ถูกใจ

แชร์

การอ่านผลการตรวจฮอร์โมนคอร์ติซอล

การจัดการน้ำหนักถาม-ตอบคณะที่ปรึกษาสัตวแพทย์ Meongsiljang

รวบรวมประเภทการตรวจคอร์ติซอลในสุนัขและแมว ค่าปกติ ความหมายเมื่อค่าสูงหรือต่ำ และการตรวจติดตาม เพื่อให้เจ้าของเข้าใจได้ง่าย

What Is a Cortisol Test?

A veterinarian drawing blood from a puppy.

A cortisol test is a blood test that measures the level of this stress hormone produced by the adrenal glands to help identify hormonal disorders such as Cushing’s disease and Addison’s disease. What’s truly important is that we don’t rely on a single blood cortisol level alone. Cortisol levels can fluctuate significantly depending on stress and time of day, so functional tests like the ACTH stimulation test are necessary for an accurate diagnosis. Please don’t jump to conclusions about whether your pet has a disease or not based on just one number on the results sheet.

When Should You Get Tested?

Cortisol-related hormonal disorders often develop gradually, making their symptoms easy to mistake for normal aging. If you notice any of the following signs persisting for more than two weeks, consider having your pet evaluated. - Polyuria and polydipsia: Drinking significantly more water than usual and producing larger volumes of urine - Increased appetite: Continuing to act hungry even after finishing meals - Abdominal distension: A protruding, sagging belly accompanied by muscle wasting - Hair loss and thinning skin: Symmetrical hair loss on both sides of the body with noticeably thinner skin - Lethargy and vomiting: In cases of Addison’s disease, sudden dehydration and shock can occur

Comparison of Cortisol Test Types

รายการ	기초 코티솔	ACTH 자극 검사	저용량 덱사메타손 억제 검사
목적	스크리닝	애디슨 확진·쿠싱 스크리닝	쿠싱 스크리닝
소요 시간	15분	1~2시간	8시간
채혈 횟수	1회	2회	3회
정확도	낮음	높음	매우 높음
공복 여부	필요 없음	필요	필요

수의사가 의심되는 질환과 반려동물 상태에 따라 검사를 선택해요

How to Interpret Normal Reference Ranges

Cortisol levels can vary slightly depending on the laboratory and the units used, so it’s important to review the "reference range" listed on your results sheet. Here’s how to interpret the general guidelines: - Basal cortisol: A level roughly between 2 and 6 μg/dL is considered within the normal range. - After ACTH stimulation: A level typically between 6 and 18 μg/dL is normal. If the result exceeds the upper limit of the reference range (18 μg/dL), Cushing’s disease is suspected. If it remains below the lower limit of the reference range (6 μg/dL) even after stimulation, Addison’s disease is suspected. - After dexamethasone administration: Blood is drawn 4 and 8 hours later to confirm that cortisol levels have been sufficiently suppressed below the normal reference range. According to veterinary internal medicine textbooks, the key to diagnosis lies not in a single value, but in the "pattern of change before and after the test."

A scene showing the review of cortisol test results.

Important Considerations for Interpreting Results

Do not rely on a single cortisol test to confirm a diagnosis. The stress of a vet visit alone can significantly alter baseline cortisol levels. Additionally, recent use of steroid medications—whether topical creams, inhalers, eye drops, or oral drugs—can be absorbed into the body and suppress the hypothalamic-pituitary-adrenal (HPA) axis, leading to distorted adrenal function test results. These changes caused by external steroids will only normalize once the medication is gradually tapered off, allowing the HPA axis to recover. Therefore, it is essential to inform your veterinarian about all medications used recently, including ear, skin, and eye treatments, to ensure accurate interpretation of the test results.

What Does a High Result Mean?

If cortisol levels rise excessively above the normal reference range upper limit (18 μg/dL) after ACTH stimulation, we suspect Cushing’s disease (hyperadrenocorticism). Cushing’s disease is broadly categorized into two types based on the underlying cause: - Pituitary-dependent type: A pituitary tumor overproduces ACTH, causing both adrenal glands to enlarge. - Adrenal tumor type: A tumor develops in one adrenal gland, leading to uncontrolled cortisol production. However, the ACTH stimulation test alone cannot distinguish between these two types. Because treatment options, including medication and the need for surgery, differ significantly depending on the type, further diagnostic tests such as a high-dose dexamethasone suppression test (which can identify the cause in approximately 75% of dogs) or an abdominal ultrasound are necessary to pinpoint the source.

Ultrasound examination of a dog's adrenal glands

What Does a Low Result Mean?

If cortisol levels fail to rise above the lower limit of the normal reference range (6 μg/dL) during an ACTH stimulation test, Addison’s disease (hypoadrenocorticism) should be suspected. Because Addison’s disease commonly presents with nonspecific symptoms such as vomiting, diarrhea, and lethargy, it is often mistaken for gastrointestinal illness. When accompanied by electrolyte imbalances—specifically hyperkalemia and hyponatremia—it can progress to an Addisonian crisis, a life-threatening emergency requiring immediate veterinary care with intravenous fluids and steroid therapy.

