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14 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the two types of HPA response in regard to Cortisol?
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Fast - to rate of change in cortisol
Slow - response to [Cortisol] |
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What is the prevalence of Pituitary dependent vs. Adrenal dependent HAC?
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80% are pituitary
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What clinical signs do you typically see with Pituitary Macroadenomas?
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obtundation, blindness, seizures
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Problems with Pituitary adenoma result from a failure to respond to ___.
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negative feedback.
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Typical signalment for Pituitary Dependent HAC?
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9yo fs <20kg
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Problems with ADHAC result from __.
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failure of adrenal to stop pumping cortisol once the ACTH stops.
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Typical signalment for ADHAC dog
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>9yo >20kg
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Most common clinical signs of HAC
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PU/PD/PP
Potbelly Tachypnea - Pickwickian Weakness (Cortisol is catabolic) And some less common clinical signs? |
Alopecia Comedones Ventral hyperpigmentation Bruising Calcinosis cutis |
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Cortisol antagonizes what major hormone?
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Insulin
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HAC common clin path values
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polycythemia (cortisol triggers EPO)
Stress leukogram Thrombocytosis ALP in the thousands High cholesterol, lipemia Low USG Proteinuria Ca Ox crystals |
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So, you decide to do a LDDS. What are the ranges?
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If it suppresses, it's not HAC.
If it doesn't suppress @ 8hr, it's HAC. If it suppresses (into gray or <50% baseline) @ 4hr, it's PDHAC. |
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Which would be more helpful in detecting HAC? CT or MRI?
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MRI. CT is for bone.
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What is the goal of the Utrecht protocol?
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Create a permanent Addisonian by burning out the adrenals with Mitotane.
It should be considered for? |
Atypical HAC
Patient intolerant of HAC Meds |
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Major differences in HAC Cats from dogs?
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EXTREMELY Fragile skin - tears off in sheets
1/3 will have calcified adrenals LDDS needs 10x dog dose 50% are unregulated diabetics Nothing works prescription-wise - Bilat adrenalectomy or Pituitary irradiation eACTH excellent test for cats |
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