Disease of Cushing

Hiperadrenocorticismo: Disease of Cushing

The disease of Cushing or hiperadrenocorticismo is a disease caused by an excess of corticoesteroides in the sanguineous circulation, by the production increased of suprarrenales hormones of the adrenal gland (suprarenales) or an exogenous administration.
It affects to old, normally greater adult dogs to of 6 years, with slight predisposition in the females in the case of neoplasias adrenal. The prearranged races are German Shepherd, Teckel, Caniche and Beagle, but it can affect any race.
The etiología (cause) can be divided in three great groups:

1. The excessive administration of corticoesteroides denominates iatrogénico Cushing to him. The corticoids, as it is known, have numerous and intense indirect effect when they are used in the long term, emphasizing the appearance of the syndrome of this call iatrogénico Cushing, it is more probable to observe it when slowed down injectable forms of reiterated way are used, even can be caused after the continuous application of topical corticoids. This it is simplest to cure, as soon as the administration of the corticoesteroide interrupts itself, slowly, to allow that the organism of the animalito returns to the normal function. The rest is more difficult.
2. By bad operation of the gland and excessive production of endogenous corticoids, the primary Cushing in general is due to a tumor of the suprarrenal gland (adrenal adenomas or adenocarcinomas) that produces great amount of suprarrenales hormones.
   
3. Sobreestímulo of the normal suprarrenales glands by the hormones that control it by the excess of hipofisaria secretion of ACTH (hipofisiario tumor) that causes one hiperplasia adrenocortical call dependent hiperadrenocorticismo of hipófisis (80-85% of the cases in canine).

Sintomatología:

* Obesity and oscillating abdomen!
* Polidipsia/Poliuria (they drink much water and they tinkle much, but much much)
* Polifagia (much appetite)
* Depression, adinámia, muscular weakness
* Hirsutismo and loss of the hair (distributed generally uniformly in both sides of the body)
* Testicular Pigmentación in males and hipertrofia of clítoris in females
* Susceptibility to the infections of the skin and the diabetes
* Arterial hypertension
* Neurological alterations
* Other symptoms.

Diagnosis:
The diagnosis can be done with several analyses of blood: directly or indirectly, this includes several type of analysis with or without administration of corticoids and it is evaluated and dosando the answers of adrenal hormones and the adrenocorticotróficas.
The x-rays and the ecografías can help to determine if a suprarrenal tumor of the gland is present.

Treatment:
The iatrogénico Cushing (cause 1) is but easy to cure (as or we said) cutting or reducing the administration of the corticoesteroides, if it is fundamental for the life of the patient to continue administering corticoid (disease autoinmune s), she recommends herself re-to evaluate the therapeutic plan and to change or to replace the corticoids by others (injectable by oral day by means, ej.) with the less indirect effect respecting the circadian rythm of each species.
If it can be determined that there is a suprarrenal tumor of the gland (cause 2), can be extirpated and this constitutes the therapeutic pillar of these cases but in general, eye! , it is recommended that it is carried out by a specialist since the surgical risks can be high.
The pituitarios tumors of the gland (cause 3) do not take off generally in veterinary medicine and the therapeutic one is symptomatic.
Medicines like the Lysodren can be used or ketaconazole, these selectively destroy the external layer of the suprarrenal gland that produces corticoesteroides. Administering it in appropriate amounts it is possible to eliminate single the necessary thing to assure a minimum production corticoesteroides.
The average life expectancy of the dogs diagnosed with dependent Cushing of the hipófisis with or without the treatment is considered in 2 years, the treatment of these cases improves the quality of life.

Prognosis:
The prognosis of the hiperadrenocorticismo of is reserved to bad depending much on the moment of the diagnosis and the concomitante etiología.

Bibliography

Author: MV Adelaida A. Goldman
www.mascotia.com/oncologia
agoldman@mascotia.com

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