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.

Hyperadrenocorticism in a crab-eating fox (Cerdocyon thous) kept under human care / Hiperadrenocorticismo em cachorro-do-mato (Cerdocyon thous) mantido sob cuidados humanos

Hyperadrenocorticism is a relatively common endocrine disease affecting the adrenal glands of domestic dogs. However, there are few reports of this disease in wild canids. A crab-eating fox (Cerdocyon thous) kept under human care was diagnosed with the disease after detection of conformational abnormalities in the adrenal glands visualized by ultrasonography, a cortisol suppression test after low-dose dexamethasone, and the detection of proteinuria and bacteria in urinalysis. After the diagnosis, the patient was treated with trilostane with a satisfactory clinical response. This report aims to report the sonographic and laboratory findings of hyperadrenocorticism and its treatment in a specimen of the species.

O hiperadrenocorticismo é uma doença endócrina que acomete as glândulas adrenais relativamente comum em cães domésticos. Porém, em canídeos selvagens, poucos são os relatos descritos dessa enfermidade. Um exemplar de cachorro-do-mato (Cerdocyon thous), mantido sob cuidados humanos, foi diagnosticado com a doença após detecção de anormalidades conformacionais em glândulas adrenais visibilizadas via ultrassonografia, teste de supressão de cortisol após uso de baixa dose de dexametasona, além de detecção de proteinúria e bactérias em urinálise. Após o diagnóstico, instituiu-se tratamento medicamentoso a base de trilostano com resposta clínica satisfatória. Este relato objetiva reportar os achados ultrassonográficos e laboratoriais de hiperadrenocosticismo e seu tratamento em um exemplar da espécie.

Conduta diagnóstica em equino da raça Crioula com síndrome de Cushing / Diagnostic process in a crioulo horse with Cushing’s syndrome

Background: Equine pituitary pars intermedia dysfunction, also known as equine Cushing’s syndrome, is a neurodegenerative disease. An important risk factor for Cushing’s is advanced aging and it is the most common endocrine disorder inolder horses. The prevalence in horses aged over 10 and 15 years is reported as 9.3% and 21%, respectively. Due to the slowprogressive nature of the disease, seasonal variation in hormone output and overlapping endocrine response to other events,accurate diagnosis is challenging. The diagnosis requires the combination of anamnesis, clinical signs, in addition to laboratory tests results. This study aimed to report Cushing’s syndrome in a Crioulo breed horse focusing on diagnostic methods.Case: A 13-year-old male Crioulo breed, orchiectomized, was attended at the Universidade de Passo Fundo (UPF), in PassoFundo, RS, Brazil. The owner reported that the animal had progressive weight loss and coat abnormal growth, with curlyappearance. From visual inspection, body condition score was 4 (1-9) bulging abdomen was noticed, hirsutism, depressionand lethargy. Also, there was a large neoplastic mass on the left side of gluteal region. Later, this mass was classified inhistopathological examination as a fibroblastic sarcoid and was treated. The animal presented physical parameters withinthe physiological limits of the specie. Normochromic normocytic anemia and neutrophilic leukocytosis were reported in thehematologic evaluation. In coproparasitological examination, there were 300 eggs per gram of feaces. Hyperadrenocorticismwas suspected in the clinical examination and dexamethasone suppression test was performed to confirm the fact. Basal serumwas collected at 17 h (M0) and subsequently 40 µg/kg of dexamethasone was administered intramuscular...

