Updates on hypoadrenocorticism
Hypoadrenocorticism may be difficult to recognize because of its varied clinical presentation. Furthermore, it may not be first on your differential diagnosis list because it is a relatively uncommon endocrine disease in dogs. However, it is important to be able to quickly identify this disease since prompt diagnosis and treatment can result in an excellent long-term prognosis. To help you better recognize and treat affected patients, this review discusses the etiology, diagnosis, and treatment of the different types of hypoadrenocorticism in dogs.
TYPES OF HYPOADRENOCORTICISM
Immune-mediated destruction of the adrenal cortex is the most common cause of primary hypoadrenocorticism.2,3 Other less common causes include neoplasia, thromboembolism, and granulomatous disease.2 Secondary hypoadrenocorticism may develop from pituitary damage due to neoplasia, inflammation, or trauma.2,5,8 Iatrogenic hypoadrenocorticism may result from the administration of adrenocorticolytic drugs such as mitotane or long-term glucocorticoid therapy.9
Hypoadrenocorticism is most often diagnosed in young to middle-aged female dogs but has been recognized in both male and female dogs between 4 months and 14 years of age.6,8 Standard poodles, Portuguese water dogs, Great Danes, rottweilers, West Highland white terriers, and Wheaton terriers are some of the overrepresented breeds.8,10 Hypoadrenocorticism may be inherited in certain breeds, such as Portuguese water dogs, and a complete genetic evaluation of hypoadrenocorticism is being investigated in many breeds.10