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Treatment and monitoring of naturally occurring Cushing's syndrome by primary care veterinarians in selected European countries

Title: Treatment and monitoring of naturally occurring Cushing's syndrome by primary care veterinarians in selected European countries
Authors: Carvalho, Miguel F; Bennaim, Michael; Golinelli, Stefania; Fracassi, Federico; Arenas, Carolina; Pérez-Alenza, Maria; Galac, Sara; Mooney, Carmel T; Leal, Rodolfo O; Interne geneeskunde GD; OnGo; CS_Cancer
Publication Year: 2026
Subject Terms: PCVs; canine; hypercortisolism; monitoring; treatment; General Veterinary; SDG 3 - Good Health and Well-being
Description: BACKGROUND: Treatment of naturally occurring Cushing's syndrome includes surgery or medical management but there is little information on how primary care veterinarians (PCVs) select and monitor such treatment. HYPOTHESIS/OBJECTIVES: Determine how PCVs from selected European countries treat and monitor Cushing's syndrome in dogs. METHODS: Cross-sectional survey study assessing treatment and monitoring protocols used by PCVs when managing dogs with Cushing's syndrome. RESULTS: A total of 2178 responses from 9 European countries were included. Overall, 1694 (77.8%) respondents attempted to differentiate functional adrenal tumor (FAT) from pituitary-dependent hypercortisolism (PDH). Adrenalectomy and hypophysectomy were recommended in 67.8% and 30.5% dogs with FAT and PDH, respectively. When surgery was not considered, 23.9% of respondents did not always suggest medical management. Of those recommending medical treatment, 1895/2163 (87.6%) respondents used trilostane either once (60.7%) or twice (39.3%) daily. Time to first follow-up was < 10, 10-14, and 15-30 days for 6.1%, 59.8%, and 31.1% of respondents, respectively. Long-term follow-up was every 3-4 (41.7%) or 5-6 months (37.9%). Monitoring is performed using ACTH stimulation test (54.6%), pre-pill plasma cortisol concentration (18.4%), and both pre- and post-pill plasma cortisol concentration (13.3%). CONCLUSIONS AND CLINICAL IMPORTANCE: Approximately one-third of PCVs do not recommend adrenalectomy for FAT and two-thirds do not recommend hypophysectomy in PDH. Despite demonstrated benefits of medical treatment, one-quarter of respondents do not always recommend it, which may adversely affect life expectancy and quality of life. Treatment and monitoring protocols vary among PCVs. These results suggest that further education of PCVs about management of Cushing's syndrome in dogs may be warranted.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 0891-6640
Relation: https://dspace.library.uu.nl/handle/1874/480937
Availability: https://dspace.library.uu.nl/handle/1874/480937
Rights: info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.B3A1DA4C
Database: BASE