Conduta diagnóstica em equino da raça Crioula com síndrome de Cushing / Diagnostic process in a crioulo horse with Cushings syndrome

Background: Equine pituitary pars intermedia dysfunction, also known as equine Cushings syndrome, is a neurodegenerative disease. An important risk factor for Cushings is advanced aging and it is the most common endocrine disorder inolder horses. The prevalence in horses aged over 10 and 15 years is reported as 9.3% and 21%, respectively. Due to the slowprogressive nature of the disease, seasonal variation in hormone output and overlapping endocrine response to other events,accurate diagnosis is challenging. The diagnosis requires the combination of anamnesis, clinical signs, in addition to laboratory tests results. This study aimed to report Cushings syndrome in a Crioulo breed horse focusing on diagnostic methods.Case: A 13-year-old male Crioulo breed, orchiectomized, was attended at the Universidade de Passo Fundo (UPF), in PassoFundo, RS, Brazil. The owner reported that the animal had progressive weight loss and coat abnormal growth, with curlyappearance. From visual inspection, body condition score was 4 (1-9) bulging abdomen was noticed, hirsutism, depressionand lethargy. Also, there was a large neoplastic mass on the left side of gluteal region. Later, this mass was classified inhistopathological examination as a fibroblastic sarcoid and was treated. The animal presented physical parameters withinthe physiological limits of the specie. Normochromic normocytic anemia and neutrophilic leukocytosis were reported in thehematologic evaluation. In coproparasitological examination, there were 300 eggs per gram of feaces. Hyperadrenocorticismwas suspected in the clinical examination and dexamethasone suppression test was performed to confirm the fact. Basal serumwas collected at 17 h (M0) and subsequently 40 µg/kg of dexamethasone was administered intramuscular...(AU)

Eosinophilic cystitis, a rare cause of persistent haematuria in a diabetic dog / Cistite eosinofílica, uma causa rara de hematúria persistente em um cão diabético

Eosinophilic cystitis is a rare inflammatory disorder characterized by eosinophilic infiltration of entire layers of the bladder wall. The condition has been described in adults, children, and dogs. However, there are no consensus guidelines for the treatment of eosinophilic cystitis. Although human and veterinary literature reviews show some effectiveness in management with corticosteroids, antihistamines, and antibiotics, a variety of serious and frequent side effects are associated with steroid therapy. As a result, steroids are relatively contraindicated for patients with diabetes mellitus and Cushing's syndrome. A five-year-old neutered male chow-chow with controlled diabetes was referred with an 18-month history of malodorous urine, gross haematuria, and dysuria that were nonresponsive to antibiotics. The findings on general examination were unremarkable except for abdominal suprapubic discomfort. The complete blood count and biochemical profile (such as urea and creatinine) were normal except for mild peripheral eosinophilia. Although ultrasonography, bladder contrast radiography, and urine cytology findings indicated malignancy, with the presence of atypical urothelial cells, histopathology confirmed eosinophilic cystitis. Management with cyclosporine was adequate with complete remission of haematuria. This case report presents the first reported successful use of cyclosporine for the treatment of eosinophilic cystitis in a dog with diabetes.(AU)

A cistite eosinofílica é uma doença inflamatória rara caracterizada por infiltração eosinofílica de todas as camadas da parede da bexiga. Essa enfermidade já foi descrita em adultos, crianças e cães. No entanto, não há um consenso de diretrizes sobre o seu tratamento. Mesmo que as literaturas humana e veterinária mostrem alguma eficácia no manejo com corticosteroides, anti-histamínicos e antibióticos, uma variedade de efeitos colaterais graves e frequentes está associada à terapia com esteroides. Dessa forma, o uso de esteroides é relativamente contraindicado para pacientes com diabetes mellitus e síndrome de Cushing, por exemplo. Um chow-chow, macho, castrado, de cinco anos e diabético estável foi encaminhado para atendimento com histórico de urina fétida, hematúria macroscópica e disúria não responsiva a antibióticos há 18 meses. A avaliação dos parâmetros físicos estava dentro dos padrões, exceto por desconforto abdominal suprapúbico à palpação. O hemograma e o perfil bioquímico (como a ureia e a creatinina) estavam dentro da normalidade para a espécie, exceto por eosinofilia periférica leve. Embora a ultrassonografia, a radiografia contrastada da bexiga e os achados da urinálise indicassem malignidade, com a presença de células uroteliais atípicas, a histopatologia confirmou o diagnóstico definitivo de cistite eosinofílica. O manejo com ciclosporina foi satisfatório, com ausência completa da hematúria. Este relato de caso apresenta o primeiro uso documentado de ciclosporina para o tratamento de cistite eosinofílica com sucesso em um cão com diabetes.(AU)

