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Canine Hyperadrenocorticism
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Introduction
Canine hyperadrenocorticism (HAC or canine Cushing’s syndrome) is one of the more frequently encountered endocrinopathies in dogs, characterized by clinical signs of cortisol excess; the most common presenting signs are polyuria and polydipsia. HAC can be caused by either an adrenal tumor (AT, 15% of cases) or a pituitary tumor, resulting in pituitary-dependent hyperadrenocorticism (PDH, 85% of cases). Iatrogenic hyperadrenocorticism, caused by excessive administration of glucocorticoids, is also possible. Adrenal tumors directly secrete excess cortisol, whereas with pituitary tumorsexcess adrenocorticotropic hormone (ACTH) is released, stimulating the adrenal cortex to secrete excess cortisol. Most cases of PDH are caused by a microadenoma, a tumor so small that it does not cause neurological signs. However, macroadenomas can also occur, and these may eventually lead to neurological disease.
Key Points
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Naturally-occurring hyperadrenocorticism is a result of excess cortisol secretion, which is caused by either an adrenal or pituitary tumor. Physical examination and history findings are key to making a diagnosis.
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There are a variety of screening
and differentiating tests for hyperadrenocorticism, and the clinician needs to exercise judgment in both the choice of test and interpretation of the results. -
Treatment is not recommended in patients if there are no clinical signs.
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Optimal treatment for patients with adrenal tumors is adrenalectomy, whereas medical treatment is recommended in patients with pituitary-dependent disease.
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