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Lindholm, Jenny, 2021. Kliniska tecken och prognos hos storpudlar med binjurebarksinsufficiens. Second cycle, A2E. Uppsala: SLU, Dept. of Clinical Sciences


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Abstract

Binjurebarksinsufficiens eller hypoadrenokorticism uppkommer till följd av en bristande förmåga
att producera gluko- och mineralkortikoider i binjurebarken. Bristen på kortisol och aldosteron leder
ofta till vaga kliniska tecken och livslång supplementering av hormon krävs. Sjukdomen anses vara
relativt ovanlig hos hund men sjukdomsprevalensen har setts vara högre inom vissa raser, däribland
storpudlar. Prognosen betraktas som god men i dagsläget baseras underlaget endast på ett fåtal publicerade studier. Denna retrospektiva studie syftade till att utvärdera prognosen samt sjukdomspresentationen bland storpudlar som diagnosticerats med binjurebarksinsufficiens i Sverige.
Studien inkluderade 51 storpudlar som diagnosticerats med hjälp av ACTH-stimulering under tidsperioden 2001 – 2013. Vid studieperiodens slut var två hundar fortsatt vid liv medan sex hundar var
lost to follow-up. Medianålder vid diagnos var 3,4 år men de hundar som uppvisat elektrolytnivåer
inom referensintervall vid tidpunkten för diagnos var äldre med en medianålder på 5 år. Åldern vid
diagnos var oberoende kön och kastrationsstatus.
Presentationen av kliniska tecken stämde väl överens med litteraturen där letargi, anorexi, viktminskning och kräkning förekom mest frekvent. En oväntat stor andel hundar visade även tecken
på minskad törst och vinglighet vid diagnos. Samtliga hundar uppvisade fler än två kliniska tecken
vid diagnos och durationen varade vanligen i en vecka upp till flera månader.
Medianen för överlevnad efter diagnos beräknades till 5,8 år vilket är högre än tidigare rapporterat
och prognosen anses därför vara god. Andelen dödsfall som bedömdes relatera till binjurebarksinsufficiensen var dock överraskande stor (42 % och dessa hundar visade sig ha en förkortad livslängd
jämfört med övriga). Behandlingssvaret var även lägre än förväntat där endast 64% av de tillfrågade
djurägarna upplevde att hunden svarat tillfredställande på medicinering. Resultaten av denna studie
tyder på att livskvalitén hos storpudlar med binjurebarksinsufficiens inte varit optimal och att det i
framtiden finns utrymme för att förbättra sjukdomsprognosen ytterligare.

,

Adrenocortical insufficiency or hypoadrenocorticism is a relatively uncommon disease in dogs
which results from a lacking ability to produce mineral- and glucocorticoids in the cortex of the
adrenal glands. The deficiency of aldosterone and cortisol often presents as vague clinical signs.
Once the disease has been diagnosed, a lifelong medication is required. Studies have shown that
certain breeds are at higher risk of developing the disease, whereas the Standard Poodle is one of
them. The prognosis is believed to be excellent, but only a few studies have been published in the
area. The aim of this retrospective study was to investigate clinical presentation and prognosis of
naturally occurring adrenocortical insufficiency in a population of Standard Poodles in Sweden.
The study included 51 Standard Poodles whose diagnosis of adrenocortical insufficiency was confirmed with an ACTH-stimulation test performed between 2001 and 2013. Two dogs were still alive
at the end of the study and six dogs were lost to follow-up. The median age at diagnosis was 3.4
years for all dogs. Dogs with serum sodium and potassium concentrations within reference ranges
were significantly older (median age, 5 years), than dogs with serum electrolyte abnormalities (median age, 3,2 years). Gender and castration status did not affect the age at diagnosis.
The presented clinical signs were in agreement with what previously has been reported in the literature. The most commonly reported clinical signs in the Standard Poodles were lethargy, anorexia,
weight loss and vomiting. An unexpectedly large number of dogs showed signs of oligo- or adipsia
and ataxia. All dogs presented with two or more clinical signs at the time of diagnosis. The signs
had most commonly been seen in a week up to several months before diagnosis.
The median overall survival time was 5.8 years. This result is considered to be excellent, but the
calculated deaths related to adrenocortical insufficiency was surprisingly high (42%). The dogs that
died due to disease-related causes had a significantly shorter life expectancy. The response to treatment was lower than previously reported; only 64% of the dog-owners considered their dog to have
a good or excellent response. In conclusion, in the present study, Standard Poodles diagnosed with
adrenocortical insufficiency showed suboptimal clinical response to treatment and shorter survival
time than expected. Therefore, there is room for future treatment optimizations.

Main title:Kliniska tecken och prognos hos storpudlar med binjurebarksinsufficiens
Authors:Lindholm, Jenny
Supervisor:Hanson, Jeanette
Examiner:Hamlin, Helene
Series:UNSPECIFIED
Volume/Sequential designation:UNSPECIFIED
Year of Publication:2021
Level and depth descriptor:Second cycle, A2E
Student's programme affiliation:VY002 Veterinary Medicine Programme 330 HEC
Supervising department:(VH) > Dept. of Clinical Sciences
Keywords:binjurebarksinsufficiens, Addisons sjukdom, hypoadrenokorticism, hund, storpudel, kliniska tecken, överlevnad, prognos
URN:NBN:urn:nbn:se:slu:epsilon-s-16499
Permanent URL:
http://urn.kb.se/resolve?urn=urn:nbn:se:slu:epsilon-s-16499
Subjects:Animal diseases
Language:Swedish
Deposited On:05 Mar 2021 07:29
Metadata Last Modified:06 Mar 2021 02:09

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