Eosinophilic cystitis, a rare cause of persistent haematuria in a diabetic dog / Cistite eosinofílica, uma causa rara de hematúria persistente em um cão diabético

Eosinophilic cystitis is a rare inflammatory disorder characterized by eosinophilic infiltration of entire layers of the bladder wall. The condition has been described in adults, children, and dogs. However, there are no consensus guidelines for the treatment of eosinophilic cystitis. Although human and veterinary literature reviews show some effectiveness in management with corticosteroids, antihistamines, and antibiotics, a variety of serious and frequent side effects are associated with steroid therapy. As a result, steroids are relatively contraindicated for patients with diabetes mellitus and Cushing's syndrome. A five-year-old neutered male chow-chow with controlled diabetes was referred with an 18-month history of malodorous urine, gross haematuria, and dysuria that were nonresponsive to antibiotics. The findings on general examination were unremarkable except for abdominal suprapubic discomfort. The complete blood count and biochemical profile (such as urea and creatinine) were normal except for mild peripheral eosinophilia. Although ultrasonography, bladder contrast radiography, and urine cytology findings indicated malignancy, with the presence of atypical urothelial cells, histopathology confirmed eosinophilic cystitis. Management with cyclosporine was adequate with complete remission of haematuria. This case report presents the first reported successful use of cyclosporine for the treatment of eosinophilic cystitis in a dog with diabetes.(AU)

A cistite eosinofílica é uma doença inflamatória rara caracterizada por infiltração eosinofílica de todas as camadas da parede da bexiga. Essa enfermidade já foi descrita em adultos, crianças e cães. No entanto, não há um consenso de diretrizes sobre o seu tratamento. Mesmo que as literaturas humana e veterinária mostrem alguma eficácia no manejo com corticosteroides, anti-histamínicos e antibióticos, uma variedade de efeitos colaterais graves e frequentes está associada à terapia com esteroides. Dessa forma, o uso de esteroides é relativamente contraindicado para pacientes com diabetes mellitus e síndrome de Cushing, por exemplo. Um chow-chow, macho, castrado, de cinco anos e diabético estável foi encaminhado para atendimento com histórico de urina fétida, hematúria macroscópica e disúria não responsiva a antibióticos há 18 meses. A avaliação dos parâmetros físicos estava dentro dos padrões, exceto por desconforto abdominal suprapúbico à palpação. O hemograma e o perfil bioquímico (como a ureia e a creatinina) estavam dentro da normalidade para a espécie, exceto por eosinofilia periférica leve. Embora a ultrassonografia, a radiografia contrastada da bexiga e os achados da urinálise indicassem malignidade, com a presença de células uroteliais atípicas, a histopatologia confirmou o diagnóstico definitivo de cistite eosinofílica. O manejo com ciclosporina foi satisfatório, com ausência completa da hematúria. Este relato de caso apresenta o primeiro uso documentado de ciclosporina para o tratamento de cistite eosinofílica com sucesso em um cão com diabetes.(AU)

Disfunção da Pars Intermédia da Pituitária (PPID) em equinos – em ascensão mas ainda pouco conhecida

A disfunção da pars intermédia da pituitária (ppid), também conhecida como Síndrome de Cushing, é uma doença degenerativa dos neurônios dopaminérgicos afetando a pars intermédia da glândula pituitária ou hipófise e está relacionada à idade em equinos. Um em cada quatro equinos a partir de 10 anos são diagnosticados nos eua e Austrália. Os sintomas da doença são hirsutismo, laminite, perda de musculatura epaxial, infecções recorrentes, feridas de difícil cicatrização e ocorrem devido ao aumento da produção de peptídeos derivados do pró-opiomelanocortina (pomc), como o adrenocorticotrófico (acth). Muitos pacientes vem a óbito devido ao diagnóstico tardio, cronicidade da doença e ineficiência do tratamento em casos avançados. Por isso o alerta para que o diagnóstico e tratamento sejam precoces e efetivos.

