Transcription of SNAP Cortisol Testing Guide - IDEXX US
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SNAP Cortisol Testing Guide - IDEXX US
Diagnosing and Treating Cases of Suspected Canine Hyperadrenocorticism or Addison s DiseaseACTH Stimulation TestDiagnostic Protocol for Cases of Suspected Canine Hyperadrenocorticism or Addison s Disease History, physical exam, CBC, chemistry panel, electrolytes and urinalysis consistent with Canine Hyperadrenocorticism or Addison s diseaseDraw 1-hour Cortisol (Cortrosyn ) or 1 and 2-hour Cortisol (ACTH gel).Perform an ACTH stimulation test with Cortrosyn 5 g/kg IV or ACTH gel U/kg ,Cushing s possibleNormalIf both results are <2 g/dL, results are consistent with hypoadrenocorticismInconclusivePre- and Post-ACTH<2 g/dLPost-ACTH>22 g/dLPost-ACTH2 6 g/dLPre-ACTH: 2 6 g/dLPost-ACTH: 6 18 g/dLPost-ACTH18 22 g/dLDraw baseline Cortisol treatment with mineralocorticoid and/or glucocorticoid as Cushing sPerform high-dose dexamethasone* suppression to discriminate between PDH and ATH,ACTH level and/or abdominal ultrasound.
Post-ACTH serum cortisol >1.5 µg/dL (>40 nmol/L) and clinically well Continue treatment at current dose. Assess degree of clinical improvement. Stop trilostane and evaluate patient. CBC and biochemistry profile, including electrolytes. Emergency medical attention may be needed in some dogs. Treat as needed. Post-ACTH serum cortisol
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