ABSTRACT
Hyperadrenocorticism is a relatively common endocrinopathy in middle-aged and older dogs, which has become increasingly frequent in the clinical routine. The diagnosis is made by information obtained by history, physical exam findings and results of screening and specific endocrine tests. In addition to laboratory tests, imaging diagnosis, such as ultrasound, can aid on evaluation of possible changes in these cases; also, they may reveal the possible involvement of other organs and systems. The aim of this study was to present the main ultrasonographic changes observed in 18 dogs with hyperadrenocorticism, diagnosed from 2013 to 2020 by the low-dose dexamethasone suppression test, among which hepatomegaly, splenomegaly, gallbladder sludge, renal changes, cystitis and changes in adrenal size, such as bilateral and/or unilateral adrenomegaly, can be cited. Ultrasound examination, therefore, is an examination that can help the clinician in confirming the diagnosis of hyperadrenocorticism, in addition to allowing differentiation between pituitary-dependent hyperadrenocorticism (PDH) and adrenal tumors, and the evaluation of possible secondary changes to the disease.(AU)
iperadrenocorticismo é uma endocrinopatia relativamente comum em cães de meia idade e idosos, que tem se tornado cada vez mais frequente na rotina clínica O diagnóstico é confirmado por informações obtidas pelo histórico, achados de exame físico e resultados de exames de triagem e endócrinos específicos. Além dos exames laboratoriais, os exames de ima-gem, como a ultrassonografia, podem auxiliar na avaliação de possíveis alterações nesses casos; ademais, eles também podem revelar o possível envolvimento de outros órgãos e sistemas. O objetivo deste estudo foi apresentar as principais alterações ultrassonográficas observadas em 18 cães com hiperadrenocorticismo, diagnosticados de 2013 a 2020 pelo teste de supressão por dexametasona em baixa dose, dentre as quais podem ser citadas hepatomegalia, esplenomegalia, lama biliar, alterações renais, cistite e alterações no tamanho e formato das adrenais, como adrenomegalia bilateral e/u unilateral. A avaliação ultras-sonográfica, portanto, é um exame que pode ajudar o clínico a confirmar o diagnóstico de hiperadrenocorticismo, além de ajudar a diferenciar entre hiperadrenocorticismo hipófise-dependente (HHD) e tumores adrenais, e na avaliação de possíveis alterações secundárias à doença.(AU)
Subject(s)
Animals , Adrenocortical Hyperfunction/diagnostic imaging , Dogs , Glucocorticoids/analysis , Ultrasonics/methods , Hepatomegaly/veterinaryABSTRACT
Background: Myelolipomas are benign tumors composed of a mixture of fat and hematopoietic tissue similar to the bone marrow. They are rare tumors in humans and dogs, and occur generally in the spleen, liver, spinal canal and in the adrenal glands. When they develop in the adrenal glands they feature non-secretory and endocrinologically inactive characteristics, usually without clinical signs or other dysfunctions. Thus, they are often an incidental finding during necropsy. This paper aims to describe a case of functional adrenal gland myelolipoma and spleen myelolipoma in a female dog with clinical signs and laboratory tests compatible with hyperadrenocorticism.Case: A 12 year-old female dog, undefined breed, was treated at the Hospital Unit for Companion Animals of the Pontifical Catholic University of Paraná (PUCPR), São José dos Pinhais, Paraná, Brazil, with polyuria, polydipsia, polyphagia, cutaneous hypotonia and central obesity. Blood tests showed hypercholesterolemia and increased alkaline phosphatase; urinalysis identified isostenuria with proteinuria; and ultrasound and MRI of the abdomen indicated right adrenomegaly, with heterogeneous characteristics, without invasion of attached blood vessels and splenic nodules. The low dose dexamethasone suppression test was performed which confirmed hyperadrenocorticism. The animal was submitted to adrenalectomy and splenectomy, and tissue specimens were obtained for histopathological examination, which revealed mature adipocytes and hematopoietic elements in different phases of maturation, compatible with adrenal and spleen myelolipoma. After surgical treatment, there was a progressive improvement of the clinical manifestations and laboratory abnormalities of hypercortisolemia, without recurrence during one year.[...](AU)
Subject(s)
Animals , Female , Dogs , Myelolipoma/diagnosis , Myelolipoma/complications , Myelolipoma/veterinary , Adrenocortical Hyperfunction/diagnostic imaging , Adrenocortical Hyperfunction/surgery , Adrenocortical Hyperfunction/veterinaryABSTRACT
Background: Myelolipomas are benign tumors composed of a mixture of fat and hematopoietic tissue similar to the bone marrow. They are rare tumors in humans and dogs, and occur generally in the spleen, liver, spinal canal and in the adrenal glands. When they develop in the adrenal glands they feature non-secretory and endocrinologically inactive characteristics, usually without clinical signs or other dysfunctions. Thus, they are often an incidental finding during necropsy. This paper aims to describe a case of functional adrenal gland myelolipoma and spleen myelolipoma in a female dog with clinical signs and laboratory tests compatible with hyperadrenocorticism.Case: A 12 year-old female dog, undefined breed, was treated at the Hospital Unit for Companion Animals of the Pontifical Catholic University of Paraná (PUCPR), São José dos Pinhais, Paraná, Brazil, with polyuria, polydipsia, polyphagia, cutaneous hypotonia and central obesity. Blood tests showed hypercholesterolemia and increased alkaline phosphatase; urinalysis identified isostenuria with proteinuria; and ultrasound and MRI of the abdomen indicated right adrenomegaly, with heterogeneous characteristics, without invasion of attached blood vessels and splenic nodules. The low dose dexamethasone suppression test was performed which confirmed hyperadrenocorticism. The animal was submitted to adrenalectomy and splenectomy, and tissue specimens were obtained for histopathological examination, which revealed mature adipocytes and hematopoietic elements in different phases of maturation, compatible with adrenal and spleen myelolipoma. After surgical treatment, there was a progressive improvement of the clinical manifestations and laboratory abnormalities of hypercortisolemia, without recurrence during one year.[...]
Subject(s)
Female , Animals , Dogs , Adrenocortical Hyperfunction/surgery , Adrenocortical Hyperfunction/diagnostic imaging , Adrenocortical Hyperfunction/veterinary , Myelolipoma/complications , Myelolipoma/diagnosis , Myelolipoma/veterinaryABSTRACT
BACKGROUND: Medical treatment with trilostane improves clinical signs, causes unclear insulin requirement changes, and variable survival times in cats. OBJECTIVES/HYPOTHESIS: To characterize the long-term efficacy of trilostane in treating cats with hyperadrenocorticism (HAC). ANIMALS: Fifteen client-owned cats with spontaneous HAC. METHODS: Multicenter descriptive retrospective study with a search performed on all medical records for cats diagnosed with spontaneous HAC. RESULTS: Clinical signs (13 of 15 cats) and ACTH stimulation testing results (13 of 15) improved with trilostane therapy. Diabetes mellitus was reported in 9/15 cases. Insulin requirements decreased by 36% within 2 months in 6/9 diabetic cats. Median survival time was 617 days for all cats (range 80-1,278 days). Complications included weight loss, urinary tract infections, chronic kidney disease, seizures, and recurrent pancreatitis. Hypocortisolemia was documented in 1 case. Cause of death occurred as a result of nonadrenal or nondiabetic illnesses (renal failure, seizures [caused by hypoglycemia or unknown]), or lymphoma. CONCLUSIONS AND CLINICAL IMPORTANCE: Trilostane ameliorates clinical signs of HAC in cats, is tolerated well in the long term, and can lead to improved regulation of diabetes.