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Summer 2015
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Dear Veterinary Colleague,
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 Welcome to our Summer 2015 edition of The Veterinary Reporter! Since it's so commonly seen in our practices, for this issue, we're addressing Hyperadrenocorticism (Cushing's Disease). We also present an interesting Intermusclar Lipoma case study and a compelling literature review that looks at client information overload.
As always, please let us know if you have questions or would like additional information about any of our newsletter topics. And never hesitate to let us know whenever we can be of assistance to you, your clients and patients. Thanks for your continuing support and trust!
David Bruyette, DVM, DACVIM
Medical Director
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Internal Medicine
CANINE PITUITARY DEPENDENT HYPERADRENOCORTICISM (CUSHING'S DISEASE)
 This article provides an overview and the diagnostics of Canine PDH, a common endocrine disorder in older dogs. The diagnosis of PDH requires incorporating information from the history, physical examination, and routine laboratory tests. Specific endocrine tests and imaging modalities are available to diagnose HAC and distinguish between the various causes of hypercortisolism; however, no single test is perfect and if the initial screening test is negative, and high clinical suspicion of HAC exists, additional tests should be performed to rule in or rule out HAC.
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Internal Medicine
IDENTIFYING AND MANAGING
ATYPICAL HYPERADRENOCORTICISM
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The term Atypical Hyperadrenocorticism is used to describe dogs in which clinical signs and response to treatment are consistent with a diagnosis of HAC, but the standard screening test (ACTH stimulation test, low-dose dexamethasone suppression test) results are within the reference range. The reasons for the clinical signs in these patients are currently unknown. In this article we discuss identifying and managing occult HAC.
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Surgery/Imaging Case Study
INTERMUSCULAR LIPOMA IN A 12-YEAR-OLD
DOBERMAN PINSCHER
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Figaro, a male neutered Doberman Pinscher, presented to our Surgical Service for evaluation of swelling of the right pelvic limb. It had been present for 2 years, but recently seemed to be growing rapidly. Cytology of the mass had been performed by the rDVM, and it was consistent with a lipoma.
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Internal Medicine
LITERATURE REVIEW: THE PATERNALISM PREFERENCE - CHOOSING UNSHARED
DECISION MAKING
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A recent editorial in the NEJM, "The Paternalism Preference - Choosing Unshared Decision Making," raises an important question. Is it possible to provide too much information to a patient or in our case, a client? This editorial reviews the pros and cons of such information overload and emphasizes what I believe to be the case, namely, that owners want you to be the doctor.
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CLINICAL TRIALS:
Call for Cases
VCA West Los Angeles Animal Hospital is currently conducting four clinical studies that our hospital is actively seeking participant cases for from veterinarians. Following is a brief outline of the trials. For more details about each of these studies, please click on the "Read More" links below.
 Yunnan Baiyao Study
This trial evaluates the effect of Yunnan Baiyao on coagulability in dogs with hemangiosarcoma using Thromboelastography (TEG).
Read More
Feline y/d Study
A clinical study to evaluate the safety and efficacy of Hill's Feline y/d in the management of clinical signs and biochemical abnormalities in cats with newly diagnosed hyperthyroidism.
Read More
 Laparoscopic-assisted Cystotomy Study
Our hospital is enrolling cats with confirmed cystic calculi for an on-going study to compare the surgical times, postoperative pain and outcomes between laparoscopic-assisted cystotomy and traditional open cystotomy.
Read More
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INTERNAL MEDICINE
Canine Pituitary Dependent
Hyperadrenocorticism
(Cushing's Disease)
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Identifying and Managing Atypical Hyperadrenocorticism
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SURGERY/
IMAGING
CASE STUDY
Intermuscular
Lipoma in a
12-year-old
Doberman Pinscher
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INTERNAL MEDICINE
Literature Review: The Paternalism Preference - Choosing Unshared Decision Making ______________
CLINICAL TRIALS:
CALL FOR CASES
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MEET OUR
VETERINARY SPECIALISTS!
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