• 1. Capen CC, Martin SL, Koestner A. Neoplasms in the adenohypophysis in dogs. Vet Pathol 1967; 4: 301325.

  • 2. Kelly DF, Siegel ET, Berg P. The adrenal gland in dogs with hyperadrenocorticism. Vet Pathol 1971; 8: 385400.

  • 3. Schelling CG. Ultrasonography of the adrenal gland. Probl Vet Med 1991; 3: 604617.

  • 4. Grooters AM, Biller DS, Theisen SK, et al. Ultrasonographic characteristics of the adrenal glands in dogs with pituitary-dependent hyperadrenocorticism: comparison with normal dogs. J Vet Intern Med 1996; 10: 110115.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Besso JG, Penninck DG, Gliatto JM. Retrospective ultrasonographic evaluation of adrenal lesions in 26 dogs. Vet Radiol Ultrasound 1997; 38: 448455.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Hoerauf A, Reusch CE. Ultrasonographic characteristics of both adrenal glands in 15 dogs with functional adrenocortical tumors. J Am Anim Hosp Assoc 1999; 51: 193199.

    • Search Google Scholar
    • Export Citation
  • 7. Benchekroun G, de Fornel-Thibaud P, Rodríguez Piñeiro MI, et al. Ultrasonography criteria for differentiating ACTH dependency from ACTH independency in 47 dogs with hyperadrenocorticism and equivocal adrenal asymmetry. J Vet Intern Med 2010; 24: 10771085.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Waller KR, O'Brien RT, Zagzebski JA. Quantitative contrast ultrasound analysis of renal perfusion in normal dogs. Vet Radiol Ultrasound 2007; 48: 373377.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Pey P, Vignoli M, Haers H, et al. Contrast-enhanced ultrasonography of the normal canine adrenal gland. Vet Radiol Ultrasound 2011; 52: 560567.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. Haers H, Saunders JH. Review of clinical characteristics and applications of contrast-enhanced ultrasonography in dogs. J Am Vet Med Assoc 2009; 234: 460470.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Brown S, Atkins C, Bagley R, et al. Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med 2007; 21: 542558.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Keene BW, Bonagura JD. Management of heart failure in dogs. In: Bonagura JD, Twedt DC, eds. Kirk's current veterinary therapy. 14th ed. St Louis: Saunders, 2009;771.

    • Search Google Scholar
    • Export Citation
  • 13. Feldman EC, Nelson RW. The adrenal gland. In: Feldman EC, Nelson RW, eds. Canine and feline endocrinology and reproduction. 3rd ed. Philadelphia: WB Saunders Co, 2004;251484.

    • Search Google Scholar
    • Export Citation
  • 14. Meijer JC, de Bruijne JJ, Rijnberk A, et al. Biochemical characterization of pituitary-dependent hyperadrenocorticism in the dog. J Endocrinol 1978; 77: 111118.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Meijer JC, Lubberink AA, Rijnberk A, et al. Adrenocortical function tests in dogs with hyperfunctioning adrenocortical tumours. J Endocrinol 1979; 80: 315319.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Feldman EC. Comparison of ACTH response and dexamethasone suppression as screening tests in canine hyperadrenocorticism. J Am Vet Med Assoc 1983; 182: 506510.

    • Search Google Scholar
    • Export Citation
  • 17. Feldman EC, Nelson RW, Feldman MS. Use of low- and high-dose dexamethasone tests for distinguishing pituitary-dependent from adrenal tumor hyperadrenocorticism in dogs. J Am Vet Med Assoc 1996; 209: 772775.

    • Search Google Scholar
    • Export Citation
  • 18. Galac S, Kooistra HS, Teske E, et al. Urinary corticoid/creatinine ratios in the differentiation between pituitary-dependent hyperadrenocorticism and hyperadrenocorticism due to adrenocortical tumour in the dog. Vet Q 1997; 19: 1720.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Rodríguez Piñeiro MI, Benchekroun G, de Fornel-Thibaud P, et al. Accuracy of an adrenocorticotropic hormone (ACTH) immunoluminometric assay for differentiating ACTH-dependent from ACTH-independent hyperadrenocorticism in dogs. J Vet Intern Med 2009; 23: 850855.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Scott-Moncrieff JC, Koshko MA, Brown JA, et al. Validation of a chemiluminescent enzyme immunometric assay for plasma adrenocorticotropic hormone in the dog. Vet Clin Pathol 2003; 32: 180187.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Kooistra HS, Voorhout G, Mol JA, et al. Correlation between impairment of glucocorticoid feedback and the size of the pituitary gland in dogs with pituitary-dependent hyperadrenocorticism. J Endocrinol 1997; 152: 387394.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22. Auriemma E, Barthez PY, van der Vlugt-Meijer RH, et al. Computed tomography and low-field magnetic resonance imaging of the pituitary gland in dogs with pituitary-dependent hyperadrenocorticism: 11 cases (2001–2003). J Am Vet Med Assoc 2009; 235: 409414.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Barberet V, Pey P, Duchateau L, et al. Intra- and interobserver variability of ultrasonographic measurements of the adrenal glands in healthy beagles. Vet Radiol Ultrasound 2010; 51: 656660.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24. Barthez PY, Nyland TG, Feldman EC. Ultrasonographic evaluation of the adrenal glands in dogs. J Am Vet Med Assoc 1995; 207: 11801183.

