Peer-reviewed veterinary case report
Controversies surrounding critical illness-related corticosteroid insufficiency in animals.
- Journal:
- Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
- Year:
- 2015
- Authors:
- Creedon, Jamie M Burkitt
- Affiliation:
- Critical Consultations · United States
Plain-English summary
This study discusses a condition called critical illness-related corticosteroid insufficiency (CIRCI), which can happen in pets when their bodies don't produce enough of a hormone called cortisol during severe illness. The exact reasons for this condition can vary and may involve problems with hormone regulation in the body. Diagnosing CIRCI in pets is tricky because there isn't a clear test to confirm it, and veterinarians often rely on how well pets respond to treatment with a medication called hydrocortisone. The good news is that if a pet recovers from their critical illness, they usually do well and can stop needing hydrocortisone.
Abstract
OBJECTIVES: To describe the controversies surrounding critical illness-related corticosteroid insufficiency (CIRCI) and the use of hydrocortisone in critically ill patients, and to present published diagnostic and therapeutic strategies in companion veterinary species. ETIOLOGY: Critical illness-related corticosteroid insufficiency may be due to hypothalamic-pituitary-adrenal (HPA) axis dysfunction, alterations in cortisol-plasma protein binding, target cell enzymatic changes, changes in glucocorticoid receptor (GR) function, or a combination of these or other factors present during critical illness. DIAGNOSIS: Appropriate tests to diagnose CIRCI are unknown. The diagnosis in people is currently based on response to treatment with hydrocortisone. There is currently no consensus on appropriate diagnostic feature(s) in veterinary species. THERAPY: Low-dose hydrocortisone is the treatment of choice for patients with CIRCI. PROGNOSIS: If the patient survives the critical illness, prognosis for resolution of CIRCI and hydrocortisone dependence is very good.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/25516097/