{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T01:56:18Z","timestamp":1793066178305,"version":"4.5.0"},"reference-count":6,"publisher":"American Veterinary Medical Association (AVMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To summarize findings from a case of adrenocortical hemorrhage following tetracosactide injection during ACTH stimulation testing for monitoring of trilostane therapy in a dog.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>ANIMAL<\/jats:title>\n<jats:p>A 12-year old neutered male dog with adrenal-dependent hypercortisolism.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES<\/jats:title>\n<jats:p>4 hours after ACTH stimulation testing, the patient developed vomiting, lethargy, and abdominal pain. Abdominal ultrasound was performed before and after an ACTH stimulation test. Following ACTH stimulation testing, there was progressive bilateral adrenal enlargement and free abdominal fluid had developed. This was considered to be caused by adrenocortical inflammation and hemorrhage secondary to the synthetic ACTH analog, tetracosactide, used during stimulation testing. A resting cortisol performed 5 hours after tetracosactide injection was not consistent with iatrogenic hypoadrenocorticism.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>TREATMENT AND OUTCOME<\/jats:title>\n<jats:p>The patient was managed with analgesia, IV fluids, and corticosteroids and made a full recovery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>To the authors\u2019 knowledge, this was the first reported case of adrenocortical hemorrhage following administration of a synthetic ACTH analog in a dog. This should be considered as a rare potential complication of ACTH stimulation testing.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/javma.23.07.0391","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T20:23:29Z","timestamp":1699043009000},"page":"1-4","source":"Crossref","is-referenced-by-count":2,"title":["Adrenocortical hemorrhage following intravenous tetracosactide in a dog with hypercortisolism"],"prefix":"10.2460","volume":"262","author":[{"given":"Sophia","family":"Wyatt","sequence":"first","affiliation":[{"name":"Veterinary Specialist Services, Jindalee, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Singer","sequence":"additional","affiliation":[{"name":"Veterinary Specialist Services, Carrara, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"King","sequence":"additional","affiliation":[{"name":"Veterinary Specialist Services, Jindalee, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"23","key":"ref1","series-title":"Vet Rec","first-page":"597","article-title":"Pre-trilostane and three-hour post-trilostane cortisol to monitor trilostane therapy in dogs","volume":"179","author":"Macfarlane L","year":"2016","unstructured":"Macfarlane L, Parkin T, Ramsey I. Pre-trilostane and three-hour post-trilostane cortisol to monitor trilostane therapy in dogs. Vet Rec. 2016;179(23):597. doi:10.1136\/vr.103744"},{"issue":"1","key":"ref2","series-title":"Emerg Radiol","first-page":"53","article-title":"CT of the adrenal gland: the many faces of adrenal hemorrhage","volume":"19","author":"Sacerdote MG","year":"2012","unstructured":"Sacerdote MG, Johnson PT, Fishman EK. CT of the adrenal gland: the many faces of adrenal hemorrhage. Emerg Radiol. 2012;19(1):53-60. doi:10.1007\/s10140-011-0989-9"},{"issue":"3","key":"ref3","series-title":"Domest Anim Endocrinol","first-page":"155","article-title":"Adrenocorticotropic hormone, but not trilostane, causes severe adrenal hemorrhage, vacuolization, and apoptosis in rats","volume":"40","author":"Burkhardt WA","year":"2011","unstructured":"Burkhardt WA, Guscetti F, Boretti FS,  Adrenocorticotropic hormone, but not trilostane, causes severe adrenal hemorrhage, vacuolization, and apoptosis in rats. Domest Anim Endocrinol. 2011;40(3):155-164. doi:10.1016\/j.domaniend.2010.10.002"},{"issue":"6","key":"ref4","series-title":"J Small Anim Pract","first-page":"307","article-title":"Adrenal necrosis in a dog receiving trilostane for the treatment of hyperadrenocorticism","volume":"45","author":"Chapman PS","year":"2004","unstructured":"Chapman PS, Kelly DF, Archer J, Brockman DJ, Neiger R. Adrenal necrosis in a dog receiving trilostane for the treatment of hyperadrenocorticism. J Small Anim Pract. 2004;45(6):307-310. doi:10.1111\/j.1748-5827.2004.tb00241.x"},{"issue":"4","key":"ref5","series-title":"J Clin Endocrinol Metab","first-page":"995","article-title":"Approach to the patient with adrenal hemorrhage","volume":"108","author":"Elhassan YS","year":"2023","unstructured":"Elhassan YS, Ronchi CL, Wijewickrama P, Baldeweg SE. Approach to the patient with adrenal hemorrhage. J Clin Endocrinol Metab. 2023;108(4):995-1006. doi:10.1210\/clinem\/dgac672"},{"issue":"5","key":"ref6","series-title":"J Vet Intern Med","first-page":"1637","article-title":"Comparison of 2 doses for ACTH stimulation testing in dogs suspected of or treated for hyperadrenocorticism","volume":"30","author":"Aldridge C","year":"2016","unstructured":"Aldridge C, Behrend EN, Kemppainen RJ,  Comparison of 2 doses for ACTH stimulation testing in dogs suspected of or treated for hyperadrenocorticism. J Vet Intern Med. 2016;30(5):1637-1641. doi:10.1111\/jvim.14528"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/262\/2\/javma.23.07.0391.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/262\/2\/javma.23.07.0391.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/262\/2\/javma.23.07.0391.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T13:06:25Z","timestamp":1741352785000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/262\/2\/javma.23.07.0391.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":6,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.2460\/javma.23.07.0391","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2024,2,1]]}}}