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Fludrocortisone Acetate for Veterinary Use
by Barbara Forney, VMD
Fludrocortisone acetate is a synthetic corticosteroid that is used to treat adrenocortical insufficiency (Addison’s disease) in dogs and cats. Although it has both glucocorticoid and mineralocorticoid activity, it is a considerably stronger mineralocorticoid. Its potency is 125 times that of hydrocortisone. Fludrocortisone acetate may also be used as an adjunct to the treatment of hyperkalemia.
Dogs and Cats
Fludrocortisone acetate is most commonly used to treat chronic adrenocortical insufficiency. It is more often used in dogs than in cats.
At the beginning of therapy with fludrocortisone acetate, serum electrolytes, urea nitrogen, and creatinine should be monitored weekly until the animal is stabilized. At this point the animal should be re-evaluated on a monthly basis. If the animal remains stable after 3-6 months, the interval between evaluations can be lengthened. For many dogs on long-term maintenance, the required daily dose of fludrocortisone acetate tends to drift upwards. About half of the dogs with hypoadrenocorticism will also need supplementation with glucocorticoids.
- Side effects are frequently a result of chronic, subclinical overdosage.
- Some dogs may develop polyuria and polydypsia. These dogs in particular may need a re-evaluation of their glucocorticoid status.
- Animals that are stressed may need additional supplementation of glucocorticoids.
- Fludrocortisone acetate is excreted in milk. Puppies or kittens of animals receiving this drug should receive milk replacement.
- Fludrocortisone acetate and amphotericin B: increased likelihood of hyperkalemia.
- Fludrocortisone acetate and potassium depleting diuretics (furosemide): increased possibility of developing hypokalemia.
- Fludrocortisone acetate and aspirin: reduced salicylates levels.
- Overdose may cause hypertension, hypokalemia, and edema.
- Serum electrolytes, particularly potassium, should be followed and supplemented as needed.
About the Author
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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