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VetVine Client Care
Corticosteroid Use In The Critically Ill And In Addisonians
Emergency & Critical Care
This question was submitted in relation to a past webinar titled Canine Addison's Disease ...
Question:
According to emergency textbooks, current consensus of corticosteroid use in critically ill patients seems to be reserved for hypotensive dogs non-responsive to fluid therapy and vasopressor, and the recommendation is that 0.5 mg/kg/day of hydrocortisone be given. It would be grateful to have your comment on this.
Answer provided by Elisa Mazzaferro, MS, DVM, PhD, DACVECC:
Hi, so the use of hydrocortisone in patients not responding to vasopressors and fluid therapy is to treat relative adrenal insufficiency and should not be confused with true adrenal insufficiency = hypoadrenocorticism = Addison's.
In cases of true Addison's disease, I treat with Dexamethasone 0.2 mg/kg IV Q12h in an adrenal crisis, then once more stable, transition to 0.2 mg/kg/day prednisone or prednisolone.