Question of the Day

Think of iatrogenic hyperadrenocorticism (Cushing disease, HAC) in dogs receiving chronic glucocorticoids (e.g., prednisone). An iatrogenic problem is one caused by the therapy itself.

Dogs with iatrogenic HAC have clinical findings and lab changes consistent with Cushing Dz. Perform an ACTH stimulation test to differentiate iatrogenic from naturally occurring HAC. Dogs with iatrogenic Cushing will not respond to ACTH due to suppression of the adrenal axis by exogenous steroids.

Always taper exogenous steroids in dogs on chronic therapy so the adrenal axis can recover thus preventing iatrogenic Addison disease (i.e., hypoadrenocorticism).