnormality was observed in physical examination, complete blood count, biochemistry, a...

A magnetic resonance imaging‐based classification system for indication of trans‐sphenoidal hypophysectomy in canine pituitary‐dependent hypercortisolism

“…Thereafter, all cases received appropriate postoperative hormone substitution therapy, including doses of 1 mg/kg hydrocortisone (Hydrocortone, Banyu Pharmaceutical Co., Ltd., Tokyo, Japan) iv four times daily for corticosteroid supplementation and 0·1 µg/kg desmopressin acetate (Desmopressin, Kyowa Hakko Kogyo Co., Ltd., Tokyo, Japan) sc/or one drop into the conjunctival sac, SID‐BID (Hara et al . ) for antidiuretic hormone supplementation. When the dogs had resumed drinking and eating, oral hormone substitution therapy with dose of 0·5 mg/kg prednisolone orally, twice daily (Predonine, Shionogi & Co., Ltd., Osaka, Japan) instead of hydrocortisone was initiated; 20 µg/kg levothyroxine orally, twice daily (Thyradin‐S, Aska Pharmaceutical Co., Ltd., Tokyo, Japan) was additionally provided for thyroid hormone supplementation.…”

Cushing's Disease Complicated with Thrombosis in a Dog

“…In the present case, due to the complication of thrombosis, risks in surgical procedures of hypophysectomy were a concern. However, since continuous treatment to reduce circulating cortisol concentrations with mitotane and trilostane may potentially accelerate the growth of macroadenoma, which may result in neurologic symptoms, surgical treatment was selected in the present case [2,14,25,28,29]. Since the central diabetes insipidus (CDI) persisted after the hypophysectomy, two points were considered.…”

Functional and Morphological Changes in the Hypothalamus-Pituitary Posterior Lobe System after Hypophysectomy in the Dog

“…In our previous study, severe diabetes insipidus-like symptoms developed within a few hr after hypophysectomy in dogs, but the symptoms disappeared within about 2 weeks [10]. In the present study, we investigated the disappearance of postoperative diabetes insipidus-like symptoms.…”