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. 2023 Mar;37(2):578-585.
doi: 10.1111/jvim.16620. Epub 2023 Feb 16.

Clinical features of muscle stiffness in 37 dogs with concurrent naturally occurring hypercortisolism

Stefania Golinelli  1 , Federico Fracassi  1 , Ezio Bianchi  2 , Álan Gomes Pöppl  3 , Diego Daniel Miceli  4 , Leontine Benedicenti  5 , Viviani De Marco  6 , Audrey K Cook  7 , Laura Espada Castro  8 , Ian Ramsey  8 , Kyoung Won Seo  9 , Carlo Cantile  10 , Gualtiero Gandini  1 , Sean E Hulsebosch  11 , Edward C Feldman  11
Affiliations

Clinical features of muscle stiffness in 37 dogs with concurrent naturally occurring hypercortisolism

Stefania Golinelli et al. J Vet Intern Med. 2023 Mar.

Abstract

Background: Severe muscle stiffness (SMS) in dogs with hypercortisolism (HC) is uncommon.

Objectives: To evaluate signalment, presentation, treatments, and long-term outcomes of dogs with concurrent HC and SMS.

Animals: Thirty-seven dogs.

Methods: Medical records of dogs with HC and concurrent SMS were recruited from 10 institutions. Clinical information, test results, therapeutic responses, and survival times were reviewed.

Results: All 37 dogs with HC and SMS had pituitary-dependent hypercortisolism (PDH); 36/37 weighed <20 kg. Signs and test results were typical of PDH aside from SMS, initially diagnosed in all 4 limbs in 9, pelvic limbs of 22, and thoracic limbs of 6 dogs. Hypercortisolism and SMS were diagnosed together in 3 dogs; HC 1-36 months before SMS in 23; SMS 1-12 months before HC in 11. Mitotane or trilostane, given to control HC in 36/37 dogs, improved or resolved HC signs in 28; SMS did not resolve, remaining static or worsening in 31/36 dogs, mildly improving in 5/19 dogs given additional therapies. Progression of SMS included additional limbs in 10 dogs and the masticatory muscles of 2. The median survival time from diagnosis of SMS was 965 days (range, 8-1188).

Conclusions and clinical importance: Concurrent SMS and HC is uncommon, possibly affecting only dogs with PDH. Development of SMS might occur before or after diagnosis of HC. Apart from SMS, the clinical picture and survival time of these dogs seem indistinguishable from those of dogs with HC in general. However, while muscle weakness usually resolves with HC treatment SMS does not.

Keywords: dive bomber sound; median survival time; myotonia; pituitary dependent hypercortisolism; rigidity; treatment.

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Conflict of interest statement

Stefania Golinelli is the recipient of a PhD scholarship from Dechra Veterinary Products Ltd at the University of Bologna. Dechra Veterinary Products Ltd did not have any input in the design of the study, the analysis and the interpretation of data or in the writing of the manuscript. Other authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
High‐frequency discharges recorded at electromyography. (A) Myotonic discharges characterized by waxing and waning of amplitudes. (B) Complex repetitive discharges characterized by stable amplitudes and an abrupt end. (C) Spontaneous discharges of single muscle fibers time linked together (complex repetitive discharges). (D) Spontaneous discharges of a single muscle fiber consisting of a train of positive sharp waves
FIGURE 2
FIGURE 2
Semimembranosus muscle biopsy of 1 dog included in the study. Variation in fiber size, lobular myofibers with accumulation of mitochondria (arrows), and interstitial fibrosis (asterisks). Cryostatic section, cytochrome C oxidase staining, bar = 50 μm
FIGURE 3
FIGURE 3
Semi‐thin section of plastic embedded peroneal nerve biopsy of 1 dog included in the study. Mild loss of nerve fibers, inappropriately thin myelinated fibers (arrows), and occasional axonal degeneration (asterisk). Toluidine blue staining, 500×
FIGURE 4
FIGURE 4
Kaplan–Meier curve to show overall survival of dogs with hypercortisolism and concurrent muscle stiffness
See this image and copyright information in PMC

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