Peer-reviewed veterinary case report
How vets diagnose Cushing's disease in dogs
By Peterson, Mark E·Published in Clinical techniques in small animal practice·2007·Bobst Hospital of The Animal Medical Center, United States·View original on PubMed →
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Original publication title: Diagnosis of hyperadrenocorticism in dogs.
- Species:
- dog
Plain-English summary
A dog showing signs of excessive thirst, increased urination, and a pot-bellied appearance may be suffering from hyperadrenocorticism, also known as Cushing's disease. To diagnose this condition, veterinarians often start with physical exams and routine lab tests, but they may also use specific tests like the ACTH stimulation test or low-dose dexamethasone suppression test to confirm the diagnosis. However, these tests can sometimes give misleading results, so they are usually performed when the disease is strongly suspected. Once diagnosed, further tests help determine whether the cause is related to the pituitary gland or the adrenal glands. Treatment options can vary depending on the underlying cause.
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Abstract
A presumptive diagnosis of hyperadrenocorticism in dogs can be made from clinical signs, physical examination, routine laboratory tests, and diagnostic imaging findings, but the diagnosis must be confirmed by use of pituitary-adrenal function tests. Screening tests designed to diagnose hyperadrenocorticism include the corticotropin (adrenocorticotropic hormone; ACTH) stimulation test, low-dose dexamethasone suppression test, and the urinary cortisol:creatinine ratio. None of these screening tests are perfect, and all are capable of giving false-negative and false-positive test results. Because of the limitation of these diagnostic tests, screening for hyperadrenocorticism must be reserved for dogs in which the disease is strongly suspected on the basis of historical and clinical findings. Once a diagnosis has been confirmed, the next step in the workup is to use one or more tests and procedures to distinguish pituitary-dependent from adrenal-dependent hyperadrenocorticism. Endocrine tests in this category include the high-dose dexamethasone suppression test and endogenous plasma ACTH measurements. Imaging techniques such as abdominal radiography, ultrasonography, computed tomography, and magnetic resonance imaging can also be extremely helpful in determining the cause.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/17542191/