Disfunção da Pars Intermédia da Pituitária (PPID) em equinos em ascensão mas ainda pouco conhecida

A disfunção da pars intermédia da pituitária (ppid), também conhecida como Síndrome de Cushing, é uma doença degenerativa dos neurônios dopaminérgicos afetando a pars intermédia da glândula pituitária ou hipófise e está relacionada à idade em equinos. Um em cada quatro equinos a partir de 10 anos são diagnosticados nos eua e Austrália. Os sintomas da doença são hirsutismo, laminite, perda de musculatura epaxial, infecções recorrentes, feridas de difícil cicatrização e ocorrem devido ao aumento da produção de peptídeos derivados do pró-opiomelanocortina (pomc), como o adrenocorticotrófico (acth). Muitos pacientes vem a óbito devido ao diagnóstico tardio, cronicidade da doença e ineficiência do tratamento em casos avançados. Por isso o alerta para que o diagnóstico e tratamento sejam precoces e efetivos.(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)

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)

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.

Myolipoma associated with hyperadrenocorticism and diabetes mellitus in a female poodle / Miolipoma associado a hiperadrenocorticismo e diabetes mellitus em uma poodle fêmea

This report provides an unpublished account of an intra-abdominal myolipoma in a 11-year-old female Poodle with hyperadrenocorticism and diabetes mellitus. The patient was well controlled for both endocrine diseases; however, was suffering for severe abdominal discomfort. Ultrasound scan revealed a huge abdominal mass. At necropsy a pinkish mass (35cm x 28cm x 12cm) of elastic consistency attached to the broad ligament of the left uterine horn was reported. Histologically, this mass was constituted of a mixed population of well-differentiated adipocytes and of spindle-shaped mesenchymal cells. Both tumor cells were positive for vimentin at immunohistochemistry, while the spindle-shaped cells were positive for desmin and actin, compatible with smooth muscle cells. Immunohistochemistry was crucial for myolipoma characterization.(AU)

Este relato apresenta um caso inédito de miolipoma intra-abdominal em um poodle fêmea de 11 anos de idade com hiperadrenocorticismo e diabetes mellitus concomitante. A paciente apresentava um bom controle das doenças endócrinas, porém, grande desconforto abdominal. Ao ultrassom abdominal evidenciou-se uma massa de grandes proporções. Na necropsia uma massa rosácea (35cm x 28cm x 12cm) de consistência elástica unida ao ligamento largo do corno uterino esquerdo foi identificada. Histologicamente esta massa era constituída de uma população mista de adipócitos bem diferenciados e células fusiformes mesenquimais. Ambos tipos celulares foram positivos para vimentina na imuno-histoquímica, enquanto as células fusiformes foram positivas também para desmina e actina, compatível com músculo liso. A imuno-histoquímica foi crucial para o diagnóstico do miolipoma.(AU)

Granulosa cell tumor associated with occult hyperadrenocorticism in a yorkshire terrier bitch

