Adrenal cortex tumor in dogs (adrenocortical carcinoma)

When you should take your dog to the vet

In case of suspected a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs should you promptly, ideally within 2 to 3 days, Consult a veterinarian. This is especially important if your dog is drinking significantly more, urinating more frequently, develops a distended abdomen, pants heavily, is losing muscle mass, or shows unusual changes in its skin and coat. If the condition worsens, your dog appears weak, eats poorly, collapses, or suddenly experiences shortness of breath, it should be taken to an animal hospital immediately. From a veterinary perspective, it is particularly important not to wait too long in the case of hormonally active adrenal tumors. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It is rare, but can grow very invasively locally and massively disrupt the hormonal balance.

Adrenal cortex tumor in dogs
Adrenal cortex tumor in dogs 2

What an adrenocortical carcinoma (tumor of the adrenal cortex) means in dogs

A Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Adrenal insufficiency is a malignant tumor that originates in the cortex of the adrenal gland. The adrenal glands are located directly in front of the kidneys and produce hormones that are essential for blood pressure, electrolyte balance, metabolism, stress response, and numerous other bodily functions. When an adrenal insufficiency develops, it can form a malignant tumor in the cortex of the adrenal gland. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs When the adrenal gland is hormonally active, it often produces too much cortisol. The dog then develops typical signs of adrenal-mediated Cushing's syndrome, such as increased thirst, increased urination, panting, thin skin, symmetrical hair loss, muscle weakness, and a potbelly. Less frequently, other hormones such as aldosterone or sex hormones are produced in abnormal amounts.

From a veterinary perspective, it is crucial to understand that not every adrenal gland enlargement is automatically a carcinoma. Benign adenomas or other types of tumors, such as pheochromocytoma, also occur. This is precisely why a single blood test is never sufficient. Only the combination of clinical presentation, hormone diagnostics, ultrasound, and often CT scan allows for a sound diagnosis. In dogs with spontaneous hypercortisolism, the majority of cases are pituitary in origin; adrenal-related cases represent only a small proportion. This explains why a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Overall, it is considered rare.

Why adrenocortical carcinoma (tumor of the adrenal cortex) is often diagnosed late in dogs

A Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Adrenal insufficiency often develops gradually. Many owners initially only notice that their dog is drinking more or needs to go out more often at night. Others, when they notice hair loss, reduced performance, or weight gain, first suspect age, arthritis, or a dietary issue. This is precisely where the difficulty lies. The typical changes are often not suddenly dramatic, but rather creep into everyday life slowly. In practice, we therefore repeatedly see dogs that have been showing symptoms for weeks or months before the adrenal glands are even examined.

In addition, a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Adrenal tumors not only cause hormonal problems but can also become locally dangerous. The tumor can grow into adjacent vessels, especially venous structures, significantly complicating surgical planning. Right-sided adrenal tumors, in particular, are often anatomically unfavorable. It is therefore important for owners to understand that even if the dog appears relatively stable in everyday life, the disease can already be surgically challenging. From a veterinary perspective, early imaging is therefore not a luxury but often crucial for prognosis. Studies on adrenal tumors in dogs show that tumor size, metastases, and vascular thrombi significantly influence survival time.

Causes and origin

The exact cause of a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs The exact cause is not yet fully understood. Genetic and molecular alterations in the tumor tissue are suspected, leading to the uncontrolled proliferation of adrenal cortex cells and their hormone production escaping normal regulation. In veterinary consultations, it is important to remain honest: owners are almost never at fault. Neither a specific food nor a single environmental factor can be definitively identified as the cause in everyday practice. There are considerations regarding genetic involvement and alterations in signaling pathways, which are also known from human medicine, but much remains the subject of research in dogs.

For owners, the question of what the tumor does to the body is usually more practically relevant than the cause. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It can be hormonally active or hormonally inactive. Hormonally active carcinomas are often noticed due to Cushing's symptoms. In contrast, hormonally inactive carcinomas are frequently discovered incidentally during ultrasound or only when the tumor's size causes discomfort. This also explains why some dogs with a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Some show classic skin and hormone problems, while others are more noticeable due to abdominal girth, weakness, pain, or a prominent mass in the image.

