Dominique Begon

Ultrasonography Criteria for Differentiating ACTH Dependency from ACTH Independency in 47 Dogs with Hyperadrenocorticism and Equivocal Adrenal Asymmetry

BACKGROUND Adrenal ultrasonography (US) in dogs with hyperadrenocorticism (HAC) is commonly used to distinguish adrenocorticotropic hormone (ACTH)-independent (AIHAC) and ACTH-dependent hyperadrenocorticism (ADHAC). To date, no cut-off values for defining adrenal atrophy in cases of adrenal asymmetry have been determined. Given that asymmetrical hyperplasia is sometimes observed in ADHAC, adrenal asymmetry without ultrasonographic proof of adrenocortical tumor such as vascular invasion or metastasis can be equivocal. OBJECTIVE The purpose of this study was to compare adrenal US findings between cases of ADHAC and AIHAC in dogs with equivocal adrenal asymmetry (EAA), and to identify useful criteria for their distinction. ANIMALS Forty dogs with EAA were included. METHODS Ultrasound reports of HAC dogs with adrenal asymmetry without obvious vascular invasion or metastases were reviewed. Dogs were classified as cases of ADHAC (n = 28) or AIHAC (n = 19), determined by plasma ACTH concentration. The thickness, shape, and echogenicity of both adrenal glands and presence of adjacent vascular compression were compared between AIHAC and ADHAC groups. RESULTS The maximal dorsoventral thickness of the smaller gland (SDV) ranged from 2.0 to 5.0 mm in AIHAC and from 5.0 to 15.0 mm in ADHAC. The 95% confidence intervals for estimated sensitivity and specificity of a SDV cut-off set at 5.0 mm in the diagnosis of AIHAC were 82-100 and 82-99%, respectively. Other tested US criteria were found to overlap extensively between the 2 groups, precluding their usefulness for distinction. CONCLUSION AND CLINICAL IMPORTANCE In EAA cases, an SDV ≤5.0 mm is an appropriate cut-off for AIHAC ultrasonographic diagnosis.

Unusual Case of Osteopenia Associated With Nutritional Calcium and Vitamin D Deficiency in an Adult Dog

A 6-year-old, spayed female rottweiler was presented for facial enlargement from swelling of the maxilla and mandible. The dog was fed a homemade diet deficient in calcium and vitamin D, suggesting that rubber jaw syndrome was a secondary nutritional disorder. Radiographic and tomodensitometric examinations revealed diffuse bone resorption in the skull. The plasma parathormone concentration was high, and serum 25-hydroxycholecalciferol concentration was low. Based on these findings, nutritional calcium and vitamin D deficiency associated with secondary hyperparathyroidism was diagnosed. Dietary correction resulted in clinical and biological improvement, with an increase in skull mineralization.

Trilostane therapy for hyperadrenocorticism in three dogs with adrenocortical metastasis.

IN dogs, more than half of the adrenal tumours responsible for hyperadrenocorticism are malignant ([Reusch and Feldman 1991][1]). They can be metastasised by the time of diagnosis or after surgical resection. Medical management is therefore required to control the clinical signs. Trilostane is an

Follicular growth monitoring in the female cat during estrus

Follicular growth in the feline ovary is usually detected indirectly, through behavior observation, vaginal smears, or more invasively, by estradiol assay in blood. This study was designed to describe follicular dynamics by transabdominal ultrasonography. Secondly, the stage of follicular growth was associated to behavioral and vaginal changes. Ovarian ultrasonography was performed during nine anovulatory and 12 ovulatory cycles. Forty-eight follicles were followed during anovulatory cycles: on the first day of estrus behavior, 4.8 ± 0.2 follicles (2 to 7 per female) of 2.3 ± 0.01 mm mean diameter were present. Follicular growth continued at a rate of 0.2 ± 0.04 mm per day. At least one follicle in the cohort reached a diameter greater than 3.0 mm. Maximal follicular growth (when one follicle of the cohort reached the maximal diameter observed for the whole estrus) was reached 3.8 ± 0.3 days after the onset of estrus with the largest follicle reaching a diameter of 3.5 ± 0.04 mm. Growth of the various follicles within a cohort was not exactly synchronous. When no ovulation took place, the follicular diameter decreased by 0.1 ± 0.01 mm per day until the end of estrus. The first day after the end of behavioral estrus, the diameter of the largest follicle in each cohort was 2.7 ± 0.05 mm. No correlation was found between follicular development and either vaginal smear characteristics, or time elapsed since the onset of estrus. When ovulations were mechanically induced after one follicle had reached 3.0 mm in diameter, artificial insemination produced normal pregnancy rate and litter size: four pregnant females out of nine, and 2 to 4 kittens per litter. Ultrasonography proved thus to allow the monitoring of follicular growth in the female cat, with low correlation with behavior and vaginal smear modifications. Further studies are needed to evaluate the interest of an ultrasonographic ovarian follow-up to determine the optimal moment for ovulation induction prior to artificial insemination.