Clinic of Small Animals - Internal Medicine, Justus-Liebig-University Giessen.
Clinic of Small Animal Surgery and Reproduction, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian-University.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2020 Apr;48(2):132-138. doi: 10.1055/a-1122-7837. Epub 2020 Apr 23.
A 13-year old miniature poodle presented with a 3-day episode of vomiting, anorexia, and lethargy. Lack of micturition had been noted for 2 days. Clinical examination indicated dehydration and a tense, painful abdomen. Laboratory parameters (severe azotaemia, hyperkalaemia, severe hyponatraemia, hypochloraemia, and hyperphosphataemia with glucosuria and proteinuria) were consistent with anuric acute kidney injury (AKI). Abdominal ultrasound revealed bilateral adrenal masses. ACTH stimulation test was diagnostic for Addison's disease. Computed tomography confirmed bilateral adrenal masses and indicated multifocal liver nodules. Additionally, infiltration of the caudal vena cava with partial luminal occlusion was demonstrated. Surgical removal of the adrenal masses with venous plasty intervention and stenting of the vessels deemed unrewarding in this patient in respect to progressed tumour growth with assumed metastatic spread. The dog was treated for Addison's disease and discharged with good overall condition. Eight weeks later, the dog was euthanized due to progressive caudal vena cava occlusion. Whilst hypoadrenocoticism typically affects young to middle aged dogs, in old dogs primary Addison's disease might be caused by neoplastic bilateral adrenal gland destruction. This is the first case report of hypovolaemia leading to AKI secondary to bilateral adrenal masses causing Addison's disease in a dog.
一只 13 岁的迷你贵宾犬出现了 3 天的呕吐、食欲不振和嗜睡症状。已经注意到它有 2 天没有排尿。临床检查表明它出现脱水和腹部紧张、疼痛。实验室参数(严重的氮血症、高钾血症、严重的低钠血症、低氯血症和高磷血症,伴有糖尿和蛋白尿)与无尿性急性肾损伤(AKI)一致。腹部超声显示双侧肾上腺肿大。ACTH 刺激试验诊断为艾迪生病。计算机断层扫描证实了双侧肾上腺肿块,并表明肝脏有多处结节。此外,还显示尾腔静脉浸润伴部分管腔闭塞。考虑到肿瘤生长进展和假设的转移扩散,手术切除肾上腺肿块、静脉成形术干预和血管支架置入术对该患者来说没有益处。该犬接受了艾迪生病的治疗,并在整体状况良好的情况下出院。8 周后,由于尾腔静脉进行性闭塞,该犬被安乐死。虽然低肾上腺皮质激素症通常影响年轻到中年犬,但在老年犬中,原发性艾迪生病可能是由双侧肾上腺肿瘤破坏引起的。这是首例因双侧肾上腺肿块导致艾迪生病而引起低血容量性 AKI 的犬病例报告。