Plasma sodium and potassium concentrations after hypophysectomy in dogs with corticotroph adenomas.
Cushing's disease
diabetes insipidus
electrolyte
hypernatremia
pituitary adenoma
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
revised:
21
11
2021
received:
02
04
2021
accepted:
23
11
2021
pubmed:
17
12
2021
medline:
27
1
2022
entrez:
16
12
2021
Statut:
ppublish
Résumé
Electrolyte abnormalities, especially hypernatremia, are frequent complications after transsphenoidal hypophysectomy in dogs with pituitary-dependent hypercortisolism. To describe electrolyte abnormalities after transsphenoidal hypophysectomy and to investigate possible associations between postoperative hypernatremia and clinical and surgical variables as well as with postoperative outcome. One hundred and twenty-seven client-owned dogs. Dogs with pituitary corticotroph adenomas that underwent transsphenoidal hypophysectomy were retrospectively included. Plasma sodium and potassium concentrations were measured -2, +2, +8, +24, and +48 hours from hypophysectomy. Clinical (breed, age, body weight, skull type, urinary cortisol/creatinine ratio, percentage of suppression to dexamethasone) and surgical variables (duration of anesthesia and surgery, pituitary dimensions) were compared to the development of hypernatremia. Postoperative hypernatremia developed in 46.5% (57/127) of dogs and hyponatremia in 6.3% (8/127). Plasma sodium concentration increased after surgery and peaked at 8 hours after surgery, normalizing after 24 to 48 hours. Plasma potassium concentration increased without exceeding the reference limit. No significant associations were found between clinical and surgical variables and hypernatremia, or between hypernatremia and postoperative death, long-term survival or recurrence. Surgery time was significantly longer in dogs that developed persistent diabetes insipidus (P = .02) and persistent diabetes insipidus occurred more frequently in dogs with enlarged pituitary glands (P = .01). Hypernatremia remains a frequent postoperative complication after transsphenoidal hypophysectomy but did not appear to have an impact on postoperative outcome. No predisposing factor to postoperative hypernatremia was identified. Variations in plasma potassium concentrations do not seem to influence postoperative outcome.
Sections du résumé
BACKGROUND
BACKGROUND
Electrolyte abnormalities, especially hypernatremia, are frequent complications after transsphenoidal hypophysectomy in dogs with pituitary-dependent hypercortisolism.
OBJECTIVES
OBJECTIVE
To describe electrolyte abnormalities after transsphenoidal hypophysectomy and to investigate possible associations between postoperative hypernatremia and clinical and surgical variables as well as with postoperative outcome.
ANIMALS
METHODS
One hundred and twenty-seven client-owned dogs.
METHODS
METHODS
Dogs with pituitary corticotroph adenomas that underwent transsphenoidal hypophysectomy were retrospectively included. Plasma sodium and potassium concentrations were measured -2, +2, +8, +24, and +48 hours from hypophysectomy. Clinical (breed, age, body weight, skull type, urinary cortisol/creatinine ratio, percentage of suppression to dexamethasone) and surgical variables (duration of anesthesia and surgery, pituitary dimensions) were compared to the development of hypernatremia.
RESULTS
RESULTS
Postoperative hypernatremia developed in 46.5% (57/127) of dogs and hyponatremia in 6.3% (8/127). Plasma sodium concentration increased after surgery and peaked at 8 hours after surgery, normalizing after 24 to 48 hours. Plasma potassium concentration increased without exceeding the reference limit. No significant associations were found between clinical and surgical variables and hypernatremia, or between hypernatremia and postoperative death, long-term survival or recurrence. Surgery time was significantly longer in dogs that developed persistent diabetes insipidus (P = .02) and persistent diabetes insipidus occurred more frequently in dogs with enlarged pituitary glands (P = .01).
CONCLUSION AND CLINICAL IMPORTANCE
CONCLUSIONS
Hypernatremia remains a frequent postoperative complication after transsphenoidal hypophysectomy but did not appear to have an impact on postoperative outcome. No predisposing factor to postoperative hypernatremia was identified. Variations in plasma potassium concentrations do not seem to influence postoperative outcome.
Identifiants
pubmed: 34914137
doi: 10.1111/jvim.16337
pmc: PMC8783358
doi:
Substances chimiques
Sodium
9NEZ333N27
Potassium
RWP5GA015D
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
39-48Informations de copyright
© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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