Cardiovascular indicators and mitral valve disease in dogs with spontaneous hypercortisolism - prospective evaluation

Background: Canine hypercortisolism (HC) is the most prevalent endocrinopathy in dogs in southern Brazil. The prognosis depends on several factors including the general health status, owners´ commitment, and the development of disease complications and comorbidities occurrence, such as cardiovascular complications including mitral valve disease (MVD), systemic arterial hypertension, and left ventricular hypertrophy. The main objective of the present study was to assess cardiovascular parameters in canine HC, based on investigating survival-related variables. The study also aimed to evaluate the influence of concurrent preclinical (MVD) on dogs` survival and the impact of HC on MVD progression. Materials, Methods & Results: A total of 25 dogs with spontaneous HC were enrolled and divided into 2 subgroups accordingly to their echocardiographic findings: group HC (normal echocardiography at first evaluation, n = 16); and group HC + MVD (concurrent presence of stages B1 and B2 MVD diagnosed at the first evaluation, n = 9). The patients were evaluated at diagnosis (T0); 6 months after treatment begging (T1); and after 12 months of treatment (T2). The owners were further contacted by phone or e-mail for 1 more year after T2 regarding survival information. A control group (CG, n = 20) was also evaluated at T0 and T1. At each evaluation, dogs were submitted to a complete clinical evaluation and physical exam, associated with a minimum database (CBC, serum biochemistry, and urine analysis) and cardiovascular evaluation composed of systolic blood pressure determination, electrocardiogram (ECG), and echodopplercardiography. In the HC group, 11/16 dogs underwent the evaluation at T2, while 4/9 dogs from the HC + MVD group and 17/20 dogs from the CG underwent the evaluation at T2. Five dogs (31.25%) from the HC group and 4 dogs (44.44%) from the HC + MVD group died before the end of the follow-up period. In the control group, only 1 dog (5.26%) died before the end of the study. Despite the higher mortality in the HC + MVD group during the follow-up period, there was no significant difference (P = 0.632) in survival when compared with the HC group. The MVD of 4 dogs included in the HC + MVD group was classified as stage B1, while the other 5 dogs were classified as stage B2. Only 1 dog from the CG developed stage B1 MVD in the period studied; however, progression of the MVD stage was documented in 1/4 of dogs in the HC + MVD group and MVD development was documented in 3/11 of dogs from the HC group from T0 to T2. The odds ratio (OR) and respective 95% confidence interval (95%CI) for HC as a risk factor for MVD progression were 4.267 (0.4268 - 42.65; P = 0.342). Exercise intolerance (12/16 dogs) and dyspnea (6/16 dogs) were the cardiorespiratory clinical signs with the highest incidence in the HC group at T0. When compared to the control group, both exercise intolerance (P < 0.001) and dyspnea (P = 0.03) occurrence were significantly higher in the HC group. The age (P = 0.001) and the occurrence of dyspnea (P = 0.036) at diagnosis were significantly higher in dogs with HC that died during the follow-up than those that remained alive. Regarding the occurrence of cardiac arrhythmias verified by ECG, no statistically significant differences were observed among groups. Discussion: The study suggests that systemic hypertension and altered echocardiographic measurements did not interfere with dogs' survival; however, dyspnea was associated with a worse prognosis. Finally, it is possible to conclude that mitral valve degeneration is a common comorbidity in dogs with HC, however, it was not evidenced their interference in the survival of dogs with this endocrine disease or even a role of the HC in the progression of the MVD.

Chronic expanding hematoma secondary to excision of recurrent myxomas in a bitch

Background: Expanding chronic hematoma is a relatively common postoperative complication in humans, not in dogs, nevertheless, is important understand this condition because it may affect the animal's health. A hematoma could be formed within hours and usually stabilizes spontaneously with the reabsorption of its content. However, occasionally the hematoma slowly expands, becomes encapsulated and forms a mass, causing a chronic expanding hematoma. Possibly skin and adipose tissue are displaced secondary to trauma, causing the formation of blood-filled cysts surrounded by a fibrous capsule. The aim of this document is to present the first report of a postsurgical chronic expanding hematoma in dog. Case: A case of chronic expanding hematoma secondary to excision of recurrent myxoma in a bitch was described. Physical examination showed a hard, firm, non-mobile mass enclosed within the deep muscular layers. This mass was between the sternum and the cranial abdomen, similar to previous lesions excised by another veterinarian. Fine needle aspiration indicated the presence of blood. Radiology demonstrated that the bone-cartilage tissue was not involved. Due to the size of the mass, a skin stretching pre-suturing technique using self-adhesive tape was applied around the mass 48 h before surgery. The mass was removed with wide excision margins and portions of the affected muscles, but a large wound with great tension was created; consequently, a parallel to the wound incision and the thoraco-lumbar vertebrae was made. Six months after surgery, the animal presented recurrence of the same lesion, which was also removed. The bleeding times were within the normal range, but the animal was diagnosed with hyperadrenocorticism. After both surgeries histopathological exam revealed a hematoma, that had thrombosis and granulation tissue with fibrosis and severe panniculitis, in addition of multifocal, chronic, moderate lymphohistiocytic myositis; all these changes were compatible with a chronic expanding hematoma. Discussion: Chronic expanding hematoma is a mass that grows slowly secondary to hemorrhage and does not exhibit elements of malignancy. However, it can occasionally be confused for a soft-tissue neoplasm. It has been reported frequently in humans but not in small animals. The first case was reported in 2002: 5 puppies with a cervical hematoma classified as a chronic expanding hematoma was described. In addition, 3 cases were reported: 1 cat with perirenal chronic expanding hematoma; 1 bitch with intra-abdominal presentation, and 1 cat with this pathology on the right pelvic limb after an intramuscular injection. The etiology of chronic expansive hematoma is unidentified in dogs, nevertheless, it is stipulated that is not an inflammatory process as previously assumed, but rather a neoplastic process. As in other cases, it was difficult to determine the origin of the chronic expanding hematoma. The coagulation times and platelets count were within ranges. Similarly, it is very complicated to relate hyperadrenocorticism with chronic expanding hematoma because dogs with Cushing's disease generally present hypercoagulopathies. Myxomas are associated with endocrinopathies in humans and dogs, therefore, hyperadrenocorticism is possibly related with this neoplasia. Myxomas have an expansive growth pattern, contrasting with myxosarcomas, which are infiltrating; Although in the present case the skin mass appeared to be invasive, both macroscopical and histopathological appearance of it corresponded to a well-shaped capsule compatible with chronic expanding hematoma. In summary, to the best of our knowledge, this is the first report of a post-surgical chronic expanding hematoma in a dog.

Crises epilépticas reativas por hiperlipidemia em cão Maltês / Reactive seizures due to hyperlipidemia in a maltese dog

Background: Primary hyperlipidemia is a condition that affects some specific breeds. It has been previously describedin Miniature Shnauzer, Beagles, Shetland Shepdog and West Highland White Terrier. There are no reports of primaryhyperlipidemia in Maltese dogs. It is a hereditary disorder of lipoprotein metabolism. The etiology is unknown and maybe related to a genetic problem in lipoprotein lipase or to the absence of apaprotein CII. Clinical signs include spontaneousarterosclerosis, retinal lipemia, cutaneous xanthomas, abdominal pain, lethargy, vomiting and / or diarrhea. Neurologicalmanifestations such as seizures and behavioral changes may also occur. The aim of this report is to describe a case ofreactive seizures due to hyperlipidemia in a dog.Case: A 5-year-old male Maltese dog was admitted with a history of seizures. Hypertension and abdominal distensionwith large amounts of intestinal gases were found in general physical examination. Neurological examination revealedimpaired nasal septum sensory perception, which was slightly bilaterally reduced, and pain on cervical palpation and inthe brachial plexus region. Based on history and clinical examination, it was possible to locate the lesion in the thalamocortical region and to suspect idiopathic epilepsy, reactive seizures, and symptomatic epilepsy due to meningoencephalitisof unknown origin. The diagnosis of primary hyperlipidemia was made by exclusion with the aid of laboratory tests andultrasound. After the establishment of a fat restriction diet, bezafibrate, phenobarbital, and omega-3 supplementation, theanimal improved significantly with the reduction of epileptic seizures.Discussion: The initial clinical suspicion was hyperadrenocorticism as the primary cause of hyperlipidemia. This suspicion was based on the presence of polyphagia, polydipsia, polyuria and abdominal distension, together with laboratory...

