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Endocrin -Adrenal (Hyperadrenocorticism (Clinical signs/suspicion (History…

- - - - increased urine cortisol
    - - will be very elevated, especially in comparison to other liver enzymes
  - - - PU/PD
      - depression
      - Polyphagia
    - - hair loss
      - thin skin, poor wound healing
      - Pot-bellied
    - - Steroid induced ALP
      - Other liver enzyme elevation (not as high as ALP)
      - cholesterol
    - - mild proteinuria
      - isosthenuria
    - - stress leukogram
  - - - majority of dogs escape suppression (>40 nmol/L) at 8 hours
      - concentration at 4 hours aids in distinction of pit tumor or adrenal tumor
      - measured at 0, 4, and 8 hours
    - - will have an exaggerated response (over 600 nmol/L)
  - - - Pituitary tumor
      - Adrenal tumor
        
        low to normal ACTH concentrations
    - - OR suppress to less than 50% of baseline cortisol at 4/8 hours
        
        pituitary tumor
      - usually escape suppression at 8 hours
      - Suppress cortisol to less than 40 nmol/L at 4 hours
      - adrenal tumors typically do not suppress at all
    - - Pituitary tumor
        
        less than 40 nmol at 4/8 hours
        
        OR suppressed by half the baseline at 4/8 hours
      - adrenal tumor
        
        do not suppress
- - - - NO eosinopenia
      - maybe a mild anemia
    - - inadequate concentration if hypovolemic
    - - hypotensive
      - hypovolemic
      - bradycardia
      - ill
    - - prerenal azotema
      - hypoglycemia
      - electrolyte abnormalities
      - hypercalcemia
    - - young-middle aged
      - female
  - - - <23:1
      - 27:1-23:1 suggestive
  - - - cortisol will remain low!
      - less then 50 nmol/L at 1 hour