Pituitary dwarfism, patent duct arteriosus and Cushing's syndrome in a dog

A 3-month-old, intact female Czechoslovakian wolfdog was referred for growth retardation. General physical examination revealed an IV/VI left basilar continuous murmur, a body condition score of 3/9, body weight 2.2 kg, and dermatological alterations. Transthoracic echocardiography diagnosed patent duct arteriosus. Genetic testing revealed that the dog had a Lhx3 mutation and the low concentration of insulin-like growth factor 1 confirmed the diagnosis of pituitary dwarfism. The endocrine disorder was treated with levothyroxine, and the congenital heart disease was corrected interventionally, leading to a net improvement in the clinical condition. After 3 years, the dog was referred for polyuria, polydipsia, polyphagia, and alopecia. Diagnostic workup revealed pituitary-dependent hypercortisolism due to a pituitary macroadenoma. In addition to levothyroxine, the dog was treated with trilostane with resolution of the clinical signs.