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Normal dogs generally have post stimulation cortisol levels > 10 ug/dl. Post stimulation levels < 2 ug/dl is considered diagnostic and most Addison's patients are < 1 ug/dl. The ACTH stimulation test does not distinguish between primary and secondary hypoadrenocorticism, or adrenocortical destruction caused by mitotane overdose.
The ACTH test (also called the cosyntropin, tetracosactide, or Synacthen test) is a medical test usually requested and interpreted by endocrinologists to assess the functioning of the adrenal glands' stress response by measuring the adrenal response to adrenocorticotropic hormone (ACTH; corticotropin) or another corticotropic agent such as tetracosactide (cosyntropin, tetracosactrin; Synacthen ...
Adrenocorticotropic hormone is used as a medication and as diagnostic agent in the ACTH stimulation test. [ 1 ] [ 2 ] : 316, 1165 [ 3 ] : 84, 271 The form that is purified from pig pituitary glands is known as corticotropin [ 1 ] [ 2 ] : 316 is a medication and naturally occurring polypeptide tropic hormone produced and secreted by the anterior ...
Low-dose and high-dose variations of the test exist. [4] The test is given at low (usually 1–2 mg) and high (8 mg) doses of dexamethasone, and the levels of cortisol are measured to obtain the results. [5] A low dose of dexamethasone suppresses cortisol in individuals with no pathology in endogenous cortisol production.
Lifelong treatment is required, but the prognosis for dogs with hypoadrenocorticism is very good. [55] Hypoadrenocorticism can also occur in cats but is extremely rare. It is usually caused by an immune reaction, resulting in adrenal insufficiency. An ACTH stimulation test is used to diagnosis the condition. [58]
To determine the origin of dysfunction, the ACTH stimulation test is the best initial test as it can differentiate between primary and secondary adrenal insufficiency. [2] If cortisol levels remain low following ACTH stimulation, then the diagnosis is primary adrenal insufficiency. [2]
A study of 66 dogs with Cushing's found 91% of dogs to have either polyuria or polydipsia, 79% to have polyphagia, and 77% to have alopecia. [ 4 ] Signs of ectopic adrenocorticotropic hormone secretion that accompany the rapidly progressing physical changes are high plasma levels of adrenocorticotropic hormones and cortisol alongside hypokalaemia .
An ACTH stimulation test involving administration of corticotropin-releasing hormone (CRH) or another agent can differentiate this condition from ectopic ACTH secretion. In a patient with Cushing's disease, the tumor cells will be stimulated to release corticotropin and elevated plasma corticotropin levels will be detected. [ 8 ]