Pharmacokinetics and pharmacodynamics of desoxycorticosterone pivalate in dogs with hypoadrenocorticism
Open Access
- 21 January 2026
- journal article
- Published by Oxford University Press (OUP) in Journal of Veterinary Internal Medicine
- Vol. 40 (1)
Abstract
Background: Desoxycorticosterone pivalate (DOCP) is commonly used to treat mineralocorticoid deficiency in dogs with hypoadrenocorticism (HA). Hypothesis/Objective: To determine the pharmacokinetics and pharmacodynamics of DOCP. Animals: Twenty-one dogs with newly diagnosed HA. Methods: Prospective clinical trial. Dogs were randomly assigned to treatment with an SC injection of either 1.1 mg/kg (low-dose) or 2.2 mg/kg (label-dose) DOCP. Blood samples were collected at set time points for measurement of serum drug concentrations, serum electrolyte concentrations, and plasma renin activities (PRAs). A one-compartment model was used to determine pharmacokinetics variables. Pharmacodynamics variables including duration of DOCP action and duration of overtreatment were estimated from serum electrolyte concentrations and PRA. Pharmacokinetics and pharmacodynamics variables were compared between low-dose and label-dose groups. Results: Maximum drug concentrations and overall drug exposures were higher in label-dose dogs (1.22 ± 0.46 ng/mL and 32.1 ± 12.3 day × ng/mL) than in low-dose dogs (0.69 ± 0.32 ng/mL and 19.6 ± 5.3 day × ng/mL; P = .008 for both comparisons). However, duration of DOCP action as determined by PRA in label-dose (55 ± 16 days) and low-dose (45 ± 12 days) dogs was not different (P = .2). Serum electrolyte concentrations overestimated the duration of action in the combined group by a mean of 10 days when compared with PRA (P < .001). Conclusions and clinical importance: Pharmacokinetics and pharmacodynamics data suggest that low-dose DOCP administered every 5-7 weeks is a reasonable treatment strategy for most dogs with HA. Prolonging dosing intervals > 7-8 weeks based solely on electrolyte concentrations should be avoided.Keywords
Funding Information
- Stanton Foundation Spectrum of Care Clinical Research Program
This publication has 41 references indexed in Scilit:
- Development of mass spectrometric methods for determination of desoxycorticosterone pivalate and its esterase product in canine serumToxicology Mechanisms and Methods, 2025
- Evaluation of symmetric dimethylarginine and creatinine in dogs with primary hypoadrenocorticism receiving long‐term mineralocorticoid replacement therapyVeterinary Record, 2021
- Adrenal insufficiencyThe Lancet, 2021
- Plasma renin levels are associated with cardiac function in primary adrenal insufficiencyEndocrine, 2019
- DLA class II haplotypes show sex-specific associations with primary hypoadrenocorticism in Standard Poodle dogsImmunogenetics, 2019
- An Update on Addison’s DiseaseExperimental and Clinical Endocrinology & Diabetes, 2018
- Mineralocorticoid substitution and monitoring in primary adrenal insufficiencyBest Practice & Research Clinical Endocrinology & Metabolism, 2015
- Lower initial dose desoxycorticosterone pivalate for treatment of canine primary hypoadrenocorticismAustralian Veterinary Journal, 2013
- Evidence for an increased rate of cardiovascular events in patients with primary aldosteronismJACC, 2005
- EVIDENCE THAT PATIENTS WITH ADDISON'S DISEASE ARE UNDERTREATED WITH FLUDROCORTISONEThe Lancet, 1984