Diagnosis and management of Cushing's syndrome in dogs explored
Hyperadrenocorticism (Cushing’s syndrome) is one of the most common endocrine diseases in dogs attending primary-care practice, affecting 0.28% of UK dogs. Dogs with hyperadrenocorticism are typically diagnosed and managed within primary-care practice however, until now, there has been limited evidence examining this population of dogs. This VetCompass™ study therefore provides generalisable benchmark data describing how cases are diagnosed and managed in primary-care practice.
The study was conducted by analysing data from 193,814 dogs attending 110 VetCompass™ participating clinics between 2009 and 2013. Key findings include:
- The current expert recommended gold standard diagnostic screening test is the low dose dexamethasone suppression test. However this was only recorded in 32.0% of cases in the current study.
- Differentiation of disease origin (pituitary or adrenal disease) is considered ‘an important step’ by the American College of Veterinary Internal Medicine. In this population 21.1% of cases were differentiated.
- 94.1% of cases received trilostane treatment (Vetoryl Capsules, Dechra Veterinary Products Ltd).
- 50% of dogs lived to 510 days (Interquartile range: 412 – 618 days) following their diagnosis of Cushing’s syndrome.
- Older age at diagnosis, a greater bodyweight and no alteration to the starting trilostane dose were associated with poorer survival.
Imogen Schofield, lead researcher on this study said: ‘This study has highlighted the importance of directing research at the primary-care level to provide a generalisable overview of disease management. The study demonstrates the practicalities of diagnosing hyperadrenocorticism within primary-care practice in England, with the ACTH stimulation test the predominant method of diagnosis and disease origin infrequently differentiated, contrary to current expert recommendation. Additionally providing prognostic information can guide decision-making in the management of these cases ’.
RVC’s VetCompass™ project analyses anonymised veterinary clinical records from over 1,000 UK vet clinics to enhance understanding and improve the health and welfare of all companion animals. The study, ‘Survival analysis of 219 dogs with hyperadrenocorticism attending primary care practice in England.’, has been published by the Veterinary Record.
Research reference: SCHOFIELD, I., BRODBELT, D. C., WILSON, A. R. L., NIESSEN, S., CHURCH, D. & O'NEILL, D. 2019. Survival analysis of 219 dogs with hyperadrenocorticism attending primary care practice in England. Veterinary Record, vetrec-2018-105159. http://veterinaryrecord.bmj.com/cgi/rapidpdf/vr.105159?ijkey=CfKD5RL0zwmBdWU&keytype=ref
