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Canine pituitary-dependent hypercortisolism (PDH) management with trilostane usually demands lifelong therapy. The greater the dose needed, the greater the risk of side effects. Selegiline therapy has been previously described but not commonly used for PDH treatment. The present work aimed to assess the efficacy of selegiline and trilostane combined therapy for canine PDH treatment. Fifteen client-owned dogs diagnosed with spontaneous PDH were enrolled. The patients were treated with trilostane (Tri group, n = 8, initial dose of 0.5 mg/kg, PO, q12h), or with trilostane and selegiline (Tri + Sel group, n = 7, initial trilostane dose of 0.5 mg/kg, PO, q12h and selegiline 1 mg/kg, PO, q24h). Dogs underwent clinical examination, serum biochemical analysis, urinalysis, abdominal ultrasound, and eACTH and post-ACTH cortisol measurements on treatment days zero (D0), 30 (D30), 90 (D90), and 180 (D180). There was a lack of adverse effects due to the combined therapy. Both groups showed a similar clinical response and lower post-ACTH cortisol levels at the study's end. There was no significant difference in trilostane dosage at D180 between groups. There was no documented increase in either right or left adrenal gland thickness in the Tri + Sel group in contrast with patients in the Tri group. However, there was no statistical difference between the groups regarding eACTH at D0 and D180. Patients in the Tri + Sel group achieved better serum triglycerides control at the end of the study. The association of selegiline with trilostane might be a feasible therapy for canine PDH; however, its eventual advantages need larger studies.

Using portable blood glucose meters (PBGMs) to measure blood glucose (BG) concentration is a common procedure in veterinary practice. Our objective was to evaluate the analytical and clinical accuracy of a human PBGM (Accu-Chek Performa®), (AC) and a veterinary PBGM (GlucoCalea®), (GC) in feline patients. Central venous blood samples were collected from 48 cats at a Brazilian Veterinary teaching hospital. Two devices from each model were used and compared to a reference method (RM). Analytical accuracy was assessed according to ISO 15197:2013 requirements for human PBGMs. Data were compared using Wilcoxon’s nonparametric test and represented by Bland-Altman plots. Hematocrit’s effect on BG measurements was evaluated by the Spearman correlation coefficient. Clinical accuracy was determined using error grid analysis (EGA). Values of BG were significantly higher in all PBGMs compared to the RM. Although ISO’s analytical accuracy requirements could not be met by any of the devices, AC meters were more accurate than GC meters. All AC measurements - but not GC ones - were within zones A and B of the EGA, meeting ISO requirements for clinical accuracy. Significant hematocrit interference was observed in all devices. Therefore, AC showed greater accuracy compared to GC using feline whole blood samples.

Hyperadrenocorticism (HAC) is one of the most common endocrinopathies in dogs, caused by excessive synthesis of cortisol. Atypical or occult HAC is a syndrome characterized by the presentation of clinical, biochemical, and imaging alterations compatible with hypercortisolism, but normal results in endocrine tests that are conventionally used for HAC diagnosis. However, these patients present high serum concentrations of precursors or other corticoadrenal hormones. The present study describes the case of an 8 years old female canine, Bichón Frisé, epileptic and treated with phenobarbital, presenting clinical signs associated with HAC, in which the low-dose dexamethasone suppression test and stimulation with ACTH resulted within normal values. The measurement of adrenal steroids, after ACTH stimulation, showed abnormal elevation of estrogen and progesterone, the latter persisting after the patient was spayed. Treatment with trilostane allowed the reduction of progesterone levels and the partial resolution of clinical signs. However, full clinical recovery was only achieved after the diagnosis and treatment of concomitant hypothyroidism. The challenge that represent the diagnosis of atypical HAC highlights the importance of performing and having availability of panels that include measurement of adrenal steroid hormones other than cortisol, as well as considering the occurrence of other concomitant endocrine metabolic diseases

