Wednesday, September 4, 2013

Top Endocrine Publications of 2012: The Canine Adrenal Gland

In my seventh compilation of the canine and feline endocrine publications of 2012, I’m moving on to disorders of the canine adrenal gland.

Listed below are 40 research papers written in 2012 that deal with a variety of adrenal gland issues of clinical importance in dogs. I've already reviewed 4 of these papers; to read my reviews, see the links at the bottom of the reference list.

These range from the investigations of trilostane and dosing (1,11,35) or its effect on steroid hormone metabolism in adrenal glands and corpora lutea (32) to a study of an evaluation of compounded trilostane (6); from investigations of the sudden acute blindness that can develop in dogs with pituitary-dependent hyperadrenocorticism (PDH) (3,4) to the vitamin-D status in dogs with PDH (7); and from studies of the effect of cortisol excess (Cushing's syndrome) on renal function (37-39) to the use of low-dose insulin administration to prevent the onset on overt diabetes in dogs with PDH (27).

Other research studies included a review of the animal models of adrenocortical tumorigenesis (2) to a review of diagnostic tests for Cushing's syndrome (21); from studies to compare IV and IM formulations of ACTH in dogs (5) to ultrasound studies of the adrenal gland in normal dogs, dogs treated with steroids, or dogs with adrenal tumor (8,9,33); from reports of adrenalectomy for treatment of dogs with adrenal tumor causing  hyperaldosteronism (12,15), or pheochromocytoma (17); and finally, from studies of the relationship between gallbladder mucoceles and glucocorticoid excess (22) to a number of studies of the effects of exogenous glucocorticoids and iatrogenic Cushing's syndrome in dogs (18,20,22-24,26,31,33,40)

