Peer-reviewed veterinary case report
Treating canine Cushing's syndrome: Current options and future prospects.
- Journal:
- Veterinary journal (London, England : 1997)
- Year:
- 2018
- Authors:
- Sanders, K et al.
- Affiliation:
- Department of Clinical Sciences of Companion Animals · Netherlands
- Species:
- dog
Plain-English summary
Cushing's syndrome, or hypercortisolism, is a common hormonal disorder in dogs, often caused by a tumor in the pituitary gland or the adrenal glands. To choose the best treatment, it's important to know which type of tumor is present. Surgery to remove the tumor is an option, but it can be risky and isn't available everywhere, so medication is often used instead. For dogs with a pituitary tumor, a drug called trilostane is commonly prescribed, while dogs with an adrenal tumor may receive either trilostane or another drug called mitotane. While these treatments can be effective, they also have some drawbacks, and researchers are looking into new medications that could be more targeted and safer for dogs with Cushing's syndrome.
Abstract
Naturally occurring hypercortisolism, also known as Cushing's syndrome, is a common endocrine disorder in dogs that can be caused by an adenocorticotrophic hormone (ACTH)-producing pituitary adenoma (pituitary-dependent hypercortisolism, PDH; 80-85% of cases), or by an adrenocortical tumor (ACT; 15-20% of cases). To determine the optimal treatment strategy, differentiating between these two main causes is essential. Good treatment options are surgical removal of the causal tumor, i.e. hypophysectomy for PDH and adrenalectomy for an ACT, or radiotherapy in cases with PDH. Because these options are not without risks, not widely available and not suitable for every patient, pharmacotherapy is often used. In cases with PDH, the steroidogenesis inhibitor trilostane is most often used. In cases with an ACT, either trilostane or the adrenocorticolytic drug mitotane can be used. Although mostly effective, both treatments have disadvantages. This review discusses the current treatment options for canine hypercortisolism, and considers their mechanism of action, efficacy, adverse effects, and effect on survival. In addition, developments in both adrenal-targeting and pituitary-targeting drugs that have the potential to become future treatment options are discussed, as a more selective and preferably also tumor-targeted approach could have many advantages for both PDH and ACTs.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/30340659/