Crises epilépticas reativas por hiperlipidemia em cão Maltês / Reactive seizures due to hyperlipidemia in a maltese dog

Background: Primary hyperlipidemia is a condition that affects some specific breeds. It has been previously describedin Miniature Shnauzer, Beagles, Shetland Shepdog and West Highland White Terrier. There are no reports of primaryhyperlipidemia in Maltese dogs. It is a hereditary disorder of lipoprotein metabolism. The etiology is unknown and maybe related to a genetic problem in lipoprotein lipase or to the absence of apaprotein CII. Clinical signs include spontaneousarterosclerosis, retinal lipemia, cutaneous xanthomas, abdominal pain, lethargy, vomiting and / or diarrhea. Neurologicalmanifestations such as seizures and behavioral changes may also occur. The aim of this report is to describe a case ofreactive seizures due to hyperlipidemia in a dog.Case: A 5-year-old male Maltese dog was admitted with a history of seizures. Hypertension and abdominal distensionwith large amounts of intestinal gases were found in general physical examination. Neurological examination revealedimpaired nasal septum sensory perception, which was slightly bilaterally reduced, and pain on cervical palpation and inthe brachial plexus region. Based on history and clinical examination, it was possible to locate the lesion in the thalamocortical region and to suspect idiopathic epilepsy, reactive seizures, and symptomatic epilepsy due to meningoencephalitisof unknown origin. The diagnosis of primary hyperlipidemia was made by exclusion with the aid of laboratory tests andultrasound. After the establishment of a fat restriction diet, bezafibrate, phenobarbital, and omega-3 supplementation, theanimal improved significantly with the reduction of epileptic seizures.Discussion: The initial clinical suspicion was hyperadrenocorticism as the primary cause of hyperlipidemia. This suspicion was based on the presence of polyphagia, polydipsia, polyuria and abdominal distension, together with laboratory...(AU)

Canine endogenous adrenocorticotrophic hormone preanalytical stability after sample shipping in dry ice or recyclable ice bars / Estabilidade pré-analítica do hormônio adrenocorticotrófico endógeno canino após remessa de amostras em gelo seco ou com barras de gelo reciclável

Endogenous adrenocorticotrophic hormone (eACTH) measurement is useful in hypercortisolism and hypoadrenocorticism investigation; however, since the hormone is highly unstable, blood samples require proper processing and storage, as well as shipping is often a step limiting since few laboratories offer this assay in Brazil. The aim of this note was to compare overnight dog´s eACTH preanalytical stability when frozen samples were shipped in dry ice (DI), or with recyclable ice bars (RIB). A total of 56 paired samples for eACTH measurement were analyzed. Blood samples were properly handled, plasma aliquots transferred into plastic microtubes, and stored at -80ºC. The fifty-six paired samples were overnight shipped in two thermic isolated boxes with DI or involved by RIB. Despite there was a high correlation between results from both shipping methods (r Spearman = 0.958, P<0.001), the Wilcoxon matched-pairs rank test showed that the shipping method may influence results (P<0.001). However, this difference does not affect results interpretation. By this way, when DI shipping was not possible, RIB shipping may represent a risk to eACTH preanalytical stability.(AU)

A mensuração do hormônio adrenocorticotrófico endógeno (ACTHe) é útil na investigação do hipercortisolismo e hipoadrenocorticismo. No entanto, como o hormônio é bastante instável, as amostras de sangue necessitam um manejo adequado no processamento e armazenamento, assim como o envio para laboratórios pode ser um passo limitante, uma vez que poucos laboratórios oferecem este ensaio no Brasil. O objetivo deste trabalho foi comparar a estabilidade pré-analítica do ACTHe durante longo período de envio de amostras congeladas em gelo seco (GS), ou com barras de gelo reciclável (BGR). Um total de 56 amostras pareadas para mensuração de ACTHe foram analisadas. As amostras de sangue foram adequadamente manejadas, sendo o plasma transferido para micro tubos plásticos estocados a -80ºC. Os 56 pares de amostras foram enviados à tarde para chegada ao laboratório na manhã seguinte em dois isopores, um com GS e outro com BGR. Apesar de uma alta correlação entre os resultados dos diferentes métodos de envio (r Spearman = 0,958, P<0,001), o teste de Wilcoxon para amostras pareadas mostrou que o método de envio influencia os resultados P<0,001). Apesar desta diferença, os resultados não afetaram a interpretação dos resultados. Desta forma, quando o envio em gelo seco não for possível, o envio das amostras com barras de gelo reciclável pode representar um risco à estabilidade pré-analítica do ACTHe.(AU)

Aortic and iliac thrombosis in a dog with adrenal-dependent hypercortisolism due to bilateral adrenocortical adenoma / Trombose aórtica e ilíaca em um cão com hipercortisolismo adrenal-dependente devido a adenoma adrenocortical bilateral

Hypercortisolism is a common endocrinopathy in dogs; however, in a few cases, bilateral functional adrenocortical adenomas cause spontaneous disease, and thrombotic events are considered uncommon complications. The aim of this report was to describe a case of bilateral adrenocortical adenoma in a dog with hyperadrenocorticism associated with distal aortic and iliac thrombosis, with emphasis on clinical and pathological aspects. A 15-year-old spayed female Dachshund with a previous clinical history of hyperadrenocorticism presented with acute bilateral hindlimb paraparesis. A vertebral thoracolumbar radiography was performed and did not present any evidence of intervertebral disk disease or vertebral abnormalities; however, abdominal ultrasound and vascular Doppler evaluation revealed bilateral adrenal enlargement in addition to an aortic and external iliac artery thrombus. The animal was euthanized. At necropsy, both adrenal glands were enlarged by well-demarcated neoplastic nodules in the parenchyma, and a thrombus caudal to the abdominal aorta bifurcation within the external iliac arteries that extended to the left external iliac artery was noted. Histological evaluation revealed a well-differentiated neoplastic proliferation of cortical epithelial cells, consistent with bilateral adenoma, and muscular necrosis in the pelvic limbs was also observed. Bilateral functional adrenocortical adenoma; although, very rare, should be considered as a cause of hypercortisolism, and aortic thrombosis in dogs should be considered as a possible consequence.(AU)

