RESUMEN
Hyperadrenocorticism (HAC) and diabetes mellitus (DM) are two diseases that can occur concurrently in dogs. The objective of this study was to evaluate the coexistence of HAC and DM, and the risk factors involved that could contribute to the development of DM in dogs with HAC. A total of 235 dogs with HAC were studied and, according to their fasting glycemia, they were divided into three groups: <5.6mmol/L, between 5.6 and 10.08mmol/L and >10.08mmol/L. The following parameters were evaluated: age, gender, cause of HAC, body condition, glycemia, total cholesterol, triglycerides, urinary cortisol:creatinin ratio (UCCR) and survival time. A 13.61% concurrence of HAC and DM was observed. Dogs with a fasting glycemia >5.6mmol/L, with dislipemia, with Pituitary-Dependent Hyperadrenocorticism, UCCR >100×10-6 and non-castrated females showed a higher risk of developing DM. The development of DM in dogs with HAC reduces the survival time.
Asunto(s)
Hiperfunción de las Glándulas Suprarrenales/veterinaria , Diabetes Mellitus/veterinaria , Enfermedades de los Perros/patología , Hiperfunción de las Glándulas Suprarrenales/complicaciones , Hiperfunción de las Glándulas Suprarrenales/patología , Animales , Glucemia , Diabetes Mellitus/patología , Perros , Femenino , Masculino , Factores de RiesgoRESUMEN
O hiperadrenocorticismo (HAC) é uma alteração endócrina resultante de elevadas concentrações séricas de glicocorticoides. Quando endógeno, pode ser hipófise-dependente ou adrenal-dependente. A literatura propõe que casos adrenal-dependentes, unilaterais e sem metástase sejam tratados cirurgicamente, mas essa conduta ainda não é rotina no Brasil. Uma análise dos estudos publicados nas últimas décadas evidencia, no entanto, significativa redução na taxa de mortalidade perioperatória desses pacientes. O presente trabalho relata o caso de uma cadela de dez anos, sem raça definida, com HAC adrenal-dependente, que se mostrou irresponsiva ao tratamento clínico e foi submetida a adrenalectomia, enfatizando os cuidados pré e pós-operatórios que contribuíram para o sucesso da intervenção.
Hyperadrenocorticism (HAC) is an endocrine condition resulting from elevated serum glucocorticoid levels. When endogenous, it may be pituitary-dependent or adrenal-dependent. Literature reports suggest that cases of adrenal-dependent unilateral HAC without metastases be treated surgically, but this conduct is not routine in Brazil yet. A review of studies published in the last decades shows, however, significant reduction in the perioperative mortality rate of such patients. The current study reports the case of a crossbreed 10-year-old female dog with adrenal-dependent HAC that was unresponsive to medical treatment and was submitted to adrenalectomy. We emphasize both preoperative and post-operative care measures that contributed to the success of the surgery.
El hiperadrenocorticismo (HAC) es una enfermedad endocrina que se produce debido a concentraciones elevadas de glucocorticoides. En los casos en que el origen es endógeno el HAC puede ser hipófisis o adrenal-dependiente. La literatura indica que aquellos casos adrenal-dependientes, unilaterales y sin metástasis deben ser tratados mediante cirugía, aunque esta práctica aún no es común en Brasil. Un análisis de los estudios publicados en las últimas décadas indica que ha habido una significativa reducción en la tasa de mortalidad perioperatoria de esos pacientes. El presente trabajo relata el caso de una perra mestiza de diez años con un HAC adrenal-dependiente, que no mostró respuesta al tratamiento clínico y en la que se realizó una adrenalectomia, haciendo énfasis en el manejo pre y post operatorio, que fue importante para el éxito de la intervención.
