Diurnal ACTH and plasma cortisol variations in healthy dogs and in those with pituitary-dependent Cushing’s syndrome before and after treatment with retinoic acid

Castillo, V.; Blatter, M.F. Cabrera; Gomez, Nestor A.; Sinatra, V.; Gallelli, María Florencia; Ghersevich, María Carolina

doi:10.1016/j.rvsc.2008.06.006

Cited by 28 publications

(17 citation statements)

References 43 publications

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“…Canine ACTH is secreted from the pituitary gland in an episodic, pulsatile fashion in healthy dogs and those with PDH . A circadian rhythm has not been convincingly demonstrated, although 1 study reported higher plasma cACTH concentrations in late afternoon than in the morning . Concentrations of cACTH do not differ between healthy dogs and those with PDH, and its measurement is not useful to screen for HAC .…”

Section: Differentiating Testsmentioning

confidence: 93%

Diagnosis of Spontaneous Canine Hyperadrenocorticism: 2012 ACVIM Consensus Statement (Small Animal)

Behrend

Kooistra

Nelson

et al. 2013

Veterinary Internal Medicne

198

333

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Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) provide the veterinary community with up-to-date information on the pathophysiology, diagnosis, and treatment of clinically important animal diseases. The ACVIM Board of Regents oversees selection of relevant topics, identification of panel members with the expertise to draft the statements, and other aspects of assuring the integrity of the process. The statements are derived from evidence-based medicine whenever possible and the panel offers interpretive comments when such evidence is inadequate or contradictory. A draft is prepared by the panel, followed by solicitation of input by the ACVIM membership which may be incorporated into the statement. It is then submitted to the Journal of Veterinary Internal Medicine, where it is edited prior to publication. The authors are solely responsible for the content of the statements. This report offers a consensus opinion on the diagnosis of spontaneous canine hyperadrenocorticism. The possibility that a patient has hyperadrenocorticism is based on the history and physical examination. Endocrine tests should be performed only when clinical signs consistent with HAC are present. None of the biochemical screening or differentiating tests for hyperadrenocorticism are perfect. Imaging can also play a role. Awareness of hyperadrenocorticism has heightened over time. Thus, case presentation is more subtle. Due to the changes in manifestations as well as test technology the Panel believes that references ranges should be reestablished. The role of cortisol precursors and sex hormones in causing a syndrome of occult hyperadrenocorticism remains unclear. Diagnosis of Spontaneous

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Section: Differentiating Testsmentioning

confidence: 93%

Diagnosis of Spontaneous Canine Hyperadrenocorticism: 2012 ACVIM Consensus Statement (Small Animal)

Behrend

Kooistra

Nelson

et al. 2013

Veterinary Internal Medicne

198

333

View full text Add to dashboard Cite

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“…Methods of evaluating stress levels in canine and human patients include the measurement of elements of the hypothalamic-pituitary-adrenal (HPA) axis or sympatho-medullary-adrenal (SAM) axis; most commonly, cortisol concentrations are examined (Castillo et al, 2009; Kobelt et al, 2003). Salivary cortisol concentrations have been shown to closely parallel plasma cortisol concentrations, and can be collected less invasively (Beerda et al, 1996; Hellhammer et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Salivary cortisol concentrations and behavior in a population of healthy dogs hospitalized for elective procedures

