Peer-reviewed veterinary case report
Dog developed low adrenal function after high-dose ketoconazole
By Hernandez-Bures, Andrea et al.·Published in Journal of veterinary internal medicine·2019·Florida Veterinary Referral Center and 24-Hour Emergency, United States·View original on PubMed →
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Original publication title: Presumptive iatrogenic hypoadrenocorticism induced by high-dose ketoconazole administration in a dog.
- Species:
- dog
Plain-English summary
An 11-year-old male neutered Shih Tzu was brought in after showing signs of weight loss, decreased appetite, excessive thirst, and lethargy. He had been treated with a high dose of ketoconazole for skin problems, which likely caused his adrenal glands to stop producing enough cortisol, a condition known as hypoadrenocorticism (HA). After stopping the ketoconazole and giving him a short course of corticosteroids, follow-up tests showed that his cortisol levels returned to normal. The dog improved after the treatment, confirming that the ketoconazole was the cause of his adrenal issues.
People also search for: Shih Tzu weight loss · dog lethargy and thirst · ketoconazole side effects in dogs · hypoadrenocorticism treatment in dogs
Abstract
A 11-year-old male neutered Shih Tzu was referred to a tertiary facility with a history of weight loss, decreased appetite, polydipsia, and lethargy. The dog had a 10-year history of nonspecific allergic dermatitis and was being treated with 16 mg/kg of ketoconazole q12h for Malassezia dermatitis. Vague gastrointestinal signs, hypocholesterolemia, and lack of a stress leukogram increased suspicion for hypoadrenocorticism (HA). An adrenocorticotropic hormone (ACTH) stimulation test identified hypocortisolemia on pre- and post-ACTH samples and ketoconazole was discontinued. After a short course of corticosteroid treatment, an ACTH stimulation test was repeated and pre-ACTH cortisol concentration was within the reference range, and the post-ACTH cortisol concentration was mildly increased. The temporal association between return of adequate adrenocortical cortisol production and discontinuation of ketoconazole led to the conclusion that the dog had developed iatrogenic HA secondary to ketoconazole treatment.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31448839/