The purpose of this study was to propose a standard for differentiation between normal dogs and patients with hyperadrenocorticism (HAC) by measuring skin thickness via ultrasonography in small breed dogs. Significant changes in skin thickness of patients treated with prednisolone (PDS) or patients with HAC treated with trilostane were evaluated. Skin thickness was retrospectively measured on three abdominal digital images obtained from small breed dogs weighing < 15 kg that underwent abdominal ultrasonography. Mean skin thickness of normal dogs was 1.03 ± 0.25 mm (mean ± SD). Both the HAC and PDS groups showed significantly thinner skin than that in the normal group. Seven of the 10 HAC patients treated with trilostane had increased skin thickness. The area under the curve value of 0.807 was based on the receiver operating characteristics (ROC) curve for differentiating normal dogs from HAC patients. Sensitivity was 76% and specificity was 73% when skin thickness was less than the 0.83 mm cutoff value. In conclusion, measurement of skin thickness in small breed dogs by using ultrasonography is likely to provide clinical information useful in differentiating HAC patients from normal dogs. However, exposure to PDS, trilostane, and other conditions may have a significant effect on skin thickness.
Adrenocortical Hyperfunction ; Animals ; Dogs ; Humans ; Prednisolone ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Skin ; Ultrasonography

Diagnosis of an adrenal tumor without typical clinical signs related to hyperadrenocorticism and elevated alkaline phosphatase is challenging. This report describes a sex hormone-secreting adrenal tumor in a 10-year-old castrated male Shih Tzu evaluated through repetitive ultrasonographic examination. An adrenocorticotropic hormone stimulation test revealed elevated concentrations of androstenedione and 17-hydroxyprogesterone but a normal cortisol concentration. A mass was surgically excised and adenoma was diagnosed histopathologically. In the present case, adrenal tumor was strongly suspected based on a gradual increase in adrenal size and a change from peanut shape to an irregular mass on repetitive ultrasonography. Repetitive ultrasonographic examination of the adrenal gland is recommended when an abnormal ultrasonographic appearance of adrenal gland is identified, even in an asymptomatic dog.
17-alpha-Hydroxyprogesterone ; Adenoma* ; Adrenal Gland Neoplasms ; Adrenal Glands ; Adrenocortical Hyperfunction ; Adrenocorticotropic Hormone ; Alkaline Phosphatase ; Androstenedione ; Animals ; Arachis ; Child ; Diagnosis ; Diagnostic Imaging ; Dogs ; Humans ; Hydrocortisone ; Male ; Ultrasonography

Hyperadrenocorticism (HAC) is a common endocrinopathy among dogs that causes multisystemic signs. This study was conducted to evaluate cardiocirculatory, biochemical, and hemostatic parameters in dogs with HAC at diagnosis, in addition to verifying whether abnormal parameters could be controlled by initial treatment with trilostane. Fifteen dogs with HAC were assessed by systolic blood pressure measurement, electrocardiography, Doppler echocardiography, serum concentration of troponin I, and biochemical and hemostatic profile at diagnosis and after trilostane therapy. Unlike biochemical parameters, hemostatic and cardiocirculatory parameters were not significantly influenced by the onset of treatment. The authors believe that clinical treatment with trilostane for 3 to 4 months might not be sufficient for the stabilization of cardiocirculatory abnormalities such as hypertension. Therefore, dogs with HAC must receive cardiocirculatory monitoring at diagnosis and during drug treatment.
Adrenocortical Hyperfunction* ; Animals ; Blood Pressure ; Cardiology ; Diagnosis* ; Dogs* ; Echocardiography, Doppler ; Electrocardiography ; Endocrinology ; Hypertension ; Troponin I

Insulin detemir is a long-acting basal insulin analogue recently introduced in veterinary medicine for treatment of canine diabetes mellitus. As there are only limited studies in dogs, long-term evaluation of insulin detemir in veterinary medicine is required. In this study, we investigated trends in12-hour blood glucose concentration during hospitalization and evaluated initial and following doses of insulin detemir for several months in six diabetic dogs. The mean levels of blood glucose over 12-hour periods were between 113.5 to 327.2 mg/dL, and the average glucose nadir was 103 mg/dL in the six dogs. The dogs were treated with a mean dosage of 0.24 U/kg of insulin detemir, but hypoglycemia was observed in four of the dogs at the first monthly follow-up. Thus, insulin doses were adjusted according to the nadir levels of glucose observed during the follow-up periods (range, 1 to 16 months). The total range of insulin doses throughout the study period was between 0.1 and 0.4 U/kg. Changes in insulin doses in each dog during the follow-up period were not variable. We suggest that insulin detemir might be not only an alternative choice against traditional insulin for patients with insulin resistance or concurrent disease but also an effective home therapy medication in canine patients with DM. This study could help inform veterinary practitioners regarding the use of insulin detemir for canine insulin-dependent DM.
Adrenocortical Hyperfunction ; Animals ; Blood Glucose ; Diabetes Mellitus* ; Diabetic Ketoacidosis ; Dogs* ; Follow-Up Studies ; Glucose ; Hospitalization ; Humans ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Insulin Detemir ; Veterinary Medicine

Ten dogs were enrolled in this study: two healthy dogs, two obese dogs without other medical issues and six obese dogs with underlying diseases including pemphigus, chronic active hepatitis, hyperadrenocorticism, narcolepsy, otitis media and heartworm infection. Pyrosequencing of the 16S rRNA gene to explore the gut bacterial diversity revealed that distal gut bacterial communities of samples from patients with pemphigus, otitis media and narcolepsy consisted primarily of Firmicutes, while the major phylum of the distal gut bacterial communities in patients with chronic active hepatitis and hyperadrenocorticism was Fusobacteria. Proteobacteria were the dominant phylum in heartworm infected obese patients.
Adrenocortical Hyperfunction ; Animals ; Dogs* ; Fusobacteria ; Genes, rRNA ; Hepatitis, Chronic ; Humans ; Microbiota* ; Narcolepsy ; Otitis Media ; Pemphigus ; Pilot Projects* ; Proteobacteria

