Changes

 

Also known as: '''''Cushings Disease'''''

Also known as: '''''Cushings Disease'''''

Grossly the adrenals have an irregular surface with protruding nodules of cortical tissue; the hyperplased zona fasciculata cells.  

Grossly the adrenals have an irregular surface with protruding nodules of cortical tissue; the hyperplased zona fasciculata cells.  

===Adrenal Dependant Hyperadrenocorticism===

===Adrenal Dependant Hyperadrenocorticism===

'''Clinical pathology''' results may lead to an indicative diagnosis. Roughly 85 - 95% of cases will show [[Lymphopenia|lymphocytopenia]] and [[eosinopenia]] and marked elevation of plasma alkaline phosphatase (ALP). Hypercholoesterolaemia has also been identified in 90% of dogs with this condition. Hyperglycaemia and hypernatraemia are sometimes noted, as is an increased urinary cortisol : creatinine ratio.

'''Clinical pathology''' results may lead to an indicative diagnosis. Roughly 85 - 95% of cases will show [[Lymphopenia|lymphocytopenia]] and [[eosinopenia]] and marked elevation of plasma alkaline phosphatase (ALP). Hypercholoesterolaemia has also been identified in 90% of dogs with this condition. Hyperglycaemia and hypernatraemia are sometimes noted, as is an increased urinary cortisol : creatinine ratio.

Other specific diagnostic procedures include: '''ACTH Stimulation test''': measure cortisol before and 30-60 mins after i/v ''Synacthen'' administration. A positive result is initially high cortisol followed by a markedly elevated cortisol after stimulation (>600nmol/l).  

Other specific diagnostic procedures include: '''ACTH Stimulation test''': measure cortisol before and 30-60 mins after i/v ''Synacthen'' administration. A positive result is initially high cortisol followed by a markedly elevated cortisol after stimulation (>600nmol/l).  

Ultrasound of the adrenal glands can also be performed to distinguish if one is large or if both are bilaterally enlarged. This would distinguish from PDH (bilateral) and an adrenal tumour (one enlarged).  

Ultrasound of the adrenal glands can also be performed to distinguish if one is large or if both are bilaterally enlarged. This would distinguish from PDH (bilateral) and an adrenal tumour (one enlarged).  

== Treatment ==

== Treatment ==

Pituitary tumours may be treated with ''radiotherapy'' or ''surgery''. A bilateral adrenalectomy can be performed in some cases. Hypophysectomy has been performed in some countries with good success rates. This involves removal of the gland through the nose and must be performed in a specialist referral centre.

Pituitary tumours may be treated with ''radiotherapy'' or ''surgery''. A bilateral adrenalectomy can be performed in some cases. Hypophysectomy has been performed in some countries with good success rates. This involves removal of the gland through the nose and must be performed in a specialist referral centre.

 

 

== References ==

== References ==

Bexfield, N. and Lee, K. (2010)''' BSAVA Guide to Procedures in Small Animal Practice''', ''British Small Animal Veterinary Association  

Bexfield, N. and Lee, K. (2010)''' BSAVA Guide to Procedures in Small Animal Practice''', ''British Small Animal Veterinary Association  

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Blood, D.C. and Studdert, V. P. (1999) Saunders Comprehensive Veterinary Dictionary (2nd Edition), Elsevier Science.

Blood, D.C. and Studdert, V. P. (1999) '''Saunders Comprehensive Veterinary Dictionary''' (2nd Edition),'' Elsevier Science''.

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Church, D (2008) Endocrine System Stugy Guide, Royal Veterinary College.

Church, D (2008)''' Endocrine System Stugy Guide, '''''Royal Veterinary College.''

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Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition), W.B. Saunders Company.

Ettinger, S.J. and Feldman, E. C. (2000)''' Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2''' (Fifth Edition),'' W.B. Saunders Company.''

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Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2), W.B. Saunders Company.

Ettinger, S.J, Feldman, E.C. (2005)''' Textbook of Veterinary Internal Medicine '''(6th edition, volume 2),'' W.B. Saunders Company''.

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Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition), Mosby Elsevier.

Fossum, T. W. et. al. (2007) '''Small Animal Surgery''' (Third Edition), ''Mosby Elsevier.''

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Foster, A, and Foll, C. (2003) BSAVA small animal dermatology (second edition), British Small Animal Veterinary Association.

Foster, A, and Foll, C. (2003)''' BSAVA small animal dermatology '''(second edition), ''British Small Animal Veterinary Association.''

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Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition), Merial.

Merck & Co (2008)''' The Merck Veterinary Manual''' (Eighth Edition), ''Merial.''

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Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition), Mosby Elsevier.  

Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine '''(Fourth Edition),'' Mosby Elsevier. ''

[[Category:Bones_-_Metabolic_Pathology]] [[Category:Expert_Review]] [[Category:Neurological_Diseases_-_Dog]] [[Category:Endocrine_Diseases_-_Dog]] [[Category:Adrenal_Glands_-_Pathology]]

[[Category:Bones_-_Metabolic_Pathology]] [[Category:Expert_Review - Small Animal]] [[Category:Neurological_Diseases_-_Dog]] [[Category:Endocrine_Diseases_-_Dog]] [[Category:Adrenal_Glands_-_Pathology]]