Peer-reviewed veterinary case report
Dog with adrenal disease vomits and has bleeding after ACTH test
By Wyatt, Sophia et al.·Published in Journal of the American Veterinary Medical Association·2024·1Veterinary Specialist Services, Australia·View original on PubMed →
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Original publication title: Adrenocortical hemorrhage following intravenous tetracosactide in a dog with hypercortisolism.
- Species:
- dog
Plain-English summary
A 12-year-old neutered male dog with adrenal-dependent hypercortisolism (Cushing's disease) started vomiting, became lethargic, and showed signs of abdominal pain just hours after receiving an injection of tetracosactide during a hormone test. An ultrasound revealed swelling of the adrenal glands and fluid in the abdomen, likely due to bleeding caused by the injection. The dog was treated with pain relief, IV fluids, and corticosteroids, and he made a full recovery.
People also search for: dog vomiting after ACTH test · Cushing's disease treatment in dogs · dog abdominal pain after tetracosactide
Abstract
OBJECTIVE: To summarize findings from a case of adrenocortical hemorrhage following tetracosactide injection during ACTH stimulation testing for monitoring of trilostane therapy in a dog. ANIMAL: A 12-year old neutered male dog with adrenal-dependent hypercortisolism. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: 4 hours after ACTH stimulation testing, the patient developed vomiting, lethargy, and abdominal pain. Abdominal ultrasound was performed before and after an ACTH stimulation test. Following ACTH stimulation testing, there was progressive bilateral adrenal enlargement and free abdominal fluid had developed. This was considered to be caused by adrenocortical inflammation and hemorrhage secondary to the synthetic ACTH analog, tetracosactide, used during stimulation testing. A resting cortisol performed 5 hours after tetracosactide injection was not consistent with iatrogenic hypoadrenocorticism. TREATMENT AND OUTCOME: The patient was managed with analgesia, IV fluids, and corticosteroids and made a full recovery. CLINICAL RELEVANCE: To the authors' knowledge, this was the first reported case of adrenocortical hemorrhage following administration of a synthetic ACTH analog in a dog. This should be considered as a rare potential complication of ACTH stimulation testing.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37922711/