According to the 2012 American College of Veterinary Internal Medicine (ACVIM) consensus statement on canine hyperadrenocorticism: --Only the use of synthetic ACTH (Cosyntropin) is recommended, whereas the utilization of compounded ACTH ("gel") is discouraged due to lower purity and lower quality control. --Acceptable doses for Cosyntropin are 5 µg/kg or 250 µg/dog IV or IM (lower doses than 5 µg/kg have never been validated in Cushing dogs), and 2.2 U/kg IM for compounded ACTH. --Using Cosyntropin, the cortisol peak occurs 60 - 90 minutes post injection, with no significant difference between 60 and 90 minutes. --Using compounded ACTH ("gel"), cortisol concentrations are similar across various compounded ACTH products (and to the gold standard Cosyntropin 5 µg/kg IV) at 60 minutes post injection, whereas cortisol concentrations vary considerably at later times.
Remove from red cells and place sample in an additive free transport tube.