| Title | Use of a Low-Dose ACTH Stimulation Test for Diagnosis of Hypoadrenocorticism in Dogs. | | Author(s) | Lathan P, Moore GE, Zambon S, Scott-Moncrieff JC | | Institution | Purdue University School of Veterinary Medicine, West Lafayette, IN, USA. | | Source | J Vet Intern Med 2008 Jun 3. | | Abstract | Background: Although definitive diagnosis of hypoadrenocorticism usually is made by an adrenocorticotrophic hormone (ACTH) stimulation test using 250 mug/dog of synthetic ACTH (cosyntropin/tetracosactrin), increased costs have prompted a search for less-expensive diagnostic methods. Hypothesis: A low-dose ACTH stimulation test (5 mug/kg) will distinguish between dogs with nonadrenal illness and hypoadrenocorticism. Additionally, administration of cosyntropin will not affect the results of another ACTH stimulation test performed 24 hours later. Animals: Eight healthy adult dogs and 29 hospitalized dogs with suspected hypoadrenocorticism.
Methods: In this prospective study, each healthy dog received 4 ACTH stimulation tests. Dogs received either 5 mug/kg or 250 mug/dog of cosyntropin on day 1 and the alternate dose on day 2. The opposite dosing sequence was used after a 2-week washout period (days 15 and 16). Dogs with suspected Addison's disease received 2 ACTH stimulation tests, 24 hours apart, using either a dose of 5 mug/kg cosyntropin or 250 mug/dog on the 1st day and the alternate dose on the 2nd day.
Results: In healthy dogs, poststimulation cortisol concentrations on days 2 and 16 and days 1 and 15 were equivalent (90% confidence interval [CI]: 86.7-101.2%). In dogs with suspected Addison's disease, mean (+/-SD) cortisol responses to ACTH in the 5 mug/kg dose (16.2+/-7.7 mug/dL) and 250 mug/dog dose (15.9+/-6.3 mug/dL) were statistically equivalent (90% CI: 91.2-105.4%). Conclusions and Clinical Importance: Low-dose ACTH stimulation testing distinguishes between dogs with nonadrenal illness and hypoadrenocorticism. Additionally, the administration of 2 ACTH stimulation tests on consecutive days does not affect results of the second test. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 18537878 |
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