Critical illness‐related corticosteroid insufficiency in a dog with septic shock

Abstract

This case is the first published report of hydrocortisone-responsive hypotension and transient CIRCI associated with naturally occurring septic shock in a dog.

Controversies surrounding critical illness‐related corticosteroid insufficiency in animals

“…Treatment regimens have been published primarily in case reports, reviews, and book chapters, with no reliable clinical trial data available in veterinary species. A single case report in a dog with pressor‐refractory septic shock describes the use of hydrocortisone 0.5 mg/kg IV q6h to treat suspected CIRCI . Pressors were discontinued within hours of starting the hydrocortisone, and the steroid dose was tapered over many days beginning 4 days after pressor independence.…”

“…For individuals that recover from the acute or critical illness, prognosis for return of normal HPA axis function following an episode of CIRCI is very good …”

Anti-inflammatory Drugs in Equine Neonatal Medicine. Part II: Corticosteroids

“…The condition has also been reported in humans [57,58] and dogs [59][60][61] with acute critical illness, severe sepsis, and septic shock. Several studies suggested that RAI or CIRCI may occur in septic neonatal foals: one case report of transient HPA axis dysfunction in a septic neonatal foal was described [62], and three independent studies measured basal ACTH and cortisol concentrations in healthy and septic foals and found significantly increased ACTH-to-cortisol ratio in nonsurviving septic foals [63][64][65].…”

Hydrocortisone therapy in a cat with vasopressor‐refractory septic shock and suspected critical illness‐related corticosteroid insufficiency

“…Previous reports of treatment of suspected CIRCI in veterinary medicine include a dog with hydrocortisone‐responsive septic shock and a cat with polytrauma‐related hypotension responsive to intravenous dexamethasone . Additionally, one abstract reports a prospective blinded placebo‐controlled study in eight dogs treated with either hydrocortisone or an equivalent volume of saline, but results were inconclusive due to the small number of dogs enrolled .…”