>Dr. Williams mentioned in a post in March (see, I really did search the
>archives) that 25% will do fine on pred, 25% need pred and DOCP, and 50%
>don't need anything.  How do you make this determination?
 
The determination is made on the basis of clinical signs and lab work.  If
the animal motors on without any problems after bilateral adrenal surgery -
in such cases it is probably not a true bilateral removal, or the animal
has abundant ectopic tissue - then it doesn't need any medication post op.
If the animal loses energy and crashes after surgery, and the bloodwork
shows that it is hypoglycemic, prednisone alone may relieve the problems.
Some animals, if they are part of the minority that secrete cortisol, may
have problems with hypoglycemia after surgery.  Prednsione is an effective
agent for raising blood glucose.
 
Finally if the animal crashes up to a month out from surgery, and the Na:K
ratio is abnormal - usually around 25, it suggests that the animal suffers
from mineralocorticoid depletion, and DOCP is used to straighten out this
electrolyte balance.
 
Close observation is required in many cases to get the problems
straightened out.
 
With kindest regards,
Bruce Williams, DVM, DACVP
 
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[Posted in FML issue 3500]