Peer-reviewed veterinary case report
How low-dose dexamethasone test patterns help diagnose dog Cushing's
By Bennaim, Michael et al.·Published in Journal of veterinary internal medicine·2018·University College Dublin Veterinary Hospital·View original on PubMed →
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Original publication title: Evaluation of individual low-dose dexamethasone suppression test patterns in naturally occurring hyperadrenocorticism in dogs.
- Species:
- dog
Plain-English summary
A group of 123 dogs suspected of having hyperadrenocorticism (HAC), a condition where the body produces too much cortisol, underwent a low-dose dexamethasone suppression test to help diagnose the issue. The results showed that nearly half of the dogs had HAC, while the others had different health problems. The test was most effective when it showed a lack of suppression, indicating a high likelihood of HAC. Dogs with this pattern were more likely to be correctly diagnosed, while those with escape or inverse patterns were less likely to have HAC.
People also search for: dog hyperadrenocorticism symptoms · low-dose dexamethasone test for dogs · dog cortisol test results
Abstract
BACKGROUND: Dogs with hyperadrenocorticism (HAC) may be more mildly affected at the time of diagnosis today, which could influence the prevalence of associated clinical and clinicopathological abnormalities and diagnostic test performance. Different low-dose dexamethasone suppression test (LDDST) result patterns have not been evaluated individually. OBJECTIVES: To assess the current features of HAC and evaluate if the diagnostic test performance of individual LDDST result patterns differ. ANIMALS: One hundred and twenty-three dogs undergoing investigation for HAC. METHODS: Retrospective evaluation of dogs in which a LDDST was performed and HAC confirmed or excluded by alternative means. Cases with basal cortisol concentrations (t) < 1 μg/dL were excluded. Each LDDST result was classified as (a) complete suppression (tand t < 1 μg/dL), (b) lack of suppression (tand t > 1 μg/dL and both > 50% t), (c) partial suppression (tand t > 1 μg/dL but either < 50% t), (d) escape (t > 1 μg/dL and t < 1 μg/dL) or (e) inverse (t > 1 μg/dL and t < 1 μg/dL) pattern. RESULTS: Fifty-nine (48%) dogs were diagnosed with HAC and 64 (52%) with non-adrenal illness. Hyperadrenocorticism cases had similar clinicopathological abnormalities compared to previous reports. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) (95% confidence interval [CI]) of the LDDST for diagnosing HAC were 96.6 (91.9-100)%, 67.2 (55.7-78.7)%, 73.1 (63.2-82.9)%, and 95.6 (89.5-100)%, respectively. Lack of suppression pattern had the highest PPV (93.9 [85.8-100]%) followed by the partial suppression pattern (67.9 [50.6-85.2]%) and escape or inverse pattern (36.8 [15.1-58.5]%). CONCLUSIONS AND CLINICAL IMPORTANCE: A lack of suppression LDDST pattern has the highest PPV for diagnosing HAC followed by a partial suppression pattern. By contrast, the escape or inverse pattern provided limited support of HAC.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/29498108/