    • Search Google Scholar
    • Export Citation
  • 25. Choi J, Kim H, Yoon J. Ultrasonographic adrenal gland measurements in clinically normal small breed dogs and comparison with pituitary-dependent hyperadrenocorticism. J Vet Med Sci 2011; 73: 985989.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26. Delorme S, Krix M. Contrast-enhanced ultrasound for examining tumor biology. Cancer Imaging 2006; 6: 148152.

  • 27. Levkowitz H. Color scales for image data: design and evaluation. In: Levkowitz H, ed. The international series in engineering and computer science. Philadelphia: Springer Publishing, 1997;109132.

    • Search Google Scholar
    • Export Citation
  • 28. Ohlerth S, Dennler M, Rüefli E, et al. Contrast harmonic imaging characterization of canine splenic lesions. J Vet Intern Med 2008; 22: 10951102.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29. Kanemoto H, Ohno K, Nakashima K, et al. Characterization of canine focal liver lesions with contrast-enhanced ultrasound using a novel contrast agent—Sonazoid. Vet Radiol Ultrasound 2009; 50: 188194.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30. Nakamura K, Takagi S, Sasaki N, et al. Contrast-enhanced ultrasonography for characterization of canine focal liver lesions. Vet Radiol Ultrasound 2010; 51: 7985.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31. Nakamura K, Sasaki N, Murakami M, et al. Contrast-enhanced ultrasonography for characterization of focal splenic lesions in dogs. J Vet Intern Med 2010; 24: 12901297.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32. Ortega TM, Feldman EC, Nelson RW, et al. Systemic arterial blood pressure and urine protein/creatinine ratio in dogs with hyperadrenocorticism. J Am Vet Med Assoc 1996; 209: 17241729.

    • Search Google Scholar
    • Export Citation
  • 33. O'Brien RT, Iani M, Matheson J, et al. Contrast harmonic ultrasound of spontaneous liver nodules in 32 dogs. Vet Radiol Ultrasound 2004; 45: 547553.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34. Hurley KJ, Vaden SL. Evaluation of urine protein content in dogs with pituitary-dependent hyperadrenocorticism. J Am Vet Med Assoc 1998; 212: 369373.

    • Search Google Scholar
    • Export Citation
  • 35. Goy-Thollot I, Pechereau D, Keroack S, et al. Investigation of the role of aldosterone in hypertension associated with spontaneous pituitary-dependent hyperadrenocorticism in dogs. J Small Anim Pract 2002; 43: 489492.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36. Novellas R, de Gopegui RR, Espada Y. Determination of renal vascular resistance in dogs with diabetes mellitus and hyperadrenocorticism. Vet Rec 2008; 163: 592596.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37. Heaney AP, Hunter SJ, Sheridan B, et al. Increased pressor response to noradrenaline in pituitary dependent Cushing's syndrome. Clin Endocrinol 1999; 51: 293299.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38. Martinez NI, Panciera DL, Abbott JA, et al. Evaluation of pressor sensitivity to norepinephrine infusion in dogs with iatrogenic hyperadrenocorticism. Pressor sensitivity in dogs with hyperadrenocorticism. Res Vet Sci 2005; 78: 2531.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39. Smith L, Smith JB. Regulation of sodium-calcium exchanger by glucocorticoids and growth factors in vascular smooth muscle. J Biol Chem 1994; 269: 2752727531.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40. Magiakou MA, Smyrnaki P, Chrousos GP. Hypertension in Cushing's syndrome. Best Pract Res Clin Endocrinol Metab 2006; 20: 467482.

  • 41. Polzin DJ. Chronic kidney disease. In: Ettinger SJ, Feldman EC, eds. Veterinary internal medicine. 7th ed. St Louis: Saunders, 2010;1992.

