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Hydrocortisone CRI vs dexamethasone in canine adrenal crisis — what does the evidence support?
VETSIDE
## Clinical Direction
Use hydrocortisone CRI at 0.5–0.625 mg/kg/h IV alongside fluid resuscitation. Outcomes equivalent to dexamethasone — HC provides balanced gluco- and mineralocorticoid activity. [doi:10.1111/jvim.17017]
## Evidence Basis
Rule out dexamethasone if ACTH stim is pending — HC does not interfere with the cortisol assay. [doi:10.1111/jvim.17017]
Monitor sodium closely — rapid shifts occurred in 30% of cases. [doi:10.1111/jsap.12473]
## Caveats
Clinical interpretation: CRI may increase monitoring burden — weigh against resource availability before choosing over bolus dosing.
📚
JVIM 2023
📚
JSAP 2015
🌐
PMC 2024
40K+ peer-reviewed articles
4s to first response
40,000+ peer-reviewed articles
28 veterinary journals
Strength-scored sources
12-month conversation memory
Built by a DACVECC
SEE WHAT A VETSIDE ANSWER LOOKS LIKE

A real question. A real answer.

This is an actual Vetside response to a real clinical query. Every citation below links to a verified DOI.

Try your own question
Clinical query

“How to treat non-cardiogenic pulmonary oedema in a dog”

Response in 4.2s

Every citation in this response links to a real peer-reviewed DOI. This is not a demonstration — it is the actual output from Vetside.

VETSIDE 3.9s
## Clinical Direction

Prioritise removal of the inciting cause alongside supplemental oxygen titrated to severity. Escalate to HFNC early if COT response is insufficient within 1–2 hours. Furosemide is not a cornerstone — used in only 40% of cases and not routinely indicated. [doi:10.2460/javma.25.02.0118] [doi:10.1111/vec.13290]

## Evidence Basis

Rule out cardiogenic cause first — NCPE pathophysiology is distinct, arising from altered vascular permeability, neurologic disease, airway obstruction, or ARDS. [doi:10.1111/vec.13278]

Assess for upper airway obstruction — the most common identified cause, accounting for 45% of cases. [doi:10.1111/vec.13290]

Consider HFNC over COT if no improvement at 1–2h — significantly better RR, SpO₂, and dyspnoea scores at 24h. [doi:10.2460/javma.25.02.0118]

Do not use furosemide routinely — only 40% of cases received it; risk of worsening hypovolaemia in neurogenic or permeability-driven oedema. [doi:10.1111/vec.13290]

Escalate to MV only if refractory — only 33% of ventilated dogs survived to discharge; MV is the only parameter significantly associated with mortality (P=0.03). [doi:10.1111/vec.13290]

## Caveats & Gaps

Evidence is largely retrospective; the largest cohort included only 31 animals. [doi:10.1111/vec.13290] HFNC data are from a single retrospective study with no RCT. [doi:10.2460/javma.25.02.0118] Clinical interpretation: furosemide may be appropriate where post-obstructive or hydrostatic components are suspected — but routine use risks worsening hypovolaemia in permeability-driven oedema.

## Comparison Table
Option Key advantage Limitation
COT Widely available, standard of care May be insufficient moderate-severe
HFNC Better RR, SpO₂, dyspnoea at 24h Single retrospective study, no RCT
Mechanical ventilation Rescue for refractory hypoxaemia 33% survival; strongly predicts mortality
Furosemide Useful in select post-obstructive cases Not indicated in permeability-driven NCPE
## Next Questions
At what SpO₂ or dyspnoea threshold should HFNC be initiated vs escalating to MV? ↗
Is the underlying cause identified — post-obstructive, neurogenic, or ARDS — as this determines furosemide vs sympatholytics vs cause-directed therapy? ↗
Sources
📚
CORPUS NCPE management retrospective cohort
2022 · UAO most common cause (45%); survival 74%; MV predicts mortality
88% match
↗
📚
CORPUS HFNC vs COT in canine NCPE
2025 · HFNC superior RR, SpO₂, dyspnoea score at 24h
76% match
↗
📚
CORPUS Non-cardiogenic pulmonary oedema — aetiology
2021 · Pathophysiology review; permeability vs hydrostatic mechanisms
61% match
↗
🌐
WEB Neurogenic pulmonary oedema — Frontiers Vet Sci
Post-seizure NCPE may resolve with cause-directed therapy alone…
43% match
↗
STRENGTH-OF-RECOMMENDATION SCORING

Not every citation carries the same weight. Vetside tells you which ones do.

Every source in a Vetside answer is scored for relevance to your specific clinical question. Weak matches look weak. Strong matches look strong. You know at a glance how much to trust each piece of evidence.

📚
CORPUS
NCPE retrospective cohort study
JVECC 2023
UAO most common cause (45%); survival 74%; MV the only parameter significantly associated with mortality. Median duration of hospitalization was 48 hours.
Strength of recommendation 88%
Strong match
📚
CORPUS
Cardiogenic pulmonary oedema review
JVIM 2021
Pathophysiology and treatment of cardiogenic pulmonary oedema — overlapping mechanisms but distinct management approach.
Strength of recommendation 54%
Moderate match
📚
CORPUS
Pulmonary physiology — textbook chapter
Vet Internal Medicine 2019
General pulmonary physiology reference — broad background context, not specific to NCPE presentation or management.
Strength of recommendation 28%
Weak match — not cited
How we score it

An algorithm analyses each search result passes for best available evidence to help you make informed decisions. The score reflects how well the article answers your specific question — not the type of the study. A case report that matches your scenario can outrank a meta-analysis that doesn’t.

