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Survival analysis of 219 dogs with hyperadrenocorticism attending primary care practice in England
  1. Imogen Schofield1,
  2. David C Brodbelt1,
  3. Anna R L Wilson2,
  4. Stijn Niessen3,
  5. David Church3 and
  6. Dan O'Neill1
  1. 1 Pathobiology and Population Science, Royal Veterinary College, Hatfield, Hertfordshire, UK
  2. 2 Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
  3. 3 Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
  1. Correspondence to Imogen Schofield; ischofield6{at}


Background Hyperadrenocorticism is an endocrine disease routinely encountered within primary care practice; however, few studies evaluating survival beyond diagnosis have studied this population.

Methods This retrospective cohort study analysed the electronic patient records of 219 cases of hyperadrenocorticism from a sample of dogs attending primary care practices in England. Kaplan-Meier plots examined the cumulative survival and Cox proportional hazard regression modelling identified factors associated with the hazard of all-cause mortality.

Results In the analysis, 179/219 (81.7 per cent) hyperadrenocorticism cases died during the study period with a median survival time from first diagnosis of 510 days (95% CI 412 to 618 days). Trilostane was used in 94.1 per cent of cases and differentiation between pituitary-dependent and adrenal-dependent disease was made in 20.1 per cent of cases. In the multivariable analysis, dogs weighing greater than or equal to 15 kg (HR 1.51, 95% CI 1.06 to 2.15, P=0.023) and those diagnosed greater than or equal to 13 years of age (HR 3.74, 95% CI 2.29 to 6.09, P<0.001) had increased hazards of all-cause mortality. Dogs that had their initial trilostane dose increased had a favourable prognosis (HR 0.49, 95% CI 0.32 to 0.76, P=0.015).

Conclusion This study shows that survival from diagnosis of hyperadrenocorticism appears fair for many dogs and provides primary care practitioners with relatable benchmark prognostic figures.

  • VetCompass
  • electronicpatientrecords
  • primary-care
  • hyperadrenocorticism
  • survival

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  • Contributors All authors made contributions to conception and design, acquisition and extraction of data and to analysis and interpretation of the results. All authors were involved in drafting and revising the manuscript and gave final approval of the version to be published. Each author agrees to be accountable for all aspects of the accuracy or integrity of the work.

  • Funding IS is supported at the RVC by a PhD sponsorship from Dechra Veterinary Products. Dechra Veterinary Products did not have any input in the design of the study, the collection, analysis and interpretation of data or in writing the manuscript.

  • Competing interests IS is supported at the RVC by a PhD sponsorship from Dechra Veterinary Products, the manufacturers of Vetoryl Capsules. The remaining authors have no conflicts of interest to declare.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was granted by the RVC Ethics and Welfare Committee (URN 2015 1369).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open-access repository.

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