Background: Hyperadrenocorticism (HAC), is considered a set of symptoms due to excessive exposure to cortisol. Naturally occurring HAC is most often related to pituitary tumors (pituitary-dependent HAC - PDH). Occult HAC, is referred as a clinical picture highly consistent with HAC; however, routine screening tests are negative. In addition, one or more steroids are elevated following administration of adrenocorticotrophic hormone (ACTH). Ovarian granulosa cell tumors, can produce steroids leading to paraneoplastic syndromes. The objective of this study was to report an unpublished case of ovarian granulosa cell tumor associated with occult hyperadrenocorticism in a Yorkshire Terrier.Case: A 13-year-old intact female dog, Yorkshire Terrier, was brought for consultation with slight weight loss, polyuria, polydipsia, irregular estrous cycles, increased abdominal volume and thin coat. On physical examination the animal was gasping and presented severe periodontal disease, bulging abdomen, alopecia and skin hyperpigmentation. Complete blood count presented no changes; however, serum biochemistry evaluation highlighted hyperalbuminemia, hypertriglyceridemia, alkaline phosphatase increased activity, and urinary specific gravity and creatinine below reference values. On abdominal ultrasonography left adrenal gland measured 2.08 cm x 1.08 cm and the right adrenal gland measured 2.11 cm x 0.84 cm, indicating bilateral adrenomegaly compatible with PDH. In the hypogastric abdomen, a large heterogeneous hypoechogenic mass was also observed, with areas of cystic cavities, measuring 5.80 cm x 7.30 cm. A low dose dexamethasone suppression test (LDDST) was performed, due to PDH suspicion. The test did not confirm HAC, suspecting, then, to be a case of occult/atypical HAC. Due to the strong clinical suspicion, and owner financial problems for further investigated occult HAC, trilostane treatment was initiated.[...]

Granulosa cell tumor associated with occult hyperadrenocorticism in a yorkshire terrier bitch

Background: Hyperadrenocorticism (HAC), is considered a set of symptoms due to excessive exposure to cortisol. Naturally occurring HAC is most often related to pituitary tumors (pituitary-dependent HAC - PDH). Occult HAC, is referred as a clinical picture highly consistent with HAC; however, routine screening tests are negative. In addition, one or more steroids are elevated following administration of adrenocorticotrophic hormone (ACTH). Ovarian granulosa cell tumors, can produce steroids leading to paraneoplastic syndromes. The objective of this study was to report an unpublished case of ovarian granulosa cell tumor associated with occult hyperadrenocorticism in a Yorkshire Terrier.Case: A 13-year-old intact female dog, Yorkshire Terrier, was brought for consultation with slight weight loss, polyuria, polydipsia, irregular estrous cycles, increased abdominal volume and thin coat. On physical examination the animal was gasping and presented severe periodontal disease, bulging abdomen, alopecia and skin hyperpigmentation. Complete blood count presented no changes; however, serum biochemistry evaluation highlighted hyperalbuminemia, hypertriglyceridemia, alkaline phosphatase increased activity, and urinary specific gravity and creatinine below reference values. On abdominal ultrasonography left adrenal gland measured 2.08 cm x 1.08 cm and the right adrenal gland measured 2.11 cm x 0.84 cm, indicating bilateral adrenomegaly compatible with PDH. In the hypogastric abdomen, a large heterogeneous hypoechogenic mass was also observed, with areas of cystic cavities, measuring 5.80 cm x 7.30 cm. A low dose dexamethasone suppression test (LDDST) was performed, due to PDH suspicion. The test did not confirm HAC, suspecting, then, to be a case of occult/atypical HAC. Due to the strong clinical suspicion, and owner financial problems for further investigated occult HAC, trilostane treatment was initiated.[...](AU)

Síndrome da fragilidade cutânea adquirida e diabetes mellitus secundários ao hiperadrenocorticismo em um gato / Acquired skin fragility syndrome and diabetes mellitus secondary to hyperadrenocorticism in a cat

