Adrenal hormone levels after ACTH test in dogs with Cushing's disease

Abstract

BACKGROUND: Increases of adrenal hormone concentrations other than cortisol have been reported in dogs with hyperadrenocorticism (HAC). HYPOTHESIS/OBJECTIVES: Measuring noncortisol adrenal hormone concentrations will help identify HAC in dogs. The objective was to determine plasma cortisol, androstenedione, estradiol, progesterone, testosterone, and 17-hydroxyprogesterone concentrations during ACTH stimulation testing of dogs with clinical signs of HAC to ascertain their utility in diagnosis of the disease. ANIMALS: Ninety dogs with clinical findings consistent with HAC had ACTH stimulation tests performed. Results from 29 dogs were excluded from analysis because diagnoses were inconclusive for a variety of reasons. Results from 32 dogs with HAC and 29 dogs with disease other than HAC were analyzed. METHODS: Prospective observational study. Concentrations of adrenocortical hormones were determined before and 1 hour after injecting 5 &#x3bc;g/kg ACTH IM. Diagnoses were determined by response to therapy, histopathology or both. RESULTS: Post-ACTH cortisol (P < .001), progesterone (P = .001), and 17-hydroxyprogesterone (P < .001) concentrations were associated with a diagnosis of HAC. Sensitivity and specificity, respectively, for diagnosing HAC for post-ACTH cortisol were 84 and 59%, progesterone 88 and 55%, and 17-hydroxyprogesterone 91 and 59%, and for post-ACTH cortisol, progesterone and 17-hydroxyprogesterone combined were 88 and 55%. Of 5 dogs with HAC and normal post-ACTH cortisol concentrations, 5 had increased progesterone and 4 had increased 17-hydroxyprogesterone. CONCLUSIONS AND CLINICAL IMPORTANCE: Serum progesterone and 17-hydroxyprogesterone concentrations were useful to diagnose HAC in this study, but were not more sensitive or specific than cortisol concentration.