Hyoeradrenocorticism 1 Flashcards
Does hyperadrenocorticism have a characteristic clinical picture?
- changes can be subtle early on in dz
- insidious onset means presentation at variable stages
- 2* problems frequently -> death
What is hyperadrenocorticism?
- clinical problem d/t subacute over exposure to GCs
> naturally occouring - clinical signs don’t indicate causality
- can be pituitary dependant (PDH) or adrenal dependent (ADH)
> iatrogenic - chronically administered under dosage
Hx findings with HAC?
- PUPD
- appetite
- excercise intolerance
- anoestrus (intact females)
- abdominal distension (50%)
- coat Changes (50%)
- alopecia and hyperligmentation (30%)
Clinical signs HAC?
- panting
- muscle weakness and atrophied
- hepatomegaly and abdominal distension
- ^ abdo fat deposition
- testicular atrophy and increased vulva size, gynacomastia
- dermal changes
- altered mentation (underwhelmed)
Detail the dermal changes potentially seen with HAC
- non primary
- symmetrical alopecia (trunk»extremities)
- non-pruritic
- hyperpigmentation
- hyperkeratosis and flaking skin
- comedons
- calcinosis cutis (deposition Ca P)
- infections or infestations (recurrent, esp skin)
- can see subcut BVs
- thin, wrinkly, aged skin
Updated clinical picture with HAC in the dog
- PUPD
- panting excessively (weak muscles, ^ abdo cavity size, ^ risk pulmonary thromboemboli)
- relatively inactive (usually put down to ‘old for their age’)
- epaxial muscle wastage
Updated clinical picture of HAC in the cat
- difficult to manage DM (^GC can cause DM in the cat but NOT DOG - cats b cells get damaged/worn out, dogs dont)
- varying degrees of insulin resistance
- present for varying periods of time
- usually no other signs
- UNCOMMON
Clin path with hyperadrenocorticism
- eosinopeania, lymohopeania
- ^ ALP, ^ ALT (disproportionate ^ ALP in dog, microenvironment changes ^ ALP and ISOENZYME of ALP stimulated by GC - not in cats )
- hyoercholesterolaemia
- ^ thrombocyte count
- v urine specific gravity (??)
Why do animals most commonly die with hyperadrenoocorticsm
- PTS d/t 2* problems
How does hyperadrenocorticism cause alopecia?
- telogen effluvium type alopecia
- non pruritic
- most common over trunk (normal head and limbs)
When else may telogen effluvium be seen?
Parturition d/t hormonal changes
Why does abdomenal distenion occour with hyperadrenocorticism?
- muscle pathology (myotonia)
- redistribution subcut fat -> abdo
Why is testicular atrophy seen with HAC?
- ve feedback
What causes the PUPD with HAC?
1* PD mostly
- some degree of ADH interference but minimal
Which disease is severe insulin resistance seen?
laminitis
