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Hyperadrenocorticism (Cushings) (Diagnosis (Supportive lab work…
Hyperadrenocorticism
(Cushings)
Diagnosis
Clinical Signs
Supportive lab work
Increased:
Alk Phos
ALT & GGT
Cholesterol
(sometimes) triglycerides
Lipase or PLI
Normal to mild increase in glucose
Thrombocytosis
Urinalysis:
USG: <1.020
Proteinuria
High-end normal Hct
Adrenal secondary hyperparathyroidism:
increased PTH
Unknown cause
Increased serum phosphate
Normal Serum calcium
Increased calcium excretion in urine --> risk for calcium oxalate stones
Steroid leukogram
Rule-out other disorders
Dynamic adrenal gland testing:
ACTH stim test
Low-dose dex suppression test
Imaging
History
PU/PD
Polyphagia
Dermatologic changes
Physical Exam
Muscle atrophy (myogonia)
Abdominal distension
Skin Changes
Hepatomegaly
Hypertension
Treatment
Trilostane (most common)
Mitotane
Hypophysectomy
Bilateral adrenalectomy
Radiation Therapy
Monitor response - clinical signs should improved
Recheck at 2 weeks to ensure not geting sick & ACTH stim @ 4 weeks
Prognosis
Most dogs do well with treatment
Most die of unrelated disorders