Central Diabetes Insipidus after Transsphenoidal Surgery in Dogs with Cushings Disease
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概要
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Transsphenoidal surgery (TSS) is an effective treatment for canine Cushings disease, as well as human Cushings disease. In humans, only the pituitary adenoma tissue is resected by TSS. However, in dogs, the whole pituitary including normal tissue is resected. Hence, central diabetes insipidus (CDI) may complicate the postoperative course in almost all dogs with Cushings disease treated by TSS. However, it is difficult to assess the duration of the postoperative CDI, and whether it may be transient or permanent. In this study, postoperative CDI in 21 dogs with Cushings disease and its predicted prognosis by preoperative parameters was investigated. In this study, CDI after TSS was classified as either transient or permanent based on the requirement for desmopressin. Preoperative circulating serum cortisol concentrations and pre- and post-operative plasma AVP concentrations were not significantly different between the transient CDI dogs and permanent CDI dogs. The duration of postoperative CDI was not correlated to the signal intensity ratio (posterior lobe of the pituitary/cerebral cortex), which is obtained from preoperative magnetic resonance imaging (MRI). However, the pituitary height/brain area (P/B) ratio of the permanent CDI dogs was significantly greater than that of the transient CDI dogs. In addition, there was a significant difference between the enlarged-pituitary (P/B ratio >0.31) transient CDI dogs and the permanent CDI dogs. These results suggest that the incidence of postoperative permanent CDI is strongly influenced by the pituitary size.
著者
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TERAMOTO Akira
Departments of Neurosurgery, Nippon Medical School
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HARA Yasushi
Divisions of Veterinary Surgery, School of Veterinary Medicine, Nippon Veterinary and Life Science U
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TESHIMA Takahiro
Divisions of Veterinary Surgery, School of Veterinary Medicine, Nippon Veterinary and Life Science U
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TAODA Takahiro
Department of Small Animal Surgery 2, School of Veterinary Medicine, Kitasato University
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TAGAWA Masahiro
Divisions of Veterinary Surgery, School of Veterinary Medicine, Nippon Veterinary and Life Science U
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