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The Greatest Pretenders: Challenging Adrenal Insufficiencies

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Adrenocortical insufficiency can be life threatening and may be difficult to identify. This is because of a multitude of factors including uncommon patient signalments, vague clinical signs, normal hemograms, co-morbidities, and variances in types of adrenal insufficiency. In this lecture presented by Veterinary Criticalist Christin Reminga, DVM, DACVECC, we’ll highlight these difficulties and go through four unique cases and how they were diagnosed and successfully treated for adrenal insufficiency.

This talk is specifically RACE-approved for 1 DVM or Technician CE credit.
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Christin Reminga's picture
Christin Reminga


Enrolled: 06/2019

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Jennevie Stephenson's picture

At about 22:27, when Dr. Reminga covers endogenous ACTH testing and the low-does stimulation test, the slide says that primary atypical Addison's will have a low ACTH level and secondary will have an elevated level in response. However, what she says (per closed captioning) seems to be the opposite. Am I just misunderstanding what she's referring to with those values?

Christin Reminga's picture

Hello Jennevie, Thank you so much for making this comment since my powerpoint slide has a typo yet what I stated was correct! Primary Addisons disease, which is caused by direct destruction of the adrenal glands, would have an elevated ACTH level. Secondary Addisons will instead have a low ACTH level since it a deficiency of the pituitary's ability to create and thus secrete ACTH. So it should read "Elevated = Primary Atypical Addisons disease (likely require mineralocorticoid supplementation in days to months. Low = Secondary Atypical Addisons disease (will not require mineralocorticoid supplementation)". Thank you again and happy learning! ~ Dr. Christin Reminga, DVM, DACVECC