Adrenocortical Function

Question 1

Common Routine Laboratory Findings with Hypercortisolemia

Answer 1

• Steroid leukogram
• Increased ALP in dogs (and GGT), hyperglycemia, hypercholesterolemia, lipemia
• Relatively unconcentrated, isosthenuric, or hyposthenuric urine, glucosuria in horses.

Question 2

Common Routine Laboratory Findings with Hypocortisolemia

Answer 2

• Absence of steroid leukogram in stressed, ill patients (particularly lack of lymphopenia, possible lymphocytosis or eosinophilia)
• Hyponatremia, hypochloremia, hyperkalemia, hypercalcemia, hypoglycemia, azotemia
• Inappropriately low USG with azotemia

Question 3

ACTH is expected to be WRI or increased in animals with…

Answer 3

PDH, primary hypoadrenocorticism, perhaps with ectopic production of ACTH, and perhaps after stressful stimuli

Question 4

ACTH is expected to be decreased in animals with…

Answer 4

FAN, secondary hypoadrenocorticism, after dexamethasone injections, and while they are being given therapeutic doses of glucocorticoids

Question 5

Interpret: (dog)
LDDST: Predex: 4.5, 4h: 3.0, 8h: 3.5
HDDST: Predex: 3.5, 4h: 3.3, 8h: 2.9

Answer 5

either PDH or FAN
LDDST indicates PDH, FAN, or nonadrenal disorder
HDDST indicates FAN more likely, can be PDH

Question 6

Interpret: (dog)
LDDST: Predex: 7.0, 4h: 1.0, 8h: 3.8
HDDST: Predex: 6.2, 4h: 0.8, 8h: 0.6

Answer 6

PDH or hyperresponsive adrenal gland because of a nonadrenal disorder

Question 7

Interpret: (dog)
LDDST: Predex: 5.0, 4h: 0.9, 8h: 0.6
HDDST: Predex: 5.5, 4h: 0.5, 8h: 0.3

Answer 7

Healthy, PDH, or nonadrenal disorder

Question 8

Interpret: (dog)
LDDST: Predex: 6.5, 4h: 3.2, 8h: 2.8
HDDST: Predex: 4.5, 4h: 0.8, 8h: 0.4

Answer 8

PDH or nonadrenal disorder

Question 9

Interpret: (dog)
LDDST: Predex: 0.2, 4h: 0.1, 8h: 0.1

Answer 9

hypoadrenal state, HDDST not needed