primary: pit dependent- high levels of ACTH-> high cortisol-> hyperplasia of adrenal glands

secondary: adrenal dependent: low levels of ACTH cause cortisol autonomous secretion from adrenal glands, atrophy of contralateral gland

iatrogenic: admin of glucocorticoids

high cortisol

high cholesterol

low T4

high ALT, AP

pot bellied

bilateral alopecia

fragile skin-cats

SMILED leucogram

LDDS- PDH and ADH resistant

ACTH stim- primary will respond, adh will respsond but not very much

PDH and ADH: trilostane, mitotane, RT, Surgery

iatrogenic: over time withdraw medication but dont want to get an addisonian crisis

admin vit D and ca supplementation

acute: calcium gluconate slowly, monitor HR

monitor ca.conc. weekly

IV NaCl fluid

surgery

monitor for hypo. 

if renal: treat renal disease

nutritional: treat dietary deficiency, cage rest, aproppriate analgesia

test for hyperthyroidism

T3 suppression test

suppose to cause suppression of T4

also look at TSH levels-low TSH

medical: methimazole, carbimazole

Surgery

RT

Radioactive isotopes- ectopic thyroid tissue, need isolated 

primary and secondary

primary

lymphocytic

idiopathic follicular atrophy

neoplasia

secondary: acquired- inadequate production of TSH

no