Hipercortisolismo é uma endocrinopatia comum em cães, no entanto, apenas em poucos casos adenomas adrenocorticais funcionais bilaterais são a causa de doença espontânea, e eventos trombóticos são considerados complicações incomuns. O objetivo deste relato foi descrever um caso de adenoma adrenocortical bilateral em um cão com hiperadrenocorticismo associado a trombose aórtica distal e ilíaca, com ênfase nos aspectos clínicos e patológicos. Um cão, Dachshund, fêmea castrada, de 15 anos, com histórico clínico prévio de hiperadrenocorticismo, apresentou paraparesia aguda dos membros posteriores. Foi realizada radiografia toracolombar vertebral, a qual não mostrou nenhuma evidência de doença do disco intervertebral ou anormalidades vertebrais; no entanto, ultrassonografia abdominal e Doppler vascular revelaram um trombo na aorta e artéria ilíaca externa, e adrenomegalia bilateral. O animal foi submetido à eutanásia. Na necropsia, ambas as adrenais estavam distendidas por nódulos neoplásicos bem delimitados no parênquima e notou-se um trombo caudalmente à bifurcação da aorta abdominal às artérias ilíacas externas, estendendo-se à ilíaca externa esquerda. Na avaliação histológica observou-se proliferação neoplásica bem diferenciada de células epiteliais corticais, consistente com adenoma bilateral; também foi observada necrose muscular nos membros pélvicos. O adenoma adrenocortical funcional bilateral, embora muito raro, deve ser considerado uma causa de hipercortisolismo, e a trombose aórtica em cães deve ser considerada uma possível consequência.(AU)

Técnica de microagulhamento para tratamento de alopecia x em cães / Microneedling technique for treatment of alopecia X in dogs

A alopecia X é uma dermatopatia hormonal que afeta principalmente raças nórdicas e tem como características a ocorrência de alopecia não inflamatória bilateral e simétrica, melanodérmica. Ela não afeta a região distal dos membros e cabeça, acometendo, sobretudo, a região cervical, dorsal e perianal. O diagnóstico é baseado nos sinais clínicos que o animal apresenta, na exclusão de dermatopatias endócrinas como hiperadrenocorticismo e hipotireoidismo, em exames laboratoriais e em biopsia cutânea. O tratamento consiste na castração, melatonina, trilostano e/ou hormônio do crescimento. Recentemente, o microagulhamento tem sido uma alternativa viável em pacientes com alopecia X. O presente trabalho teve como objetivo relatar o uso da técnica de microagulhamento em cães com alopecia X. Foram acompanhados dois cães, machos, da raça Spitz Alemão, com 2 e 5 anos de idade respectivamente, com um quadro alopécico e melanodermia na região de dorso e flanco e região cervical, caudal e perianal há mais de 2 anos. Depois de caracterizados como pacientes alopécicos X, os animais foram conduzidos à técnica de microagulhamento, exibindo repilação nas áreas alopécicas. Conclui-se dessa forma que o microagulhamento é uma técnica promissora para o tratamento da alopecia X.

Alopecia X is a hormonal dermatopathy that affects mainly Nordic breeds and has as its characteristics the occurrence of bilateral and symmetrical, melanodermic non-inflammatory alopecia. It does not affect the distal region of the limbs and head, mainly affecting the cervical, dorsal and perianal regions. The diagnosis is based on the clinical signs that the animal presents in the exclusion of endocrine dermatopathies such as hyperadrenocorticism and hypothyroidism, in laboratory tests and in cutaneous biopsy. Treatment consists of castration, melatonin, trilostan and/or growth hormone. Recently, microneedling has been a viable alternative in patients with alopecia X. The present work aimed to report the use of the microneedling technique in dogs with alopecia X. Two male German Spitz dogs, 2 and 5 years old respectively, with alopecia and melanodermia in the dorsum and flank region and cervical, caudal and perianal region for more than 2 years were followed. After being characterized as alopecia X patients, the animals were conducted to the microneedling technique, exhibiting repopulation in the alopecia areas. The conclusion is that microneedling is a promising technique for the treatment of alopecia X.

Técnica de microagulhamento para tratamento de alopecia x em cães / Microneedling technique for treatment of alopecia X in dogs

A alopecia X é uma dermatopatia hormonal que afeta principalmente raças nórdicas e tem como características a ocorrência de alopecia não inflamatória bilateral e simétrica, melanodérmica. Ela não afeta a região distal dos membros e cabeça, acometendo, sobretudo, a região cervical, dorsal e perianal. O diagnóstico é baseado nos sinais clínicos que o animal apresenta, na exclusão de dermatopatias endócrinas como hiperadrenocorticismo e hipotireoidismo, em exames laboratoriais e em biopsia cutânea. O tratamento consiste na castração, melatonina, trilostano e/ou hormônio do crescimento. Recentemente, o microagulhamento tem sido uma alternativa viável em pacientes com alopecia X. O presente trabalho teve como objetivo relatar o uso da técnica de microagulhamento em cães com alopecia X. Foram acompanhados dois cães, machos, da raça Spitz Alemão, com 2 e 5 anos de idade respectivamente, com um quadro alopécico e melanodermia na região de dorso e flanco e região cervical, caudal e perianal há mais de 2 anos. Depois de caracterizados como pacientes alopécicos X, os animais foram conduzidos à técnica de microagulhamento, exibindo repilação nas áreas alopécicas. Conclui-se dessa forma que o microagulhamento é uma técnica promissora para o tratamento da alopecia X.(AU)

Alopecia X is a hormonal dermatopathy that affects mainly Nordic breeds and has as its characteristics the occurrence of bilateral and symmetrical, melanodermic non-inflammatory alopecia. It does not affect the distal region of the limbs and head, mainly affecting the cervical, dorsal and perianal regions. The diagnosis is based on the clinical signs that the animal presents in the exclusion of endocrine dermatopathies such as hyperadrenocorticism and hypothyroidism, in laboratory tests and in cutaneous biopsy. Treatment consists of castration, melatonin, trilostan and/or growth hormone. Recently, microneedling has been a viable alternative in patients with alopecia X. The present work aimed to report the use of the microneedling technique in dogs with alopecia X. Two male German Spitz dogs, 2 and 5 years old respectively, with alopecia and melanodermia in the dorsum and flank region and cervical, caudal and perianal region for more than 2 years were followed. After being characterized as alopecia X patients, the animals were conducted to the microneedling technique, exhibiting repopulation in the alopecia areas. The conclusion is that microneedling is a promising technique for the treatment of alopecia X.(AU)

Epidemiological, clinical, and laboratory aspects in a case series of canine hyperadrenocorticism: 115 cases (2010-2014)

ABSTRACT: Diseases clinical-epidemiological characterization assists in directing the diagnosis. The objective of this study was to describe epidemiological, clinical and laboratorial aspects of a case series of canine hyperadrenocorticism (HAC). One-hundred fifteen records of dogs diagnosed by the low dose dexamethasone suppression test and/or ACTH stimulation test were evaluated. Of the cases, 81.3% were HAC ACTH-dependent and 18.7% HAC ACTH-independent. Females were more affected, representing 69.3% of the cases. The mean age was 10.3±2.5 years and 64.9% were gonadectomized. Most of the patients were small size dogs, weighting less than 10kg (73.9%). The most frequent breeds were: Poodle (27%), Dachshund (17.4%), and Yorkshire Terrier (10.4%). The most frequent clinical manifestations were polyphagia (86%), polydipsia (82.6%), polyuria (80%), abdominal enlargement (82.6%), thin skin (79.1%), muscular weakness (78.3%) and panting (74.8%). However, eventually unusual HAC-associated signs would be present in some dogs in a more important way compared with the classic disease´s clinical signs. The CBC showed neutrophilia (66%), eosinopenia (58.3%) and lymphopenia (42.6%) as main hematological abnormalities. The most common findings in serum biochemistry were increased alkaline phosphatase activity (81.74%), increased ALT activity (62.6%), hypercholesterolemia (66%) and hypertriglyceridemia (54.7%). Urinalysis revealed hyposthenuria in 14.9% and isostenuria in 13.5%; besides proteinuria in 50% of the cases. Abdominal ultrasound showed bilateral adrenal hyperplasia (92.2%) with adrenal asymmetry in 20.8% of the cases, in addition to hepatomegaly (80.9%), biliary sludge (67.8%) and hepatic hyperechogenicity (47.8%). It was concluded that small size gonadectomized female dogs, mainly Poodles and Dachshunds, presented higher frequency in the population studied, and that the main changes observed in clinical and complementary tests were polyphagia, polyuria, polydipsia, abdominal enlargement, adrenal hyperplasia, increased phosphatase alkaline and hyperlipidemia. These results corroborated to a better disease characterization at Brazil. This work concluded that the population studied resembles the profile describe in European and North American epidemiologic studies, and that the HAC dog´s clinical picture looks similar worldwide.

