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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 ==

[[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]]