Peer-reviewed veterinary case report
Best ways to monitor trilostane treatment in dogs with high cortisol
By Golinelli, Stefania et al.·Published in Journal of veterinary internal medicine·2021·Department of Veterinary Medical Science, Italy·View original on PubMed →
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Original publication title: Comparison of methods to monitor dogs with hypercortisolism treated with trilostane.
- Species:
- dog
Plain-English summary
A group of 45 dogs with hypercortisolism (a condition causing excessive cortisol) were treated with a medication called trilostane. Researchers looked at various tests to see which ones best indicated how well the treatment was working. They found that measuring haptoglobin levels in the blood was particularly helpful, as it correctly identified 90% of dogs that were well-controlled on the medication. Other tests, like alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT), also provided useful information about treatment effectiveness. These findings can help veterinarians better monitor dogs with this condition.
People also search for: dog hypercortisolism treatment · trilostane for dogs · dog blood test results interpretation
Abstract
BACKGROUND: The use of adrenocorticotropic hormone stimulation test as method to monitor efficacy of trilostane treatment of hypercortisolism (HC) in dogs has been questioned. OBJECTIVES: To evaluate and compare 12 methods with which to monitor efficacy of trilostane treatment in dogs with HC. ANIMALS: Forty-five client-owned dogs with HC treated with trilostane q12h. METHODS: Prospective cross-sectional observational study. The dogs were categorized as well-controlled, undercontrolled, and unwell through a clinical score obtained from an owner questionnaire. The ability to correctly identify trilostane-treatment control of dogs with HC with the following variables was evaluated: before trilostane serum cortisol (prepill), before-ACTH serum cortisol, post-ACTH serum cortisol, plasma endogenous ACTH concentrations, prepill/eACTH ratio, serum haptoglobin (Hp) concentration, serum alanine aminotransferase (ALT), gamma-glutamyl transferase (γGT) and alkaline phosphatase activity, urine specific gravity, and urinary cortisol : creatinine ratio. RESULTS: Ninety-four re-evaluations of 44 dogs were included; 5 re-evaluations of 5 unwell dogs were excluded. Haptoglobin was significantly associated with the clinical score (P < .001) and in the receiver operating characteristic analysis, Hp cutoff of 151 mg/dL correctly identified 90.0% of well-controlled dogs (specificity) and 65.6% of undercontrolled dogs (sensitivity). Alanine aminotransferase (P = .01) and γGT (P = .009) were significantly higher in undercontrolled dogs. Cutoff of ALT and γGT greater than or equal to 86 U/L and 5.8 U/L, respectively, were significantly associated with poor control of HC by trilostane. CONCLUSIONS AND CLINICAL IMPORTANCE: Of all the 12 variables, Hp, and to a lesser degree ALT and γGT, could be considered additional tools to the clinical picture to identify well-controlled and undercontrolled trilostane-treated dogs.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/34672018/