Da Silva Adrien Joaquim, Gunn Eilidh, Ramos Pedro Jose Guzmán, Shiel Robert Edward, Bree Laura, Mooney Carmel Therese
University College Dublin Veterinary Hospital, Dublin, Ireland.
North Downs Specialist referrals, Bletchingley, UK.
Ir Vet J. 2024 Sep 28;77(1):18. doi: 10.1186/s13620-024-00280-1.
Naturally occurring hypoadrenocorticism is an uncommon endocrine disorder in dogs but has significant morbidity and mortality. Some dogs present with apparent glucocorticoid deficiency alone as evidenced by eunatraemia and eukalaemia. Few studies have compared dogs with hypoadrenocorticism with or without electrolyte disturbances and there are no large case series of affected dogs from Ireland.
Retrospective observational study.
Ninety-two cases diagnosed with hypoadrenocorticism subdivided into those with supportive electrolyte disturbances (Group 1; n = 72) and those without (Group 2; n = 20). Dogs in Group 1 were significantly (p = 0.001) younger (4.0 (3.0-6.0) years) than dogs in Group 2 (6.0 (4.75-8.25) years). Dogs in Group 1 presented significantly more commonly with vomiting (Group 1: 52/71 (73.2%), Group 2: 6/20 (30.0%); p < 0.001), total hyperproteinaemia (Group 1: 21/71 (29.6%), Group 2: 1/20 (5.0%); p = 0.023), increased urea (Group 1: 52/72 (72.2%), Group 2: 5/20 (25.0%); p < 0.001), increased creatinine (Group 1: 31/72 (43.1%), Group 2: 3/20 (15.0%); p = 0.021) and hyperphosphataemia (Group 1: 40/71 (56.3%), Group 2: 2/20 (10.0%); p < 0.001), and significantly less commonly with reticulocytosis (Group 1: 4/38 (10.5%), Group 2: 5/13 (38.5%), p = 0.023). An undetectable basal aldosterone concentration had a positive predictive value of 94.3% for diagnosing undetectable post-ACTH aldosterone concentration. Of the thirteen dogs in Group 2 that had aldosterone concentrations measured and secondary disease excluded, 7 (53.8%) had or subsequently developed evidence of aldosterone deficiency, although not always with electrolyte abnormalities.
Dogs with hypoadrenocorticism from Ireland are similar to other reported cases. An undetectable basal aldosterone concentration is highly predictive of mineralocorticoid deficiency. Dogs with apparent glucocorticoid deficiency alone can progress to more typical disease and should be monitored appropriately.
自发性肾上腺皮质功能减退是犬类中一种罕见的内分泌疾病，但发病率和死亡率较高。一些犬只仅表现出明显的糖皮质激素缺乏，如血钠正常和血钾正常所证明。很少有研究比较有或没有电解质紊乱的肾上腺皮质功能减退犬，且没有来自爱尔兰的大量受影响犬只的病例系列。
回顾性观察研究。
92例被诊断为肾上腺皮质功能减退的病例分为有支持性电解质紊乱的犬只（第1组；n = 72）和无电解质紊乱的犬只（第2组；n = 20）。第1组的犬只（4.0（3.0 - 6.0）岁）比第2组的犬只（6.0（4.75 - 8.25）岁）显著更年轻（p = 0.001）。第1组的犬只更常出现呕吐（第1组：52/71（73.2%），第2组：6/20（30.0%）；p < 0.001）、总蛋白血症（第1组：21/71（29.6%），第2组：1/20（5.0%）；p = 0.023）、尿素升高（第1组：52/72（72.2%），第2组：5/20（25.0%）；p < 0.001）、肌酐升高（第1组：31/72（43.1%），第2组：3/20（15.0%）；p = 0.021）和高磷血症（第1组：40/71（56.3%），第2组：2/20（10.0%）；p < 0.001），而网织红细胞增多症则显著较少见（第1组：4/38（10.5%），第2组：5/13（38.5%），p = 0.023）。基础醛固酮浓度检测不到对诊断促肾上腺皮质激素刺激后醛固酮浓度检测不到具有94.3%的阳性预测值。在第2组中测量了醛固酮浓度且排除了继发性疾病的13只犬中，7只（53.8%）有或随后出现醛固酮缺乏的证据，尽管并非总是伴有电解质异常。
来自爱尔兰的肾上腺皮质功能减退犬与其他报道的病例相似。基础醛固酮浓度检测不到高度预示着盐皮质激素缺乏。仅表现出明显糖皮质激素缺乏的犬只可能进展为更典型的疾病，应进行适当监测。