Typical symptoms in dogs

A Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It often manifests itself through a cluster of typical symptoms. Particularly suspicious are excessive thirst, frequent urination, increased appetite, a distended abdomen, panting, muscle weakness, thin skin, and symmetrical hair loss. Many dogs don't appear acutely ill, but rather "somehow changed": less resilient, more easily fatigued, less muscular, and visibly older. Some owners report that their dog suddenly has difficulty getting up or that the fur on its torso is becoming increasingly thin.

If a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs If the tumor grows locally or metastasizes, further symptoms may occur, such as abdominal pain, decreased performance, weakness, weight loss, or, in advanced cases, signs of internal complications. However, with hormonal activity, the Cushing's syndrome often dominates initially. This is precisely why a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Initially, it is not uncommon for the diagnosis to be based on general hypercortisolism before imaging diagnostics reveal the adrenal cause. The ACVIM consensus diagnostics explicitly emphasize that endocrine tests are only useful if clinical signs are consistent with hyperadrenocorticism. From a veterinary perspective, therefore, the overall clinical assessment remains the starting point for any sound diagnosis.

This is how the diagnostic process works in practice.

If there is suspicion of a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs If hypercortisolism is suspected, I always begin my veterinary examination with a thorough medical history and a complete clinical examination. This is followed by blood tests, organ function tests, electrolyte analysis, urinalysis, and, depending on the findings, further hormone tests. The aim is not only to confirm the diagnosis but also to assess the dog as a potential surgical patient and to monitor for comorbidities such as urinary tract infections, hypertension, liver abnormalities, or thromboembolic risks.

The next step involves crucial imaging. Ultrasound can visualize the adrenal gland and often reveal whether a tumor is present on one side and the other side appears smaller. However, ultrasound alone is not always sufficient for surgical planning. A CT scan is particularly valuable when we need to know the size of the tumor, whether blood vessels are involved, and whether metastases are present. These very questions often determine operability, surgical approach, and risk later on.

In specialized centers, a CT scan is therefore often recommended before a planned adrenalectomy. Endogenous ACTH measurement, suppression tests, and other endocrine tests help to differentiate between pituitary and adrenal causes. This is important in practice because the treatment can be completely different. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs is not treated in the same way as a pituitary form of the Cushing's syndrome.

Treatment: What really helps

The most important therapy for a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs The surgical removal of the affected adrenal gland is the only option, provided the tumor is operable and the dog is expected to tolerate the procedure well. This is not a routine operation. Tumors on the right side, and those involving blood vessels, in particular, require considerable experience, precise imaging, careful anesthesia planning, and a team experienced in adrenal surgery. From a veterinary perspective, it is therefore advisable to refer affected dogs to a suitably equipped center as early as possible.

However, not every dog is a suitable candidate for surgery. If metastases are present, there is significant vascular invasion, or serious comorbidities make the anesthetic risk too high, curative surgery is not always the primary option. In such cases, pharmacological control of hormone production, for example with trilostane, can help alleviate clinical symptoms and stabilize the dog's quality of life. This does not replace tumor removal, but it can be a sensible palliative strategy in inoperable or metastatic cases.

Recent case reports show that trilostane can at least temporarily control hormonal symptoms. At the same time, recent data clearly indicate that invasive, unoperated adrenal tumors in dogs have, on average, only short survival times. This is precisely why I always openly discuss the difference between symptomatic stabilization and true tumor control with owners. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It almost always requires an honest assessment of feasibility, risk, prognosis, and quality of life.

Prognosis and follow-up

The forecast for a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs The prognosis depends primarily on four factors: operability, tumor size, vascular invasion, and metastasis status. Dogs with completely resectable tumors without distant metastases have a significantly better chance of longer survival times. The prognosis becomes more difficult with tumors that have a larger axis, with proven metastasis, or with venous tumor extension. These factors have repeatedly been described as having a poor prognosis in surgical case series.

Post-operative care involves much more than just wound checks. After surgery, circulation, electrolytes, blood pressure, pain management, and endocrine function must be closely monitored. Some dogs require temporary or long-term hormone replacement therapy because their bodies need time to adjust to the new situation. Depending on the findings, we also check hormone levels, perform ultrasound or CT scans, and perform general laboratory tests. During consultations with owners, I always emphasize: Even if the surgery went well, the treatment of a dog with this condition doesn't end there. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Not with the skin suture. Good aftercare is an active part of the therapy.