When Test Results Are in the Borderline Range

If test results fall in the borderline range between normal and abnormal, we recommend retesting in 4 to 8 weeks or conducting additional functional tests. Don’t worry over a single “equivocal” value; instead, work with your veterinarian to make a diagnosis based on a combination of clinical signs, imaging studies, and follow-up test results. Starting treatment prematurely can actually disrupt normal adrenal function.

Pre-Test Preparation and Follow-Up Care

To ensure accurate test results, please follow these guidelines: - Fasting: Withhold food for 8–12 hours before the test, but water is allowed. - Medication Review: Provide your veterinarian with a list of any steroids, anticonvulsants, or immunosuppressants your pet has taken in the past month. - Minimize Stress: Bring your pet’s familiar blanket or toys on the day of the test to help reduce stress-induced fluctuations in the results. After diagnosis, follow-up tests should be conducted every 3–6 months to adjust medication dosages as needed. For more detailed information on Cushing’s disease treatment, please refer to our Cushing’s Disease Management Guide.

สัตวแพทย์ผู้ตรวจสอบคอนเทนต์นี้

Dr. Tony — Punnawat Phongkittirak

สัตวแพทย์

สัตวแพทย์ผู้สำเร็จการศึกษาด้านสัตวแพทยศาสตร์จากมหาวิทยาลัยขอนแก่น ประเทศไทย และผ่านหลักสูตร IVSA ที่ North Carolina State University สหรัฐอเมริกา ด้วยประสบการณ์ทางคลินิกในโรงพยาบาลสัตว์ ปัจจุบันทำงานในสายงานเฮลท์แคร์สัตว์เลี้ยง และมุ่งมั่นสร้างระบบการดูแลดิจิทัลที่เชื่อมผู้เลี้ยงกับสัตวแพทย์

Frequently Asked Questions

코티솔 검사 비용은 얼마쯤 해요?

병원마다 다르지만 기초 코티솔은 비교적 저렴하고, ACTH 자극 검사는 약제비가 포함돼 더 높아요. 정확한 금액은 방문 병원에 문의해보세요.

검사 당일 바로 결과가 나와요?

원내 검사 장비가 있는 병원은 1~2시간 안에 나와요. 외부 검사실로 보내면 2~3일 걸릴 수 있어요.

고양이도 같은 방식으로 검사해요?

기본 원리는 같지만 고양이는 쿠싱이 드물고 당뇨와 동반되는 경우가 많아요. 정상 수치 범위와 해석 기준도 강아지와 조금 달라요.

검사 결과가 정상이면 완전히 안심해도 되나요?

증상이 계속되면 초기 단계일 수 있어서 4~8주 뒤 재검사를 고려해요. 호르몬 질환은 서서히 진행되기 때문에 한 번의 정상 결과가 '평생 안전'을 보장하지는 않아요.

병원 스트레스로 수치가 잘못 나올까 걱정돼요.

기초 코티솔은 영향을 받지만 ACTH 자극 검사는 투여 전후 변화폭을 보기 때문에 스트레스 영향이 훨씬 적어요. 기능 검사가 더 신뢰할 만해요.

แชร์

คอนเทนต์ที่เกี่ยวข้อง

อาการและวิธีรักษาโรคผิวหนังจากเชื้อราในสุนัข

อาการข้ออักเสบในแมวและวิธีดูแล

คู่มือขั้นตอนการผ่าตัดสะบ้าในสุนัขและการฟื้นตัว

ยาและวิธีจัดการความเจ็บปวดหลังผ่าตัดในสุนัขและแมว

วิธีอ่านผลตรวจปัสสาวะ — แปลผลภาวะเลือดในปัสสาวะ โปรตีนในปัสสาวะ และผลึกอย่างครบถ้วน

พันธุกรรมและลักษณะเด่นของแมวสามสีหรือแคลิโก — เหตุใดจึงแทบทั้งหมดเป็นเพศเมีย?

การรับมือฉุกเฉินเมื่อสัตว์เลี้ยงได้รับสารพิษ

คู่มือพื้นฐานการปฐมพยาบาลสัตว์เลี้ยง — วิธีรับมือด้วยการช่วยฟื้นคืนชีพ·ภาวะสำลัก·เลือดออก

สาเหตุและการรักษาแผลกระจกตาในแมว

อาหารอบเตาคืออะไร? ข้อดี ข้อเสีย และเกณฑ์การเลือก

เอกสารอ้างอิง

[1] Feldman EC, Nelson RW, Reusch C, Scott-Moncrieff JC. Canine and Feline Endocrinology, 4th Edition, Elsevier Saunders, 2015

[2] Ettinger SJ, Feldman EC, Cote E. Textbook of Veterinary Internal Medicine, 8th Edition, Elsevier, 2017

[3] Behrend EN et al., Diagnosis of spontaneous canine hyperadrenocorticism: 2012 ACVIM Consensus Statement, Journal of Veterinary Internal Medicine, 2013