hypoadrenocorticism

Question 1

difference between typical and atypical hypoA

Answer 1

typical features stress leukogram and hyponatraemia, hyperkalaemia or both.
atypical features no electrolyte abnormalities, no stress leukogram and normal aldosterone

Question 2

what is CIRCI

Answer 2

critical illness related corticosteroid insufficiency - healthy normally, but when ill, can’t handle requirement

Question 3

signalement

Answer 3

a dz of young to middle aged dogs, less common in cats, in dogs = 2x more common in females. predisposed breeds - leonburgers, poodles, NSDT retrievers, bearded collies

Question 4

clinical signs

Answer 4

“unwell” - v+, d+, lethargy, depressed, azotaemia, weak, inappetant, melaena
collapsed, severely compromised patient - poor circulatory integrity, usually hypovolaemic or dehydrated

Question 5

suggestive clin path

Answer 5

hypoglycaemia, hypercalcaemia, azotaemia, dilute urine, no stress leukogram, hypoproteinaemic? hyponatraemia/hyperkalaemia, mild-moderate anaemia

Question 6

dx

Answer 6

ACTH stim test demonstrating subnormal levels of cortisol before and after ACTH

Question 7

tx of the acute patient

Answer 7

IVFT, hormone supplementation that is short acting (hydrocortisone sodium succinate)

Question 8

tx of chronic patient

Answer 8

NaCl supplementation, drugs w balance of gluco and mineralocorticoids = FLUDROCORTISONE ± CORTISOL (

Question 9

monitoring

Answer 9

mineralocorticoid activity evaluated by sodium and potassium levels,
glucocorticoid levels evaluated by leukogram