Eastwood J M, Elwood C M, Hurley K J
Davies White Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, Hertfordshire SG5 3HR.
J Small Anim Pract. 2003 Mar;44(3):126-31. doi: 10.1111/j.1748-5827.2003.tb00133.x.
A 13-year-old, crossbreed dog presented with a history of recent onset polydipsia, progressive lethargy, weakness and reduced appetite. Blood tests showed raised concentrations of alkaline phosphatase and alanine aminotransferase with marginally low serum potassium. There was a leucocytosis with a mature neutrophilia and no eosinophils. Endocrine tests showed a normal aldosterone concentration and an exaggerated adrenocorticotropic hormone (ACTH) stimulation test, consistent with a diagnosis of hyperadrenocorticism (HAC). A diagnosis of adrenal-dependent HAC was made, based on the presence of a calcified mass involving the left adrenal gland, and hepatomegaly, on radiography and ultrasonography. The owners declined surgical adrenalectomy. Medical management with trilostane rapidly improved the clinical signs and normalised the serum chemistry. ACTH stimulation tests showed an improvement in post-ACTH cortisol concentrations and were used to make dose adjustments where necessary. At the time of writing, no adverse side effects had been seen and the dog remained well after 80 weeks of treatment.
一只13岁的杂种犬，近期出现烦渴、进行性嗜睡、虚弱和食欲减退的症状。血液检查显示碱性磷酸酶和丙氨酸转氨酶浓度升高，血清钾略低。白细胞增多，以成熟中性粒细胞增多为主，无嗜酸性粒细胞。内分泌检查显示醛固酮浓度正常，促肾上腺皮质激素（ACTH）刺激试验结果异常，符合肾上腺皮质功能亢进症（HAC）的诊断。根据X线摄影和超声检查发现左侧肾上腺有钙化肿块以及肝脏肿大，诊断为肾上腺依赖性HAC。主人拒绝进行肾上腺切除术。用曲洛司坦进行药物治疗迅速改善了临床症状，并使血清生化指标恢复正常。ACTH刺激试验显示ACTH注射后皮质醇浓度有所改善，并用于在必要时调整剂量。在撰写本文时，未观察到任何不良副作用，这只狗在治疗80周后仍然状况良好。
