{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T16:17:09Z","timestamp":1763741829836,"version":"3.45.0"},"reference-count":24,"publisher":"American Animal Hospital Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study aimed to retrospectively describe the clinical progression following diagnosis of iatrogenic hypocortisolemia (iHC) in 48 dogs receiving trilostane for pituitary-dependent hyperadrenocorticism. Cortisol concentrations were \u22651.5 mg\/dL within 6 mo following diagnosis of iHC in 76.3% of dogs (95% confidence interval [CI] 59.8\u201388.6%). At the time of study completion, 25% of dogs (95% CI 13.6\u201339.6%) were receiving either glucocorticoids or mineralocorticoids or both; 42% of dogs (95% CI 27.6\u201356.8%) were on no adrenal-related medications; and the remaining 33% of dogs (95% CI 20.4\u201348.4%) were receiving trilostane. No patient-, clinicopathologic-, or trilostane-associated factors were identified to influence adrenal recovery following diagnosis of iHC, and it remains difficult to predict the clinical progression in this population of dogs.<\/jats:p>","DOI":"10.5326\/jaaha-ms-7076","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T16:59:24Z","timestamp":1628528364000},"page":"217-224","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of Iatrogenic Hypocortisolemia Following Trilostane Therapy in 48 Dogs with Pituitary-Dependent Hyperadrenocorticism"],"prefix":"10.5326","volume":"57","author":[{"given":"Elizabeth","family":"Appleman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Schrage","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth E.","family":"Lamb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy","family":"Langston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3280","reference":[{"key":"i1547-3317-57-5-217-b1","series-title":"Vet Clin North Am Small Anim Pract","first-page":"269","article-title":"Trilostane in dogs","volume":"40","year":"2010","unstructured":"Ramsey\n              IK.\n            \n          \n          Trilostane in dogs.\n\t\t\t\t\tVet Clin North Am Small Anim Pract2010;\n\t\t\t\t\t40:\n\t\t\t\t\t269\u2013\n\t\t\t\t\t83."},{"key":"i1547-3317-57-5-217-b2","series-title":"Can Vet J","first-page":"397","article-title":"Update on the use of trilostane in dogs","volume":"59","year":"2018","unstructured":"Lemetayer\n              J\n            \n            \n              Blois\n              S.\n            \n          \n          Update on the use of trilostane in dogs.\n\t\t\t\t\tCan Vet J2018;\n\t\t\t\t\t59:\n\t\t\t\t\t397\u2013\n\t\t\t\t\t407."},{"key":"i1547-3317-57-5-217-b3","series-title":"J Am Vet Med Assoc","first-page":"1231","article-title":"Evaluation of twice-daily, low-dose trilostane treatment administered orally in dogs with naturally occurring hyperadrenocorticism","volume":"232","year":"2008","unstructured":"Vaughan\n              M,\n            \n            \n              Feldman\n              E,\n            \n            \n              Hoar\n              B,\n            \n          \n          .\n\t\t\t\t\tEvaluation of twice-daily, low-dose trilostane treatment administered orally in dogs with naturally occurring hyperadrenocorticism.\n\t\t\t\t\tJ Am Vet Med Assoc2008;\n\t\t\t\t\t232:\n\t\t\t\t\t1231\u2013\n\t\t\t\t\t328."},{"issue":"6","key":"i1547-3317-57-5-217-b4","series-title":"J Vet Intern Med","first-page":"1478","article-title":"Evaluation of 2 trilostane protocols for the treatment of canine pituitary-dependent hyperadrenocorticism: twice daily versus once daily","volume":"27","year":"2013","unstructured":"Arenas\n              C,\n            \n            \n              Melian\n              C,\n            \n            \n              Perez-Alenza\n              MD.\n            \n          \n          Evaluation of 2 trilostane protocols for the treatment of canine pituitary-dependent hyperadrenocorticism: twice daily versus once daily.\n\t\t\t\t\tJ Vet Intern Med2013;\n\t\t\t\t\t27(\n\t\t\t\t\t6):\n\t\t\t\t\t1478\u2013\n\t\t\t\t\t85."