Recognizing Adrenal Disease in Dogs

by Vicki Hopkins
(Cordova, Tn.)

Reader Question:

My 10 year old large Sheltie has high liver counts, but he eats all the time, drinks lots of water, more than he ever has, but has no issues with holding urine. I don't believe it is a liver issue since his appetite is so good, He was on carfropen for the past 5 years, could that be the cause? We have him off of it and he is scheduled for the adrenal blood test in a week, other than being tired, he eats, drinks alot, and still goes on two walks a day, I just don't know which direction to go?

Veterinarian Response

Hello Vicki,

Adrenal testing is a very reasonable next step in your dog’s diagnostic workup. His symptoms are consistent with Cushing’s disease (hyperadrenocorticism) but also with a relatively long list of other conditions. Unfortunately, Cushing’s disease is not always the easiest condition to diagnose. In some cases, the results of several different tests in combination with the dog’s clinical picture are necessary before a definitive diagnosis can be made.

I will often start with a urine cortisol to creatinine ratio as a screening test. If the results are normal, this test can rule-out Cushing’s, but an abnormal result only indicates that the disease is still a possibility. One (or more) of several different types of blood tests (ACTH stimulation test, dexamethasone suppression tests, etc.) must be run to definitively diagnose Cushing’s disease.

I don’t know the details of your dog’s case, but if he were my patient and testing for Cushing’s was negative, I might recommend an abdominal ultrasound next.

Best of luck,
Jennifer Coates, DVM

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