What you should consider for your dog

If your dog has a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs When the situation is critical, clear observations from daily life are extremely helpful. Note down fluid intake, urination, appetite, abdominal girth, activity level, panting, and any changes in skin and coat. Bring any previous findings, medication lists, and, if possible, photos of previous coat conditions. This information is valuable to us veterinarians because it shows how quickly the disease has developed and whether hormonal activity is likely.

It's also important not to put unnecessary strain on the dog. Strenuous activity, long walks in the heat, or administering medication without consulting a veterinarian are detrimental. For dogs that have undergone surgery, consistent rest, careful wound monitoring, and frequent contact with the veterinarian are crucial in the first few weeks if vomiting, weakness, diarrhea, collapse, lethargy, or loss of appetite occur. Owners don't need to have medical expertise; their primary goal is to recognize changes early. By doing so, they can play a vital role in preventing and managing the dog's health. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs a key contribution to treatment.

Further foreign sources

For those who would like to read more, reputable international sources can be found here:

MSD Veterinary Manual: Hyperadrenocorticism in animals ACVIM Consensus Statement on the Diagnosis of Spontaneous Hyperadrenocorticism in Dogs AAHA Selected Endocrinopathies Guidelines 2023 JAVMA: Prognostic factors after adrenalectomy in dogs Frontiers in Veterinary Science: Laparoscopic vs. Open Adrenalectomy Frontiers in Veterinary Science: Trilostane in recurrent adrenocortical carcinoma

Frequently asked questions about adrenocortical carcinoma (tumor of the adrenal cortex) in dogs

1. Is an adrenocortical carcinoma (tumor of the adrenal cortex) in dogs always synonymous with Cushing's disease?

No. One Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs A tumor can trigger Cushing's syndrome, but it doesn't have to. The crucial factor is whether the tumor is hormonally active. If it produces too much cortisol, we often see the classic Cushing's signs: polydipsia, polyuria, polyphagia, panting, abdominal distension, thin skin, and hair loss. If, on the other hand, the tumor produces no or only small amounts of clinically relevant hormones, it can present quite differently. In that case, a mass in the abdomen, weight loss, weakness, or an incidental finding on imaging are more likely to be the primary symptoms. This is precisely why one shouldn't automatically assume Cushing's syndrome based on every case of Cushing's. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Conversely, not every adrenal tumor should be defined solely by its hormone levels.

In practice, this distinction is extremely important because it influences treatment. Most dogs with spontaneous hypercortisolism do not have an adrenal tumor, but rather a pituitary cause. Only when the hormone profile and imaging results match does a pituitary tumor become a likely culprit. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs The focus is on the overall picture. From a veterinary perspective, the diagnostic process is therefore structured in stages. We first check whether clinically relevant hypercortisolism is present at all. Then we differentiate whether the cause is more likely pituitary or adrenal. For owners, this means: Please don't focus on individual findings. The decisive factor is always the overall picture, including symptoms, laboratory results, and imaging.

2. How is an adrenocortical carcinoma (tumor of the adrenal cortex) reliably diagnosed in dogs?

A secure classification of Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Hypercortisolism is almost never diagnosed with just one test. The path to diagnosis begins with a thorough medical history. I ask about fluid intake, urine output, appetite, changes in coat, muscle weakness, abdominal girth, recurrent infections, and the animal's medication history. This is followed by blood tests, urinalysis, electrolyte analysis, and, depending on the case, endocrine tests such as LDDST, ACTH stimulation, or endogenous ACTH. These steps help to identify hypercortisolism and narrow down its cause.

The second, often crucial, part is imaging. Ultrasound can frequently reveal whether an adrenal gland is enlarged and what the opposite side looks like. However, ultrasound is not always sufficient for precise surgical planning. A CT scan shows size, shape, positional relationships, and, above all, any potential vascular invasion much more accurately. This is precisely what is needed in the case of... Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Prognostically and surgically extremely relevant.

The more precisely we know beforehand where the tumor is located and whether metastases are present, the more realistic our advice can be. The final histological assessment of the removed tissue then usually provides the most reliable tumor classification. It's important for owners to understand: diagnostics are not an end in themselves. They determine surgical feasibility, risk, costs, prognosis, and aftercare. Therefore, especially when a tumor is suspected, it's crucial to have it checked thoroughly. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Don't just do "any old Cushing test", but proceed in a targeted and systematic way.

