- This is a 16 year old, FS, Cockapoo with elevated cortisol levels on a LDDT, isosthenuria, urine protein to creatinine ratio>3.0, ALT=165.The dog is currently on amlodipine and enalapril for systemic hypertension.
- Abdominal ultrasound shows bilateral adrenal gland masses, splenic hilar thrombus, multiple, bilateral, renal cortical cysts, and heterogeneous hepatic parenchyma.
- The left adrenal gland mass is mineralzied. The right adrenal gland mass is >4.0cm in diameter. It is complex with multiple nodules and possible cysts.
- This is a 16 year old, FS, Cockapoo with elevated cortisol levels on a LDDT, isosthenuria, urine protein to creatinine ratio>3.0, ALT=165.The dog is currently on amlodipine and enalapril for systemic hypertension.
- Abdominal ultrasound shows bilateral adrenal gland masses, splenic hilar thrombus, multiple, bilateral, renal cortical cysts, and heterogeneous hepatic parenchyma.
- The left adrenal gland mass is mineralzied. The right adrenal gland mass is >4.0cm in diameter. It is complex with multiple nodules and possible cysts.
- The left adrenal gland does not show vascular invasion. Patient movement precluded full color flow Doppler evaluation of the right adrenal gland for local vascular invasion.
- Would it be safe to say that this is NOT pituitary based hyperadrenocorticism or is an FNA required? I have not seen such an atypical right adrenal gland with PDH.
- What treatment options are available if both adrenal glands have masses? Surgical debulking or just trilostane or mitotane with Plavix and blood pressure control?
