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1426 Hyperadrenocorticism: Mitotane Induction for Pituitary Disease

Hyperadrenocorticism: Mitotane Induction for Pituitary Disease
VetBooks.ir See also the Mitotane Maintenance for Pituitary Disease algorithm.

Mitotane loading dose
40–50 mg/kg divided BID

• Decreased appetite, vomiting, diarrhea,
listlessness, or water intake <60 mL/kg/d
OR
• Maximum of 8 days

ACTH stimulation test

Response below ideal Response ideal Response above ideal

• No further mitotane Begin maintenance • Continue loading dose
• Retest in 2–3 weeks 50 mg/kg/wk divided • Recheck ACTH stim in
over several days (e.g., 5–7 days
Monday, Wednesday, OR
Friday) when recognize decreased
Response below ideal Response ideal appetite, vomiting, diarrhea,
or water intake <60 mL/kg/d

If cortisol non-
detectable,
+
measure Na /K +
Note: Ideal range is approximately 30–150nmol/L pre- andpost-ACTH: normalresting rangeis
approximately 10-160 nmol/L.

ACTH stim, ACTH stimulation test.
(From Rand J, Behrend E, Gunn-Moore D, Campbell-Ward M, editors: Clinical endocrinology of companion animals. New York: Wiley-Blackwell, 2013.)
AUTHOR & EDITOR: Ellen N. Behrend, VMD, PhD, DACVIM

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