RESUMO: A caracterização clínica-epidemiológica de doenças auxilia no direcionamento do diagnóstico. O objetivo deste trabalho foi descrever aspectos epidemiológicos, clínicos e laboratoriais de uma série de casos de hiperadrenocorticismo (HAC) canino. Foram avaliados 115 prontuários de cães diagnosticados pelo teste de supressão por baixa dose de dexametasona e/ou teste de estimulação com ACTH. Os casos de HAC ACTH-dependentes representaram 81,3% da população, e 18,7% foram ACTH-independentes. As fêmeas foram mais acometidas, representando 69,3% dos casos. A média de idade foi 10,3 ± 2,5 anos e 64,9% eram gonadectomizados. A maioria dos cães foi de porte pequeno, de até 10 kg (73,9%). As raças mais frequentes foram Poodle (27%), Dachshund (17,4%) e Yorkshire (10,4%). As manifestações clínicas mais relatadas foram polifagia (86%), polidipsia (82,6%), poliúria (80%), abdome pendular (82,6%), atrofia cutânea (79,1%), fraqueza muscular (78,3%) e dispneia (74,8%). Entretanto, eventualmente sinais clínicos pouco associados ao HAC se manifestaram de forma mais importante que os sinais clássicos da doença. O hemograma revelou neutrofilia (66%), eosinopenia (58,3%) e linfopenia (42,6%) como principais alterações hematológicas. Na bioquímica sérica foi observado aumento de fosfatase alcalina (81,74% dos casos), aumento da atividade da ALT (62,6%), hipercolesterolemia (66%) e hipertrigliceridemia (54,7%). A urinálise revelou hipostenúria em 14,9% e isostenúria em 13,5%; além de proteinúria em 50% dos casos. A ecografia abdominal evidenciou hiperplasia bilateral de adrenal (92,2%) com assimetria de adrenais em 20,8% dos casos, além de hepatomegalia (80,9%), lama biliar (67,8%) e hiperecogenicidade hepática (47,8%). Concluiu-se que fêmeas castradas de pequeno porte, principalmente das raças Poodles e Dachshunds, apresentaram maior frequência na população estudada e que as principais alterações observadas clínicas e nos exames complementares foram polifagia, poliúria, polidipsia, aumento abdominal, hiperplasia da adrenal, aumento de fosfatase alcalina e hiperlipidemia. Estes resultados corroboram para melhor caracterização da doença no Brasil. Este estudo concluiu que a população estudada se assemelha ao perfil populacional de cães com HAC descrito em estudos Europeus e Norte Americanos de forma que o perfil dos casos ao redor do globo parece similar.

Epidemiological, clinical, and laboratory aspects in a case series of canine hyperadrenocorticism: 115 cases (2010-2014) / Aspectos epidemiológicos, clínicos e laboratoriais em uma série de cães com hiperadrenocorticismo: 115 casos (2010-2014)

Diseases' clinical-epidemiological characterization assists in directing the diagnosis. The objective of this study was to describe epidemiological, clinical and laboratorial aspects of a case series of canine hyperadrenocorticism (HAC). One-hundred fifteen records of dogs diagnosed by the low dose dexamethasone suppression test and/or ACTH stimulation test were evaluated. Of the cases, 81.3% were HAC ACTH-dependent and 18.7% HAC ACTH-independent. Females were more affected, representing 69.3% of the cases. The mean age was 10.3±2.5 years and 64.9% were gonadectomized. Most of the patients were small size dogs, weighting less than 10kg (73.9%). The most frequent breeds were: Poodle (27%), Dachshund (17.4%), and Yorkshire Terrier (10.4%). The most frequent clinical manifestations were polyphagia (86%), polydipsia (82.6%), polyuria (80%), abdominal enlargement (82.6%), thin skin (79.1%), muscular weakness (78.3%) and panting (74.8%). However, eventually unusual HAC-associated signs would be present in some dogs in a more important way compared with the classic disease´s clinical signs. The CBC showed neutrophilia (66%), eosinopenia (58.3%) and lymphopenia (42.6%) as main hematological abnormalities. The most common findings in serum biochemistry were increased alkaline phosphatase activity (81.74%), increased ALT activity (62.6%), hypercholesterolemia (66%) and hypertriglyceridemia (54.7%). Urinalysis revealed hyposthenuria in 14.9% and isostenuria in 13.5%; besides proteinuria in 50% of the cases. Abdominal ultrasound showed bilateral adrenal hyperplasia (92.2%) with adrenal asymmetry in 20.8% of the cases, in addition to hepatomegaly (80.9%), biliary sludge (67.8%) and hepatic hyperechogenicity (47.8%). It was concluded that small size gonadectomized female dogs, mainly Poodles and Dachshunds, presented higher frequency in the population studied, and that the main changes observed in clinical and complementary tests were polyphagia, polyuria, polydipsia, abdominal enlargement, adrenal hyperplasia, increased phosphatase alkaline and hyperlipidemia. These results corroborated to a better disease characterization at Brazil. This work concluded that the population studied resembles the profile describe in European and North American epidemiologic studies, and that the HAC dog´s clinical picture looks similar worldwide.(AU)

A caracterização clínica-epidemiológica de doenças auxilia no direcionamento do diagnóstico. O objetivo deste trabalho foi descrever aspectos epidemiológicos, clínicos e laboratoriais de uma série de casos de hiperadrenocorticismo (HAC) canino. Foram avaliados 115 prontuários de cães diagnosticados pelo teste de supressão por baixa dose de dexametasona e/ou teste de estimulação com ACTH. Os casos de HAC ACTH-dependentes representaram 81,3% da população, e 18,7% foram ACTH-independentes. As fêmeas foram mais acometidas, representando 69,3% dos casos. A média de idade foi 10,3 ± 2,5 anos e 64,9% eram gonadectomizados. A maioria dos cães foi de porte pequeno, de até 10 kg (73,9%). As raças mais frequentes foram Poodle (27%), Dachshund (17,4%) e Yorkshire (10,4%). As manifestações clínicas mais relatadas foram polifagia (86%), polidipsia (82,6%), poliúria (80%), abdome pendular (82,6%), atrofia cutânea (79,1%), fraqueza muscular (78,3%) e dispneia (74,8%). Entretanto, eventualmente sinais clínicos pouco associados ao HAC se manifestaram de forma mais importante que os sinais clássicos da doença. O hemograma revelou neutrofilia (66%), eosinopenia (58,3%) e linfopenia (42,6%) como principais alterações hematológicas. Na bioquímica sérica foi observado aumento de fosfatase alcalina (81,74% dos casos), aumento da atividade da ALT (62,6%), hipercolesterolemia (66%) e hipertrigliceridemia (54,7%). A urinálise revelou hipostenúria em 14,9% e isostenúria em 13,5%; além de proteinúria em 50% dos casos. A ecografia abdominal evidenciou hiperplasia bilateral de adrenal (92,2%) com assimetria de adrenais em 20,8% dos casos, além de hepatomegalia (80,9%), lama biliar (67,8%) e hiperecogenicidade hepática (47,8%). Concluiu-se que fêmeas castradas de pequeno porte, principalmente das raças Poodles e Dachshunds, apresentaram maior frequência na população estudada e que as principais alterações observadas clínicas e nos exames complementares foram polifagia, poliúria, polidipsia, aumento abdominal, hiperplasia da adrenal, aumento de fosfatase alcalina e hiperlipidemia. Estes resultados corroboram para melhor caracterização da doença no Brasil. Este estudo concluiu que a população estudada se assemelha ao perfil populacional de cães com HAC descrito em estudos Europeus e Norte Americanos de forma que o perfil dos casos ao redor do globo parece similar.(AU)

