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Case Studies

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OSEA

Osea (“oh-see”), a 10y Labrador with 

adrenal-dependent hyperadrenocorticism.

Presentation: PUPD, coat colour changed, 

more lethargic.

Results of diagnostic tests: isosthenuria; hyperlipidae-mia; T4/TSH normal; low-dose dexamethasone suppression test 58nmol/L (28-250), 64 (<40) and 77 (<40); abdominal ultrasound: right adrenal mass Surgery: right adrenalectomy (no venotomy) 5x8x4cm mass. 

Analgesia: methadone/midazolam and IV paracetamol pre-medication; morphine- bupivacaine epidural; fentanyl intra-operatively; methadone as required post-operatively. 

Surgical equipment: bipolar diathermy tweezers, bipolar dissecting forceps, Surgiclips, cotton-tips, and two vets scrubbed in. Blood donor dog in hospital on standby – not needed.

Post-op care: analgesia and fluid support, intravenous steroids

Discharge: home the following day, on Pardale, tramadol and prednisolone

Progress: excellent progress, no longer PUPD, slow hair-coat regrowth whilst weaning off steroids. Osea had a bout of pancreatitis one month post-op which resolved with symptomatic treatment. 

ACTH stimulation test due in 4-6 weeks’ time, a couple of weeks after the steroids have finished.

SADIE

Sadie, a 2y Labrador with 

adrenal-dependent hyperadrenocorticism.

Presentation: PUPD, coat colour changed, 

more lethargic.

Results of diagnostic tests: isosthenuria; hyperlipidae-mia; T4/TSH normal; low-dose dexamethasone suppression test 58nmol/L (28-250), 64 (<40) and 77 (<40); abdominal ultrasound: right adrenal mass Surgery: right adrenalectomy (no venotomy) 5x8x4cm mass. 

Analgesia: methadone/midazolam and IV paracetamol pre-medication; morphine- bupivacaine epidural; fentanyl intra-operatively; methadone as required post-operatively. 

Surgical equipment: bipolar diathermy tweezers, bipolar dissecting forceps, Surgiclips, cotton-tips, and two vets scrubbed in. Blood donor dog in hospital on standby – not needed.

Post-op care: analgesia and fluid support, intravenous steroids

Discharge: home the following day, on Pardale, tramadol and prednisolone

Progress: excellent progress, no longer PUPD, slow hair-coat regrowth whilst weaning off steroids. Osea had a bout of pancreatitis one month post-op which resolved with symptomatic treatment. 

ACTH stimulation test due in 4-6 weeks’ time, a couple of weeks after the steroids have finished.