Desoxycorticosterone Pivalate (DOCP): veterinary dose and monograph

At a glance

Drug class

Veterinary drug

Also known as

DOCP, Percorten-V, Zycortal

Species with doses

Dogs, Cats and Ferrets

General dose range

1.5–2.2 mg/kg SC every ~25–30 days — check the species tables for the indication

Routes

SC, IM

Last reviewed

1 October 2026

Indications

• Maintenance mineralocorticoid replacement in primary (typical) hypoadrenocorticism (Addison's)
• Correction of hyponatraemia/hyperkalaemia of aldosterone deficiency
• Long-term Addisonian management for owners preferring monthly injection over daily tablets

Desoxycorticosterone Pivalate (DOCP) dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Addison's maintenance: Papich 5e: 2.2 mg/kg SC or IM q25 days, adjusted by electrolytes — many dogs are managed starting at 1.5 mg/kg with a 28–30-day interval. Plumb’s p.364: label 2.2 mg/kg IM q25 days; recheck Na/K at 12 and 25 days — increase dose 10% if abnormal at day 12, shorten interval by 2 days if abnormal only at day 25 (Reusch); reduce 10%/month if normal at 30 days — some dogs need only 1 mg/kg q30 days (Scott-Moncrieff). Always supply a glucocorticoid (DOCP has none).

Cats

• Addison's maintenance (rare): Papich 5e: 2.2 mg/kg SC every 25 days, adjusted by monitoring. Plumb’s p.364: 2.2 mg/kg IM every 25 days with prednisolone 0.25–1 mg per cat twice daily (Reusch); or 10–12.5 mg per cat IM monthly with electrolytes every 1–2 weeks initially (Bruyette 2002).

Ferrets

• Adrenal insufficiency after bilateral adrenalectomy: Carpenter's 6th ed (Ferret endocrine table): 2 mg/kg IM every 21 days to manage iatrogenic hypoadrenocorticism following bilateral adrenalectomy (with glucocorticoid supplementation).

Contraindications

Congestive heart failure, severe renal disease with sodium-retention concerns, and oedematous states (mineralocorticoid sodium/water retention). Primary (atypical) hypoadrenocorticism without mineralocorticoid deficiency may not need it. Known hypersensitivity.

Species-specific warnings

Dogs: Always pair with a glucocorticoid (DOCP supplies no glucocorticoid) and ensure the owner has a stress-dosing/crisis plan.

Adverse effects

• Polyuria/polydipsia
• Sodium/water retention, hypertension, oedema (over-dosing)
• Hypokalaemia (over-dosing)
• Injection-site reaction (rare)

Drug interactions

• Potassium-wasting diuretics (furosemide/thiazides): additive hypokalaemia
• NSAIDs: increased sodium retention
• No major metabolic drug interactions of note

Pregnancy and lactation

Continue replacement in a pregnant Addisonian dam (untreated disease is life-threatening); monitor electrolytes.

Monitoring

• Serum sodium and potassium (Na:K ratio) — at ~10–14 days and ~25–30 days after each early dose, then periodically; the key to titration
• Body weight, PU/PD, blood pressure
• Confirm glucocorticoid co-therapy and stress-dose plan
• Adjust BOTH dose and interval to the individual dog

Toxicity and overdose

Over-dosing causes mineralocorticoid excess — sodium/water retention, hypertension, oedema and hypokalaemia. Under-dosing (or too long an interval) risks recurrent hyperkalaemia/hyponatraemia and Addisonian crisis. The therapeutic art is titrating dose AND interval to electrolytes.

Management: No specific antidote. For mineralocorticoid excess: withhold the next dose, correct electrolytes (treat hypokalaemia), manage hypertension/oedema, and lengthen the interval / reduce the dose going forward. Supportive care.

Clinical pearls

• Monthly mineralocorticoid injection for Addison's — titrate DOSE and INTERVAL to electrolytes (many dogs end up needing well below the starting dose)
• It has NO glucocorticoid activity — every patient also needs low-dose prednisolone, increased during stress/illness/surgery
• Shake the suspension well and store as labelled (Zycortal refrigerated)
• Check Na/K mid-cycle and end-cycle early on to find each dog's individual dose/interval
• An alternative to daily fludrocortisone — choose based on owner preference and electrolyte control

Mechanism of action

A potent mineralocorticoid that binds the aldosterone (mineralocorticoid) receptor in the distal nephron, driving sodium (and water) reabsorption and potassium/hydrogen-ion excretion — restoring the sodium and potassium balance lost in aldosterone-deficient Addison's disease. The pivalate ester forms a subcutaneous depot for slow release over weeks. It has negligible glucocorticoid effect (hence the need for separate glucocorticoid).

Formulations and products

• Injectable suspension 25 mg/mL (Zycortal/Percorten-V)
• Zycortal (Dechra) — 25 mg/mL suspension, SC injection
• Percorten-V (Elanco) — 25 mg/mL suspension, SC/IM injection

Storage

Injectable suspension: refrigerate (2–8 °C) per label (Zycortal) or store per product; SHAKE WELL before use (suspension). Do not freeze.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other hormones, emergency drugs, supplements and other drugs

• Dantrolene
• Deferoxamine (Desferrioxamine)
• Deslorelin
• Desmopressin (DDAVP)
• Diazoxide
• Dimercaprol (BAL)
• Dinoprost (PGF2α)
• Diphenhydramine

Frequently asked questions