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18 Cards in this Set
- Front
- Back
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What are the functions of glucocorticoids?
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Promote gluconeogenesis
Promote glycogenolysis Promote catabolism Anti-inflammatory effect Immunosuppressive effect |
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What is hyperadrenocorticism?
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excess glucocorticoid
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What are the two main causes of hyperadrenocorticism?
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pituitary dependant microadenoma resulting in bilateral adrenal gland hyperplasia
Adrenal dependent (ADH) half benign/malignant resulting in atrophy in contralateral adrenal gland |
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What are the clinical signs of hyperadrenocortisim?
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bilateral non-prurutuc alopecia, potbelly, pyoderma, PU/PD
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What causes the pot belly in hyperadrenocortisicm patients?
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muscle wasting
fat distribution hepatomegaly |
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What are the four differential diagnosis of PU/PD in a hyperadrenocorticism case?
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Cushings
Diabetes mellitus Renal failure Pyelonephritis |
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What will tests show on a hyperadrenocorticism patient for
CBC? Chem? Urine? |
CBC - stress leukogram, increased RBCs
Chem- increase ALP (not in cats) and ALT Urine - Low USG |
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Why is it hard to detect a UTI in an hyperadrenocorticism patient?
What should be done instead? |
Increase cortisol causes immunosuppression, keeps WBC from going to infection
Culture the urine |
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What are the different possible results for the LDDST?
Can ACTH stim diff b/w PDH and ADH? |
If at 4 or 8hrs is < 50% baseline is PDH, if not can be either PDH or ADH
No-> both will hyper secrete cortisol |
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What does the HDDST show for a PDH?
ADH? |
In 75% cases suppression of cortisol occurs
Suppression never occurs-> adrenal do not respond to anyone |
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What does the endogenous ACTH levels show for a PDH? ADH?
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PDH-> abnormally high ACTH
ADH-> abnormally low ACTH |
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What is not associated with cushings?
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pruritus
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What is the other name for Mitotane? What does this cause?
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o,p'-DDD, Lydosren
Progressive necrosis of zona fasiculata & reticularis |
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What any of the four signs do you look for in the induction phase of mitotane? If none are seen?
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1) Eat slowly or stop eating
2) Vomiting or diarrhea 3) Decreased water consumption 4) Lethargy Do ACTH stim at 5-7 days |
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What test do you do once you see signs of Addisons on mitotane? What do you want to see? If animal "sick" what can you give?
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ACTH stim
To stim flat Prednisone |
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What do you use as the maintenance for Cushings? What is the chance of "escape" in the first year? How often do you need to do a ACTH stim?
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Lysodren 50mg/kg/week
50% 1-3 mo into therapy then every 3-6mo |
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How is Trilosane different from Lyodren?
How does it work? When do you see improvement of PU/PD? Skin? |
Start low and increase dose until get proper stim
Inhibits synthesis of cortisol and aldosterone > 4wks > 4mo |
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When will you start to see the symptoms of Cushing disappear on Lysodrene?
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5-7 days when you start seeing Addisonian signs
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