CHAPTER 22 ENDOCRINOPATHIES, ATYPICAL 341
THERAPEUTICS
General Considerations
Frequent bathing with antiseborrheic shampoos to reduce scaling, comedones, and
bacterial folliculitis.
Treatment of secondary bacterial folliculitis with appropriate antibiotics.
With exception of tumors, conditions are cosmetic, resulting in hair coat loss and
hyperpigmentation; consider risk of treatment before initiating therapy.
Alopecia X
Melatonin: 3 mg PO BID for small breeds and 6–12 mg PO BID for large breeds; hair
regrowth should occur within 3 months; effective in approximately 40% of cases; once
hair regrowth has occurred, discontinue treatment; begin supplementation again if
hair loss redevelops.Melatonin at high doses can cause insulin resistance; use with caution in diabetic
patients.
Mitotane: 15–2 mg/kg PO q24h as induction: followed by twice-weekly maintenance;
hair regrowth occurs in a portion of dogs; use of this drug can result in an addisonian
crisis; electrolytes and ACTH stimulation testing should be monitored regularly.Trilostane: dosages as described for treatment of Cushing’s syndrome; hair regrowth
occurs in a portion of dogs; use of this drug can result in an addisonian crisis; elec-
trolytes and ACTH stimulation testing should be monitored regularly.Reported but not recommended treatments include synthetic growth hormone
0.15 IU/kg subcutaneously twice weekly for 6 weeks: may cause diabetes mellitus;
deslorelin 4.7 mg implant every 6 months (intact male dogs); methyltestosterone;
fulvestrant; medroxyprogesterone acetate.Microneedling (tiny pinpoint perforations to stimulate hair growth): recent reported
success in stimulating hair regrowth.
Sex Hormone Imbalances
Diagnose and surgically excise ovarian cysts or tumors and abdominal or scrotal tes-
ticular tumors.
Neutering of intact animals may stimulate hair coat regrowth (usually temporary).
Methyltestosterone 1 mg/kg (maximum dosage of 30 mg/dog) every other day until
hair regrowth, then once every 4–7 days; can result in behavioral changes, cholangio-
hepatitis, and seborrhea oleosa; monitor hepatic chemistries.Diethylstilbestrol 0.1–1 mg/kg PO q24h for 14–21 days; discontinue 7 days; repeat
until hair coat regrowth, then administer 2–3 times weekly; monitor blood count
frequently.