Presumptive nontraumatic adrenal hemorrhage preceding hypoadrenocorticism in a dog

Lee, Namsoon; Choi, Jihye; Yoon, Junghee

doi:10.1111/jvim.16531

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Given the normal plasma aldosterone concentration on day 1, the patient likely did not have aldosterone deficiency at this time, but this result does not rule out pre-existing cortisol deficiency. Hypoadrenocorticism could have developed in this dog independent of the intoxication caused by idiopathic destruction, immune-mediated or metastatic disease or an ischemic event [ 11 , 12 , 13 ]. However, the dog’s initial and subsequent diagnostic work-up revealed no evidence of embolic disease or neoplasia, making these differentials unlikely.…”

Section: Discussionmentioning

confidence: 99%

Hypoadrenocorticism in a Dog Following Recovery from Alpha-Amanitin Intoxication

Cohen

Moeller

Dear

2023

Veterinary Sciences

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A 10-year-old, female spayed Labrador Retriever was referred for acute hepatopathy and urinary retention. Blood work from the initial presentation (day 0) revealed a severe, mixed hepatopathy. Over the course of the patient’s hospitalization, the patient developed liver insufficiency. Urine was submitted for toxicological screening and revealed detection of a trace concentration of alpha-amanitin. The patient was treated supportively for alpha-amanitin intoxication and was discharged from the hospital on day 8, with most biochemical parameters being markedly improved. The patient was persistently hyporexic at the time of discharge. On day 15, at a recheck appointment, the patient had lost 2.4 kg and liver enzymology revealed improved values. On day 24, the patient was presented for anorexia and vomiting and had lost another 2.3 kg. Blood work and endocrinological testing at that time were consistent with hypoadrenocorticism. The patient was started on glucocorticoids and mineralocorticoids. At day 106, the patient was doing well clinically while receiving monthly mineralocorticoids and daily glucocorticoids. This case report is the first to describe the chronological association between alpha-amanitin-induced liver dysfunction and the subsequent development of adrenal insufficiency in a dog.

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Section: Discussionmentioning

confidence: 99%

Hypoadrenocorticism in a Dog Following Recovery from Alpha-Amanitin Intoxication

Cohen

Moeller

Dear

2023

Veterinary Sciences

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Presumptive nontraumatic adrenal hemorrhage preceding hypoadrenocorticism in a dog

Lee

Choi

Yoon

2022

Veterinary Internal Medicne

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Nontraumatic adrenal hemorrhage (NTAH) has been associated with stress‐induced catecholamines release in underlying conditions such as sepsis and recent surgery in humans. It can lead to primary hypoadrenocorticism (HOAC) when both adrenal glands are involved, with nonspecific clinical signs and laboratory findings that can lead to a missed diagnosis. Bilateral thickening of the adrenal glands with periadrenal fat stranding was identified in a 10‐year‐old male Maltese dog after abdominal surgery. The dog showed clinical signs and biochemical changes consistent with HOAC, but treatment for presumed critical illness‐related corticosteroid insufficiency was initiated. Clinical signs relapsed with a 3‐week dose reduction of hydrocortisone, and a reduction in adrenal size was observed on follow‐up ultrasound examination. Hormonal testing confirmed HOAC in the dog. To the best of our knowledge, HOAC caused by spontaneous NTAH has not been reported in the veterinary literature. This report describes a dog that developed HOAC with presumed adrenal atrophy after suspected spontaneous bilateral NTAH.

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Comparison between typical primary and eunatraemic, eukalaemic hypoadrenocorticism: 92 cases

Da Silva,

Gunn,

Ramos

et al. 2024

Ir Vet J

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Background Naturally occurring hypoadrenocorticism is an uncommon endocrine disorder in dogs but has significant morbidity and mortality. Some dogs present with apparent glucocorticoid deficiency alone as evidenced by eunatraemia and eukalaemia. Few studies have compared dogs with hypoadrenocorticism with or without electrolyte disturbances and there are no large case series of affected dogs from Ireland. Methods Retrospective observational study. Results Ninety-two cases diagnosed with hypoadrenocorticism subdivided into those with supportive electrolyte disturbances (Group 1; n = 72) and those without (Group 2; n = 20). Dogs in Group 1 were significantly (p = 0.001) younger (4.0 (3.0–6.0) years) than dogs in Group 2 (6.0 (4.75–8.25) years). Dogs in Group 1 presented significantly more commonly with vomiting (Group 1: 52/71 (73.2%), Group 2: 6/20 (30.0%); p < 0.001), total hyperproteinaemia (Group 1: 21/71 (29.6%), Group 2: 1/20 (5.0%); p = 0.023), increased urea (Group 1: 52/72 (72.2%), Group 2: 5/20 (25.0%); p < 0.001), increased creatinine (Group 1: 31/72 (43.1%), Group 2: 3/20 (15.0%); p = 0.021) and hyperphosphataemia (Group 1: 40/71 (56.3%), Group 2: 2/20 (10.0%); p < 0.001), and significantly less commonly with reticulocytosis (Group 1: 4/38 (10.5%), Group 2: 5/13 (38.5%), p = 0.023). An undetectable basal aldosterone concentration had a positive predictive value of 94.3% for diagnosing undetectable post-ACTH aldosterone concentration. Of the thirteen dogs in Group 2 that had aldosterone concentrations measured and secondary disease excluded, 7 (53.8%) had or subsequently developed evidence of aldosterone deficiency, although not always with electrolyte abnormalities. Conclusions Dogs with hypoadrenocorticism from Ireland are similar to other reported cases. An undetectable basal aldosterone concentration is highly predictive of mineralocorticoid deficiency. Dogs with apparent glucocorticoid deficiency alone can progress to more typical disease and should be monitored appropriately.

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Presumptive nontraumatic adrenal hemorrhage preceding hypoadrenocorticism in a dog

Cited by 3 publications

References 17 publications

Hypoadrenocorticism in a Dog Following Recovery from Alpha-Amanitin Intoxication

Hypoadrenocorticism in a Dog Following Recovery from Alpha-Amanitin Intoxication

Presumptive nontraumatic adrenal hemorrhage preceding hypoadrenocorticism in a dog

Comparison between typical primary and eunatraemic, eukalaemic hypoadrenocorticism: 92 cases

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