Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration
Abstract Background Dogs with eunatremic, eukalemic hypoadrenocorticism (EEH) typically show signs of chronic gastrointestinal disease (CGD). Previous glucocorticoid administration (PGA) can give false‐positive results on the ACTH stimulation test (ACTHst). Hypothesis/Objectives To determine the pre...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16921 |
| _version_ | 1797349544143355904 |
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| author | Antonio Maria Tardo Francesca Del Baldo Rodolfo Oliveira Leal Giorgia Galiazzo Marco Pietra Alba Gaspardo Federico Fracassi |
| author_facet | Antonio Maria Tardo Francesca Del Baldo Rodolfo Oliveira Leal Giorgia Galiazzo Marco Pietra Alba Gaspardo Federico Fracassi |
| author_sort | Antonio Maria Tardo |
| collection | DOAJ |
| description | Abstract Background Dogs with eunatremic, eukalemic hypoadrenocorticism (EEH) typically show signs of chronic gastrointestinal disease (CGD). Previous glucocorticoid administration (PGA) can give false‐positive results on the ACTH stimulation test (ACTHst). Hypothesis/Objectives To determine the prevalence of EEH in dogs with signs of CGD, and to identify clinical and clinicopathological features for EEH and PGA. Animals One hundred twelve dogs with CGD (101 non‐PGA and 11 PGA), 20 dogs with EEH. Methods Multicenter prospective cohort study. Basal serum cortisol (BSC) concentration was measured in dogs with signs of CGD. When BSC was <2 μg/dL and in PGA dogs, ACTHst plus measurement of endogenous ACTH (eACTH) were performed. Records of dogs with EEH from 2009 to 2021 were reviewed. Results The BSC concentration was <2 μg/dL in 48/101 (47.5%) non‐PGA and in 9/11 (82%) PGA dogs. EEH was diagnosed in 1/112 dog (prevalence 0.9%; 95% CI, 0.1%‐4.8%); the ACTHst provided false‐positive results in 2/11 PGA dogs. PGA dogs showed lower C‐reactive protein‐to‐haptoglobin ratio (median 0.01, range 0.003‐0.08; P = .01), and higher haptoglobin (140, 26‐285 mg/dL; P = .002) than non‐PGA dogs (0.04, 0.007‐1.5; 38.5, 1‐246 mg/dL, respectively). eACTH was higher (P = .03) in EEH (396, 5‐>1250 pg/mL) than in non‐PGA dogs (13.5, 7.3‐46.6 pg/mL). Cortisol‐to‐ACTH ratio was lower (P < .0001 and P = .01, respectively) in EEH (0.002, 0.0002‐0.2) than in non‐PGA (0.1, 0.02‐0.2) and PGA dogs (0.1, 0.02‐0.2). Conclusions and Clinical Importance The prevalence of EEH in dogs with signs of CGD was lower than previously reported. The clinical and clinicopathological features herein identified could increase the index of suspicion for EEH or PGA in dogs with an unclear history of glucocorticoid administration. |
| first_indexed | 2024-03-08T12:31:47Z |
| format | Article |
| id | doaj.art-f29b06705ae346acaf87d3875c5f7392 |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-03-08T12:31:47Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-f29b06705ae346acaf87d3875c5f73922024-01-22T02:05:50ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762024-01-013819310110.1111/jvim.16921Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administrationAntonio Maria Tardo0Francesca Del Baldo1Rodolfo Oliveira Leal2Giorgia Galiazzo3Marco Pietra4Alba Gaspardo5Federico Fracassi6Department of Veterinary Medical Sciences University of Bologna, Ozzano dell'Emilia Bologna ItalyDepartment of Veterinary Medical Sciences University of Bologna, Ozzano dell'Emilia Bologna ItalyCIISA – Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine University of Lisbon Lisbon PortugalDepartment of Veterinary Medical Sciences University of Bologna, Ozzano dell'Emilia Bologna ItalyDepartment of Veterinary Medical Sciences University of Bologna, Ozzano dell'Emilia Bologna ItalyDepartment of Veterinary Medical Sciences University of Bologna, Ozzano dell'Emilia Bologna ItalyDepartment of Veterinary Medical Sciences University of Bologna, Ozzano dell'Emilia Bologna ItalyAbstract Background Dogs with eunatremic, eukalemic hypoadrenocorticism (EEH) typically show signs of chronic gastrointestinal disease (CGD). Previous glucocorticoid administration (PGA) can give false‐positive results on the ACTH stimulation test (ACTHst). Hypothesis/Objectives To determine the prevalence of EEH in dogs with signs of CGD, and to identify clinical and clinicopathological features for EEH and PGA. Animals One hundred twelve dogs with CGD (101 non‐PGA and 11 PGA), 20 dogs with EEH. Methods Multicenter prospective cohort study. Basal serum cortisol (BSC) concentration was measured in dogs with signs of CGD. When BSC was <2 μg/dL and in PGA dogs, ACTHst plus measurement of endogenous ACTH (eACTH) were performed. Records of dogs with EEH from 2009 to 2021 were reviewed. Results The BSC concentration was <2 μg/dL in 48/101 (47.5%) non‐PGA and in 9/11 (82%) PGA dogs. EEH was diagnosed in 1/112 dog (prevalence 0.9%; 95% CI, 0.1%‐4.8%); the ACTHst provided false‐positive results in 2/11 PGA dogs. PGA dogs showed lower C‐reactive protein‐to‐haptoglobin ratio (median 0.01, range 0.003‐0.08; P = .01), and higher haptoglobin (140, 26‐285 mg/dL; P = .002) than non‐PGA dogs (0.04, 0.007‐1.5; 38.5, 1‐246 mg/dL, respectively). eACTH was higher (P = .03) in EEH (396, 5‐>1250 pg/mL) than in non‐PGA dogs (13.5, 7.3‐46.6 pg/mL). Cortisol‐to‐ACTH ratio was lower (P < .0001 and P = .01, respectively) in EEH (0.002, 0.0002‐0.2) than in non‐PGA (0.1, 0.02‐0.2) and PGA dogs (0.1, 0.02‐0.2). Conclusions and Clinical Importance The prevalence of EEH in dogs with signs of CGD was lower than previously reported. The clinical and clinicopathological features herein identified could increase the index of suspicion for EEH or PGA in dogs with an unclear history of glucocorticoid administration.https://doi.org/10.1111/jvim.16921Addison's diseaseatypical hypoadrenocorticismcaninechronic enteropathycortisol |
| spellingShingle | Antonio Maria Tardo Francesca Del Baldo Rodolfo Oliveira Leal Giorgia Galiazzo Marco Pietra Alba Gaspardo Federico Fracassi Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration Journal of Veterinary Internal Medicine Addison's disease atypical hypoadrenocorticism canine chronic enteropathy cortisol |
| title | Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration |
| title_full | Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration |
| title_fullStr | Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration |
| title_full_unstemmed | Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration |
| title_short | Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration |
| title_sort | prevalence of eunatremic eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration |
| topic | Addison's disease atypical hypoadrenocorticism canine chronic enteropathy cortisol |
| url | https://doi.org/10.1111/jvim.16921 |
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