Adrenal Hemorrhage: A Rare Complication of the ACTH Stim Test

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This article discusses a rare, but potential, complication of ACTH stim testing—adrenal hemorrhage. Although the ACTH stim test is generally safe and does not cause adverse reactions for most dogs, it’s worth being aware of this potential risk and its symptoms.

Background

Adrenal hemorrhage is a term used to describe bleeding from a ruptured blood vessel of the adrenal glands. In 2023, the American Veterinary Medical Association (AVMA) published a report about a Beagle who experienced adrenal hemorrhage following an ACTH stim test. This was thought to be caused by a rare reaction to tetracosactide (also known as cosyntropin) injection used for testing.

Symptoms

A dog with adrenal hemorrhage will display symptoms such as vomiting, lethargy, abdominal pain, and fever. In cases of hemorrhage following an ACTH stim test, these symptoms will usually appear within a few hours after testing.

Treatment

Adrenal hemorrhage is a potentially life-threatening condition that needs to be treated by a veterinarian. The Beagle in the case report was managed with analgesia, IV fluids, and corticosteroids and made a full recovery.

Key takeaway

We want to emphasize that adrenal hemorrhage is an extremely rare reaction to the ACTH stim test. For most dogs, ACTH stim testing is a safe way to monitor cortisol levels and does not cause harmful side effects. That being said, if your dog does develop symptoms after testing, it’s important to contact a veterinarian as soon as possible. Adrenal gland hemorrhage is a serious condition that requires immediate care.

Remember: you are your dog’s best advocate.

Reference

Wyatt S, Singer L, King J. Adrenocortical hemorrhage following intravenous tetracosactide in a dog with hypercortisolism. J Am Vet Med Assoc. 2023 Nov 3;262(2):1-4.