Studies in adrenal insufficiency.

Abstract

Duration of survival of pregnant dogs after adrenalectomy.—The period of survival has been seen to be greatly increased in pregnancy. Two examples will be given: one in which the second adrenal was removed soon (probably no more than a week) after impregnation, and another in which gestation was from half to two-thirds over when the second adrenalectomy was performed. One dog (1036), known to have been impregnated in the interval between removal of the first and second adrenal, lived 46 days 3 hours after the second operation. Even then the immediate cause of death was perforation of a duodenal ulcer (15 to 20 mm. in diameter). The fatal symptoms developed abruptly on the 46th day. The coma was temporarily relieved by intravenous injections of Ringer-dextrose solution and 3 pups were born, two of them dead. Three more were found at autopsy, which was performed immediately. The breasts did not seem to contain milk. The pups were probably within about a week of full term. As the only coition took place 5 to 8 days before removal of the second adrenal, impregnation could not have occurred more than 54 days before delivery. The average period of gestation in dogs is in the neighborhood of 60 days. It is a matter of speculation how much the survival period would have been lengthened but for the complication of the duodenal ulcer. All that can be said is that it would certainly have exceeded 46 days. In our experience ulcers (gastric and duodenal) are not very commonly encountered post mortem in dogs dying from adrenal deficiency (5 times in 31 autopsies carried out immediately after death). The case mentioned is the only one out of 60 animals in which death was due to perforation.