Canine hyperadrenocorticism (HAC) is one of the most common causes of general osteopenia. In this study, quantitative computed tomography (QCT) was used to compare the bone mineral densities (BMD) between 39 normal dogs and 8 dogs with HAC (6 pituitary-dependent hyperadrenocorticism [PDH]; pituitary dependent hyperadrenocorticism, 2 adrenal hyperadrenocorticism [ADH]; adrenal dependent hyperadrenocorticism) diagnosed through hormonal assay. A computed tomogaraphy scan of the 12th thoracic to 7th lumbar vertebra was performed and the region of interest was drawn in each trabecular and cortical bone. Mean Hounsfield unit values were converted to equivalent BMD with bone-density phantom by linear regression analysis. The converted mean trabecular BMDs were significantly lower than those of normal dogs. ADH dogs showed significantly lower BMDs at cortical bone than normal dogs. Mean trabecular BMDs of dogs with PDH using QCT were significantly lower than those of normal dogs, and both mean trabecular and cortical BMDs in dogs with ADH were significantly lower than those of normal dogs. Taken together, these findings indicate that QCT is useful to assess BMD in dogs with HAC.
Adrenocortical Hyperfunction* ; Animals ; Bone Density* ; Bone Diseases, Metabolic ; Dogs* ; Linear Models ; Spine

A 10-year-old castrated male Korean shorthair cat weighing 4 kg was referred with signs of insulin-resistant diabetes mellitus based on clinical signs of polyuria, polydipsia, and polyphagia. Diagnosis of pituitary-dependent hyperadrenocorticism (PDH) was made based on results of an adrenocorticotropic hormone stimulation test and a dexamethasone screening test. In addition, plasma concentrations of insulin-like growth factor 1 (IGF-1) increased. Radiography, ultrasonography, and computed tomography (CT) revealed hepatomegaly, renomegaly, and adrenomegaly affecting both adrenal glands as well as multiple cysts in a generally enlarged pancreas. Magnetic resonance imaging (MRI) showed that the cat's pituitary gland was enlarged. The pituitary gland had a predominantly unilateral extension to the left. The signal intensity of the pituitary gland on precontrast T1 weighted images was hypointense compared to that of soft tissue and hyperintense compared to that of cerebrospinal fluid. On T2 weighted images, the pituitary gland was predominantly hypointense with a hyperintense rim. Contrast enhancement of the pituitary gland was not evident, and a mild degree of ring-like enhancement was seen. In addition, mild peritumoral edema was present. This is the first report of a cat with suspected double adenoma of the pituitary gland on the basis of compatible clinical signs, increased serum IGF-1 concentration, PDH, CT images, and MRI findings in diabetic cats with insulin resistance.
Acromegaly ; Adenoma* ; Adrenal Glands ; Adrenocortical Hyperfunction ; Adrenocorticotropic Hormone ; Animals ; Cats* ; Cerebrospinal Fluid ; Child ; Dexamethasone ; Diabetes Mellitus* ; Diagnosis ; Edema ; Hepatomegaly ; Humans ; Insulin Resistance ; Insulin-Like Growth Factor I ; Magnetic Resonance Imaging ; Male ; Mass Screening ; Pancreas ; Pituitary Gland* ; Plasma ; Polydipsia ; Polyuria ; Radiography ; Ultrasonography

Adrenal Gland Diseases ; complications ; Adrenocortical Hyperfunction ; complications ; Humans ; Liver Failure ; complications

Dystrophic calcinosis cutis associated with spontaneous hyperadrenocorticism was diagnosed in a 8-year-old female Chihuahua dog with erythematous, erosive, numerous papules, plaques, and crusts on the bilateral trunk, and inguinal region. Serum biochemical abnormalities included increases in alkaline phosphatase (ALP), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and cholesterol. Radiographs showed mild hepatomegaly and subcutaneous lobulated calcific deposits. Histopathologic examination demonstrated diffuse deposition of basophilic calcified material in the dermis. Von Kossa's stain confirmed calcium deposition. Therapy with diltiazem was useful in resolving calcinosis.
Adrenocortical Hyperfunction ; Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Basophils ; Calcinosis* ; Calcium ; Child ; Cholesterol ; Dermis ; Diltiazem* ; Dogs* ; Female ; gamma-Glutamyltransferase ; Hepatomegaly ; Humans

INTRODUCTIONWe present a rare variety of adrenocorticotrophic hormone (ACTH)-independent Cushing's syndrome known as primary pigmented nodular adrenocortical disease (PPNAD).

CLINICAL PICTUREThe patient initially underwent unilateral adrenalectomy for what was thought to be a left adrenal adenoma.

OUTCOMEPartial resolution of symptoms and demonstrable persistent hypercortisolism after surgery prompted further evaluation with findings leading to the diagnosis of Carney complex. A review of the adrenal histology was consistent with PPNAD.

CONCLUSIONThis entity of PPNAD, which has rarely been reported in Asians, forms part of the Carney complex. The diagnosis may not be simple and straightforward, as illustrated in this patient.

Adrenal Glands ; diagnostic imaging ; Adrenalectomy ; Adrenocortical Hyperfunction ; physiopathology ; Adrenocorticotropic Hormone ; metabolism ; Adult ; Bone Density ; Cushing Syndrome ; diagnosis ; metabolism ; physiopathology ; Female ; Humans ; Tomography, X-Ray Computed