},{"key":"i1547-3317-57-5-217-b5","series-title":"J Am Vet Med Assoc","first-page":"1441","article-title":"Evaluation of twice-daily, lower-dose trilostane treatment administered orally in dogs with naturally occurring hyperadrenocorticism","volume":"238","year":"2011","unstructured":"Feldman\n              E.\n            \n          \n          Evaluation of twice-daily, lower-dose trilostane treatment administered orally in dogs with naturally occurring hyperadrenocorticism.\n\t\t\t\t\tJ Am Vet Med Assoc2011;\n\t\t\t\t\t238:\n\t\t\t\t\t1441\u2013\n\t\t\t\t\t51."},{"key":"i1547-3317-57-5-217-b6","series-title":"J Vet Intern Med","first-page":"91","article-title":"Efficacy of low- and high-dose trilostane treatment in dogs (<5 kg) with pituitary-dependent hyperadrenocorticism","volume":"27","year":"2013","unstructured":"Cho\n              K,\n            \n            \n              Kang\n              J,\n            \n            \n              Chang\n              D,\n            \n          \n          .\n\t\t\t\t\tEfficacy of low- and high-dose trilostane treatment in dogs (<5 kg) with pituitary-dependent hyperadrenocorticism.\n\t\t\t\t\tJ Vet Intern Med2013;\n\t\t\t\t\t27:\n\t\t\t\t\t91\u2013\n\t\t\t\t\t8."},{"key":"i1547-3317-57-5-217-b7","series-title":"J Vet Intern Med","first-page":"1078","article-title":"Trilostane dose versus body weight in the treatment of naturally occurring pituitary-dependent hyperadrenocorticism in dogs","volume":"26","year":"2012","unstructured":"Feldman\n              E\n            \n            \n              Kass\n              P.\n            \n          \n          Trilostane dose versus body weight in the treatment of naturally occurring pituitary-dependent hyperadrenocorticism in dogs.\n\t\t\t\t\tJ Vet Intern Med2012;\n\t\t\t\t\t26:\n\t\t\t\t\t1078\u2013\n\t\t\t\t\t80."},{"key":"i1547-3317-57-5-217-b8","series-title":"J Am Vet Med Assoc","first-page":"801","article-title":"Evaluation of the use of baseline cortisol concentration as a monitoring tool for dogs receiving trilostane as a treatment for hyperadrenocorticism","volume":"237","year":"2010","unstructured":"Cook\n              AK\n            \n            \n              Bond\n              KG.\n            \n          \n          Evaluation of the use of baseline cortisol concentration as a monitoring tool for dogs receiving trilostane as a treatment for hyperadrenocorticism.\n\t\t\t\t\tJ Am Vet Med Assoc2010;\n\t\t\t\t\t237:\n\t\t\t\t\t801\u2013\n\t\t\t\t\t5."},{"key":"i1547-3317-57-5-217-b9","series-title":"J Vet Intern Med","first-page":"919","article-title":"Evaluation of baseline cortisol, endogenous ACTH, and cortisol\/ACTH ratio to monitor trilostane treatment in dogs with pituitary-dependent hypercortisolism","volume":"27","year":"2013","unstructured":"Burkhardt\n              W,\n            \n            \n              Boretti\n              F,\n            \n            \n              Reusch\n              C,\n            \n          \n          .\n\t\t\t\t\tEvaluation of baseline cortisol, endogenous ACTH, and cortisol\/ACTH ratio to monitor trilostane treatment in dogs with pituitary-dependent hypercortisolism.\n\t\t\t\t\tJ Vet Intern Med2013;\n\t\t\t\t\t27:\n\t\t\t\t\t919\u2013\n\t\t\t\t\t23."},{"key":"i1547-3317-57-5-217-b10","series-title":"J Vet Intern Med","first-page":"1214","article-title":"Urinary corticoid:creatinine ratios in dogs with pituitary-dependent hypercortisolism during trilostane treatment","volume":"23","year":"2009","unstructured":"Galac\n              S,\n            \n            \n              Buijtels\n              W,\n            \n            \n              Kooistra\n              H.\n            \n          \n          Urinary corticoid:creatinine ratios in dogs with pituitary-dependent hypercortisolism during trilostane treatment.\n\t\t\t\t\tJ Vet Intern Med2009;\n\t\t\t\t\t23:\n\t\t\t\t\t1214\u2013\n\t\t\t\t\t9."},{"key":"i1547-3317-57-5-217-b11","series-title":"Austr Vet J","first-page":"491","article-title":"Persistent isolated hypocortisolism following brief treatment with trilostane","volume":"86","year":"2008","unstructured":"Ramsey\n              I,\n            \n            \n              Richardson\n              J,\n            \n            \n              Lenard\n              Z,\n            \n          \n          .