Reply To: Hepatocutaneous syndrome
This is a really interesting case!!!!
Do you have any blood work that you could share?
Superficial necrolytic dermatitis is assumed to be secondary to an underlying metabolic disorder. The resulting hepatic and cutaneous changes are characteristic and much more severe and serious than those associated with the common secondary vacuolar hepatopathies reported with many endocrinopathies. In humans, most cases have a glucagon-secreting tumor and concurrent diabetes mellitus. A few dogs have been reported with glucagonomas, which are usually metastatic, and one case has been reported in a dog with an insulinoma. In most canine cases, there is no identifiable mass, serum glucagon concentration is normal, and the cause remains obscure. Superficial necrolytic dermatitis also has been reported in 11 dogs being treated with phenobarbital, although the contribution of the antiepileptic to the disease was unclear in this retrospective study and the response to stopping treatment was not known.
The adrenal changes is interesting. I suppose you would have to go down the road of demonstrating it is not functional. You could consider serial BP measurements, catecholamine assessment, ACTH stim or LDDST.
What is that plan with the dog?
Thanks so much for sharing!