Background: Acquired skin fragility syndrome is a rare disorder which affects adult to senior cats with no history of skin trauma. Acquired skin fragility syndrome and diabetes mellitus, unlike the dog, are highly associated to feline hyperadrenocorticism (HAC) and, often, undiagnosed, what may accentuate the skin lesions and cause management complications. This report aimed to describe a case of acquired skin fragility syndrome and diabetes mellitus secondary to spontaneous hyperadrenocorticism in a cat, focusing on the chronic dermatological signs and their management, as well as on the treatment of the primary disease.Case: An approximately 7 year-old male mixed breed feline was admitted to the University Veterinary Hospital of an Institution with a history of polyphagia, polyuria and polydipsia, and skin ulcers on the trunk and in the cervical region about 2 months after onset and difficult to heal. Laboratory examinations indicated leukocytosis with lymphopenia, decreased urine specific gravity, glycosuria and hyperglycemia. The fasting plasma glucose level, the dexamethasone suppression test and the bilateral adrenal gland enlargement, visualized by ultrasonography, revealed diabetes mellitus and spontaneous hyperadrenocorticism, respectively. Histological skin findings indicated feline acquired skin fragility syndrome. Skin wound treatment through cleaning, protection and antibiotic therapy, and administration of insulin and trilostane were performed. After 6 months of trilostane therapy, adrenocorticotropic hormone (ACTH) stimulation test was performed, which demonstrated normal cortisol values 4 h after administration, which allowed maintenance of the dosage. After 12 months of the diagnosis of skin fragility syndrome and diabetes mellitus secondary to HAC, the patient did not present new skin lesions, fasting glycemia was within the reference values without insulin therapy and maintained only the prescription of trilostane.[...]

Síndrome da fragilidade cutânea adquirida e diabetes mellitus secundários ao hiperadrenocorticismo em um gato / Acquired skin fragility syndrome and diabetes mellitus secondary to hyperadrenocorticism in a cat

Background: Acquired skin fragility syndrome is a rare disorder which affects adult to senior cats with no history of skin trauma. Acquired skin fragility syndrome and diabetes mellitus, unlike the dog, are highly associated to feline hyperadrenocorticism (HAC) and, often, undiagnosed, what may accentuate the skin lesions and cause management complications. This report aimed to describe a case of acquired skin fragility syndrome and diabetes mellitus secondary to spontaneous hyperadrenocorticism in a cat, focusing on the chronic dermatological signs and their management, as well as on the treatment of the primary disease.Case: An approximately 7 year-old male mixed breed feline was admitted to the University Veterinary Hospital of an Institution with a history of polyphagia, polyuria and polydipsia, and skin ulcers on the trunk and in the cervical region about 2 months after onset and difficult to heal. Laboratory examinations indicated leukocytosis with lymphopenia, decreased urine specific gravity, glycosuria and hyperglycemia. The fasting plasma glucose level, the dexamethasone suppression test and the bilateral adrenal gland enlargement, visualized by ultrasonography, revealed diabetes mellitus and spontaneous hyperadrenocorticism, respectively. Histological skin findings indicated feline acquired skin fragility syndrome. Skin wound treatment through cleaning, protection and antibiotic therapy, and administration of insulin and trilostane were performed. After 6 months of trilostane therapy, adrenocorticotropic hormone (ACTH) stimulation test was performed, which demonstrated normal cortisol values 4 h after administration, which allowed maintenance of the dosage. After 12 months of the diagnosis of skin fragility syndrome and diabetes mellitus secondary to HAC, the patient did not present new skin lesions, fasting glycemia was within the reference values without insulin therapy and maintained only the prescription of trilostane.[...](AU)

Hidrocefalia Congênita Canina Seguida De Hiperadrenocorticismo Iatrogênico: Revisão De Literatura E Relato De Caso / Canine Congenital Hydrocephalus Followed By An Iatrogenic Hiperadrenocorticism Status: Review And Case Report / Hidrocefalia Canina Congenita Con Consecuente Hiperadrenocorticismo Iatrogenico: Revisión De Literatura Y Reporte De Caso