Asunto(s)
Animales , Glucocorticoides , Hiperfunción de las Glándulas Suprarrenales/patología , Perros/clasificaciónRESUMEN
O hiperadrenocorticismo (HAC) é uma alteração endócrina resultante de elevadas concentrações séricas de glicocorticoides. Quando endógeno, pode ser hipófise-dependente ou adrenal-dependente. A literatura propõe que casos adrenal-dependentes, unilaterais e sem metástase sejam tratados cirurgicamente, mas essa conduta ainda não é rotina no Brasil. Uma análise dos estudos publicados nas últimas décadas evidencia, no entanto, significativa redução na taxa de mortalidade perioperatória desses pacientes. O presente trabalho relata o caso de uma cadela de dez anos, sem raça definida, com HAC adrenal-dependente, que se mostrou irresponsiva ao tratamento clínico e foi submetida a adrenalectomia, enfatizando os cuidados pré e pós-operatórios que contribuíram para o sucesso da intervenção.(AU)
Hyperadrenocorticism (HAC) is an endocrine condition resulting from elevated serum glucocorticoid levels. When endogenous, it may be pituitary-dependent or adrenal-dependent. Literature reports suggest that cases of adrenal-dependent unilateral HAC without metastases be treated surgically, but this conduct is not routine in Brazil yet. A review of studies published in the last decades shows, however, significant reduction in the perioperative mortality rate of such patients. The current study reports the case of a crossbreed 10-year-old female dog with adrenal-dependent HAC that was unresponsive to medical treatment and was submitted to adrenalectomy. We emphasize both preoperative and post-operative care measures that contributed to the success of the surgery.(AU)
El hiperadrenocorticismo (HAC) es una enfermedad endocrina que se produce debido a concentraciones elevadas de glucocorticoides. En los casos en que el origen es endógeno el HAC puede ser hipófisis o adrenal-dependiente. La literatura indica que aquellos casos adrenal-dependientes, unilaterales y sin metástasis deben ser tratados mediante cirugía, aunque esta práctica aún no es común en Brasil. Un análisis de los estudios publicados en las últimas décadas indica que ha habido una significativa reducción en la tasa de mortalidad perioperatoria de esos pacientes. El presente trabajo relata el caso de una perra mestiza de diez años con un HAC adrenal-dependiente, que no mostró respuesta al tratamiento clínico y en la que se realizó una adrenalectomia, haciendo énfasis en el manejo pre y post operatorio, que fue importante para el éxito de la intervención.(AU)
Asunto(s)
Animales , Hiperfunción de las Glándulas Suprarrenales/patología , Glucocorticoides , Perros/clasificaciónRESUMEN
Pituitary-dependent hyperadrenocorticism (PDH) is frequent in dogs. Little is known about its presentation in different age groups and its characteristics. Dividing the population under study (n=107) into three age groups we observed that 11.2% were young, 51.4% adults and 37.4% aged. Using magnetic resonance, pituitary tumours were intra-sellar (IS) in 30.8% and extra-sellar (ES) in 62.6% and the pars intermedia (PI) was affected in 6.5%. ES are predominant in females and IS in males (p<0.0001). In the adult-aged population, the ES and PI are predominant, while in the young, the IS predominate (p<0.0001). ACTH concentration was greater in the ES vs. IS (p<0.05). alpha-MSH did not present significant differences according to tumour size, showing a negative correlation (r=-0.47; p<0.01) vs. ACTH. Differences in adenoma size according to gender and their age-related frequency of apparition could be because of different origins of the corticotrophinoma.
Asunto(s)
Adenoma Hipofisario Secretor de ACTH/veterinaria , Hiperfunción de las Glándulas Suprarrenales/veterinaria , Hormona Adrenocorticotrópica/metabolismo , Enfermedades de los Perros/patología , Neoplasias Hipofisarias/veterinaria , alfa-MSH/metabolismo , Adenoma Hipofisario Secretor de ACTH/patología , Adenoma Hipofisario Secretor de ACTH/fisiopatología , Hiperfunción de las Glándulas Suprarrenales/patología , Hiperfunción de las Glándulas Suprarrenales/fisiopatología , Factores de Edad , Animales , Enfermedades de los Perros/fisiopatología , Perros , Femenino , Imagen por Resonancia Magnética , Masculino , Hipófisis/metabolismo , Hipófisis/patología , Hipófisis/fisiopatología , Neoplasias Hipofisarias/patología , Neoplasias Hipofisarias/fisiopatología , Estudios Retrospectivos , Factores SexualesRESUMEN
Trabecular bone morphometry was done on rib samples of beagles with hyperadrenocorticism and adrenal adenomas to evaluate bone loss and the remodeling changes responsible. Beagles diagnosed as having clinical hyperadrenocorticism and those with milder or subclinical hyperadrenocorticism diagnosed on the basis of adrenal and pituitary lesions at necropsy had increased adrenal and pituitary gland weights. In a group of dogs with adrenal cortical adenomas there was atrophy of remaining cortex, and the combined weight of adrenal glands or pituitary weights were not increased. In dogs with clinical hyperadrenocorticism, mean trabecular bone volume was 25% less than controls (P = 0.10). In both clinical and subclinical hyperadrenocorticism groups, the extent of trabecular surface with unmineralized osteoid matrix and osteoblasts was significantly reduced. There were no changes in resorption surfaces or number of osteoclasts present. No bone changes were seen in dogs with adrenal adenomas. In dogs with hyperadrenocorticism it appeared that decreased bone formation was primarily responsible for the relative osteopenia that developed. Although parathyroid glands were moderately enlarged in those dogs for which weights were available, the bone changes were not those of increased remodeling expected in hyperparathyroidism.