Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hypoadrenocorticism was diagnosed in 42 dogs over a two-and-a-half-year period. The disease occurred more commonly in young to middle-aged dogs, with a female:male ratio of 2:1. Most dogs had chronic intermittent signs (eg, poor appetite, lethargy and vomiting), but more than a third were in acute adrenal crisis at the time of diagnosis. Serum biochemical testing revealed azotaemia, hyperphosphataemia, hyperkalaemia and hyponatraemia in almost all the dogs. In all dogs, results of adrenocorticotrophic hormone (ACTH) stimulation testing revealed a low to low-normal serum baseline cortisol concentration that failed to increase after ACTH administration. In two dogs with persistently normal serum electrolytes concentration, one had a markedly high plasma ACTH concentration diagnostic for primary hypoadrenocorticism, whereas the other had a low concentration confirming secondary hypoadrenocorticism. Fludrocortisone acetate was initially used for mineralocorticoid replacement in 33 of the 37 treated dogs with primary hypoadrenocorticism (final median dosage, 27.0 micrograms/kg/day), but supplementation was changed to desoxycorticosterone pivalate (DOCP) in four dogs because of poor response or adverse effects. Seven dogs with primary hypoadrenocorticism were treated with DOCP (final median dosage, 2.02 mg/kg/month). Prednisone, initially administered to 36 dogs, was discontinued in 11 dogs because of side effects. Of the dogs treated with fludrocortisone, the response was considered good to excellent in 26 dogs (78.8 per cent), fair in three, and poor in four. All dogs treated with DOCP responded well.
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PMID:Diagnosis and treatment of naturally occurring hypoadrenocorticism in 42 dogs. 880 97

Following recent tick exposure in Arkansas, a 2-year-old, female spayed Labradoodle was examined because of a one-week history of lethargy and shifting-leg lameness. The dog was febrile, had prominent lymph nodes, dull mentation, a stiff gait, and left forelimb lameness. Thrombocytopenia was the only initial hematological or biochemical abnormality. Despite treatment with doxycycline for suspected Rocky Mountain spotted fever, the dog continued to have waxing and waning clinical signs including inappetence, fever, shifting-leg lameness, lymphadenopathy, splenomegaly, and weight loss in association with moderate to severe hematological abnormalities, including anemia, thrombocytopenia, neutrophilia, and monocytosis. Sequential serological testing confirmed Bartonella henselae, Bartonella koehlerae and R. rickettsii seroconversion. Doxycycline, enrofloxacin and clarithromycin were administered in sequential combination for treatment of rickettsioses, B. henselae and B. koehlerae. Prednisone, thyroid supplementation and other drugs were administered to elicit symptomatic improvement. Based upon seroreversion, and the eventual resolution of all clinical and hematological abnormalities, therapeutic elimination of all three pathogens was seemingly achieved. Whether cortisol insufficiency due to adrenal exhaustion syndrome or post-infectious immune-mediated sequelae contributed to the symptoms and pathophysiological abnormalities reported in this dog was not determined, but are considerations for future cases.
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PMID:Bartonella henselae, Bartonella koehlerae and Rickettsia rickettsii seroconversion and seroreversion in a dog with acute-onset fever, lameness, and lymphadenopathy followed by a protracted disease course. 3101 51