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Hypoadrenocorticism (Addison’s disease) in a 2 year old FS Rottweiler

Case Study

Case Study

Hypoadrenocorticism (Addison’s disease) in a 2 year old FS Rottweiler

A 2-year-old FS Rottweiler dog was presented for lethargy, vomiting, and anorexia. The CBC demonstrated a leukocytosis consisting of a lymphocytosis, an eosinophilia, and a basophilia. Blood chemistry revealed azotemia, hyperphosphatemia, hyponatremia, and hyperamylasemia. The CBC and chemistry were repeated 3 days later and revealed persistence of the lymphocytosis. The serum biochemical profile revealed a decreased creatinine, hypoproteinemia, hypoalbuminemia, hyperkalemia, hypomagnesemia and hyperamylasemia.

A 2-year-old FS Rottweiler dog was presented for lethargy, vomiting, and anorexia. The CBC demonstrated a leukocytosis consisting of a lymphocytosis, an eosinophilia, and a basophilia. Blood chemistry revealed azotemia, hyperphosphatemia, hyponatremia, and hyperamylasemia. The CBC and chemistry were repeated 3 days later and revealed persistence of the lymphocytosis. The serum biochemical profile revealed a decreased creatinine, hypoproteinemia, hypoalbuminemia, hyperkalemia, hypomagnesemia and hyperamylasemia. The urinalysis showed a low specific gravity, and no bacterial growth was noted on the urine culture.

Sonographic Differential Diagnosis

Flattened isoechoic adrenal glands. In light of appropriate clinical signs, overt or emerging Addison`s disease should be considered.

Image Interpretation

The right adrenal has a flattened and largely isoechoic appearance. The vena cava and aorta interface ensures the correct position for imaging the right adrenal gland. The adrenal landmarks for the left adrenal are the left renal artery and aorta. A slightly hypoechoic and flattened left adrenal gland may be seen and measures approximately 0.25 cm in width.

DX

Hypoadrenocorticism

Outcome

ACTH stimulation found hypoadrenocorticism after small isoechoic adrenal glands were visualized on the sonogram. The patient responded to IV fluid therapy and steroids. The patient is stable and doing well clinically 7 months post diagnosis.

Comments

More on “Sonographic parameters of Addisonian adrenal glands” may be found under resources tab at SonoPath.com. Abstract ECVIM 2012, Seville, Spain.

Clinical Differential Diagnosis

Hypoadrenocorticism, gastroenteritis (dietary indiscretion, infectious (parasitic due to the eosinophilia and basophilia, bacterial, viral, fungal), foreign body ingestion, inflammatory bowel disease, neoplasia (lymphoma, adenocarcinoma, leiomyoma, leiomyosarcoma, mast cell tumor), pancreatitis, acute renal failure secondary to leptospira sp. infection.

Sampling

ACTH stimulation revealed Hypoadrenocorticism (Addison`s disease).

Video

Video Player
Video Player

Patient Information

Patient Name : Gypsy A
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 07_00023

Clinical Signs

  • Anorexia
  • Lethargy
  • Vomiting

Images

ATLAS260GypsyA_03192011121405gypsyackersonleftadrenaladdisons0700023_07162011100453

Blood Chemistry

  • Albumin, Low
  • Amylase, High
  • Azotemia
  • Magnesium, Low
  • Phosphorus, High
  • Potassium, High
  • Sodium, Low
  • Total Protein, Low

CBC

  • Basophils, High
  • Eosinophils, High
  • Lymphocytes, High
  • WBC, High

Clinical Signs

  • Anorexia
  • Lethargy
  • Vomiting

Urinalysi

  • Culture negative
  • Specific Gravity Low