Methylprednisolone acetate (MPA) is often prescribed to cats despite being recognized eventually as diabetogenic. To assess MPA-related insulin resistance and evaluate the efficacy of metformin or an obesity and diabetes mellitus (OD) adjuvant diet as protective factors, a randomized clinical trial was conducted with 28 owned cats undergoing glucocorticoid therapy. A single MPA dose of 20 mg intramuscularly was administered to each cat. Controls (n = 10) received only MPA. In the diet group (n = 9), replacement of their habitual diet by ad-libitum feeding of a feline commercial OD diet (Equilíbrio OD, Total Alimentos ADM) was made. In the metformin group (n = 9), metformin chlorhydrate 25mg/cat PO/q24h was administered for 30 days. All patients were clinically evaluated at baseline (T0), day 15 (T15), and day 30 (T30) and blood draw for complete blood count, serum biochemistry, and determination of insulin concentrations. Fasting Insulin Sensitivity Index (SI), Amended Insulin to Glucose Ratio (AIGR), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and Homeostatic Model Assessment of beta-cell function (HOMA-B) were calculated based on fasting glycemia and insulinemia. All groups showed significantly higher levels (P.05) of neutrophils, albumin, glucose, cholesterol, triglycerides, and serum insulin at T15. Patients in the metformin group showed also higher SI, AIGR, and HOMA-IR results at T15. Also, at T15, reduced levels (P.05) of eosinophils, lymphocytes, and creatinine were documented in all groups. An MPA single dose induced changes in insulin sensitivity in cats; however, neither metformin nor OD feeding used in this study was effective as protective factors against MPA-related insulin resistance.

A mensuração do hormônio adrenocorticotrófico endógeno (ACTHe) é útil na investigação do hipercortisolismo e hipoadrenocorticismo. No entanto, como o hormônio é bastante instável, as amostras de sangue necessitam um manejo adequado no processamento e armazenamento, assim como o envio para laboratórios pode ser um passo limitante, uma vez que poucos laboratórios oferecem este ensaio no Brasil. O objetivo deste trabalho foi comparar a estabilidade pré-analítica do ACTHe durante longo período de envio de amostras congeladas em gelo seco (GS), ou com barras de gelo reciclável (BGR). Um total de 56 amostras pareadas para mensuração de ACTHe foram analisadas. As amostras de sangue foram adequadamente manejadas, sendo o plasma transferido para micro tubos plásticos estocados a -80ºC. Os 56 pares de amostras foram enviados à tarde para chegada ao laboratório na manhã seguinte em dois isopores, um com GS e outro com BGR. Apesar de uma alta correlação entre os resultados dos diferentes métodos de envio (r Spearman = 0,958, P

Hyperadrenocorticism (HAC) is one of the most common endocrinopathies in dogs, caused by excessive synthesis of cortisol. Atypical or occult HAC is a syndrome characterized by the presentation of clinical, biochemical, and imaging alterations compatible with hypercortisolism, but normal results in endocrine tests that are conventionally used for HAC diagnosis. However, these patients present high serum concentrations of precursors or other corticoadrenal hormones. The present study describes the case of an 8 years old female canine, Bichón Frisé, epileptic and treated with phenobarbital, presenting clinical signs associated with HAC, in which the low-dose dexamethasone suppression test and stimulation with ACTH resulted within normal values. The measurement of adrenal steroids, after ACTH stimulation, showed abnormal elevation of estrogen and progesterone, the latter persisting after the patient was spayed. Treatment with trilostane allowed the reduction of progesterone levels and the partial resolution of clinical signs. However, full clinical recovery was only achieved after the diagnosis and treatment of concomitant hypothyroidism. The challenge that represent the diagnosis of atypical HAC highlights the importance of performing and having availability of panels that include measurement of adrenal steroid hormones other than cortisol, as well as considering the occurrence of other concomitant endocrine metabolic diseases., El hiperadrenocorticismo (HAC) es una de las endocrinopatías más frecuentes en caninos, producida por la síntesis excesiva de cortisol. El HAC atípico u oculto es un síndrome caracterizado por la presentación de alteraciones clínicas, bioquímicas e imagenológicas compatibles con hipercortisolismo, pero con resultados normales en las pruebas endocrinológicas utilizadas convencionalmente para diagnóstico de HAC. Sin embargo, estos pacientes presentan elevada concentración sérica de precursores u otras hormonas corticoadrenales. El presente estudio describe el caso de una canina hembra, Bichón Frisé de 8 años de edad, epiléptica y tratada con fenobarbital, presentando signos clínicos asociados a HAC, en la que el test de supresión con dexametasona a dosis bajas y de estimulación con ACTH arrojaron valores normales. La medición de esteroides adrenales, post estimulación con ACTH, mostró elevación anormal de estrógenos y progesterona, persistiendo esta última después de que la paciente fuera esterilizada. El tratamiento con trilostano permitió la disminución de los niveles de progesterona y la resolución parcial de los signos clínicos. Sin embargo, la recuperación clínica en su totalidad sólo se obtuvo después del diagnóstico y tratamiento del hipotiroidismo concomıtante. El desafío que representa el diagnóstico del HAC atípico resalta la importancia de realizar y disponer de paneles que incluyan medición de hormonas esteroideas adrenales diferentes al cortisol, además de considerar la ocurrencia de otras enfermedades endocrinas metabólicas concomitantes.

