Term
| What are the three forms of Addison's in the dog? |
|
Definition
-Primary: adrenal issue (common)
-Secondary: pituitary issue
-Iatrogenic |
|
|
Term
| What causes primary hypoadrenocorticism? |
|
Definition
| -immune mediated adrenalitis, granulomatous/neoplasia disease |
|
|
Term
| Describe the deficiencies that go along with typical primary hypoadrenocorticism. |
|
Definition
| -mineralocorticoid deficiency + glucocorticoid deficiency |
|
|
Term
| Describe the deficiencies that go along with atypical primary hypoadrenocorticism. |
|
Definition
| -gluocorticoid deficiency ONLY |
|
|
Term
| What deficiencies occur with secondary hypoadrenocorticism? |
|
Definition
| -only atypical: only glucocorticoid deficiency |
|
|
Term
| What causes iatrogenic hypoadrenocorticism? |
|
Definition
-overtreatment of HAC
-rapid withdrawal of exogenous Cs |
|
|
Term
| What are the systemic effects of hypocortisolemia seen with Addison's? |
|
Definition
-dec vascular tone: hypotension, hypoperfusion, shock
-loss of GI mucosal integrity: anorexia, hemorrhagic vomiting, and diarrhea
-dec gluconeogenesis: hypoglycemia
-dec met of glucose/fat/protein: wt loss, hypocholesterolemia
-dec erythropoiesis = non-regen anemia
-dec calciuresis: hypercalcemia |
|
|
Term
| What deficiencies do we see due to hypoaldosteronism? |
|
Definition
-hyponatremia & hypokalemia = weakness, ataxia, arrhythmias
-water loss from kidneys: hypotension, hypoperfusion, shock |
|
|
Term
| What is the typical signalment of canine hypoadrenocorticism? |
|
Definition
-medium to giant breeds
-average 4.5 y
-75% female |
|
|
Term
| What are the clinical signs of canine hypoadrenocorticism? |
|
Definition
-often waxing and waning related to stress, excitement, or exercise
-lethargy and weakness
-GI: anorexia, vomiting, diarrhea
-weight loss
-PU/PD
-shivering
-abdominal pain |
|
|
Term
| What is the test we use for a definitive diagnosis of canine hypoadrenocorticism? |
|
Definition
|
|
Term
| What do we see on CBC with canine hypoadrenocorticism? |
|
Definition
-NO STRESS LEUKOGRAM: may even see lymphocytosis and eosinophilia
-normocytic, normochromic anemia |
|
|
Term
| What do we see on biochem with canine hypoadrenocorticism? |
|
Definition
-hyperkalemia and hypohatremia
-azotemia, hypoglycemia, hypercalcemia, hypocholesterolemia, metabolic acidosis |
|
|
Term
| What do we see on UA with canine hypoadrenocorticism? |
|
Definition
|
|
Term
| What do we see on rads with canine hypoadrenocorticism? |
|
Definition
-hypovolemia: microcardia, dec caudal vena cava
-rarely see megaesophagus |
|
|
Term
| What do we see on abdominal US of canine hypoadrenocorticism? |
|
Definition
-small adrenal glands
-thin GI mucosa |
|
|
Term
| What do we see on ECG with canine hypoadrenocorticism and its resulting hyperkalemia? |
|
Definition
-bradycardia
-sinoatrial arrest
-widened QRS
-arrhythmias |
|
|
Term
| What is the protocol for a canine ACTH Stim Test? |
|
Definition
-resting serum cortisol
-administer exogeous ACTH
-1h post ACTH serum cortisol |
|
|
Term
| What results from an ACTH diagnose canine hypoadrenocorticism? |
|
Definition
|
|
Term
| What is our initial treatment with hypoadrenocorticism? |
|
Definition
| -fluids, fluids, fluids with 0.9% NaCl |
|
|
Term
| How do we treat hyperkalemia that accompanies canine hypoadrenocorticism? |
|
Definition
-fluids
-calcium gluconate (while hooked up to an ECG)
-regular insulin + dextrose
-bicarb |
|
|
Term
| What are our 6 major treatment considerations with canine hypoadrenocorticism? |
|
Definition
-hypoperfusion & dehydration: fluids
-acidosis: fluids
-nausea: anti-emetics
-pain
-bacterial translocation: Ampicillin
-Anemia: WB transfusion |
|
|
Term
| How do we treat a hypoadrenocortical crisis in a dog? |
|
Definition
-shock IV fluids
-dexamethasone
-hydrocortisone |
|
|
Term
| What are our options for maintenance therapy of glucocorticoid levels with canine hypoadrenocorticism? |
|
Definition
|
|
Term
| What are our options for maintenance therapy of mineralocorticoid levels with canine hypoadrenocorticism? |
|
Definition
|
|
Term
| What is the max dose of DOCP used to treat canine hypoadrenocorticism? How is it administered? |
|
Definition
-50 mg
-SQ
-only mineralocorticoid activity |
|
|
Term
| What is the prognosis of canine hypoadrenocorticism? |
|
Definition
|
|
Term
| Describe atypical hypoadrenocorticism therapy in a dog. |
|
Definition
-pred
-may require mineralocorticoid in the future |
|
|
Term
| Is hypoadrenocorticism common in cats? What is the typical signalment? |
|
Definition
-very rare
-middle aged of both sexes |
|
|
Term
| What are the clinical sign of hypoadrenocorticism in cats? |
|
Definition
-lethargy, depression, anorexia, weight loss, vomiting, collapse
-hyperkalemia and hyponatremia |
|
|
Term
| How do we diagnose cats with hypoadrenocorticism? |
|
Definition
|
|
