Dr Daniela Bajenaru
Tazyvet veterinary clinic
Bucharest, Romania
Singalment and hystory
Bella, presented on 12/13/2016
10 year old, female, Labrador retriever
5 month history of polydipsia, polyuria, polyphagia and pruritus
Physical examination
Abdominal enlargement
Palpable hepatomegaly
Thin, hypotonic skin, easy bruising
Phlebectasias
Erythema
Calcinosis cutis over the dorsal neck, thorax and rump
Bacterial pyoderma
Investigations
Ultrasound
Urinalysis
Coagulation time
Serum chemistry panel
Trichogram, scoch test
Bacteriological examination
ACTH stimulation test
Laboratory results
Ultrasound- hepatomegaly
Urinalysis – low specific gravity (1.005)
Coagulation time – 5’
Serum chemistry panel: GPT -361, ALP>1980, CHOL- 215, CREA -0,587, UREA -25,2
Trichogram/ scoch test – no significant findings
Bacteriological ex. – Staphylococcus aureus (++++)
Basal cortisol level > 10 µg
ACTH stimulation test – cortisol= 29,4 µg/dl
Diagnosis
CANIN HYPERCORTISOLISM (CUSHING SYNDROM)
SUSPICION: PITUITARY DEPENDENT
Treatment
TRILOSTANE -120 mg once daily
Amoxicillin with clavulanic acid -12,5 mg/kg/12h, 30 days
Probiotics
Topical: – moisturizing and desinfectant shampoo, once weekly
– antiseptic, anti inflammatory and healing gel, once daily
EFA supplements
Diet: low fat
EVOLUTION
After 3 days of topical treatment
After 3 days
Basal cortisol level > 10 µg/dl
After first bathing
After 7 weeks basal cortisol – 5,3 µg/dl
After 7 weeks basal cortisol – 5,3 µg/dl
The evolution to be continued ….