Na espécie canina há poucos estudos que demonstrem a ocorrência de alterações endócrinas adversas às neoplasias ou terapias antineoplásicas. Os objetivos deste projeto incluem a avaliação dos níveis de cortisol e de parâmetros metabólicos em cães com mastocitoma anterior ou posteriormente à sua terapia. Secundariamente avaliamos os efeitos do mastocitoma sobre as características ultrassonográficas de adrenais, o efeito de um fosfolipídio antineoplásico em cães com este tipo de neoplasia e fizemos uma revisão sobre o uso de glicocorticoides em cães com neoplasias. Desta forma esta tese resultou em cinco artigos científicos. O estudo principal envolveu a realização do teste de estimulação com ACTH em 44 cães com mastocitoma cutâneo ou subcutâneo anterior e 30 dias após sua terapia cirúrgica isoladamente (n=10) ou seguida de vimblastina e prednisona (n=12), lomustina e prednisona (n=12) ou fosfato de 2-aminoetil- diidrogênio (n=10), que foram comparados a um grupo controle (n=10). Demonstramos que cães com mastocitoma podem apresentar elevação dos níveis de cortisol pós ACTH anteriormente à terapia e, portanto, falsos positivos para hiperadrenocorticismo, com menor ocorrência deste tipo de ocorrência após o tratamento da neoplasia. Um segundo estudo comparou o resultado de parâmetros metabólicos (peso, escore de condição corporal e níveis séricos de glicose, alanina aminotransferase, fosfatase alcalina, triglicérides, colesterol) destes 44 cães com mastocitoma e comparou estes achados entre os mesmos grupos de terapia e controle. Concluiu-se que há ocorrência de elevação de alanina aminotransferase, hiperfosfatasemia, hipercolesterolemia e hipertrigliceridemia em cães tratados com quimioterápicos associados à prednisona. Descrevemos em um terceiro artigo uma revisão bibliográfica sobre o uso de glicocorticoides sintéticos em casos de neoplasias caninas. Um quarto trabalho envolveu o estudo prospectivo do uso de fosfato de 2-aminoetil-diidrogênio em 10 cães com mastocitoma no qual demonstramos que este fármaco foi seguro nestes animais. No entanto não foi suficientemente eficaz para prevenir a recidiva de novo tumor ou metástase em cães com fatores imuno-histoquímicos de mau prognóstico. Por fim, foi realizado um estudo retrospectivo das alterações de dimensões, morfologia, ecogenicidade e presença de neoformações em adrenais de cães com mastocitoma (n=120). Observou-se adrenomegalia em 30%, alterações morfológicas de adrenais em 7,5%, neoformações adrenais em 1,6% dos casos e concluiu-se que cães com mastocitoma pode apresentar alterações principalmente nas dimensões adrenais. In the canine specie, there are few studies that demonstrate the occurrence of adverse endocrine alterations to neoplasms or antineoplastic therapies. The objectives of this project include the assessment of cortisol levels and metabolic parameters in dogs with mast cell tumors before or after their therapy. Secondarily, we evaluated the effects of mast cell tumors on the sonographic characteristics of adrenals, the effect of an antineoplastic phospholipid in dogs with this type of neoplasm, and we reviewed the use of glucocorticoids in dogs with neoplasms. Thus, this thesis resulted in five scientific articles. The main study involved performing the ACTH stimulation test in 44 dogs with previous cutaneous or subcutaneous mast cell tumors and 30 days after their surgical therapy alone (n=10) or followed by vinblastine and prednisone (n=12), lomustine and prednisone ( n=12) or 2-aminoethyl-dihydrogen phosphate (n=10), which were compared to a control group (n=10). We demonstrated that dogs with mast cell tumors may present elevated cortisol levels after ACTH stimulation prior to therapy and, therefore, false positives for hyperadrenocorticism, with a lower occurrence of this type after treatment of the neoplasm. A second study compared the outcome of metabolic parameters (weight, body condition score and serum levels of glucose, alanine aminotransferase, alkaline phosphatase, triglycerides, cholesterol) of these 44 dogs with mast cell tumors and compared these findings between the same therapy and control groups. It was concluded that there is an increase in alanine aminotransferase, hyperphosphatasemia, hypercholesterolemia and hypertriglyceridemia in dogs treated with chemotherapy associated with prednisone. In a third article, we describe a literature review on the use of synthetic glucocorticoids in cases of canine neoplasms. A fourth work involved the prospective study of the use of 2-aminoethyl dihydrogen phosphate in 10 dogs with mast cell tumors in which we demonstrated that this drug was safe in these animals. However, it was not effective enough to prevent the recurrence of a new tumor or metastasis in dogs with immunohistochemical poor prognostic factors. Finally, a retrospective study of alterations in dimensions, morphology, echogenicity and the presence of neoformations in the adrenals of dogs with mast cell tumors (n=120) was performed. Adrenomegaly was observed in 30%, morphological changes of the adrenals in 7.5%, adrenal neoformations in 1.6% of the cases and it was concluded that dogs with mast cell tumors may present mainly changes in adrenal dimensions.