\n\t\t\t\t\tPersistent isolated hypocortisolism following brief treatment with trilostane.\n\t\t\t\t\tAustr Vet J2008;\n\t\t\t\t\t86:\n\t\t\t\t\t491\u2013\n\t\t\t\t\t5."},{"key":"i1547-3317-57-5-217-b12","series-title":"Veterin Arski Arhiv","first-page":"690","article-title":"Canine iatrogenic persistent hypoadrenocorticism after short-term treatment of hyperadrenocorticism with trilostane - a case report","volume":"81","year":"2011","unstructured":"Gojska-Zygner\n              O,\n            \n            \n              Lechowski\n              R,\n            \n            \n              Zygner\n              W.\n            \n          \n          Canine iatrogenic persistent hypoadrenocorticism after short-term treatment of hyperadrenocorticism with trilostane - a case report.\n\t\t\t\t\tVeterin Arski Arhiv2011;\n\t\t\t\t\t81:\n\t\t\t\t\t690\u2013\n\t\t\t\t\t705."},{"key":"i1547-3317-57-5-217-b13","series-title":"J Small Anim Pract","first-page":"307","article-title":"Adrenal necrosis in a dog receiving trilostane for the treatment of hyperadrenocorticism","volume":"45","year":"2004","unstructured":"Chapman\n              PS,\n            \n            \n              Kelly\n              DF,\n            \n            \n              Archer\n              J,\n            \n            \n              Brockman\n              DJ,\n            \n            \n              Neiger\n              R.\n            \n          \n          Adrenal necrosis in a dog receiving trilostane for the treatment of hyperadrenocorticism.\n\t\t\t\t\tJ Small Anim Pract2004;\n\t\t\t\t\t45:\n\t\t\t\t\t307\u2013\n\t\t\t\t\t10."},{"key":"i1547-3317-57-5-217-b14","series-title":"Proceedings of the British Small Animal Veterinary Association","first-page":"587","article-title":"Prolonged hypoadrenocorticism in five dogs treated with trilostane for pituitary dependent hyperadrenocorticism [abstract]","year":"2003","unstructured":"Eastwood\n              JM\n            \n            \n              Elwood\n              CM.\n            \n          \n          Prolonged hypoadrenocorticism in five dogs treated with trilostane for pituitary dependent hyperadrenocorticism [abstract].\n\t\t\t\t\tIn:Proceedings of the British Small Animal Veterinary Association,\n\t\t\t\t\tGloucester (UK):\n\t\t\t\t\tBSAVA Publications;\n\t\t\t\t\t2003. p.\n\t\t\t\t\t587."},{"key":"i1547-3317-57-5-217-b15","series-title":"Vet J","first-page":"24","article-title":"Incidence and risk factors for hypoadrenocorticism in dogs treated with trilostane","volume":"230","year":"2017","unstructured":"King\n              JB\n            \n            \n              Morton\n              JM.\n            \n          \n          Incidence and risk factors for hypoadrenocorticism in dogs treated with trilostane.\n\t\t\t\t\tVet J2017;\n\t\t\t\t\t230:\n\t\t\t\t\t24\u2013\n\t\t\t\t\t9."},{"key":"i1547-3317-57-5-217-b16","series-title":"Vet Rec","first-page":"219","article-title":"Histologic evaluation of the adrenal glands of seven dogs with hyperadrenocorticism treated with trilostane","volume":"160","year":"2007","unstructured":"Reusch\n              C,\n            \n            \n              Sieber-Ruckstuhl\n              N,\n            \n            \n              Wenger\n              M,\n            \n          \n          .\n\t\t\t\t\tHistologic evaluation of the adrenal glands of seven dogs with hyperadrenocorticism treated with trilostane.\n\t\t\t\t\tVet Rec2007;\n\t\t\t\t\t160:\n\t\t\t\t\t219\u2013\n\t\t\t\t\t24."},{"key":"i1547-3317-57-5-217-b17","series-title":"Domest Anim Endocrinol","first-page":"155","article-title":"Adrenocorticotropic hormone, but not trilostane, causes severe adrenal hemorrhage, vacuolization, and apoptosis in rats","volume":"40","year":"2011","unstructured":"Burkhardt\n              W,\n            \n            \n              Guscetti\n              F,\n            \n            \n              Boretti\n              F,\n            \n          \n          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concentrations in well-regulated dogs with hyperadrenocorticism treated with trilostane","volume":"6","year":"2015","unstructured":"Midence\n              JN,\n            \n            \n              Drobatz\n              KJ,\n            \n            \n              Hess\n              RS.