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Patients with suspected hypercortisolism require appropriate endocrine evaluation according to Endocrine Society guidelines, typically including at least two abnormal screening tests (24-hour urinary free cortisol, late-night salivary cortisol, or low-dose dexamethasone suppression testing) before confirmatory testing and specialist referral

But such offspring are not inconceivable, and a few breeders still find off-colors among their litters

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