3. When is surgery advisable for adrenocortical carcinoma (tumor of the adrenal cortex) in dogs?

Surgery is advisable when a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Adrenalectomy is considered when the tumor appears locally removable, no extensive distant metastases are present, and the dog is likely to tolerate the procedure well according to the veterinarian's assessment. The major advantage of adrenalectomy is that it offers the only realistic chance of complete tumor removal. Medications can often alleviate hormonal symptoms, but they do not eliminate the tumor. From a veterinary perspective, surgery is therefore always the first option when it is technically feasible and medically justifiable.

However, one must be very open about risks. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It can grow into large vessels, displace adjacent structures, and be challenging intraoperatively. This is especially true in cases with thrombus or vascular involvement. Such procedures should be performed by experienced surgeons. Studies show that tumor size, metastases, and venous thrombosis worsen the prognosis. At the same time, recent surgical studies show that laparoscopic procedures can also yield good results in selected cases.

The crucial question is therefore not just "surgery yes or no," but also "where, by whom, and under what conditions." For owners: Don't just accept that surgery is possible; ask specifically about the CT scan findings, vascular involvement, the team's experience, intensive monitoring, and postoperative hormone planning. These are precisely the points that determine whether surgery is the right choice for your pet. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs about the safety and success of the therapy.

4. What can be done if an adrenocortical carcinoma (tumor of the adrenal cortex) in dogs cannot be surgically removed?

If a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs If surgery is not possible, the primary goal is to control symptoms, limit complications, and maintain quality of life for as long as possible. If the tumor is hormonally active and causes adrenal-mediated Cushing's syndrome, drug therapy with an active ingredient such as trilostane can help reduce excessive cortisol production. As a result, many dogs drink less, become more resilient, pant less, and their skin problems may improve to some extent. It is important to note, however, that this treatment is palliative. It has only a very limited effect on the tumor itself and does not replace curative removal.

In addition, structured monitoring is necessary. This includes regular checks of clinical symptoms, blood tests, medication adjustments if needed, and imaging at appropriate intervals. Some dogs also benefit from adjunctive therapy for high blood pressure, urinary tract infections, muscle weakness, or gastrointestinal problems.

From a veterinary perspective, honest communication about the prognosis is particularly important here. Recent data on invasive, unoperated adrenal tumors show that survival time is often short. However, this does not mean that every palliative phase is worthless. On the contrary: with good control of hormonal symptoms, a dog with Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs They can certainly still enjoy a decent quality of life for some time. The crucial thing is for owners to discuss concrete goals with their veterinarian: What do we want to achieve, how will we measure success, and at what point will their quality of life decline? This clarity is incredibly helpful in everyday life.

5. What is the prognosis for adrenocortical carcinoma (tumor of the adrenal cortex) in dogs?

The forecast for a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs The outcome varies considerably. There is no single, reliable answer because the course of the disease and survival time depend heavily on whether the tumor can be completely removed, whether metastases are already present, the size of the lesion, and whether blood vessels are involved. These factors determine whether we can speak of a realistic chance of long-term stability or rather of a limited palliative situation. In surgical case series, larger tumors, metastases, and venous thrombosis have been associated with poorer outcomes.

For owners, it's also important to distinguish between prognosis and quality of life. A dog can still have a good period despite a serious diagnosis if hormonal symptoms are controlled and no serious complications arise. Conversely, a tumor that is generally operable can be problematic in individual cases due to anesthetic risks, accompanying illnesses, or aggressive vascular invasion. Therefore, in my veterinary consultations, I never simply say "good" or "bad," but rather discuss a tiered prognosis:

What is the short-term stability, the surgical outlook, and the long-term control? This helps owners more than any general figure. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It remains a serious diagnosis, but early and thorough investigation almost always improves the quality of decision-making. Even if the prognosis is limited, structured care often allows for a significantly calmer and more comfortable course for the dog.

Comprehensive summary

A Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs is a rare but serious tumor disease of the adrenal gland. It is important for owners to understand that a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It is not just a local cancer problem, but often also a hormonal problem. If a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs When cortisol is produced, a clinical picture often arises that strongly resembles Cushing's syndrome.

That's precisely why a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs In practice, symptoms such as polydipsia, polyuria, polyphagia, abdominal distension, panting, muscle weakness, thin skin, and hair loss are often initially noticeable. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs However, it can also have a less noticeable hormonal course and be discovered more likely through its size, its location, or as an incidental finding during abdominal ultrasound.