Epidemiological, clinical, and laboratory aspects in a case series of canine hyperadrenocorticism: 115 cases (2010-2014) / Aspectos epidemiológicos, clínicos e laboratoriais em uma série de cães com hiperadrenocorticismo: 115 casos (2010-2014)

Diseases' clinical-epidemiological characterization assists in directing the diagnosis. The objective of this study was to describe epidemiological, clinical and laboratorial aspects of a case series of canine hyperadrenocorticism (HAC). One-hundred fifteen records of dogs diagnosed by the low dose dexamethasone suppression test and/or ACTH stimulation test were evaluated. Of the cases, 81.3% were HAC ACTH-dependent and 18.7% HAC ACTH-independent. Females were more affected, representing 69.3% of the cases. The mean age was 10.3±2.5 years and 64.9% were gonadectomized. Most of the patients were small size dogs, weighting less than 10kg (73.9%). The most frequent breeds were: Poodle (27%), Dachshund (17.4%), and Yorkshire Terrier (10.4%). The most frequent clinical manifestations were polyphagia (86%), polydipsia (82.6%), polyuria (80%), abdominal enlargement (82.6%), thin skin (79.1%), muscular weakness (78.3%) and panting (74.8%). However, eventually unusual HAC-associated signs would be present in some dogs in a more important way compared with the classic disease´s clinical signs. The CBC showed neutrophilia (66%), eosinopenia (58.3%) and lymphopenia (42.6%) as main hematological abnormalities. The most common findings in serum biochemistry were increased alkaline phosphatase activity (81.74%), increased ALT activity (62.6%), hypercholesterolemia (66%) and hypertriglyceridemia (54.7%). Urinalysis revealed hyposthenuria in 14.9% and isostenuria in 13.5%; besides proteinuria in 50% of the cases. Abdominal ultrasound showed bilateral adrenal hyperplasia (92.2%) with adrenal asymmetry in 20.8% of the cases, in addition to hepatomegaly (80.9%), biliary sludge (67.8%) and hepatic hyperechogenicity (47.8%). It was concluded that small size gonadectomized female dogs, mainly Poodles and Dachshunds, presented higher frequency in the population studied, and that the main changes observed in clinical and complementary tests were polyphagia, polyuria, polydipsia, abdominal enlargement, adrenal hyperplasia, increased phosphatase alkaline and hyperlipidemia. These results corroborated to a better disease characterization at Brazil. This work concluded that the population studied resembles the profile describe in European and North American epidemiologic studies, and that the HAC dog´s clinical picture looks similar worldwide.(AU)

A caracterização clínica-epidemiológica de doenças auxilia no direcionamento do diagnóstico. O objetivo deste trabalho foi descrever aspectos epidemiológicos, clínicos e laboratoriais de uma série de casos de hiperadrenocorticismo (HAC) canino. Foram avaliados 115 prontuários de cães diagnosticados pelo teste de supressão por baixa dose de dexametasona e/ou teste de estimulação com ACTH. Os casos de HAC ACTH-dependentes representaram 81,3% da população, e 18,7% foram ACTH-independentes. As fêmeas foram mais acometidas, representando 69,3% dos casos. A média de idade foi 10,3 ± 2,5 anos e 64,9% eram gonadectomizados. A maioria dos cães foi de porte pequeno, de até 10 kg (73,9%). As raças mais frequentes foram Poodle (27%), Dachshund (17,4%) e Yorkshire (10,4%). As manifestações clínicas mais relatadas foram polifagia (86%), polidipsia (82,6%), poliúria (80%), abdome pendular (82,6%), atrofia cutânea (79,1%), fraqueza muscular (78,3%) e dispneia (74,8%). Entretanto, eventualmente sinais clínicos pouco associados ao HAC se manifestaram de forma mais importante que os sinais clássicos da doença. O hemograma revelou neutrofilia (66%), eosinopenia (58,3%) e linfopenia (42,6%) como principais alterações hematológicas. Na bioquímica sérica foi observado aumento de fosfatase alcalina (81,74% dos casos), aumento da atividade da ALT (62,6%), hipercolesterolemia (66%) e hipertrigliceridemia (54,7%). A urinálise revelou hipostenúria em 14,9% e isostenúria em 13,5%; além de proteinúria em 50% dos casos. A ecografia abdominal evidenciou hiperplasia bilateral de adrenal (92,2%) com assimetria de adrenais em 20,8% dos casos, além de hepatomegalia (80,9%), lama biliar (67,8%) e hiperecogenicidade hepática (47,8%). Concluiu-se que fêmeas castradas de pequeno porte, principalmente das raças Poodles e Dachshunds, apresentaram maior frequência na população estudada e que as principais alterações observadas clínicas e nos exames complementares foram polifagia, poliúria, polidipsia, aumento abdominal, hiperplasia da adrenal, aumento de fosfatase alcalina e hiperlipidemia. Estes resultados corroboram para melhor caracterização da doença no Brasil. Este estudo concluiu que a população estudada se assemelha ao perfil populacional de cães com HAC descrito em estudos Europeus e Norte Americanos de forma que o perfil dos casos ao redor do globo parece similar.(AU)

Picrosirius red and Masson’s Trichrome staining techniques as tools for detection of collagen fibers in the skin of dogs with endocrine dermatopathologies / Picrosirius red e Tricrômico de Masson como ferramentas para detecção de fibras colágenas em pele de cães com dermatopatologias endócrinas

Canine endocrinopathies, such as hypothyroidism and hyperadrenocortism,induce typical dermatological alterations. Collagen fibers are significant for the maintenance of structural integrity,as well as in the determination of tissue function. This study aimed at assessing the coloration caused by Picrosirius Red staining under circular polarization and Masson Trichrome staining, as tools to quantify the total collagen in the skin of dogs exhibiting endocrine dermatopathies. Skin samples taken from dogs with hypothyroidism and hyperadrenocorticism were stained using Hematoxylin and Eosin (HE), Masson’s Trichrome (MT) and Picrosirius Red (PSR). The animals with hyperadrenocorticism revealed a higher percentage of collagen area than did the animals with hypothyroidism PSRp (hypothyroidism = 43.76 ± 0.8255 and hyperadrenocorticism = 47.08 ± 0.8584). The percentage of the collagen area using MT between the groups is given in parenthesis (hypothyroidism = 52.06 ± 0.9371, hyperadrenocorticism = 61 ± 0.7529 and control = 56.88 ± 0.64) (p <0.05). It is therefore, evident that the special stains employed are useful in estimating the percentage of collagen area in the skin, as they revealed that dogs with hypothyroidism had lower collagen deposition whereas those animals with hyperadrenocorticism showed higher quantity of collagen in the dermis.