Beta-glucanos são polissacarídeos que podem melhorar diversas alterações metabólicas e de saciedade consequentes à obesidade. O objetivo do presente estudo foi avaliar os efeitos da inclusão de 0,06% de beta-glucanos na dieta de gatos obesos em parâmetros do metabolismo de carboidratos e lipídeos, indicadores de resistência insulínica, citocinas inflamatórias, parâmetros de saciedade e coeficiente de digestibilidade aparente (CDA) dos nutrientes. Nove gatos diagnosticados com obesidade não-induzida [(grupo obeso OB) escore de condição corporal (ECC) 8-9 /9] e nove gatos não obesos [(Grupo controle CO) ECC 5/9] foram alimentados por 15 dias (T0) com a dieta controle (0,0% de beta-glucanos) e depois por 90 dias (T90) com a dieta teste (0,06% de beta-glucanos). Amostras de sangue foram coletadas em T0 e T90 para avaliação do índice HOMA (insulina basal x glicemia basal/22,5), concentrações plasmáticas de triglicerídeos, colesterol e lipoproteínas (por método enzimático-colorimétrico e cromatografia líquida para separação rápida de proteínas FPLC), anandamida (por ELISA), frutosamina (por ensaio colorimétrico cinético), amilina, interleucina 10 (IL-10), grelina e peptídeo semelhante ao glucagon 1 (GLP-1) (por reação em cadeia de polimerase em tempo real quantitativo). A composição corporal também foi avaliada no início e final do estudo pelo método de diluição de isótopos de deutério. Foram utilizados sete gatos do centro de pesquisa para a determinação do CDA das dietas, pelo método de coleta total de fezes. Para avaliar a comparação entre os grupos e o efeito da dieta foi realizado teste de ANOVA com medidas repetidas no tempo. Quando houve diferença entre as médias foi realizado o teste de Tukey. Para a análise de consumo de beta-glucanos, digestibilidade e resultados da análise de expressão gênica, os dados foram analisados por análise de variância e, valores de P