From a veterinary perspective, the crucial point is that a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs must be identified early and properly classified. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Diagnosis is never solely a laboratory problem and never solely an ultrasound problem. Rather, the correct classification arises from the combination of medical history, clinical examination, blood and urine tests, endocrine tests, and imaging. If a diagnosis is suspected... Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It is not enough to simply look at the cortisol level. Likewise, it is not enough to simply describe an enlarged adrenal gland. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It must be considered in its functional and anatomical context.

It is also important for owners that a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It should not be equated with every form of Cushing's disease. Most dogs with spontaneous hypercortisolism do not have an adrenal cause, but rather a pituitary cause. This is precisely why differentiation is so important. Only when imaging and hormone patterns match does the suspicion of Cushing's disease become stronger. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs. In practical terms, this means: take suspicious symptoms seriously, but don't interpret them prematurely. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It is rare enough to warrant a structured investigation, and serious enough that unnecessary delays can be problematic.

Therapeutically, a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It is particularly amenable to positive influence when surgical removal is possible. Adrenalectomy is an option in the case of... Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs the most important curative option. However, surgery is not always necessary in the case of a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs not to be confused with a simple routine operation.

Location, lateralization, vascular contact, and potential invasion of venous structures can make the procedure very challenging. Therefore, a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Ideally, when planning surgery, choose an experienced surgical center. Owners benefit enormously if they inquire early about CT scans, vascular involvement, the surgical team's experience, and intensive care monitoring. These details are crucial when considering a... Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Not a minor matter, but part of the forecast.

Can a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs If surgery is not an option, the treatment goal shifts. Then, in the case of a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs The primary focus is usually on palliative control of hormonal symptoms. Medications such as trilostane can be used in the case of... Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs to help improve the symptoms caused by excess cortisol. This is clinically valuable for many dogs because thirst, urination, panting, and decreased performance can improve. Nevertheless, it must remain clear: Drug-based palliative therapy does not replace conventional treatment in a case of Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It is not the tumor removal itself. It primarily controls the effects of hormone production, not the malignancy of the tumor.

The forecast of a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It depends heavily on operability, tumor size, metastasis status, and vascular invasion. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs A diagnosis without metastases and without significant vascular involvement is generally more favorable than an advanced, invasive finding. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs However, the prognosis for animals with venous thrombosis or distant metastases is considerably more cautious. For owners, it's important not to focus solely on raw survival statistics. In the case of a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Quality of life is always a factor. With good care, appropriate medication, and thorough aftercare, a dog can still have a good quality of life despite a serious diagnosis.

After the operation, the care of a Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs No. Especially after an adrenalectomy, one needs... Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs Close follow-up care is essential. Circulatory stability, electrolytes, blood pressure, wound healing, pain management, and hormonal adjustment must be monitored. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs This therefore requires active collaboration between the veterinary practice, the clinic, and the owners. Those who recognize changes in the animal's daily routine early on often make a crucial difference.

These include fluid intake, activity level, appetite, bowel movements and urination, behavior, respiration, and skin condition. Especially after surgery or during ongoing medication, any significant decrease in performance should be investigated. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs be taken seriously.

The result is: One Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It is rare, complex, and always requires clarification. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs It should never be assessed based solely on a single symptom or solely on a rapid test.

A Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs This requires systematic diagnostics, an honest prognosis, and therapy tailored to the individual dog. That's precisely why early veterinary examination significantly improves the chances of recovery. Those who don't dismiss symptoms as "just old age" but seek timely action give their dog a much-needed chance of recovery. Adrenocortical carcinoma (tumor of the adrenal cortex) in dogs the decisive advantage.

Professionally classified from a veterinary perspective by Susanne Arndt, medical director and owner. Susanne Arndt studied at the Faculty of Veterinary Medicine at the University of Leipzig, worked for six years as an assistant veterinarian at the small animal clinic of Dr. Thomas Graf in Cologne, helped establish the small animal department at the Lahr Animal Health Center for a year, and has been running small animal practices in Karlsbad-Ittersbach and Karlsbad-Langensteinbach since 2013. This practical experience is complemented by a Master of Small Animal Science degree from the Free University of Berlin, ongoing professional development in the field of osteosynthesis, and membership in the German Veterinary Medical Society, the Feline Medicine Working Group of the German Society for Veterinary Medicine and Veterinary Surgery (DGK-DVG), and the Laser Medicine Working Group of the DGK-DVG.

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