Abordaje del Hiperadrenocorticismo canino. Reporte de caso.

Abstract

Hyperadrenocorticism or Cushing's Syndrome is one of the disorders of the adrenal gland, characterized by an excessive production of glucocorticoids or an abuse in the administration of corticosteroids. The latter is known as iatrogenic Cushing's syndrome. Related to the above, hyperadrenocorticism is one of the most frequently diagnosed endocrinopathies in daily clinical practice. A clinical case report of an 8-year-old male Boston Terrier breed with a history of loss of weight and muscle mass, ingestion of abundant water and abundant production of urine, pendulous abdomen and liver disease was made. Initially blood tests, blood chemistries and cortisol measurement were performed. These analyzes indicated leukocytosis with monocytosis, neutrophilia, lymphopenia, and marked bandemia. Regarding blood chemistry, the increase in the enzyme Alanine Amino Transferase (ALT), hypertriglyceridemia and marked hyperglycemia stood out. Basal cortisol measurement showed a result of 13.42 ug/dl, concluding basal hypercortisolemia. After this, an abdominal ultrasound was carried out, where the presence of biliary sludge was found in the gallbladder and bilaterally enlarged adrenal glands. Finally, as a diagnostic method, the suppression test with low doses of Dexamethasone at a dose of 0.015 mg/kg was used. The results of the measurement of basal cortisol showed that it presented basal hypercortisolemia since before the application of Dexamethasone and there was no postapplication suppression with Dexamethasone. cortisol concentrations greater than 1.4 ug/dl at four and eight hours later. Finally, oral formula was sent with; Trilostane at a dose of 3mg/kg, Selegiline at a dose of 0.5mg/kg, Aminomix pet, at a dose of 1.5 tablets, Metadoxine at a dose of 20mg/kg orally and finally Hill's ld feed 187g/day indefinitely. Currently the patient has a favorable evolution, therefore, the main presumptive diagnosis was based on Cushing's syndrome secondary type with etiology associated with pituitary neoplasia, therefore, contrastenhanced magnetic resonance imaging of the brain was suggested with emphasis on pituitary gland, which unfortunately to date has not been performed due to personal reasons of the owners.