Alternatively, your dog may be prescribed Percorten-V, an injectable containing pure
mineralocorticoid desoxycorticosterone pivalate (DOCP) and a long-acting insoluble ester of desoxycorticosterone acetate (DOCA) to cover glucocorticoid replacement.
This is true for both typical (deficiencies in Cortisol and
mineralocorticoids) and atypical (deficiency of just steroids).
The neuroretina is a novel
mineralocorticoid target: aldosterone up-regulates ion and water channels in Muller glial cells.
Patients with classic 21-hydroxylase deficiency and salt wasting require
mineralocorticoid replacement.
It has been suggested that fludrocortisone has not only
mineralocorticoid but also potent glucocorticoid activity [9].
The
mineralocorticoid receptor (MR) is a nuclear receptor that contains 984 amino acids with three functional domains, an extreme N-terminal activation function domain (AF-1), a middle DNA-binding domain (DBD), and a C-terminal ligand-binding domain (LBD) [67].
Replacement of glucocorticoids and
mineralocorticoids, particularly by hydrocortisone and fludrocortisone is the mainstay of treatment in adrenal insufficiency.
% of Median
Mineralocorticoids 24hr Dry 5a-THB 31% 45% THB 139% 157% Four-point Cortisol and Cortisone
Primary adrenal insufficiency may include an absence of
mineralocorticoids (MC) resulting in a need for daily substitution of fludrocortisone at a recommended dose of 100 [micro]g/d [8].
One of the enzymes affected is 11-beta-hydroxylase , which is responsible for the conversion of 11-desoxycorticosterone to corticosterone (both hormones possessing
mineralocorticoid activity and being precursors to aldosterone) and 11-deoxycortisol to cortisol (10).
Mineralocorticoid receptors have been identified in non-epithelial tissues such as heart fibroblasts, endothelial cells, vascular smooth muscle cells and brain.
As serum potassium remained low, at approximately 2.8 mmol/L, he was switched from amiloride to eplerenone, a
mineralocorticoid receptor antagonist that does not cause gynecomastia.