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Peer-reviewed veterinary case report

Multiple pathological bone fractures in a dog with adrenal-dependent Cushing's syndrome.

Journal:
The Journal of small animal practice
Year:
2025
Authors:
Melián, C et al.
Affiliation:
Department of Animal Pathology · Spain
Species:
dog

Plain-English summary

A 14-year-old female mixed-breed dog was diagnosed with Cushing's disease, which is a condition caused by excess cortisol. She showed signs like being very tired, weak, having trouble moving, trembling, drinking and peeing a lot, losing hair, and a swollen belly. After starting treatment with a medication called trilostane, she developed more issues, including difficulty getting up and was found to have low bone density and multiple fractures in her ribs and spine. Despite being hospitalized for eight days, her condition did not improve, and her owner ultimately decided to euthanize her. A post-mortem examination revealed cancer in her adrenal gland and significant bone problems.

Abstract

Pathological bone fractures may occur secondarily to Cushing's syndrome in people. Although low bone mineral density due to cortisol excess has been described in dogs, there is no evidence that dogs with Cushing's disease can develop osteoporosis or secondary bone fractures. Here, we report a case of a dog with Cushing's disease and multiple pathological bone fractures. A 14-year-old female spayed mixed-breed dog was attended due to progressive lethargy, weakness, difficulty moving, trembling and clinical signs of Cushing's syndrome (polyuria, polydipsia, alopecia and abdominal distension). After confirmation of the diagnosis of Cushing's disease and 2 days after starting trilostane treatment (0.27 mg/kg every 12 hours), the dog presented to our hospital with reluctance to rise. In the computed tomography scan, decreased bone density in cervical and thoracic vertebrae, ribs scapular bones and multiple rib fractures were detected. Despite 8 days of hospitalisation, reluctance to rise and walk persisted. Given the unfavourable progression of the diseases, the owner opted for euthanasia. Post mortem evaluation confirmed a cortical carcinoma of the left adrenal gland and thin, irregular spicules and trabeculae of compact bone and reduced thickness of the cortex of the ribs.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/40090760/