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Flat adrenal with normal ACTH stim

What can cause “flat” adrenals with low resting Cortisol but a normal ACTH stim?

  • 8 mo. old F Lab
  • Ongoing issues with diarrhea, puppy vaginitis/UTI, poor weight gain
  • Some urinary incontinence
  • “Flat” adrenal gland, cr. pole width 0.4cm, difficult to find.

Resting cortisol = 0.7

So ran the ACTH Stim (2 days later):

Pre = 0.9      Post = 12.2 

Do I look for other chronic disease (food intolerance, etc)?  Could this be a dog that will be Addisonian later in life?

Thanks!

What can cause “flat” adrenals with low resting Cortisol but a normal ACTH stim?

  • 8 mo. old F Lab
  • Ongoing issues with diarrhea, puppy vaginitis/UTI, poor weight gain
  • Some urinary incontinence
  • “Flat” adrenal gland, cr. pole width 0.4cm, difficult to find.

Resting cortisol = 0.7

So ran the ACTH Stim (2 days later):

Pre = 0.9      Post = 12.2 

Do I look for other chronic disease (food intolerance, etc)?  Could this be a dog that will be Addisonian later in life?

Thanks!

Karen Ebersole

Karen

5 responses to “Flat adrenal with normal ACTH stim”

  1. Altough the adrenal glands

    Altough the adrenal glands appear ultrasonographically small, functionally they are normal. With the diarrhea and poor weigh gain would look at the GI tract – exocrine pancreatic insufficiency, inflammatory bowel disease, dietary hypersensivity, parasitic enteritis.

  2. Thank you rlobetti!  We’ll

    Thank you rlobetti!  We’ll move on to evaluating the GI tract.

  3. When I notice smaller then

    When I notice smaller then expected adrenal glands I personally look at their overall diameter in comparision to that of the prenicoabdominal vein when measured at it’s own maximum distention. If the diameter is less then that of the vein he is most probably Addisonian. If it is greater by any small measure he is not. This is not the Gospel but my own personal observation thatr I stick by. Up until now it has proven accurate each time that I have suspected it ( all were confirmed with ACTH testing ). 

  4. Thank you bhylands!  That’s a

    Thank you bhylands!  That’s a great “rule of thumb”…. not Gospel :)… to have while scanning. I appreciate the tip. 

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