    • Search Google Scholar
    • Export Citation
  • 42. De Chalus T, Combes A, Bedu AS, et al. Ultrasonographic adrenal gland measurements in healthy Yorkshire Terriers and Labrador Retrievers. Anat Histol Embryol 2013; 42: 5764.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43. Grooters AM, Biller DS, Merryman J. Ultrasonographic parameters of normal canine adrenal glands: comparison to necropsy findings. Vet Radiol Ultrasound 1995; 36: 126130.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Contrast-enhanced ultrasonographic evaluation of adrenal glands in dogs with pituitary-dependent hyperadrenocorticism

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  • 1 Department of Medical Imaging of Domestic Animals and Orthopaedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
  • | 2 Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
  • | 3 Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
  • | 4 Department of Physiology and Biometry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
  • | 5 Unité de médecine interne, Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.
  • | 6 Unité de médecine interne, Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.
  • | 7 Department of Medical Imaging of Domestic Animals and Orthopaedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Abstract

Objective—To assess vascular changes induced by hyperadrenocorticism of hyperplastic adrenal glands in dogs via contrast-enhanced ultrasonography.

Animals—12 dogs with pituitary-dependent hyperadrenocorticism (PDH) and 7 healthy control dogs ≥ 7 years old.

Procedures—Dogs were assigned to the PDH and control groups and to small-breed (n = 6), medium-breed (4), and large-breed (9) subgroups. Contrast-enhanced ultrasonography of both adrenal glands in each dog was performed with IV injections of contrast agent. Time-intensity curves for the adrenal cortex, adrenal medulla, and ipsilateral renal artery of both adrenal glands were generated. Perfusion variables (time to peak [TTP], upslope of wash-in phase, and downslope of washout phase) were calculated.

Results—Contrast-enhanced ultrasonography revealed no qualitative difference between PDH and control groups. Quantitatively, TTPs were longer in the adrenal cortex and adrenal medulla of the PDH group, compared with values for the control group, particularly in the adrenal cortex and adrenal medulla of the small-breed subgroup. Washout downslopes were lower for the renal artery, adrenal cortex, and adrenal medulla of the small-breed subgroup between the PDH and control groups. No other perfusion variables differed between groups.

Conclusions and Clinical Relevance—Contrast-enhanced ultrasonography of the adrenal glands in dogs with PDH revealed a delayed TTP in the adrenal cortex and adrenal medulla, compared with values for control dogs. Contrast-enhanced ultrasonography was able to detect vascular changes induced by hyperadrenocorticism. Further studies are needed to evaluate whether reference ranges for clinically normal dogs and dogs with PDH can be determined and applied in clinical settings.

Abstract

Objective—To assess vascular changes induced by hyperadrenocorticism of hyperplastic adrenal glands in dogs via contrast-enhanced ultrasonography.

Animals—12 dogs with pituitary-dependent hyperadrenocorticism (PDH) and 7 healthy control dogs ≥ 7 years old.

Procedures—Dogs were assigned to the PDH and control groups and to small-breed (n = 6), medium-breed (4), and large-breed (9) subgroups. Contrast-enhanced ultrasonography of both adrenal glands in each dog was performed with IV injections of contrast agent. Time-intensity curves for the adrenal cortex, adrenal medulla, and ipsilateral renal artery of both adrenal glands were generated. Perfusion variables (time to peak [TTP], upslope of wash-in phase, and downslope of washout phase) were calculated.

Results—Contrast-enhanced ultrasonography revealed no qualitative difference between PDH and control groups. Quantitatively, TTPs were longer in the adrenal cortex and adrenal medulla of the PDH group, compared with values for the control group, particularly in the adrenal cortex and adrenal medulla of the small-breed subgroup. Washout downslopes were lower for the renal artery, adrenal cortex, and adrenal medulla of the small-breed subgroup between the PDH and control groups. No other perfusion variables differed between groups.

Conclusions and Clinical Relevance—Contrast-enhanced ultrasonography of the adrenal glands in dogs with PDH revealed a delayed TTP in the adrenal cortex and adrenal medulla, compared with values for control dogs. Contrast-enhanced ultrasonography was able to detect vascular changes induced by hyperadrenocorticism. Further studies are needed to evaluate whether reference ranges for clinically normal dogs and dogs with PDH can be determined and applied in clinical settings.

Contributor Notes

Dr. Pey's present address is Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, St Hyacinthe, QC J2S 7C6 Canada.

Presented in poster form at the European College of Veterinary Internal Medicine Companion Animal Congress, Seville, Spain, September 2011.

Address correspondence to Dr. Pey (pascaline_pey@hotmail.fr).