Treatments for pituitary and adrenal-dependent Cushing's

Cushing’s disease, or hyperadrenocorticism (HAC), is one of the most common endocrinopathies in companion animals and is defined as the combination of clinical signs that results from effects of hypercortisolism in the body. Typical clinical signs include polyphagia, polyuria, polydipsia, panting, pot-bellied appearance and dermatological changes. The disease is common in dogs and ferrets and is rarely, though increasingly, recognised in cats. Overproduction of adrenocorticotropic hormone by a small, benign pituitary microadenoma (pituitary-dependent hyperadrenocorticism) is the most common cause of HAC. Less commonly, the condition occurs due to the presence of an adrenal tumour (adrenal-dependent HAC, or ADH). It can be useful to differentiate between the two causes when attempting to select the most appropriate treatment modality. Treatment may be medical or surgical. The treatment method chosen for a dog with HAC depends on several factors, including availability, efficacy, potential side effects, cause and severity of disease, concurrent diseases and the preferences of the client and clinician. Cost of treatment and follow-up evaluation should also be taken into account.