06/04/2026
Chase, a 7-year-old Boston terrier, was referred to the internal medicine department from his family veterinarian. He came to us with multiple endocrine diseases. He had uncontrolled diabetes, suspected Cushing's disease that was yet to be diagnosed, and hypothyroidism.
After some testing, and changing his treatment plan, his diabetes became more controlled, and he began treatment for his Cushing's (hyperadrenocorticism). He initially had significant skin disease, and calcinosis cutis from his uncontrolled Cushing's disease (high cortisol levels). Dr. Milaszewska was not so sure about the hypothyroidism, so once everything was more under control, we discontinued his thyroid medications and retested him. He was not truly hypothyroid; with everything going on, he had been euthyroid sick.
After a few months of being treated for Cushing's, he presented to our ER department with bloody diarrhea and a poor appetite. More bloodwork was ran, and he was now presenting with Addison's disease (hypoadrenocorticism). This is not super common, but what happened was secondary to trilostane use. This caused adrenal necrosis, which is a very rare thing that can happen with this medication - leading to the opposite disease process!
He is now being treated monthly with DOCP for his Addison's disease, along with a low dose of steroids. His diabetes is much more controlled and he is doing so much better at home - and look at the changes to his skin!
Chase has been a complex case, but seeing the change is amazing! Endocrine diseases need fine tuning, and lots of initial testing to get all the information clear as to what is going on.
