International survey on the current diagnosis and management of Canine Hypercortisolism (Cushing's)
Ian Ramsey (University of Glasgow, Scotland)
Cindi Ward (Mississippi State University, USA)
Patty Latham (University of Georgia, USA)
This anonymous survey is designed to assess the current methods of diagnosing and treating canine hypercortisolism. The results will be presented at VMX 2021 and then be made available to participants and clinical researchers. The original data will be deleted after 6 months. Do you consent for your data to be used in this way?
Agree
Disagree
Where are you working in the world
North America
South America
Europe
Australia/NZ
Asia
Africa
Other
Please Specify:
What is your role within your place of work?
Primary care veterinarian
Specialist veterinarian
Veterinary nurse
Practice/office manager
Other
Please Specify:
How many years qualified are you (if you are a vet or nurse)
Less than 2 years
2-10 years
11-25 years
More than 25 years
Approximately how many cases of canine hypercortisolism (Cushing's disease) has your practice diagnosed in the last 3 years
Less than 5
5 to 10
11 to 20
21 or more
Which of the following tests do you use most frequently to confirm your clinical diagnosis of canine hypercortisolism?
ACTH stimulation
Urine corticoid creatinine ratio
Basal cortisol
Low dose dexamethasone suppression test
None of the above
Other
Please Specify:
How often are you able to differentiate between pituitary and adrenal dependent hypercortisolism?
Always
Usually
Sometimes
Rarely
Never
Which ONE OR MORE of the following are indicators of pituitary dependent hypercortisolism on a low dose dex suppression test ASSUMING that 8 hour cortisol result is > 1.4 mcg/dl (select all that apply)
4 hour cortisol < 1.4 mcg/dl (40nmol/l)
8 hour result < 1/2 baseline
4 hour cortisol < 1/2 baseline
All of the these MUST be present
Other
Please Specify:
Which other differentiating tests (besides LDDST) do you sometimes perform to determine if there is a pituitary or adrenal cause? (select all that apply)
High dose dexamethasone suppression test
Endogenous ACTH concentration
Ultrasound of adrenal glands
CT examination of the adrenal glands and/or pituitary
MRI pituitary
Very rarely or never do any discriminatory tests
Other
Please Specify:
Which other tests do you usually recommend for dogs suspected or diagnosed with hypercortisolism? (select all that apply)
Survey radiographs (Chest and abdo)
CBC (Haematology) + Biochemistry
Urinalysis
Urine culture
None
Other
Please Specify:
Which of the following statement is the best description of how you use trilostane (sold as Vetoryl)?
I (nearly) always start and stick to once daily (SID)
I usually start with SID but often switch to twice daily (BID)
I often start BID but I do have some cases on SID
I always start BID and stick to BID
I use another drug to trilostane
Other
Please Specify:
By what factor do you normally increase trilostane doses?
10-25% (e.g. 30-35 mg)
30-50% (e.g. 30mg to 50 mg, 60 mg to 90mg)
60-100% (e.g. 30mg to 60 mg, 60 mg to 120 mg)
110%-200% (e.g. 10 mg to 30 mg)
Other
Please Specify:
How are dogs in your practice usually monitored (select all that apply)
Office (clinic) visits every 3 - 6 months to assess clinical signs
Pre-trilostane cortisol
ACTH stimulation tests
No monitoring at all (e.g. Due to costs)
Routine urinalysis
Blood pressure monitoring
Other
Please Specify:
How has monitoring for hypercortisolism changed in your practice since the pandemic began
No change
Increased use of remote consultations (phone/webcam)
Increased clinical visits
Increased pre-trilostane cortisol over ACTH stims
Increased office visits and more reliance on clinical signs only
Other
Please Specify:
This anonymous survey is designed to assess the current methods of diagnosing and treating canine hypercortisolism. The results will be presented at VMX 2021 and made available to participants and to clinical researchers.
If you would like a copy of the results then please provide your Email.
There is no requirement to provide an email if you do not wish to do so. If you do provide your email then it will not be passed on to any third parties or used for any other purpose apart from providing the results. All email addresses submitted in this survey will be deleted from the server and the survey authors computer after 6 months.
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