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Her cardiac enzymes revealed a CKMB fraction of 3.4 units/L and a troponin I of 0.16 ng/mL (ref range 0.00 to 0.04).
Additional abnormalities found at initial presentation included thrombocytosis (527 K/μL, ref range 175 500 K/μL) and isosthenuria (1.007, ref range 1.015-1.050).
Baseline labs revealed DHEA-S level of 63 (ref range: 15-170).
In-house assessment of ALT activity was significantly high (2620 U/L, ref range 10 100 U/L).
Both prothrombin time (PT) and partial thromboplastin time (PTT) were significantly prolonged at 41 sec and >300 sec, respectively (ref range 11 17 s and 72 102 s).
Serum biochemical abnormalities included high alkaline phosphatase (ALP) (414 U/L, reference (ref) range 23 212 U/L) and alanine aminotransferase (ALT) (>1000 U/L, ref range 10 100 U/L) activities (Table 1) and subsequently, the dog was referred to Red Bank Veterinary Hospital (RBVH) (New Jersey) for an abdominal ultrasound.
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Autoantibody testing revealed positive cANCA (1280; ref. range <5) and PR-3 ANCA antibody titres (1587 U/mL; ref. range <10 U/mL).
Urinary free cortisol was extremely high (1024.8 μg/24 hr, ref. range 30 110) and plasma ACTH was relatively low (16 pg/ml, ref. range 0 46).
An endocrinological evaluation revealed elevated morning plasma cortisol (31 μg/dl, ref. range 5 25), and overnight dexamethasone (1 mg) failed to suppress plasma level of cortisol.
In addition, her testosterone level rose to 98 ng/dL (ref. range 14 76) with normal LH, FSH, prolactin and estradiol.
Method detection limits [determined according to methods specified in ref (32)] ranged from 0.011 to 0.076 μg/L (Table 1).
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