Complex surgery resolves Jenkins’ medically unmanageable Cushing’s

Davies Veterinary Specialists

Internal Medicine

14th January 2022

Ten-year-old cross breed dog Jenkins has been given a new lease of life thanks to skilful surgery at Davies Veterinary Specialists (Davies) to resolve a medically challenging case of Cushing’s disease.

Jenkins initially presented to the internal medicine team at Davies with a marked increase in thirst and urination, increased appetite, lethargy and severe skin disease. He had been diagnosed with hyperadrenocorticism, also known as Cushing’s disease, shortly prior to referral but his response to medical management had been disappointing.

At Davies, Jenkins had comprehensive investigations which included blood and urine tests, blood pressure measurement, ultrasound of the abdomen and dermatological tests to understand his skin changes better.

He was diagnosed with adrenal-dependent Cushing’s disease with associated high blood pressure, protein in his urine and severe dermatological changes with secondary infections.

“Adrenal-dependent Cushing’s disease is where there is a tumour on one of the adrenal glands that is producing excessive amounts of the stress hormone cortisol,” explained Katherine Clarke, who is an internal medicine vet at Davies. “In Jenkins this tumour was also invading large blood vessels local to the tumour including the caudal vena cava – an major vein carrying blood to the heart.”

Jenkins was started on additional medications to manage the protein in his urine, the high blood pressure, and his skin infections. While his response to medical management was reasonable; his skin infection resolved, blood pressure improved and his thirst reduced, his disease unfortunately remained imperfectly controlled.

“At this stage we made the decision to operate on him to remove the affected adrenal gland,” said Katherine. “This surgery was very high risk given the invasion of the tumour into local blood vessels, but also because Jenkins was at risk of developing blood clots due to the Cushing’s disease and the protein in his urine.”

Jenkins was operated on by European Specialist in Small Animal Surgery Carolyn Burton. Given the complexities of this surgery and the associated risks to Jenkins an anaesthetist was with him throughout the entire procedure.

“Despite our concerns, surgery went very well, and Jenkins recovered without event and was discharged home a few days after surgery,” said Katherine. “He is now two months down the road and is doing amazingly well – he is no longer on any medications for his Cushing’s disease, his excessive thirst has resolved, the protein content of his urine is now normal, and his blood pressure well controlled with medications. His fur is re-growing and he looks younger every time we see him!

Jenkins’s prognosis is very good, although the tumour was a cancer it is low grade and unlikely to return in the near future.

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