  1. Augusto M, Burden A, Neiger R, et al. A comparison of once and twice daily administration of trilostane to dogs with hyperadrenocorticism. Tierarztl Prax Ausg K Kleintiere Heimtiere 2012;40:415-424. 
  2. Beuschlein F, Galac S, Wilson DB. Animal models of adrenocortical tumorigenesis. Mol Cell Endocrinol 2012;351:78-86. 
  3. Cabrera Blatter MF, del Prado A, Gallelli MF, et al. Blindness in dogs with pituitary dependent hyperadrenocorticism: relationship with glucose, cortisol and triglyceride concentration and with ophthalmic blood flow. Res Vet Sci 2012;92:387-392. 
  4. Cabrera Blatter MF, Del Prado B, Miceli DD, et al. Interleukin-6 and insulin increase and nitric oxide and adiponectin decrease in blind dogs with pituitary-dependent hyperadrenocorticism. Res Vet Sci 2012. 
  5. Cohen TA, Feldman EC. Comparison of IV and IM formulations of synthetic ACTH for ACTH stimulation tests in healthy dogs. J Vet Intern Med 2012;26:412-414. 
  6. Cook AK, Nieuwoudt CD, Longhofer SL. Pharmaceutical evaluation of compounded trilostane products. J Am Anim Hosp Assoc 2012;48:228-233. 
  7. Corbee RJ, Tryfonidou MA, Meij BP, et al. Vitamin D status before and after hypophysectomy in dogs with pituitary-dependent hypercortisolism. Domest Anim Endocrinol 2012;42:43-49. 
  8. Davis MK, Schochet RA, Wrigley R. Ultrasonographic identification of vascular invasion by adrenal tumors in dogs. Vet Radiol Ultrasound 2012;53:442-445. 
  9. de Chalus T, Combes A, Bedu AS, et al. Ultrasonographic adrenal gland measurements in healthy Yorkshire Terriers and Labrador Retrievers. Anat Histol Embryol 2012. 
  10. Donnelly K, DeClue AE, Sharp CR. What is your diagnosis? 12-year-old spayed female Labrador Retriever with a history of polyuria and polydipsia. J Am Vet Med Assoc 2012;240:1283-1285. 
  11. Feldman EC, Kass PH. Trilostane dose versus body weight in the treatment of naturally occurring pituitary-dependent hyperadrenocorticism in dogs. J Vet Intern Med 2012;26:1078-1080. 
  12. Frankot JL, Behrend EN, Sebestyen P, et al. Adrenocortical carcinoma in a dog with incomplete excision managed long-term with metastasectomy alone. J Am Anim Hosp Assoc 2012;48:417-423. 
  13. Fukuta H, Mori A, Urumuhan N, et al. Characterization and comparison of insulin resistance induced by Cushing Syndrome or diestrus against healthy control dogs as determined by euglycemic-hyperinsulinemic glucose clamp profile glucose infusion rate using an artificial pancreas apparatus. J Vet Med Sci 2012;74:1527-1530. 
  14. Ginel PJ, Sileo MT, Blanco B, et al. Evaluation of serum concentrations of cortisol and sex hormones of adrenal gland origin after stimulation with two synthetic ACTH preparations in clinically normal dogs. Am J Vet Res 2012;73:237-241. 
  15. Gojska-Zygner O, Lechowski R, Zygner W. Functioning unilateral adrenocortical carcinoma in a dog.  Can Vet J 2012;53:623-625. 
  16. Gow AG, Gow DJ, Bell R, et al. Insulin concentrations in dogs with hypoadrenocorticism. Res Vet Sci 2012;93:97-99. 
  17. Guillaumot PJ, Heripret D, Bouvy BM, et al. 49-month survival following caval venectomy without nephrectomy in a dog with a pheochromocytoma. J Am Anim Hosp Assoc 2012;48:352-358. 
  18. Hicks CW, Sweeney DA, Danner RL, et al. Efficacy of selective mineralocorticoid and glucocorticoid agonists in canine septic shock. Crit Care Med 2012;40:199-207. 
  19. Hoglund K, Hanas S, Carnabuci C, et al. Blood pressure, heart rate, and urinary catecholamines in healthy dogs subjected to different clinical settings. J Vet Intern Med 2012;26:1300-1308. 
  20. Hsu K, Snead E, Davies J, et al. Iatrogenic hyperadrenocorticism, calcinosis cutis, and myocardial infarction in a dog treated for IMT. J Am Anim Hosp Assoc 2012;48:209-215. 
  21. Kooistra HS, Galac S. Recent advances in the diagnosis of Cushing's syndrome in dogs. Top Companion Anim Med 2012;27:21-24. 
  22. Kook PH, Schellenberg S, Rentsch KM, et al. Effects of iatrogenic hypercortisolism on gallbladder sludge formation and biochemical bile constituents in dogs. Vet J 2012;191:225-230. 
  23. Kovalik M, Thoday KL, Berry J, et al. Prednisolone therapy for atopic dermatitis is less effective in dogs with lower pretreatment serum 25-hydroxyvitamin D concentrations. Vet Dermatol 2012;23:125-130, e127-128. 
  24. Kovalik M, Thoday KL, Evans H, et al. Short-term prednisolone therapy has minimal impact on calcium metabolism in dogs with atopic dermatitis. Vet J 2012;193:439-442. 
  25. Lowrie M, De Risio L, Dennis R, et al. Concurrent medical conditions and long-term outcome in dogs with nontraumatic intracranial hemorrhage. Vet Radiol Ultrasound 2012;53:381-388. 
  26. Melamies M, Vainio O, Spillmann T, et al. Endocrine effects of inhaled budesonide compared with inhaled fluticasone propionate and oral prednisolone in healthy Beagle dogs. Vet J 2012;194:349-353. 
  27. Miceli DD, Gallelli MF, Cabrera Blatter MF, et al. Low dose of insulin detemir controls glycaemia, insulinemia and prevents diabetes mellitus progression in the dog with pituitary-dependent hyperadrenocorticism. Res Vet Sci 2012;93:114-120. 
  28. Miller AG, Dow S, Long L, et al. Antiphospholipid antibodies in dogs with immune mediated hemolytic anemia, spontaneous thrombosis, and hyperadrenocorticism. J Vet Intern Med 2012;26:614-623. 
  29. Monroe WE, Panciera DL, Zimmerman KL. Concentrations of noncortisol adrenal steroids in response to ACTH in dogs with adrenal-dependent hyperadrenocorticism, pituitary-dependent hyperadrenocorticism, and nonadrenal illness. J Vet Intern Med 2012;26:945-952. 
  30. Muntener T, Schuepbach-Regula G, Frank L, et al. Canine noninflammatory alopecia: a comprehensive evaluation of common and distinguishing histological characteristics. Vet Dermatol 2012;23:206-e244. 
  31. O'Neill D, Hendricks A, Summers J, et al. Primary care veterinary usage of systemic glucocorticoids in cats and dogs in three UK practices. J Small Anim Pract 2012;53:217-222. 
  32. Ouschan C, Lepschy M, Zeugswetter F, et al. The influence of trilostane on steroid hormone metabolism in canine adrenal glands and corpora lutea-an in vitro study. Vet Res Commun 2012;36:35-40. 
  33. Pey P, Daminet S, Smets PM, et al. Effect of glucocorticoid administration on adrenal gland size and sonographic appearance in beagle dogs. Vet Radiol Ultrasound 2012;53:204-209. 
  34. Proverbio D, Spada E, Perego R, et al. Potential variant of multiple endocrine neoplasia in a dog. J Am Anim Hosp Assoc 2012;48:132-138. 
  35. Reine NJ. Medical management of pituitary-dependent hyperadrenocorticism: mitotane versus trilostane. Top Companion Anim Med 2012;27:25-30. 
  36. Schteingart DE, Sinsheimer JE, Benitez RS, et al. Structural requirements for mitotane activity: development of analogs for treatment of adrenal cancer. Anticancer Res 2012;32:2711-2720. 
  37. Smets PM, Lefebvre HP, Aresu L, et al. Renal function and morphology in aged Beagle dogs before and after hydrocortisone administration. PLoS One 2012;7:e31702. 
  38. Smets PM, Lefebvre HP, Kooistra HS, et al. Hypercortisolism affects glomerular and tubular function in dogs. Vet J 2012;192:532-534. 
  39. Smets PM, Lefebvre HP, Meij BP, et al. Long-term follow-up of renal function in dogs after treatment for ACTH-dependent hyperadrenocorticism. J Vet Intern Med 2012;26:565-574. 
  40. Van der Heyden S, Croubels S, Gadeyne C, et al. Influence of P-glycoprotein modulation on plasma concentrations and pharmacokinetics of orally administered prednisolone in dogs. Am J Vet Res 2012;73:900-907. 


