Peer-reviewed veterinary case report
Association between post-ACTH cortisol and trilostane dosage in dogs with pituitary-dependent hypercortisolism.
- Journal:
- Domestic animal endocrinology
- Year:
- 2024
- Authors:
- Gouvêa, Fernanda Nastri et al.
- Affiliation:
- Graduate Program in Veterinary Science (PPGCVET) · Brazil
- Species:
- dog
Plain-English summary
This study looked at how the level of a hormone called cortisol after a specific test (the ACTH stimulation test) relates to the amount of a medication called trilostane needed to treat dogs with pituitary-dependent hypercortisolism (PDH), a condition where the body produces too much cortisol. The researchers found that dogs with higher cortisol levels at diagnosis were much more likely to need a higher dose of trilostane to manage their symptoms and keep cortisol levels in a healthy range. They analyzed data from 43 dogs and concluded that monitoring cortisol levels can help veterinarians determine the right trilostane dosage for effective treatment. Overall, the findings suggest that the cortisol level after the ACTH test is an important factor in deciding how much trilostane a dog will need for proper disease control.
Abstract
Trilostane is the current treatment of choice for managing pituitary-dependent hypercortisolism (PDH) in dogs. While prescribing higher initial doses may elevate the risk of iatrogenic hypocortisolism, opting for more conservative approach could result in delayed disease control, since most individuals end up requiring dosage increases. The adrenocorticotrophin stimulation test (ACTHst), a widely recognized hormonal test for assessing adrenal function, is an essential tool for monitoring the pharmacological treatment of canine hypercortisolism (CH) that can also be used for diagnostic purposes. The aim of this study was to investigate the relationship between post-ACTH cortisol (cpACTH) at PDH diagnosis and the required trilostane dose for sign control and endogenous cortisol regulation in dogs, considering a hypothesis that higher serum cpACTH concentration would necessitate a higher trilostane dosage for disease management. Data for 43 dogs with PDH had their diagnostic cpACTH recorded and correlated to the trilostane dosage necessary to control clinical signs and achieve satisfactory cortisol levels (ideally 2-7 μg/dL). The odds ratio (p=0.042) suggests that dogs with cpACTH ≥ 27 μg/dL at diagnosis are 96% more likely to need a higher trilostane dosage for achieving satisfactory control of PDH. Thus, cpACTH was found to be associated with the final trilostane dose for controlling PDH in dogs.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/39032188/