Treatment for Dogs with Hypoadrenocorticism

Hypoadrenocorticism can only be treated medically and consists of replacing the missing hormones aldosterone and cortisol with synthetic hormones that have similar efficacy. There are no alternative treatment methods and once initiated, treatment will have to be administered for the rest of the animal’s life.  ​​

Zycortal is a prolonged-release suspension used as replacement therapy for mineralocorticoid deficiency in dogs with primary hypoadrenocorticism. It is the only veterinary licensed mineralocorticoid replacement therapy in Europe. Zycortal contains the active ingredient is desoxycortone pivalate (DOCP), a pure mineralocorticoid hormone which regulates electrolyte and water balance. As DOCP has minimal glucocorticoid activity – dogs will need daily glucocorticoid, such as  Prednicortone^®, alongside periodic Zycortal injections.​​​

For further information on how to best use Zycortal in practice, please refer to the SPC  alongside Dechra’s 5 Golden Guidelines 

In all cases, dogs should have a diagnosis of hypoadrenocorticism before starting on Zycortal therapy. Equally, for cases of acute adrenal crisis, it is also important for patients to be stabilised and rehydrated before administration of Zycortal. Information on both of these topics can be found on the diagnosis and adrenal crisis pages.​​

Once stabilised with a definitive diagnosis, the starting dose of Zycortal is 2.2 mg/kg bodyweight, administered subcutaneously. The dose should then be adjusted according to electrolyte values and clinical signs. ​​

Clinical trials have proved the efficacy of Zycortal with clinical success rates >85% (CVMP Assessment report, 2015). Equally Zycortal has been shown to be well-tolerated at recommended dose rates.​​

In addition to approximately monthly Zycortal injections, patients should also receive daily glucocorticoid therapy. This is usually administered in the form of prednisolone. The recommended starting dose for prednisolone in patients being treated with Zycortal for hypoadrenocorticism is 0.2 – 0.4 mg/kg bodyweight once daily. The dose should then be titrated according to clinical signs.​​

More details on long term dose adjustment and monitoring of Zycortal treated dogs can be found in the 5 Golden Guidelines