Unknown said...

Hi Dr. Peterson--
Do you have any data or information on Addisonian dogs who have elevated kidney levels after starting Percorten?

My dog had elevated kidney levels prior to his diagnosis of Addison's, and at the time of his diagnosis. we began his on Prednisone and Percorten.

At Day 14, after his first Percorten the kidney levels normalized. Then they elevated again at his Day 25 (Na 150 and K 4.5) and Day 34 (Na 149 and K 4.5). My vet and I decided to give him his second dose of Percorten. should we have given him fluid therapy, or should we in the future? how long is it "normal" for Addisonian dogs to stabilize their kidney levels? do you have any ideas if our dog may have underlying issues?

He has not had the classical high potassium and low sodium in any of the labs we have done. What has been consistent is a mild to moderately low sodium and azotemia. And yet he still had tiny adrenal glands on ultrasound and a very low ACTH stim result.

If the Percorten caused his azotemia to get better, why did it come back?

I am so grateful for your publications, thank you.

Dr. Mark E. Peterson said...

Dogs with Addison's disease have prerenal azotemia. In other words, the serum creatinine and urea nitrogen may be high prior to treatment, but they should normalize quickly after treatment and stay normal.

If your dog had normal serum electrolytes prior to treatment, that makes Addison's disease less likely, especially if azotemia was severe.

We don't make a diagnosis of Addison's on the basis of small adrenal glands. We use an ACTH stimulation test (basal and post-ACTH cortisol generally both <1.0 µg/dl). If the serum potassium is normal, I would confirm primary adrenal insufficiency (Addison's disease) by either measuring a plasma ACTH level or measuring a pre- and post-ACTH aldosterone level.

It sounds to me like a further workup may need to be done to determine if your dog does have Addison's disease, or if primary renal disease is present. Talk to your veterinarian; you might need a referral to an endocrine specialist.