Transcription of ACTH Stimulation Test - IDEXX
1 ACTH Stimulation Test Diagnostic Protocol for Cases of Suspected Cushing's Syndrome or Addison's Disease History, physical exam, CBC, chemistry panel, electrolytes and urinalysis consistent with Cushing's syndrome or Addison's disease Draw baseline cortisol sample. Perform an ACTH Stimulation test with Cortrosyn IV* 5 g/kg or ACTH gel 1 IU/lb IM-max 40 IU. Draw 1-hour cortisol (Cortrosyn ) or 2-hour cortisol (ACTH gel). Pre-ACTH: 2 6 g/dL Post-ACTH. Pre- and Post-ACTH Post-ACTH Post-ACTH. <2 g/dL 2 6 g/dL Post-ACTH: 6 18 g/dL 18 22 g/dL >22 g/dL. If both results are <2 g/dL, results are Equivocal, Consistent consistent with Inconclusive Normal Cushing's possible with Cushing's hypoadrenocorticism Perform high-dose dexamethasone Begin treatment with suppression to mineralocorticoid discriminate between and/or glucocorticoid PDH and ATH, as appropriate.
2 ACTH level and/or abdominal ultrasound. *Remaining Cortrosyn can be aliquoted into 1-mL syringes containing mL Cortrosyn each. Store aliquoted syringes for up to six months, or vial can be refrigerated for up to one 1. Feldman EC, Nelson RW. Canine and Feline Endocrinology and Reproduction, 3rd ed. Philadelphia, Pa: WB Saunders; 2003:305.
