Case 6 Endocrinology Part 2 Answers

Endocrinology Case 6

Expanded Case Evaluation
Expert's Answers

A. Expanded Database - Diagnostic Test Results

1 Test / Procedure: Clotting Profile
Results:

ACT: 70 seconds; bleeding time <2.0 minutes

Review indications & protocol in notes.

What is your assessment?
Normal. Coagulopathy seems unlikely as cause of GI hemorrhage

2 Test / Procedure: ACTH Stimulation Test
Results:

Pre-cortisol: 0.5 mcg/dl (1.5-3.0 mcg/dl); Post ACTH: 0.2 mcg/dl (3.0-6.0 mcg/dl)

Review indications & protocol in notes.

What is your assessment?
Hypoadrenocorticism is confirmed. May iatrogenic or atypical addison's disease.

B. Final Diagnosis

Hypoadrenocorticism

C. Therapeutic Plan

Balanced electrolyte solution, physiologic doses of glucocorticoids, monitor appetite, weight and serum electrolytes every 3-4 months. Followup: dog did well for 4 months and then experienced weakness. Na 122, K 5.7 and Ca 10.1. Started Florinef and dog did very well. Dog most likely had adrenalitis.

Endocrinology Case 6

Expanded Case Evaluation Expert's Answers

Expanded Case Evaluation
Expert's Answers