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Hyperadrenocorticism: Mitotane Maintenance for Adrenal Tumor 1426.e1

Hyperadrenocorticism: Mitotane Maintenance for Adrenal Tumor
VetBooks.ir

Clinical signs of HAC recur
OR
Scheduled recheck

ACTH stimulation test

Response ideal Response within normal Response above normal
resting range resting range

• If no adverse mitotane • If no adverse mitotane effects, Reinstitute induction therapy
effects, continue therapy increase dose by 50% and repeat and follow induction protocol
unchanged ACTH stimulation in 4 weeks including ACTH stim
• If adverse mitotane • If adverse mitotane effects,
effects, see p. 485 see p. 485

When control achieved
as judged by ACTH stim,
reinstitute maintenance therapy
at a 50% higher dose;
perform ACTH stim in 4 weeks

Note: Ideal range is <30 nmol/L pre-and post-ACTH; normal resting range is 10–160 nmol/L.
HAC, Hyperadrenocorticism; 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

Clinical Algorithms

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