Case 7

Because of the radiographic and serum chemistry findings, you hospitalize Roscoe for intravenous diuresis with 0.9% sodium chloride solution and schedule him for emergency abdominal exploratory surgery. At surgery, you remove a piece of corn cob that is causing the obstruction, but the abdomen otherwise looks good. Roscoe experiences no anesthetic or perioperative complications. During hospitalization, you have been treating him with 0.05 mg/kg of dexamethasone given subcutaneously once a day to provide glucocorticoid support. Once Roscoe is recovered and eating again, you reinitiate the maintenance dose of oral prednisone. His electrolyte concentrations the next day are normal, and you discharge him 48 hours postoperatively.

Roscoe is presented again in one week to recheck his electrolytes now that he has had some time off of his intravenous fluids. Roscoe is feeling great, and his incision appears to be healing well.

The electrolytes are completely normal! Good job doc!

The plan is to monitor Roscoe at home (and try to keep him from eating things that he shouldn't) and to reevaluate him in three months. As for resuming his hunting activities, you recommend his owners double his dose of prednisone on the days he goes hunting. This may need to be adjusted, but it will depend on how well he handles things.

Suggested Reading

Scott –Moncrieff, JCR. Hypoadrenocorticism. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. 7th ed. Philadelphia, Pa: Saunders, 2010;1847-1857.

Lennon EM, Boyle TE, Hutchins RG, et al. Use of basal serum or plasma cortisol concentrations to rule out a diagnosis of hypoadrenocorticism in dogs: 123 cases (2000-2005). J Am Vet Med Assoc 2007;231(3):413-416.

Lathan P, Moore GE, Zambon S, et al. Use of a low-dose ACTH stimulation test for diagnosis of hypoadrenocorticism in dogs. J Vet Intern Med 2008;22(4):1070-1073.

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