A hidrocefalia congênita é caracterizada em animais pelo acúmulo excessivo de líquido cefalorraquidiano (LCR) no crânio, decorrente principalmente de infecção viral do sistema nervoso do feto no ambiente uterino; por predisposição genética ou ainda por quadros de distocia. No presente relato abordam-se os principais aspectos clínicos, diagnósticos e terapêuticos desta patologia em cães, e apresenta-se um caso clínico de hidrocefalia congênita em cão sem raça definida, que foi acompanhado clinicamente e laboratorialmente durante 12 meses, e recebeu tratamento alopático convencional e acupuntura, evoluindo para quadro de hiperadrenocorticismo secundário.(AU)

The congenital hydrocephalus is characterized in animals by high accumulation of cephalorachidian fluid (CRF) in cranium, due a viral infection of central nervous system of fetus during its development; due genetic predisposition or also due dystocia problems at birth. The main clinical, diagnosis and therapeutic aspects of this pathology in dogs are discussed in the present report. A clinical case report of a hydrocephalus mixed breed dog is also presented. Dog was clinically and laboratory followed during 12 months, and it was treated with conventional allopathic and acupuncture, with a secondary development of iatrogenic hiperadrenocorticism status.(AU)

La hidrocefalia congénita es caracterizada en animales por el acumulo excesivo de líquido cefalorraquídeo (LCR) en el cráneo, decurrente infección viral del feto en desenvolvimiento; predisposición genética o distocias. En el presente reporte los principales aspectos clínicos, diagnósticos y terapéuticos de esta patología en perros san discutidos. Se describe también un caso clínico de hidrocefalia congénita en uno perro sin raza definida, que fue acompañado clínicamente y laboratorialmente durante 12 meses, y recibió tratamiento alopático convencional y acupuntura, con desarrollo secundario hiperadrenocorticismo iatrogénico.(AU)

Hidrocefalia Congênita Canina Seguida De Hiperadrenocorticismo Iatrogênico: Revisão De Literatura E Relato De Caso / Canine Congenital Hydrocephalus Followed By An Iatrogenic Hiperadrenocorticism Status: Review And Case Report / Hidrocefalia Canina Congenita Con Consecuente Hiperadrenocorticismo Iatrogenico: Revisión De Literatura Y Reporte De Caso

A hidrocefalia congênita é caracterizada em animais pelo acúmulo excessivo de líquido cefalorraquidiano (LCR) no crânio, decorrente principalmente de infecção viral do sistema nervoso do feto no ambiente uterino; por predisposição genética ou ainda por quadros de distocia. No presente relato abordam-se os principais aspectos clínicos, diagnósticos e terapêuticos desta patologia em cães, e apresenta-se um caso clínico de hidrocefalia congênita em cão sem raça definida, que foi acompanhado clinicamente e laboratorialmente durante 12 meses, e recebeu tratamento alopático convencional e acupuntura, evoluindo para quadro de hiperadrenocorticismo secundário.

The congenital hydrocephalus is characterized in animals by high accumulation of cephalorachidian fluid (CRF) in cranium, due a viral infection of central nervous system of fetus during its development; due genetic predisposition or also due dystocia problems at birth. The main clinical, diagnosis and therapeutic aspects of this pathology in dogs are discussed in the present report. A clinical case report of a hydrocephalus mixed breed dog is also presented. Dog was clinically and laboratory followed during 12 months, and it was treated with conventional allopathic and acupuncture, with a secondary development of iatrogenic hiperadrenocorticism status.

La hidrocefalia congénita es caracterizada en animales por el acumulo excesivo de líquido cefalorraquídeo (LCR) en el cráneo, decurrente infección viral del feto en desenvolvimiento; predisposición genética o distocias. En el presente reporte los principales aspectos clínicos, diagnósticos y terapéuticos de esta patología en perros san discutidos. Se describe también un caso clínico de hidrocefalia congénita en uno perro sin raza definida, que fue acompañado clínicamente y laboratorialmente durante 12 meses, y recibió tratamiento alopático convencional y acupuntura, con desarrollo secundario hiperadrenocorticismo iatrogénico.

