Hyperadrenocorticism (Cushing's disease) is one of the most commonly misdiagnosed conditions in middle-aged to senior dogs — and one of the most consequential to miss. This course covers the full diagnostic algorithm (low-dose dexamethasone suppression test vs. ACTH stimulation), PDH vs. ADH differentiation, the evidence basis for trilostane vs. mitotane, monitoring protocols that prevent adrenal crisis, and the integrative adjuncts that address the systemic consequences of chronic hypercortisolemia — particularly hepatic support, cardiovascular risk, and quality of life. We follow Gracie, a 9-year-old Poodle mix who has been treated for 'allergies and UTIs' for two years. Earn 1.0 RACE CE credit.
Opening case: Gracie, a 9-year-old spayed female Poodle mix, presenting for recurrent skin infections and her third UTI this year. Her PU/PD has been attributed to anxiety. Her pot-belly was noticed but not pursued. Today her workup reveals the diagnosis hiding in plain sight.
The classic and subtle clinical signs of HAC, the diseases that steal Cushing's presenting complaints, and how to recognize the pattern before ordering any tests
Low-dose dexamethasone suppression test vs. ACTH stimulation test — sensitivity, specificity, and correct clinical application; urine cortisol:creatinine ratio as a screening tool; when to pursue discriminating tests (HDDST, abdominal ultrasound, endogenous ACTH); the false-positive problem
10 questions · Passing score: 70%
Complete all course modules to unlock the assessment. Upon passing, your CE certificate will be generated automatically.
Pituitary-dependent vs. adrenal-dependent disease — frequency, prognosis, ultrasound characteristics, and why the distinction changes the conversation with owners
Trilostane — mechanism, dosing protocol (starting at 2.2–6.7 mg/kg SID), ACTH stimulation monitoring schedule, dose escalation, and when BID dosing is needed; mitotane (o,p'-DDD) — induction, maintenance, monitoring; recognizing and managing hypoadrenocorticism; the adrenal crisis emergency protocol
Hepatic support for drug-induced and hypercortisolemia-induced hepatopathy; cardiovascular risk reduction; acupuncture and HPA axis modulation; client communication about disease monitoring; Gracie at 18 months