sectomy, but we have only used o,p’-DDD therapy
Plain abdominal radiographs
in our cases. For adrenal tumours, surgical
removal of the affected adrenal gland (Johnston
1977) is recommended, provided the tumour has
not already metastasised (Lubberink 1980). In
human patients, o,p’-DDD is used mainly against
inoperable adrenal tumours to alleviate pain
associated with metastases in bone. However, the
efficacy of the drug against canine adrenal
tumours is uncertain, and the few cases so treated
have relapsed after an initial improvement (Lor-
enz et af 1973; Owens and Drucker 1977).
In this case, we initiated o,p’-DDD therapy
immediately because experience indicated that
adrenal hyperplasia was more likely than an
adrenocortical tumour, the patient’s condition
was poor and deteriorating rapidly, and a delayed
return of the hormonal test results was anticipat-
ed. Such a precipitate approach is not advisable
generally, because damage to the non-neoplastic
adrenal gland by o,p’-DDD would complicate
management if adrenalectomy was undertaken
later to remove a tumour. In retrospect, it did
not affect the outcome here as the presence of
metastases made adrenalectomy unwarranted.
When hyperadrenocorticism is suspected clini-
cally in a dog, routine haematological and hio-
chemical tests should be performed initially to
verify the diagnosis. If confirmed, and iatrogenic
disease is excluded by history, further investiga-
tion is indicated using appropriate hormonal tests
(for example, basal cortisol and ACTH assays,
and either a n ACTH-response or dexamethasone
BOOK REVIEW
THE PHARMACEUTICAL CODEX
The Pharmaceutical Codex* is a renamed a n d rearranged
BPC. The a m o u n t of useful information is considerably
increased, but only a small proportion (perhaps one per cent
of the book) is directed specifically at veterinary medicine.
Entries are arranged in alphabetical order; about 900 are
monographs on drug substances with about 400 statements of
‘The Pharmaceutical Codex (pages xxll t 1101), published by The
Pharmaceutical Press, London and available in Australia from The Austra-
lian Pharmaceutical Publishing Co Ltd, 35 Walsh Street, West Melbourne
Price 567 50
158
- suppression test).
may further assist detection of a n adrenal tumour.
Once the cause of hyperadrenocorticism is deter-
mined, appropriate medical or surgical treatment
can be applied.
Acknowledgments
We thank A.O. Johnson for referring the case and C.R.
Bellenger a n d D.B. Church for assistance with its management.
The senior author was supported financially by a Lionel
Lonsdale Clinical Fellowship.
References
Chastain, C . B., Mitten, R . W. and Kluge J . P . (1978) - J .
Am. vet. med. Ass. 172: 586.
Chen, C . L., Kumar, M. S. A., Willard, M . D. and Liao, T.
F. (1978) - A m . J . vet. Res. 39: 179.
Feldman, E. C. (1981) - J . Am. vet. med. Ass. 178: 823.
Feldman, E . C., Bohannon, N. V. a n d Tyrrell, J . B. (1977)
- A m . 1. vet. Res. 38: 1643.
Johnston, D. E. (1977) - J . Am. vet. med. Ass. 170: 1092.
Ling, G. V., Stabenfeldt, G . H . , Comer, K . M . , Ciribble, D.
H . a n d Schechter, R. D. (1979) - J . Am. vet. med. Ass.
174: 1211.
Lorenz, M . D., Scott, D. W . and Pulley, L. T. (1973) -
Cornell Vet. 63: 646.
Lubberink, A. A . M . E. (1980) - I n Current Veterinary
Therapy VII, E d . R. W. Kirk, W. B. Saunders, Philadel-
phia, p. 979.
Owens, J . M . and Drucker, W. D. (1977) - Vet. Clin. N.
Am. 7: 583.
Schechter, R. D. (1974) - In Current Veterinary Therapy V,
Ed. R . W. Kirk, W. B. Saunders, Philadelphia, p. 783.
Scott, D. W . (1979) - Vet. Clin. N. Am. 9: 3 .
(Accepted for publication 27 January 1982)
variable length on topics like Abortion, Acne, Contact Lenses,
Driving a n d Drugs, a n d Drug Dependence.
Many of the d r u g entries include well-researched d a t a about
absorption, tissue distribution, excretion, half life a n d ther-
apeutic blood levels in humans; pharmacists a n d medical
practitioners will find it a n invaluable reference. Veterinarians
would find only short paragraphs on “veterinary uses’’ (and
doses) for those drugs included in the British Pharmacopoeia
(Veterinary).
R . A . Anderson
Australian Veterinary Journal, Vol. 58, April, 1982