What the score means
70–100% · Strong match · cited in response
40–69% · Moderate match · cited with context
Below 40% · Weak match · cited with caveats or discarded
STAY IN THE LOOP

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Every conversation is saved to your private history. Follow-up questions build on the same evidence — so you can narrow down, dive deeper, or switch direction without losing context. Pro users keep 12 months of searchable history.

1
Day 1 · 3:14am
Hydrocortisone CRI in canine Addisonian crisis — dose and monitoring?
VETSIDE
Use HC CRI at 0.5–0.625 mg/kg/h IV. Monitor sodium every 4–6h — rapid shifts in 30% of cases. [doi:10.1111/jvim.17017]
Initial query. Full retrieval runs — 40K articles searched, top 10 reranked, response synthesised.
→
2
Still in session · 3:19am
What sodium correction rate should I target?
VETSIDE
Target <12 mmol/L over 24h. In this case the initial Na was critically low — consider slowing or stopping the CRI if rate exceeds target.
Same context · no re-search
Follow-up builds on the same retrieved evidence. No new retrieval — faster response, consistent context.
→
3
Two weeks later
History
Hydrocortisone CRI in Addisonian crisis
3 messages · 2 weeks ago
→
Same dog is back — when do I transition to oral prednisolone?
Pro users can reload any past session and continue the conversation months later.
Pro users: your conversations are indexed and searchable.
Find the case you worked on three months ago in two keystrokes. 12 months of history, fully searchable.
See Pro features →
HOW IT WORKS

Vetside doesn’t just ask an AI. It searches, analyses, and synthesises.

Vetside is not a AI chatbot. Here is what happens in the four seconds between your question and the first word of the answer.

01
Keywords
Breaks down your question into keywords that capture its meaning and intent.
02
Search
An advanced search algorithm scans online repositories and trusted sources on the internet.
03
Analyse
Every article is analyzed for its relevance to your specific question and given a score
04
Respond
Organizes the evidence into a structured clinical response with direct links to the cited sources.
The citation guarantee

Not published. Not cited.

Vetside is an algorithm at its core. An AI chatbot will invent citations. Vetside cannot. Every citation must come from an article that was actually sourced, scored, and analysed programmatically. If an article wasn’t found, it can’t be cited.

No reference, no response
If supporting evidence is not published – Vetside will not make up its own answer.
No hallucinations
Verify the response. Click on any citation and it opens the actual peer-reviewed article.
Evidence analysis
Evidence strength, gaps, and limitations are included in every response.
COMPARE

ChatGPT. Vet AI tools. PubMed. Google Scholar.
Here’s what changes.

Vetside is specifically designed to pass the 3AM emergency shift test. And the ‘outside my specialty’ patient in your care test. And the ‘can’t remember this’, ‘am I missing something?’, ‘got to look it up’, ‘is there anything else we can do’, when you only have 2 spare minutes tests.

ChatGPT OpenVet PrimVeterinary Literature
review
Specialist-grade Vetside
Evidence source Training datano live retrieval Sources + Advisory Boardunknown Sources + Advisory BoardWiley · Elsevier Your own search30–60 min 40K+ peer-reviewed journals + Trusted internet sourcesupdated monthly
Citations ✕frequently hallucinated ✓ includes textbooks ~mostly textbooks ✓if you have them ✓DOI-linked · peer-reviewed only
Currency of evidence Training cutoff Unknownrecent textbook edn Unknownrecent textbook edn Depends on you Includes last months’ papers
Structured clinical direction ✕ ~protocol tables ~protocol tables ✕you synthesise ✓direction · protocol · evidence · caveats
Evidence quality flagged ✕ ✓method not disclosed ✕ ~if you assess it ✓explicit caveats section
Veterinary Specialists ✕ ✕advisory board only ✕advisory board only — ~DACVECC founder
Who can learn anyone gatedID required gatedvet license required — ✓anyone
WHY A VET SPECIALIST BUILT THIS
“Every existing tool missed something I actually needed at 3am.

ChatGPT hallucinates. Other vet AI tools give responses are too vague and lack depth. Textbooks take time to find and search through. What I wanted was a colleague who had read every paper, was available at 3am, and could tell me — with the evidence — what to do. So I built one.

HY
Hamsini Yagneswar
DACVECC · MRCVS · Founder, Vetside
Read the founder story →
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OUR EVIDENCE BASE

40,000+ articles. 31+ journals.
Updated monthly.

For every answer, Vetside conducts a curated search for peer-reviewed veterinary literature and trusted online sources. These sources are updated every month.

40K+
peer-reviewed articles
31
veterinary journals
30d
indexing lag for new articles
Evidence drawn from
J Vet Intern Med J Am Vet Med Assoc J Small Anim Pract Vet Rec J Vet Emerg Crit Care Front Vet Sci Vet Radiol Ultrasound J Vet Pharmacol Ther Vet Anaesth Analg J Feline Med Surg BMC Vet Res Vet Surg J Vet Cardiol Vet Dermatol J Vet Diagn Invest Vet Comp Oncol Aust Vet J J Am Anim Hosp Assoc Vet Clin Pathol Vet Pathol Vet Ophthalmol J Vet Dent J Vet Med Sci Vet J Vet Res Vet Comp Orthop Traumatol Top Companion Anim Med Am J Vet Res Vet Clin North Am In Pract
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Common questions

What counts as a query?

Each new question you send. It is counted only if you get a response. If that fails. – it isn’t counted against your total.

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