Epidemiologia Dos Endoparasitas Em Bovinos: Uma Visão Do Brasil E Do Mundo / Epidemiology Of Endoparasites In Bovines: A View Of Brazil And Of The World

Em bovinos, as enfermidades parasitárias causam prejuízos econômicos e produtivos significativos. Além disso, comprometem a saúde e o bem-estar animal. Tratando-se mais especificamente dos endoparasitas, um fator agravante é a apresentação insidiosa da doença, e assim, são subdiagnosticados e/ou negligenciados. Por isso, a realização de estudos epidemiológicos de parasitas são ferramentas úteis para a identificação das espécies de helmintos, bem como para avaliar as suas prevalências e os graus de infecção nos animais. Com base nessas informações, medidas de profilaxia e prevenção podem ser mais bem delineadas. Apesar da relevância destes tipos de estudos, há escassez de resultados recentes e atualizados sobre a situação de rebanhos bovinos frente ao parasitismo. Desta maneira, objetivou-se realizar um levantamento retrospectivo de estudos epidemiológicos versando sobre endoparasitas nas diferentes regiões do Brasil, bem como de outros países de clima semelhante ao do Brasil, que foram categorizadas de acordo com seus climas tropical, subtropical e temperado.(AU)

In bovines, parasitic diseases cause significant economic and productivity damage. Furthermore, they compromise animal health and well-being. In the more specific case of endoparasites, one aggravating factor is the insidious presentation of the disease that renders it underdiagnosed and/or neglected. For this reason, epidemiological studies of parasites serve as useful tools for the identification of species of helminths, and for evaluating their prevalences and degrees of infection in animals. These data enable better delineation of preventive and prophylactic measures. Despite the relevance of these types of studies, recent updated results on the situation of bovine herds exposed to parasitism are scarce. Thus, the present work aimed to perform a retrospective survey of epidemiological studies examining endoparasites in different regions of Brazil, which also included international data, with countries categorized according to climates (tropical, subtropical and temperate).(AU)

Epidemiologia Dos Endoparasitas Em Bovinos: Uma Visão Do Brasil E Do Mundo / Epidemiology Of Endoparasites In Bovines: A View Of Brazil And Of The World

Em bovinos, as enfermidades parasitárias causam prejuízos econômicos e produtivos significativos. Além disso, comprometem a saúde e o bem-estar animal. Tratando-se mais especificamente dos endoparasitas, um fator agravante é a apresentação insidiosa da doença, e assim, são subdiagnosticados e/ou negligenciados. Por isso, a realização de estudos epidemiológicos de parasitas são ferramentas úteis para a identificação das espécies de helmintos, bem como para avaliar as suas prevalências e os graus de infecção nos animais. Com base nessas informações, medidas de profilaxia e prevenção podem ser mais bem delineadas. Apesar da relevância destes tipos de estudos, há escassez de resultados recentes e atualizados sobre a situação de rebanhos bovinos frente ao parasitismo. Desta maneira, objetivou-se realizar um levantamento retrospectivo de estudos epidemiológicos versando sobre endoparasitas nas diferentes regiões do Brasil, bem como de outros países de clima semelhante ao do Brasil, que foram categorizadas de acordo com seus climas tropical, subtropical e temperado.

In bovines, parasitic diseases cause significant economic and productivity damage. Furthermore, they compromise animal health and well-being. In the more specific case of endoparasites, one aggravating factor is the insidious presentation of the disease that renders it underdiagnosed and/or neglected. For this reason, epidemiological studies of parasites serve as useful tools for the identification of species of helminths, and for evaluating their prevalences and degrees of infection in animals. These data enable better delineation of preventive and prophylactic measures. Despite the relevance of these types of studies, recent updated results on the situation of bovine herds exposed to parasitism are scarce. Thus, the present work aimed to perform a retrospective survey of epidemiological studies examining endoparasites in different regions of Brazil, which also included international data, with countries categorized according to climates (tropical, subtropical and temperate).