Atypical primary hypoadrenocorticism in a dog: case report

Abstract

Hypoadrenocorticism is an endocrinopathy defined as a deficiency in the production of glucocorticoids and/or mineralocorticoids. It is uncommon in dogs, with primary and secondary causes, the former having typical and atypical presentations. The clinical signs are unspecific and highly variable, and the patient may present only sporadic hyporexia, vomiting and diarrhea, or even hypovolemic shock and death. Diagnosis is based on anamnesis, clinical signs, laboratory tests and imaging, with the ACTH (adrenocorticotrophic hormone) stimulation test being the hormonal test of choice for diagnosing the disease. Treatment is based on exogenous hormone replacement, based on the patient's needs. The aim of this report is to describe the case of a five-and-a-half-year-old, neutered, male German Dane with a history of hyporexia, progressive weight loss, vomiting, intermittent pasty stool and anemia for almost a year. Based on the laboratory and imaging findings, the suspicion of hypoadrenocorticism was raised and the diagnosis was concluded based on the ACTH stimulation test and basal ACTH dosage. The treatment instituted was exogenous glucocorticoid replacement and, after a short period of treatment, the patient showed considerable clinical and hematological improvement. It was concluded that hypoadrenocorticism is a disease with an often challenging diagnosis, but with excellent prognosis if treatment is instituted quickly and assertively, which improves the quality of life both both the patient and their guardian.