Cushing's Syndrome with Concurrent Diabetes Mellitus in a Rhesus Monkey.

Area of Science:

• Veterinary Endocrinology
• Primate Medicine
• Comparative Pathology

Background:

• Cushing's syndrome (glucocorticoid overproduction) and diabetes mellitus are known endocrine diseases.
• Concurrent hyperadrenocorticism and diabetes mellitus have not been previously reported in macaques.
• This case provides a unique opportunity to study the interplay of these two diseases in a nonhuman primate model.

Purpose of the Study:

• To report and analyze a rare case of concurrent hyperadrenocorticism and diabetes mellitus in a rhesus macaque.
• To investigate the diagnostic and therapeutic challenges of managing these co-occurring endocrine disorders.
• To examine the relationship between glucocorticoid excess and glucose metabolism in a primate.

Main Methods:

• Diagnosis involved routine blood glucose monitoring, dexamethasone suppression testing, MRI, and CT scans.
• Initial treatment included L-deprenyl, followed by insulin therapy.
• Subsequent management involved switching to ketoconazole for hypercortisolism alongside insulin therapy.

Main Results:

• A 14-year-old male rhesus macaque was diagnosed with adrenocorticotropic hormone-dependent Cushing's syndrome and diabetes mellitus.
• The macaque showed a positive response to insulin therapy, requiring dosage adjustments.
• Dual therapy with insulin and ketoconazole resulted in remarkable clinical improvement, allowing the animal's return to an experimental protocol.

Conclusions:

• Concurrent hyperadrenocorticism and diabetes mellitus can be successfully managed in rhesus macaques with a combination of pharmacotherapy and strict management.
• This case highlights the importance of recognizing and treating co-existing endocrine diseases in nonhuman primates.
• Effective management strategies may involve insulin for glycemic control and ketoconazole for hypercortisolism.