For endogenous ACTH determination, be sure to separate the plasma from the blood cells when using the special aprotinin tubes provided by Antech. Aprotinin use avoids the necessity to freeze the sample for accurate results; it does not replace the need for centrifugation to separate the plasma.

Patients admitted in acute bleeding crisis may have coagulation screening test values (PT, PTT) within upper normal ranges or only slightly elevated because of stress increase in the fibrinogen and other acute-phase procoagulants. Thus, diagnosis of coagulopathy may be misleading or overlooked. Patient history (age, sex, neuter status, family, breed, current or prior events, toxin or drug exposures) and nature of bleeding (hematomas, mucosal surfaces, petechiae) are of primary concern. Once bleeding is con- trolled and resolved, a repeat coagulation profile is advised.