Diagnosis of naturally‐occurring Cushing's syndrome by primary care veterinarians in selected European countries
Abstract Background Several tests are available to diagnose naturally‐occurring Cushing's syndrome in dogs but there is a paucity of information on how primary care veterinarians (PCVs) use or interpret them. Objectives Determine how PCVs from selected European countries diagnose Cushing's...
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Wiley
2025-01-01
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| Series: | Journal of Veterinary Internal Medicine |
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| Online Access: | https://doi.org/10.1111/jvim.17166 |
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| author | Miguel F. Carvalho Rodolfo O. Leal Stefania Golinelli Federico Fracassi Carolina Arenas Maria Pérez‐Alenza Sara Galac Carmel T. Mooney Michael Bennaim |
| author_facet | Miguel F. Carvalho Rodolfo O. Leal Stefania Golinelli Federico Fracassi Carolina Arenas Maria Pérez‐Alenza Sara Galac Carmel T. Mooney Michael Bennaim |
| author_sort | Miguel F. Carvalho |
| collection | DOAJ |
| description | Abstract Background Several tests are available to diagnose naturally‐occurring Cushing's syndrome in dogs but there is a paucity of information on how primary care veterinarians (PCVs) use or interpret them. Objectives Determine how PCVs from selected European countries diagnose Cushing's syndrome in dogs. Methods Cross‐sectional survey study assessing testing protocols used by PCVs for screening and differentiation of Cushing's syndrome. Results Two thousand one hundred and seventy‐eight responses from 9 European countries were included. When Cushing's syndrome was suspected, 98.7% of respondents perform endocrine testing, whereas 1.2% rely on a treatment trial. Among the former, 59.9% reported performing screening tests in the absence of supportive clinical signs but with consistent clinicopathological abnormalities. Of 2150 respondents who performed endocrine testing, 66.6% report always using the same initial screening tests regardless of their pretest suspicion of disease. The tests most reported are the ACTH stimulation test (34.8%), low‐dose dexamethasone suppression test (LDDST; 30.4%) or a combination of different tests (25.2%). In the absence of financial constraint, 1419 (66.0%) respondents always attempted differentiation, using abdominal ultrasonography (81.0%) and LDDST (46.1%). Overall, 69.8% of respondents reported offering referral to a specialist in ≤20% of cases suspected or diagnosed with Cushing's syndrome over the previous 5 years. Conclusions and Clinical Importance Testing protocols vary among PCVs. Almost 60% of respondents potentially screen dogs without consistent clinical signs, raising concerns for overdiagnosis. A proportion never attempt differentiation, which likely affects prognosis. Cases are rarely referred to a specialist, reflecting that Cushing's syndrome is mainly managed in primary care practices. These results suggest that there is room for further education of PCVs. |
| format | Article |
| id | doaj-art-2fb2ee10cfba49468a7996b2145ee13e |
| institution | Kabale University |
| issn | 0891-6640 1939-1676 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj-art-2fb2ee10cfba49468a7996b2145ee13e2025-01-27T15:22:40ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762025-01-01391n/an/a10.1111/jvim.17166Diagnosis of naturally‐occurring Cushing's syndrome by primary care veterinarians in selected European countriesMiguel F. Carvalho0Rodolfo O. Leal1Stefania Golinelli2Federico Fracassi3Carolina Arenas4Maria Pérez‐Alenza5Sara Galac6Carmel T. Mooney7Michael Bennaim8Small Animal Clinical Studies, School of Veterinary Medicine University College Dublin Dublin IrelandCentro de Investigação Interdisciplinar em Sanidade Animal Faculdade Medicina Veterinária U. Lisboa Lisbon PortugalDepartment of Veterinary Medical Science University of Bologna Bologna ItalyDepartment of Veterinary Medical Science University of Bologna Bologna ItalyAniCura Hospital Veterinario Valencia Sur Valencia SpainHospital Clinico Veterinario Complutense University Madrid SpainDepartment of Clinical Sciences, Faculty of Veterinary Medicine Utrecht University Utrecht The NetherlandsSmall Animal Clinical Studies, School of Veterinary Medicine University College Dublin Dublin IrelandCentre Hospitalier Vétérinaire AniCura Aquivet Eysines FranceAbstract Background Several tests are available to diagnose naturally‐occurring Cushing's syndrome in dogs but there is a paucity of information on how primary care veterinarians (PCVs) use or interpret them. Objectives Determine how PCVs from selected European countries diagnose Cushing's syndrome in dogs. Methods Cross‐sectional survey study assessing testing protocols used by PCVs for screening and differentiation of Cushing's syndrome. Results Two thousand one hundred and seventy‐eight responses from 9 European countries were included. When Cushing's syndrome was suspected, 98.7% of respondents perform endocrine testing, whereas 1.2% rely on a treatment trial. Among the former, 59.9% reported performing screening tests in the absence of supportive clinical signs but with consistent clinicopathological abnormalities. Of 2150 respondents who performed endocrine testing, 66.6% report always using the same initial screening tests regardless of their pretest suspicion of disease. The tests most reported are the ACTH stimulation test (34.8%), low‐dose dexamethasone suppression test (LDDST; 30.4%) or a combination of different tests (25.2%). In the absence of financial constraint, 1419 (66.0%) respondents always attempted differentiation, using abdominal ultrasonography (81.0%) and LDDST (46.1%). Overall, 69.8% of respondents reported offering referral to a specialist in ≤20% of cases suspected or diagnosed with Cushing's syndrome over the previous 5 years. Conclusions and Clinical Importance Testing protocols vary among PCVs. Almost 60% of respondents potentially screen dogs without consistent clinical signs, raising concerns for overdiagnosis. A proportion never attempt differentiation, which likely affects prognosis. Cases are rarely referred to a specialist, reflecting that Cushing's syndrome is mainly managed in primary care practices. These results suggest that there is room for further education of PCVs.https://doi.org/10.1111/jvim.17166adrenalscaninecortisolendocrinologypituitary |
| spellingShingle | Miguel F. Carvalho Rodolfo O. Leal Stefania Golinelli Federico Fracassi Carolina Arenas Maria Pérez‐Alenza Sara Galac Carmel T. Mooney Michael Bennaim Diagnosis of naturally‐occurring Cushing's syndrome by primary care veterinarians in selected European countries Journal of Veterinary Internal Medicine adrenals canine cortisol endocrinology pituitary |
| title | Diagnosis of naturally‐occurring Cushing's syndrome by primary care veterinarians in selected European countries |
| title_full | Diagnosis of naturally‐occurring Cushing's syndrome by primary care veterinarians in selected European countries |
| title_fullStr | Diagnosis of naturally‐occurring Cushing's syndrome by primary care veterinarians in selected European countries |
| title_full_unstemmed | Diagnosis of naturally‐occurring Cushing's syndrome by primary care veterinarians in selected European countries |
| title_short | Diagnosis of naturally‐occurring Cushing's syndrome by primary care veterinarians in selected European countries |
| title_sort | diagnosis of naturally occurring cushing s syndrome by primary care veterinarians in selected european countries |
| topic | adrenals canine cortisol endocrinology pituitary |
| url | https://doi.org/10.1111/jvim.17166 |
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