Hematological and biochemical changes in a bitch with hyperadrenocorticism and diabetes mellitus: Case report

Abstract

The aim of this work was to report a case of a 12-year-old mongrel bitch, diagnosed with hiperadrenocorticism and concurrent diabetes mellitus, focusing on laboratory alterations. The hiperadrenocorticism is a cronical endocrinopathy that mainly affects elderly dogs, characterized by high cortisol concentrations in the blood flow, with predisposition to develop secondary diabetes mellitus. For an accurate diagnosis, in addition to physical examination, one must take advantage of laboratory tests, like blood count, serum biochemistry, ACTH induction and low-dose dexamethasone suppression test. Therapy is based on drugs that reduce the production of adrenal hormones and on the use of insulin to control blood glucose. In this report’s patient, the clinical signs were lethargy, distended abdomen, polyuria, polyphagia, polydipsia, skin atrophy, teleangiectasia and hyperstained mucous membranes. The main reported laboratory alterations were in the leukometry, with eosinopenia and limphopenia, in the erythrogram, with normocytic hypochromic anemia, in the serum biochemistry, with hypercholesterolemia and high levels of liver enzymes, in the abnormal elements and urinary sedimentoscopy analysis, with intense glucosuria, and in the low-dose dexamethasone suppression test, with high levels of cortisol. The patient showed improvement in the clinical picture after the start of the treatment and daily follow-up, by using trilostane, omega 3 and NPH insulin, however it came to die a few months later, probably due to insulin resistance. For a better prognosis, the importance of early hiperadrenocorticism diagnosis through laboratory tests should be considered, mainly in elderly patients, advocating for routine laboratory tests.