Endocrinopatias caninas como hipotireoidismo e o hiperadrenocortismo causam alterações dermatológicas características. As fibras de colágeno desempenham um papel vital na manutenção da integridade estrutural e também na determinação da função dos tecidos. O objetivo deste estudo foi avaliar as colorações de picrosirius red sob polarização circular e coloração tricômio de Masson como ferramentas para quantificar o colágeno total da pele de cães com dermatopatias endócrinas. Amostras de pele obtidas de cães com hipotireoidismo e hiperadrenocorticismo foram coradas por Hematoxilina e Eosina (HE), Tricrômio de Masson (MT) e Picrosirius red (PSR). A porcentagem de área de colágeno foi maior nos animais com hiperadrenocorticismo e menor nos animais com hipotireoidismo PSRp (hipotireoidismo = 43,76 ± 0.8255 e hiperadrenocorticismo = 47,08 ± 0.8584). Já a porcentagem de área de colágeno no MT entre os grupos (hipotireoidismo = 52,06 ± 0.9371, hiperadrenocorticismo = 61 ± 0,7529 e controle = 56,88 ± 0.64) (p <0.05). Concluiu-se que as colorações especiais utilizadas são úteis para avaliar a porcentagem de área de colágeno na pele, pois demonstraram que cães com hipotireoidismo demonstraram uma diminuição na deposição de colágeno e os animais com hiperadrenocorticismo apresentaram maior quantidade de colágeno na derme.

Picrosirius red and Massons Trichrome staining techniques as tools for detection of collagen fibers in the skin of dogs with endocrine dermatopathologies / Picrosirius red e Tricrômico de Masson como ferramentas para detecção de fibras colágenas em pele de cães com dermatopatologias endócrinas

Canine endocrinopathies, such as hypothyroidism and hyperadrenocortism,induce typical dermatological alterations. Collagen fibers are significant for the maintenance of structural integrity,as well as in the determination of tissue function. This study aimed at assessing the coloration caused by Picrosirius Red staining under circular polarization and Masson Trichrome staining, as tools to quantify the total collagen in the skin of dogs exhibiting endocrine dermatopathies. Skin samples taken from dogs with hypothyroidism and hyperadrenocorticism were stained using Hematoxylin and Eosin (HE), Massons Trichrome (MT) and Picrosirius Red (PSR). The animals with hyperadrenocorticism revealed a higher percentage of collagen area than did the animals with hypothyroidism PSRp (hypothyroidism = 43.76 ± 0.8255 and hyperadrenocorticism = 47.08 ± 0.8584). The percentage of the collagen area using MT between the groups is given in parenthesis (hypothyroidism = 52.06 ± 0.9371, hyperadrenocorticism = 61 ± 0.7529 and control = 56.88 ± 0.64) (p <0.05). It is therefore, evident that the special stains employed are useful in estimating the percentage of collagen area in the skin, as they revealed that dogs with hypothyroidism had lower collagen deposition whereas those animals with hyperadrenocorticism showed higher quantity of collagen in the dermis.(AU)

Endocrinopatias caninas como hipotireoidismo e o hiperadrenocortismo causam alterações dermatológicas características. As fibras de colágeno desempenham um papel vital na manutenção da integridade estrutural e também na determinação da função dos tecidos. O objetivo deste estudo foi avaliar as colorações de picrosirius red sob polarização circular e coloração tricômio de Masson como ferramentas para quantificar o colágeno total da pele de cães com dermatopatias endócrinas. Amostras de pele obtidas de cães com hipotireoidismo e hiperadrenocorticismo foram coradas por Hematoxilina e Eosina (HE), Tricrômio de Masson (MT) e Picrosirius red (PSR). A porcentagem de área de colágeno foi maior nos animais com hiperadrenocorticismo e menor nos animais com hipotireoidismo PSRp (hipotireoidismo = 43,76 ± 0.8255 e hiperadrenocorticismo = 47,08 ± 0.8584). Já a porcentagem de área de colágeno no MT entre os grupos (hipotireoidismo = 52,06 ± 0.9371, hiperadrenocorticismo = 61 ± 0,7529 e controle = 56,88 ± 0.64) (p <0.05). Concluiu-se que as colorações especiais utilizadas são úteis para avaliar a porcentagem de área de colágeno na pele, pois demonstraram que cães com hipotireoidismo demonstraram uma diminuição na deposição de colágeno e os animais com hiperadrenocorticismo apresentaram maior quantidade de colágeno na derme.(AU)

Lesões orais secundárias à leishmaniose visceral em um cão com hiperadrenocorticismo endógeno: relato de caso / Oral lesions secondary to visceral leishmaniasis in a dog with endogenous hyperadrenocorticism: case report

O objetivo do presente trabalho foi relatar um caso de leishmaniose visceral com apresentação mucosa em um cão com hiperadrenocorticismo. Um canino, macho, da raça Poodle, 11 anos de idade, foi atendido com histórico de disfagia, halitose e sialorreia. Ao exame físico, observou-se linfadenomegalia generalizada e alterações cutâneas, como rarefação pilosa, comedões, telangiectasia e atrofia cutânea. Além disso, o animal também apresentava formações orais localizadas na língua. Dos exames hematológicos e bioquímicos realizados, a única alteração encontrada foi elevação da fosfatase alcalina (1724u/L). O teste de supressão com a dexametasona em dose baixa foi executado para investigar hiperadrenocorticismo, tendo resultado positivo. Também foram realizados exames citológicos dos linfonodos, da medula óssea e das formações orais, tendo sido observada a presença de formas amastigotas de Leishmania sp. em todas as amostras. O animal foi submetido à biópsia incisional das formações orais, e a análise histopatológica demonstrou um quadro de inflamação granulomatosa com presença de grande quantidade de microrganismos morfologicamente compatíveis com formas amastigotas de Leishmania sp. no interior das células inflamatórias. Diante dos achados clínicos e dos exames complementares, diagnosticou-se um caso de leishmaniose com manifestação mucosa atípica, associado ao hiperadrenocorticismo, podendo essa endocrinopatia ter sido um fator predisponente para essa enfermidade infectocontagiosa.(AU)

The objective of the present study was to report a case of visceral leishmaniasis with mucosal presentation in a dog with hyperadrenocorticism. A canine, male, Poodle, 11 years old, was attended with a history of dysphagia, halitosis, and sialorreia. The physical examination revealed generalized lymphadenomegaly and cutaneous alterations such as hair loss, comedones, telangiectasia, and cutaneous atrophy. Futhermore, the animal also had localized oral formations on the tongue. From the hematological and biochemical tests performed, the only alteration was alkaline phosphatase elevation (1724u / L). The low dose dexamethasone suppression test was performed to investigate hyperadrenocorticism and found a positive result. In addition, cytological exams of lymph nodes, bone marrow and oral formations were also performed, and the presence of amastigote forms of Leishmania sp. were observed in all samples. The animal was submitted to incisional biopsy of the oral formations and the histopathological analysis showed a granulomatous inflammation with presence of large quantity of microorganisms morphologically compatible with amastigotes forms of Leishmania sp. within the inflammatory cells. Faced with clinical findings and complementary exams, a case of leishmaniasis with atypical mucosal manifestation, associated with hyperadrenocorticism, was diagnosed, and this endocrinopathy could have been a predisposing factor to this infectious-contagious disease.(AU)

Lesões orais secundárias à leishmaniose visceral em um cão com hiperadrenocorticismo endógeno: relato de caso / Oral lesions secondary to visceral leishmaniasis in a dog with endogenous hyperadrenocorticism: case report