Hekman

Karas

Dreschel

2012

Applied Animal Behaviour Science

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Identification of severe stress in hospitalized veterinary patients may improve treatment outcomes and welfare. To assess stress levels, in Study 1, we collected salivary cortisol samples and behavioral parameters in 28 healthy dogs hospitalized prior to elective procedures. Dogs were categorized into two groups; low cortisol (LC) and high cortisol (HC), based on the distribution of cortisol concentrations (< or ≥ 0.6 µg/dL). We constructed a stress research tool (SRT) based on three behaviors, (head resting, panting and lip licking) that were most strongly related to salivary cortisol concentrations. In Study 2, we collected salivary cortisol samples from 39 additional dogs, evaluated behavior/cortisol relationships, assigned each dog to an LC or HC group, and tested the ability of the SRT to predict salivary cortisol. Median (interquartile range) salivary cortisol concentrations were not different between Study 1 (0.43 µg/dL, 0.33 to 1.00 µg/dL) and Study 2 dogs (0.41 µg/dL, 0.28 to 0.52 µg/dL). The median salivary cortisol concentration was significantly lower (P ≤ 0.001) in LC versus HC dogs in each study; (Study 1 LC: 0.38 µg/dL, (0.19 to 0.44), n = 19, HC: 2.0 µg/dL, (1.0 to 2.8), n = 9, and Study 2 LC: 0.35 µg/dL, (0.25 to 0.48), n = 28, HC: 0.89 µg/dL, (0.66 to 1.4), n = 7). In Study 1, three behaviors were found to be associated with salivary cortisol concentrations. Duration of head resting was negatively associated with salivary cortisol (ρ = −0.60, P = 0.001), panting and lip licking were positively associated with cortisol (ρ = 0.39, P = 0.04, and 0.30, P = 0.05, respectively), Head resting (p = 0.001) and panting (p = 0.003) were also associated with LC/HC group assignment. In Study 2 dogs, the three behaviors correlated (but not significantly) with salivary cortisol concentration; of the three, only head resting was significantly associated with LC/HC group assignment (P = 0.03). The SRT derived from Study 1 was effective at prediction of salivary cortisol concentrations when applied to 20 min but not 2 min of behavioral data from Study 2. Additionally, we note that dexmedetomidine and butorphanol sedation more than 6 h prior to measurement was found to be significantly (P = 0.05) associated with lower salivary cortisol concentrations when compared to unsedated dogs. Our work offers support for eventual construction of a rating tool that utilizes the presence or absence of specific behaviors to identify higher salivary cortisol concentrations in dogs subjected to hospitalization, which may be tied to greater psychogenic stress levels. Future work to investigate the effects of stress on dogs and its mitigation in clinical situations may be approached by studying a combination o f parameters, and should consider the possible beneficial effects of sedatives.

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“…16,[47][48][49][50] The samples studied here were ob-tained in the course of consultations during the morning and afternoon. The interest of clinicians in a diagnostic technique depends not only on its accuracy, but also on the practicality of the technique.…”

mentioning

confidence: 99%

Accuracy of an Adrenocorticotropic Hormone (ACTH) Immunoluminometric Assay for Differentiating ACTH‐Dependent from ACTH‐Independent Hyperadrenocorticism in Dogs

Piñeiro

Benchekroun

Fornel-Thibaud

et al. 2009

Veterinary Internal Medicne

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Background: Adrenocorticotropic hormone (ACTH) determination has been used for 30 years to distinguish ACTHdependent hyperadrenocorticism (ADHAC) from ACTH-independent hyperadrenocorticism (AIHAC) in dogs. However, the few studies that have evaluated its diagnostic accuracy, based in the majority of cases on older assays, have been associated with systematic, but highly variable proportions of misclassified or unclassified cases.Objective: The purpose of the present study is to evaluate the accuracy of a validated ACTH immunoluminometric assay (ILMA) for differentiating between ADHAC and AIHAC.Animals: One hundred and nine dogs with hyperadrenocorticism were included: 91 with ADHAC and 18 with AIHAC. Methods: Retrospective study. Dogs displaying feedback inhibition after the dexamethasone suppression test, adrenal symmetry, or both were considered to have ADHAC. AIHAC was demonstrated by adrenal tumor histology. For each group, ACTH determination by ILMA was reviewed.Results: In the ADHAC group, plasma ACTH measurements ranged between 6 and 1250 pg/mL (median, 30 pg/mL). In the AIHAC group, all ACTH concentrations were below the lower quantification limit of the assay (o5 pg/mL). The 95% confidence interval was 85-100% for sensitivity and 97-100% for specificity in AIHAC diagnosis.Conclusion and Clinical Importance: No overlap in ACTH concentrations was observed between dogs with ADHAC and dogs with AIHAC. The use of a new technique with high analytical sensitivity made it possible to use a low threshold (5 pg/mL), avoiding the misclassification of some ADHAC cases with low, but quantifiable concentrations of ACTH. The assessment of ACTH concentrations by ILMA is an accurate tool for differentiating between ADHAC and AIHAC.

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Diurnal ACTH and plasma cortisol variations in healthy dogs and in those with pituitary-dependent Cushing’s syndrome before and after treatment with retinoic acid

Cited by 28 publications

References 43 publications

Diagnosis of Spontaneous Canine Hyperadrenocorticism: 2012 ACVIM Consensus Statement (Small Animal)

Diagnosis of Spontaneous Canine Hyperadrenocorticism: 2012 ACVIM Consensus Statement (Small Animal)

Salivary cortisol concentrations and behavior in a population of healthy dogs hospitalized for elective procedures

Accuracy of an Adrenocorticotropic Hormone (ACTH) Immunoluminometric Assay for Differentiating ACTH‐Dependent from ACTH‐Independent Hyperadrenocorticism in Dogs

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