Controversies surrounding critical illness-related corticosteroid insufficiency in animals

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Objectives: To describe the controversies surrounding critical illness-related corticosteroid insufficiency (CIRCI) and the use of hydrocortisone in critically ill patients, and to present published diagnostic and therapeutic strategies in companion veterinary species. Etiology: Critical illness-related corticosteroid insufficiency may be due to hypothalamic-pituitary-adrenal (HPA) axis dysfunction, alterations in cortisol-plasma protein binding, target cell enzymatic changes, changes in glucocorticoid receptor (GR) function, or a combination of these or other factors present during critical illness. Diagnosis: Appropriate tests to diagnose CIRCI are unknown. The diagnosis in people is currently based on response to treatment with hydrocortisone. There is currently no consensus on appropriate diagnostic feature(s) in veterinary species. Therapy: Low-dose hydrocortisone is the treatment of choice for patients with CIRCI. Prognosis: If the patient survives the critical illness, prognosis for resolution of CIRCI and hydrocortisone dependence is very good.

Original languageEnglish (US)
Pages (from-to)107-112
Number of pages6
JournalJournal of Veterinary Emergency and Critical Care
Issue number1
StatePublished - Jan 1 2015
Externally publishedYes


  • Glucocorticoid
  • Hydrocortisone
  • Relative adrenal insufficiency
  • Septic shock

ASJC Scopus subject areas

  • veterinary(all)


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