Cutaneous asthenia in a domestic cat (Felis silvestris catus)

Background: Cutaneous asthenia or Ehlers-Danlos syndrome is an inherited and rare disease. This infirmity is from an autosomal mutation that influences the collagen synthesis of the carrier. Thus, its skeleton, formed of fibers, is structurally defective. The disease is characterized by hyperelasticity and skin fragility, leading to lesions throughout the skin. The lesions may manifest in specific places or in a generalized way, being more frequent in the limbs, neck, and back. This disease does not have a specific treatment, only management care to avoid new traumas. Case: A 3-year-old male castrated, no defined race cat, was attended at one veterinary clinic with a history of intense itching. The rapid tests for feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) were negative. On physical examination, infestation by fleas, lesions all over the body, and skin hyperelasticity were observed. Topical treatment for ectoparasites as well as for body wounds was established. After the treatment, he returned without itching, but with the complaints of new lesions that did not heal. The patient underwent a total shearing to facilitate the treatment of the skin, and then he underwent blood tests, biochemistry, hormonal tests, and ultrasound, which showed no suggestive changes for hyperadrenocorticism and diabetes mellitus. His clinical signs, besides not matching with these diseases, also did not indicate skin fragility due to his history of age and balanced diet. The confirmation of the cutaneous asthenia syndrome was acquired through biopsy of skin fragment, in which it was observed disarray of collagen fibers, hypertrophy, and fibroblast hyperplasia, together with the rate of extensibility of the skin where the value reached the mark of 27.5%. Throughout the hospitalization, it was noted the progression of the disease with the appearance of new lesions, where there was no bleeding and they appeared even with the patient wearing padded clothes. Its progression lasted one year until the patient's euthanasia. Discussion: For the disposal of diabetes mellitus and hyperadrenocorticism as causes of the appearance of lesions by the body in the patient, he was submitted to the suppression tests with dexamethasone, in which he presented normality, in the biochemical examination it was dosed with fructosamine and glucose. The fructosamine was in the reference value, but the glucose was slightly altered, this increase may have been a result of stress at the time of blood collection. In addition to the patient not showing specific clinical signs such as polyphagia, polyuria, polydipsia, and weight loss, these are characteristic clinical signs of the disease. For the diagnosis of Ehlers-Danlos syndrome, histological examination, and calculation of the skin extensibility index were used, where the results obtained confirmed the suspicion. This genetic anomaly has no treatment, being progressive, so only environmental management is done to mitigate the appearance of the lesions and provide animal welfare. This case report contributes to aggregating the scientific literature in the area of veterinary medicine since skin asthenia is a rare disease and when its extent is total it becomes even more atypical. The availability of this article will provide a vision of palliative treatment for other cases, demonstrating the progressive nature of the lesions and the methods of diagnosis.

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)

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)

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.[...]