O objetivo do presente trabalho foi relatar um caso de leishmaniose visceral com apresentação mucosa em um cão com hiperadrenocorticismo. Um canino, macho, da raça Poodle, 11 anos de idade, foi atendido com histórico de disfagia, halitose e sialorreia. Ao exame físico, observou-se linfadenomegalia generalizada e alterações cutâneas, como rarefação pilosa, comedões, telangiectasia e atrofia cutânea. Além disso, o animal também apresentava formações orais localizadas na língua. Dos exames hematológicos e bioquímicos realizados, a única alteração encontrada foi elevação da fosfatase alcalina (1724u/L). O teste de supressão com a dexametasona em dose baixa foi executado para investigar hiperadrenocorticismo, tendo resultado positivo. Também foram realizados exames citológicos dos linfonodos, da medula óssea e das formações orais, tendo sido observada a presença de formas amastigotas de Leishmania sp. em todas as amostras. O animal foi submetido à biópsia incisional das formações orais, e a análise histopatológica demonstrou um quadro de inflamação granulomatosa com presença de grande quantidade de microrganismos morfologicamente compatíveis com formas amastigotas de Leishmania sp. no interior das células inflamatórias. Diante dos achados clínicos e dos exames complementares, diagnosticou-se um caso de leishmaniose com manifestação mucosa atípica, associado ao hiperadrenocorticismo, podendo essa endocrinopatia ter sido um fator predisponente para essa enfermidade infectocontagiosa.(AU)

The objective of the present study was to report a case of visceral leishmaniasis with mucosal presentation in a dog with hyperadrenocorticism. A canine, male, Poodle, 11 years old, was attended with a history of dysphagia, halitosis, and sialorreia. The physical examination revealed generalized lymphadenomegaly and cutaneous alterations such as hair loss, comedones, telangiectasia, and cutaneous atrophy. Futhermore, the animal also had localized oral formations on the tongue. From the hematological and biochemical tests performed, the only alteration was alkaline phosphatase elevation (1724u / L). The low dose dexamethasone suppression test was performed to investigate hyperadrenocorticism and found a positive result. In addition, cytological exams of lymph nodes, bone marrow and oral formations were also performed, and the presence of amastigote forms of Leishmania sp. were observed in all samples. The animal was submitted to incisional biopsy of the oral formations and the histopathological analysis showed a granulomatous inflammation with presence of large quantity of microorganisms morphologically compatible with amastigotes forms of Leishmania sp. within the inflammatory cells. Faced with clinical findings and complementary exams, a case of leishmaniasis with atypical mucosal manifestation, associated with hyperadrenocorticism, was diagnosed, and this endocrinopathy could have been a predisposing factor to this infectious-contagious disease.(AU)

Calcinose cutânea associada a Hiperglicocorticoidismo em cão: Relato de Caso / Calcinosis cutis associated to Hyperadrenocorticism in a dog: case report

Cutaneous calcinosis is an uncommon condition where it is mostly shown the deposition ofcalcium in the skin layers, generally associated with by endocrinopathies of the adrenalcortex. Here we report a case of a dog with adrenal gland hyperplasia that developedcalcinosis cutis in a middle-aged dog. In this case, the clinical typical presentation,together with histopathological and ultrasonographical findings were extremely importantin the elucidation.

Calcinose cutânea associada a Hiperglicocorticoidismo em cão: Relato de Caso / Calcinosis cutis associated to Hyperadrenocorticism in a dog: case report

Cutaneous calcinosis is an uncommon condition where it is mostly shown the deposition ofcalcium in the skin layers, generally associated with by endocrinopathies of the adrenalcortex. Here we report a case of a dog with adrenal gland hyperplasia that developedcalcinosis cutis in a middle-aged dog. In this case, the clinical typical presentation,together with histopathological and ultrasonographical findings were extremely importantin the elucidation.(AU)

Uso de baixa dose de ACTH sintético no teste de estimulação da função adrenal para o diagnóstico e controle do hiperadrenocorticismo canino: avaliação da eficácia diagnóstica / Use of low-dose of synthetic ACTH in the adrenal stimulation test for diagnosis and monitoring of canine hyperadrenocorticism: evaluation of diagnostic efficacy

O teste de estimulação com ACTH é o teste de escolha para realizar o controle dos valores de cortisol endógeno em pacientes sob tratamento para o hiperadrenocorticismo canino, podendo ser utilizado também para diagnosticar a doença. Os protocolos atuais utilizam doses que variam entre 5ug/kg a 250ug/animal por administração intravenosa ou intramuscular. Não se constatam estudos com doses menores que as de 5ug/kg em pacientes portadores de hiperadrenocorticismo. No presente estudo, foi testada a dose de 1ug/kg/IV; comparada à dose consagrada de 5ug/kg/IV, em grupos de animais suspeitos de HAC (HAC Diag), animais portadores de HAC e em tratamento (HAC Control) e animais sadios (Sadios). Na dose de 1ug/kg/IV, os valores basais de cortisol dos Sadios foram iguais à média 2,40ug/dL(+/-1,57ug/dL), dos HAC control foi de média 1,53ug/dL(+/-0,93,ug/dL) e dos HAC diag foi média 3,37ug/dL(+/-1,57ug/dL). Os valores pós-ACTH na dose de 1ug/kg foram de média 11,43ug/dL(+/-2,46ug/dL) para animais sadios, 2,67ug/dL(+/-1,39ug/dL) para o grupo HAC Control e média 16,56ug/dL(+/-7,62ug/dL) para o grupo HAC Diag. Os valores basais de cortisol na dose de 5ug/kg foram 0,89ug/dL(+/-0,23ug/dL) para o grupo HAC Control; média 3,08ug/dL(+/-1,99 ug/dL) para o grupo HAC Diag. Os valores pós-ACTH na dose de 5ug/kg foram de média 3,71ug/dL(+/-1,57ug/dL), para o grupo HAC control e média 22,52ug/dL (+/-8,75ug/dL) para o grupo HAC diag. Analisando-se os resultados obtidos, constatou-se que as doses 1 e 5ug/kg de ACTH sintético não diferem entre si, promovendo o mesmo tipo de variação nos valores de cortisol (ANOVA; p=0,225). Também, que a dose de 1ug/kg de ACTH foi igualmente eficaz na elevação dos níveis de cortisol nos três grupo testados (Sadios, HAC Control e HAC Diag; ANOVA, p<0,05). E, pelo teste de Dunn observamos que o grupo HAC control apresenta Δ-cortisol (delta =diferença entre cortisol após estimulo e o cortisol basal) significativamente menor que o dos grupos diagnóstico (p<0,05) e animais sadios (p<0,05). Concluiu-se que a dose de 1ug/kg de ACTH sintético pode ser utilizada com eficácia para a realização do teste de estimulação com ACTH.(AU)

ACTH stimulation is the gold standard test to monitor levels of endogen control of patients under treatment for canine hyperadrenocorticism and it may also be used to diagnose the disease. Current protocols use doses ranging from 5ug/kg to 250ug per animal by intravenous or intramuscular administration. There are no studies with doses inferior to 5ug/kg in adrenopatic patients. In the present investigation, the dose of 1ug/kg/IV was tested; compared with the recommended dose of d 5ug/kg/IV in groups of dogs under clinical suspicion of HAC (HAC Diag), animals under treatment for HAC (HAC Control) and healthy animals (Healthy). Under the dose of 1ug/kg/IV, average results for baseline cortisol values were equal to 2.40ug/dL(+/- 1.57ug/dL) for healthy, 1.53g/dL(+/-0.93ug/dL) for HAC Control and 3.37ug/dL(+/-1.57ug/dL) for HAC Diag. Post-ACTH values in the dose of 1ug/kg were average 11.43ug/dL(+/-2.46ug/dL) for healthy animals, 2.67ug/dL (+/-1.39ug/dL) for HAC Control and 16.56ug/dL(+/-7.62ug/dL) for HAC Diag group. Basal cortisol values at a dose of 5ug/kg were 0.89ug/dL (+/-0.23ug/dL) Control group for HAC; average 3.08ug/dL (+/-1.99ug/dL) for HAC Diag group. Baseline cortisol under the dose of 5ug/kg were average 3.71ug/dL(+/-1.57ug/dL) for HAC Control and 22.52g/dL(+/-8.75ug/dL) for HAC diag. Based on the present results, it was found that both doses of 1 and 5ug/kg of synthetic ACTH do not differ, providing the same kind of change in cortisol values (ANOVA, p=0.225). Also, the dose of 1ug/kg of ACTH was equally effective in raising levels of cortisol in the three groups tested (Healthy, HAC and HAC Control Diag; ANOVA, p<0.05). Through the Dunn test it was observed that HAC Control presented HAC-Δ cortisol (delta = difference between cortisol after stimulation and basal cortisol) significantly lower than HAC Diag (p<0.05) and healthy animals (p<0.05). Therefore the dose of 1ug/kg of synthetic ACTH can be effectively used to perform the ACTH stimulation test effectively.(AU)

