Hydrocortisone therapy in a cat with vasopressor-refractory septic shock and suspected critical illness-related corticosteroid insufficiency

Pisano, Simone R. R.; Howard, Judith; Posthaus, Horst; Kovacevic, Alan; Yozova, Ivayla D.

Previous reports of treatment of suspected CIRCI in veterinary medicine include a dog with hydrocortisoneresponsive septic shock [17] and a cat with polytraumarelated hypotension responsive to intravenous dexamethasone [18] . Additionally, one abstract reports a prospective blinded placebo-controlled study in eight dogs treated with either hydrocortisone or an equivalent volume of saline, but results were inconclusive due to the small number of dogs enrolled [19] . While intermittent and CRI administration of hydrocortisone appear to be equally effective in people with CIRCI, dexamethasone is not recommended due to its prolonged suppression of the HPA axis [4] . Although different hydrocortisone treatment regimens have been reported in both veterinary and human medicine [3, 4, 9, 10, 20] , the ultimate goal of therapy is to provide doses of hydrocortisone adequate for the needs of the patient. The cat in the present report was treated with a dose suggested in both human [4] and veterinary literature [21] , as evidence-based therapeutic guidelines for cats are lacking.