Hydrocortisone therapy in a cat with vasopressor‐refractory septic shock and suspected critical illness‐related corticosteroid insufficiency

Pisano, Simone R. R.; Howard, Judith; Posthaus, Horst; Kovačević, Alan; Yozova, Ivayla D.

doi:10.1002/ccr3.1018

Cited by 9 publications

(8 citation statements)

References 42 publications

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“…This cat had normal electrolyte levels, normal electrocardiogram, high basal cortisol levels, and diffuse adrenocortical hyperplasia on necropsy. 22 In contrast, the cat in this report developed a sudden profound hypotension, azotemia, and hyperkalemia with a sodium to potassium ratio of 22:1 and atrial premature complexes. There is no current consensus regarding the identification of CIRCI in veterinary medicine; however, clinical signs are usually vague and hyponatremia and hyperkalemia are uncommon.…”

Section: Discussionmentioning

confidence: 54%

“…[17][18][19] CIRCI has been identified in dogs with sepsis and there are 2 case reports of suspected CIRCI in cats; 1 cat with polytrauma, and the other in septic shock. [20][21][22] The cat with septic shock had persistent hypotension unresponsive to fluid therapy and vasopressors but responded to hydrocortisone. This cat had normal electrolyte levels, normal electrocardiogram, high basal cortisol levels, and diffuse adrenocortical hyperplasia on necropsy.…”

Section: Discussionmentioning

confidence: 99%

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Waterhouse–Friderichsen syndrome in a cat with Klebsiella spp. infection

Cole

Hardas

Priestnall

et al. 2021

J Vet Emergen Crit Care

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Objective: To describe a case of Waterhouse-Friderichsen syndrome of adrenocortical failure in a cat with Klebsiella spp. infection. Case Summary: A 12-year-old male neutered domestic short-haired cat was referred for respiratory failure requiring mechanical ventilation. The cat remained comatose despite successful weaning from the ventilator and developed a Klebsiella pneumoniae pneumonia. On day 4 of hospitalization, the cat acutely deteriorated with profound hypotension, azotemia, and hyperkalemia, which rapidly progressed to cardiac arrest. Necropsy findings revealed massive adrenal hemorrhage and intralesional bacteria, termed Waterhouse-Friderichsen syndrome. Waterhouse-Friderichsen syndrome was suspected to have been the cause of acquired adrenocortical insufficiency and sudden death of the cat. New or Unique Information:To the authors' knowledge, this is the first report of sepsis causing Waterhouse-Friderichsen syndrome in a veterinary species.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Waterhouse–Friderichsen syndrome in a cat with Klebsiella spp. infection

Cole

Hardas

Priestnall

et al. 2021

J Vet Emergen Crit Care

View full text Add to dashboard Cite

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“…A 2011 abstract reported 8 dogs with septic shock enrolled in a placebo‐controlled trial using HC (1 mg/kg, IV, q 6 h), but it was unclear how many dogs received HC as a treatment 15 . Furthermore, a recent case report describes successfully using an HC CRI in a feline patient with septic shock and suspected CIRCI 25 . In the current study, patients suspected of CIRCI based on vasopressor refractory hypotension either received intermittent HC administration with dosing similar to previous published reports at 0.5 mg/kg to 1 mg/kg IV every 6 hours or an HC CRI.…”

Section: Discussionmentioning

confidence: 79%

“…15 Furthermore, a recent case report describes successfully using an HC CRI in a feline patient with septic shock and suspected CIRCI. 25 In the current study, patients suspected of CIRCI based on vasopressor refractory hypotension either received intermittent HC administration with dosing similar to previous published reports at 0.5 mg/kg to 1 mg/kg IV every 6 hours or an HC CRI. Given the lack of dosing information in veterinary medicine, a modification of the human protocol is now frequently used by our hospital.…”

Section: Discussionmentioning

confidence: 87%

Retrospective evaluation of the use of hydrocortisone for treatment of suspected critical illness–related corticosteroid insufficiency (CIRCI) in dogs with septic shock (2010–2017): 47 cases

Summers

Culler

Yaxley

et al. 2021

J Vet Emergen Crit Care

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“…As a non-invasive hemodynamic indicator, SI is often used in emergency areas. In recent years, SI has unique advantages in identifying critically ill patients (19,20). Rady et al (21) found that there was a good linear relationship between SI and invasive hemodynamic parameters, such as stroke volume and cardiac index.…”

mentioning

confidence: 99%

Correlation Between Pulmonary Vascular Permeability Index, Shock Index, and Severity of Septic Shock and Their Evaluation Values for Prognosis

Xiao

Zhou

Guo

2020

Iran Red Crescent Med J

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Background: The changes before and after fluid resuscitation in patients with septic shock and their relationship with prognosis have rarely been reported. Objectives: We aimed to observe the correlation between pulmonary vascular permeability index (PVPI), shock index (SI), and severity of septic shock. Methods: This case-control study retrospectively analyzed the clinical data of 154 patients with septic shock treated at our hospital (Weifang, China) from October 2016 to October 2018. They were divided into a survival group or a death group according to the 28day prognosis. Univariate analysis was performed for vital signs, the acute physiology and chronic health evaluation II (APACHE-II) score, the sequential organ failure assessment (SOFA) score at admission, SI at admission (SI1), SI at 3 h after fluid resuscitation (SI2), PVPI at admission (PVPI1), PVPI at 3 h after fluid resuscitation (PVPI2), and lactate clearance rate (LCR). The correlations of PVPI and SI with the APACHE-II score, SOFA score, and LCR were analyzed by plotting the receiver operating characteristic curves. Results: Among the 154 cases, 70 survived after 28 days and 84 died. We observed that SI1, SI2, PVPI1, PVPI2, APACHE-II score, and SOFA score were significantly lower in the survival group than in the death group, while LCR was significantly higher (P < 0.05). Also, SI1, SI2, PVPI1, and PVPI2 were positively correlated with APSCHE-II and SOFA scores of patients with septic shock, but negatively correlated with LCR (P < 0.05). Moreover, SI2 predicted the prognosis of patients with septic shock significantly better than SI1, PVPI1, and PVPI2 did. When SI2 was 1.22, the Youden index was 0.822, the sensitivity was 91.23%, the specificity was 89.47%, the positive predictive value was 0.912, and the negative predictive value was 0.924. The positive and negative likelihood ratios were 0.897 and 0.375, respectively. Conclusions: Based on the study, SI after fluid resuscitation was more valuable for evaluating the prognosis of patients with septic shock than SI at admission, as well as PVPI values at admission and after fluid resuscitation.

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Hydrocortisone therapy in a cat with vasopressor‐refractory septic shock and suspected critical illness‐related corticosteroid insufficiency

Cited by 9 publications

References 42 publications

Waterhouse–Friderichsen syndrome in a cat with Klebsiella spp. infection

Waterhouse–Friderichsen syndrome in a cat with Klebsiella spp. infection

Retrospective evaluation of the use of hydrocortisone for treatment of suspected critical illness–related corticosteroid insufficiency (CIRCI) in dogs with septic shock (2010–2017): 47 cases

Correlation Between Pulmonary Vascular Permeability Index, Shock Index, and Severity of Septic Shock and Their Evaluation Values for Prognosis

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