Zycortal® (Dechra Veterinary Products) is indicated for replacement therapy for mineralocorticoid deficiency in dogs with primary hypoadrenocorticism. Zycortal contains desoxycortone pivalate (DOCP) – an aldosterone analogue with purely mineralocorticoid effect. Zycortal is available as a prolonged-release suspension for subcutaneous injection and the dosing interval is approximately 25 days. The exact dose to be given and the interval between treatments depend on the dog’s clinical response as well as sodium and potassium levels. A glucocorticoid (. prednisolone) is also needed daily to replace the missing cortisol. To obtain a Monitoring and Dose Adjustment Flowchart, or for further advice, contact Dechra by e-mailing technical@.
During minor illness (., flu or fever >38° C [° F]) the hydrocortisone dose should be doubled for 2 or 3 days. The inability to ingest hydrocortisone tablets warrants parenteral administration. Most patients can be educated to self administer hydrocortisone, 100 mg IM, and reduce the risk of an emergency room visit. Hydrocortisone, 75 mg/day, provides adequate glucocorticoid coverage for outpatient surgery. Parenteral hydrocortisone, 150 to 200 mg/day (in three or four divided doses), is needed for major surgery, with a rapid taper to normal replacement during the recovery. Patients taking more than 100 mg hydrocortisone/day do not need any additional mineralocorticoid replacement. All patients should wear some form of identification indicating their adrenal insufficiency status.