\n            \n          \n          Cortisol concentrations in well-regulated dogs with hyperadrenocorticism treated with trilostane.\n\t\t\t\t\tJ Vet Intern Med2015;\n\t\t\t\t\t6:\n\t\t\t\t\t152\u2013\n\t\t\t\t\t33."},{"key":"i1547-3317-57-5-217-b20","series-title":"Vet J","first-page":"75","article-title":"Effects of trilostane on the pituitary-adrenocortical and renin-aldosterone axis in dogs with pituitary-dependent hypercortisolism","volume":"183","year":"2010","unstructured":"Galac\n              S,\n            \n            \n              Buijetls\n              J,\n            \n            \n              Mol\n              J,\n            \n          \n          .\n\t\t\t\t\tEffects of trilostane on the pituitary-adrenocortical and renin-aldosterone axis in dogs with pituitary-dependent hypercortisolism.\n\t\t\t\t\tVet J2010;\n\t\t\t\t\t183:\n\t\t\t\t\t75\u2013\n\t\t\t\t\t80."},{"key":"i1547-3317-57-5-217-b21","series-title":"Domest Anim Endocrinol","first-page":"63","article-title":"Cortisol, aldosterone, cortisol precursor, androgen and endogenous ACTH concentrations in dogs with pituitary-dependent hyperadrenocorticism treated with trilostane","volume":"31","year":"2006","unstructured":"Sieber-Ruckstuhl\n              N,\n            \n            \n              Boretti\n              F,\n            \n            \n              Wenger\n              M,\n            \n          \n          .\n\t\t\t\t\tCortisol, aldosterone, cortisol precursor, androgen and endogenous ACTH concentrations in dogs with pituitary-dependent hyperadrenocorticism treated with trilostane.\n\t\t\t\t\tDomest Anim Endocrinol2006;\n\t\t\t\t\t31:\n\t\t\t\t\t63\u2013\n\t\t\t\t\t75."},{"issue":"9","key":"i1547-3317-57-5-217-b22","series-title":"Am J Vet Res","first-page":"1245","article-title":"Effect of trilostane on serum concentrations of aldosterone, cortisol, and potassium in dogs with pituitary-dependent hyperadrenocorticism","volume":"65","year":"2004","unstructured":"Wenger\n              M,\n            \n            \n              Sieber-Ruskstuhl\n              N,\n            \n            \n              Muller\n              C,\n            \n            \n              Reusch\n              C.\n            \n          \n          Effect of trilostane on serum concentrations of aldosterone, cortisol, and potassium in dogs with pituitary-dependent hyperadrenocorticism.\n\t\t\t\t\tAm J Vet Res2004;\n\t\t\t\t\t65(\n\t\t\t\t\t9):\n\t\t\t\t\t1245\u2013\n\t\t\t\t\t50."},{"key":"i1547-3317-57-5-217-b23","series-title":"J Vet Intern Med","first-page":"160","article-title":"Effect of trilostane on hormone and serum electrolyte concentrations in dogs with pituitary-dependent hyperadrenocorticism","volume":"28","year":"2014","unstructured":"Griebsch\n              C,\n            \n            \n              Lehnert\n              C,\n            \n            \n              Williams\n              G,\n            \n          \n          .\n\t\t\t\t\tEffect of trilostane on hormone and serum electrolyte concentrations in dogs with pituitary-dependent hyperadrenocorticism.\n\t\t\t\t\tJ Vet Intern Med2014;\n\t\t\t\t\t28:\n\t\t\t\t\t160\u2013\n\t\t\t\t\t5."},{"key":"i1547-3317-57-5-217-b24","series-title":"Domest Anim Endocrinol","first-page":"155","article-title":"Adrenocorticotropic hormone, but not trilostane, causes severe adrenal hemorrhage, vacuolization, and apoptosis in rats","volume":"40","year":"2011","unstructured":"Burkhardt\n              W,\n            \n            \n              Guscetti\n              F,\n            \n            \n              Boretti\n              F,\n            \n          \n          .\n\t\t\t\t\tAdrenocorticotropic hormone, but not trilostane, causes severe adrenal hemorrhage, vacuolization, and apoptosis in rats.\n\t\t\t\t\tDomest Anim Endocrinol2011;\n\t\t\t\t\t40:\n\t\t\t\t\t155\u2013\n\t\t\t\t\t64."}],"container-title":["Journal of the American Animal Hospital 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