Low‐dose ACTH stimulation testing in dogs suspected of hypoadrenocorticism

Background Low‐dose ACTH stimulation testing would lower cost and may increase sensitivity for identification of partial ACTH deficiency. Hypothesis (1) The low‐dose ACTH stimulation test will provide comparable results to the standard‐dose ACTH stimulation test in dogs suspected of hypoadrenocortic...

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Bibliographic Details
Published in:	Journal of veterinary internal medicine Vol. 32; no. 6; pp. 1886 - 1890
Main Authors:	Botsford, Annabel, Behrend, Ellen N., Kemppainen, Robert J., Gaillard, Philippe R., Oprandy, Frank, Lee, Hollie P.
Format:	Journal Article
Language:	English
Published:	Hoboken, USA John Wiley & Sons, Inc 01-11-2018
Subjects:	Addison's adrenal Adrenal Insufficiency - diagnosis Adrenal Insufficiency - veterinary Adrenocorticotropic Hormone - administration & dosage Adrenocorticotropic Hormone - blood Adrenocorticotropic Hormone - pharmacology Animals cortisol cosyntropin Cosyntropin - administration & dosage Cosyntropin - pharmacology Dog Diseases - diagnosis Dogs Female Hydrocortisone - blood Male Prospective Studies Reproducibility of Results SMALL ANIMAL cortisol adrenal Addison's cosyntropin
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Summary:	Background Low‐dose ACTH stimulation testing would lower cost and may increase sensitivity for identification of partial ACTH deficiency. Hypothesis (1) The low‐dose ACTH stimulation test will provide comparable results to the standard‐dose ACTH stimulation test in dogs suspected of hypoadrenocorticism and (2) partial ACTH deficiency exists in dogs and can result in chronic, intermittent gastrointestinal signs. Animals Thirty‐one client‐owned dogs suspected of having hypoadrenocorticism. Methods Prospective study. Dogs suspected of having hypoadrenocorticism received 1 μg/kg cosyntropin IV for the first ACTH stimulation test; the second test was performed 4 h later and dogs received 5 μg/kg cosyntropin IV. Blood samples were obtained pre‐ACTH and 1 hour post‐ACTH for each dose (4 measurements total). Samples for endogenous ACTH measurement were obtained at the time of initial blood collection. Results No significant difference was observed in the basal cortisol concentration before administration of a 1 μg/kg versus before a 5 μg/kg dose of cosyntropin (P = .544). For dogs suspected of having hypoadrenocorticism, the ACTH‐stimulated cortisol concentrations in response to both doses of ACTH were equivalent (90% confidence interval [CI], 80.5‐97.2%; P = .04). No cases with partial ACTH deficiency were identified conclusively. Conclusions and Clinical Importance A 1 μg/kg dose of cosyntropin is equivalent to a 5 μg/kg dose of cosyntropin for screening dogs suspected of hypoadrenocorticism. The existence of partial ACTH deficiency was not identified in this small group of dogs.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Corrections added on 09 November 2018 after first publication: Pages 2, 3, and 5 have been updated to remove redundant text, to fix grammatical items, and update for clarity. Funding information Interdepartmental Research Grants Program, College of Veterinary Medicine, Auburn University
ISSN:	0891-6640 1939-1676
DOI:	10.1111/jvim.15256