Diabetes mellitus tipo II concomitante a síndrome de Cushing em cão da raça Yorkshire: relato de caso

Abstract

Hyperadrenocorticism (HAC) is a common endocrinopathy in dogs, characterized by excessive cortisol production and associated with various clinical, hematological, biochemical, and metabolic alterations. A notable potential complication is concurrent diabetes mellitus, resulting from insulin resistance induced by chronic hypercortisolism. This report describes the clinical case of a Yorkshire Terrier diagnosed with hyperadrenocorticism and secondary diabetes mellitus, detailing the diagnostic approach, clinical progression, and therapeutic management. The patient presented with clinical signs including polyuria, polydipsia, bilaterally symmetrical alopecia, abdominal distension, and dermatological abnormalities. Diagnostic tests included a blood count, biochemical profile, and abdominal ultrasound. Results revealed leukocytosis (due to neutrophilia), thrombocytosis, and elevated serum concentrations of alanine aminotransferase, alkaline phosphatase, cholesterol, triglycerides, and glucose; abdominal ultrasound showed bilateral adrenomegaly. An adrenocorticotropic hormone (ACTH) stimulation test demonstrated an adrenal response consistent with hyperadrenocorticism. Treatment involved trilostane (initially at 2 mg), later supplemented with NPH insulin (100 IU/mL) at an initial dose of 0.07 IU/kg due to persistent hyperglycemia and suspected secondary diabetes mellitus. Continuous glucose monitoring using the FreeStyle Libre system allowed for the assessment of therapeutic response and aided in medication dosage adjustments. Clinical follow-up showed progressive improvement in laboratory parameters, control of hypercortisolism, and a reduction in blood glucose levels. It is concluded that early diagnosis and an integrated approach are essential for the proper management of canine hyperadrenocorticism and its comorbidities, contributing to clinical improvement and a better quality of life for affected patients