Uso de baixa dose de ACTH sintético no teste de estimulação da função adrenal para o diagnóstico e controle do hiperadrenocorticismo canino: avaliação da eficácia diagnóstica / Use of low-dose of synthetic ACTH in the adrenal stimulation test for diagnosis and monitoring of canine hyperadrenocorticism: evaluation of diagnostic efficacy

O teste de estimulação com ACTH é o teste de escolha para realizar o controle dos valores de cortisol endógeno em pacientes sob tratamento para o hiperadrenocorticismo canino, podendo ser utilizado também para diagnosticar a doença. Os protocolos atuais utilizam doses que variam entre 5ug/kg a 250ug/animal por administração intravenosa ou intramuscular. Não se constatam estudos com doses menores que as de 5ug/kg em pacientes portadores de hiperadrenocorticismo. No presente estudo, foi testada a dose de 1ug/kg/IV; comparada à dose consagrada de 5ug/kg/IV, em grupos de animais suspeitos de HAC (HAC Diag), animais portadores de HAC e em tratamento (HAC Control) e animais sadios (Sadios). Na dose de 1ug/kg/IV, os valores basais de cortisol dos Sadios foram iguais à média 2,40ug/dL(+/-1,57ug/dL), dos HAC control foi de média 1,53ug/dL(+/-0,93,ug/dL) e dos HAC diag foi média 3,37ug/dL(+/-1,57ug/dL). Os valores pós-ACTH na dose de 1ug/kg foram de média 11,43ug/dL(+/-2,46ug/dL) para animais sadios, 2,67ug/dL(+/-1,39ug/dL) para o grupo HAC Control e média 16,56ug/dL(+/-7,62ug/dL) para o grupo HAC Diag. Os valores basais de cortisol na dose de 5ug/kg foram 0,89ug/dL(+/-0,23ug/dL) para o grupo HAC Control; média 3,08ug/dL(+/-1,99 ug/dL) para o grupo HAC Diag. Os valores pós-ACTH na dose de 5ug/kg foram de média 3,71ug/dL(+/-1,57ug/dL), para o grupo HAC control e média 22,52ug/dL (+/-8,75ug/dL) para o grupo HAC diag. Analisando-se os resultados obtidos, constatou-se que as doses 1 e 5ug/kg de ACTH sintético não diferem entre si, promovendo o mesmo tipo de variação nos valores de cortisol (ANOVA; p=0,225). Também, que a dose de 1ug/kg de ACTH foi igualmente eficaz na elevação dos níveis de cortisol nos três grupo testados (Sadios, HAC Control e HAC Diag; ANOVA, p<0,05). E, pelo teste de Dunn observamos que o grupo HAC control apresenta Δ-cortisol (delta =diferença entre cortisol após estimulo e o cortisol basal) significativamente [...](AU)

ACTH stimulation is the gold standard test to monitor levels of endogen control of patients under treatment for canine hyperadrenocorticism and it may also be used to diagnose the disease. Current protocols use doses ranging from 5ug/kg to 250ug per animal by intravenous or intramuscular administration. There are no studies with doses inferior to 5ug/kg in adrenopatic patients. In the present investigation, the dose of 1ug/kg/IV was tested; compared with the recommended dose of d 5ug/kg/IV in groups of dogs under clinical suspicion of HAC (HAC Diag), animals under treatment for HAC (HAC Control) and healthy animals (Healthy). Under the dose of 1ug/kg/IV, average results for baseline cortisol values were equal to 2.40ug/dL(+/- 1.57ug/dL) for healthy, 1.53g/dL(+/-0.93ug/dL) for HAC Control and 3.37ug/dL(+/-1.57ug/dL) for HAC Diag. Post-ACTH values in the dose of 1ug/kg were average 11.43ug/dL(+/-2.46ug/dL) for healthy animals, 2.67ug/dL (+/-1.39ug/dL) for HAC Control and 16.56ug/dL(+/-7.62ug/dL) for HAC Diag group. Basal cortisol values at a dose of 5ug/kg were 0.89ug/dL (+/-0.23ug/dL) Control group for HAC; average 3.08ug/dL (+/-1.99ug/dL) for HAC Diag group. Baseline cortisol under the dose of 5ug/kg were average 3.71ug/dL(+/-1.57ug/dL) for HAC Control and 22.52g/dL(+/-8.75ug/dL) for HAC diag. Based on the present results, it was found that both doses of 1 and 5ug/kg of synthetic ACTH do not differ, providing the same kind of change in cortisol values (ANOVA, p=0.225). Also, the dose of 1ug/kg of ACTH was equally effective in raising levels of cortisol in the three groups tested (Healthy, HAC and HAC Control Diag; ANOVA, p<0.05). Through the Dunn test it was observed that HAC Control presented HAC-Δ cortisol (delta = difference between cortisol after stimulation and basal cortisol) significantly lower than HAC Diag (p<0.05) and healthy animals (p<0.05). Therefore [...](AU)

Adrenalectomy in dogs: retrospective study of 13 cases performed in Universidade Anhembi Morumbi Veterinary Hospital (2012-2015) / Adrenalectomia em cães: estudo retrospectivo de 13 casos realizados no hospital veterinário da Universidade Anhembi Morumbi (2012 a 2015)

Adrenalectomy is the most appropriate treatment for unilateral adrenal tumors. This study aimed at describing the epidemiological characteristics and perioperative behavior of canine patients submitted to adrenalectomy at Anhembi Morumbi Veterinary Hospital. Out of 13 dogs, eight were pure breeds and five were mixed breeds; 12 females, aged 9.5 ± 2.5 years old. Regarding the tumors, seven were located on the right and histopathological analysis revealed cortical adenoma in 11 and adenocarcinoma in only two dogs. Two cases had hypercortisolism recurrence associated with hyperplasia in the contralateral adrenal, as confirmed by ACTH stimulation test. The results of this study indicate that adrenalectomy is a safe procedure with few perioperative complications, despite the possibility of hypercortisolism recurrence.(AU)

Adrenalectomia é o tratamento mais indicado para neoplasias adrenais unilaterais. Objetivou-se descrever os aspectos epidemiológicos e o comportamento perioperatório em cães submetidos a adrenalectomia no Hospital Veterinário Anhembi Morumbi. Dos 13 casos, oito eram cães de raças puras e cinco eram SRD; 12 eram fêmeas e de idade de 9,5 ± 2,5 anos. Das massas adrenais, sete eram em lado direito. Os exames histopatológicos revelaram adenoma cortical em 11 cães e adenocarcinoma em dois. Dois casos recidivaram a condição de hipercortisolemia, associada à hiperplasia, na adrenal contralateral, confirmados pelo teste de estimulação por ACTH. Concluiu-se que a adrenalectomia é um procedimento seguro, com poucas complicações perioperatórias, ressalvando-se a possiblidade de recidiva do quadro de hipercortisolismo.(AU)