Vasopressin

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Vasopressin (Arginine vasopressin, argipressin, antidiuretic hormone) and its synthetic counterpart, desmopressin acetate, is an endocrine hormone produced by the neurohypophysis in the pituitary.

Vasopressin is responsible for renal water reabsorption by increasing water permeability of the collecting duct and distal convoluted tubule by inducing translocation of aquaporin-2 water channels in the collecting duct plasma membrane.

Vasopressin production by the pituitary can be interfered with by a number of condition associated with central diabetes insipidus, such as:

In nephrogenic diabetes insipidus, a different phenomenon occurs where nephron impairment results in lack of vasopressin sensitivity.

The net effect of vasopressin clinically is water retention. Loss of vasopressin activity leads to polyuria and compensatory polydipsia.

Desmopressin has also been shown to significantly increased factor VIII levels when administered subcutaneously into dogs[7].

For treatment of diabetes insipidus, the recommended initial doses of desmopressin (100 µg/mL) is 1.0 - 5.0 μg once or twice daily as an intranasal or conjunctival drop. With the oral tablets, a starting dose of 0.05 mg - 0.2 mg (50 to 100 µg) once or twice daily is initiated.

Adverse effects of desmopressin are uncommon, but overdosage can lead to fluid retention, hyponatremia and decreased plasma osmolality.

The principle drawback with the use of any of the desmopressin preparations in the treatment of central diabetes insipidus is the drug’s considerable expense.

References

  1. Foley C et al (2009) Hypothalamic-pituitary axis deficiency following traumatic brain injury in a dog. J Vet Emerg Crit Care (San Antonio) 19(3):269-274
  2. Teshima T et al (2011) Central diabetes insipidus after transsphenoidal surgery in dogs with Cushing's disease. J Vet Med Sci 73(1):33-39
  3. Meij BP et al (2012) Lymphocytic hypophysitis in a dog with diabetes insipidus. J Comp Pathol 147(4):503-507
  4. Goossens MM et al (1995) Central diabetes insipidus in a dog with a pro-opiomelanocortin-producing pituitary tumor not causing hyperadrenocorticism. J Vet Intern Med 9(5):361-365
  5. Goossens MM (1994) Diabetes insipidus in a dog with an αMSH-producing pituitary tumor. Vet Q 16(1):61
  6. Nielsen L et al (2008) Central diabetes insipidus associated with primary focal B cell lymphoma in a dog. Vet Rec 162(4):124-126
  7. Sato I & Parry BW (1998) Effect of desmopressin on plasma factor VIII and von Willebrand factor concentrations in Greyhounds. Aust Vet J 76(12):809-812