Peer-reviewed veterinary case report
Low adrenal hormone signs in dogs with chronic gut disease
By Tardo, Antonio Maria et al.·Published in Journal of veterinary internal medicine·2024·Department of Veterinary Medical Sciences, Italy·View original on PubMed →
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Original publication title: Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration.
- Species:
- dog
Plain-English summary
A group of dogs showing signs of chronic gastrointestinal disease (CGD) were tested for a rare condition called eunatremic, eukalemic hypoadrenocorticism (EEH), which can be tricky to diagnose, especially if the dog has previously received glucocorticoids (steroids). Out of 112 dogs with CGD, only one was diagnosed with EEH, indicating it’s quite rare. The study found that dogs who had received glucocorticoids often showed misleading test results, which could lead to misdiagnosis. Understanding these factors can help veterinarians better identify EEH in dogs with unclear treatment histories.
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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.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/38053513/