Peer-reviewed veterinary case report
Urine test helps monitor trilostane in dogs with pituitary
By Galac, S et al.·Published in Journal of veterinary internal medicine·2009·Department of Clinical Sciences of Companion Animals, Netherlands·View original on PubMed →
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Original publication title: Urinary corticoid: creatinine ratios in dogs with pituitary-dependent hypercortisolism during trilostane treatment.
- Species:
- dog
Plain-English summary
An 8-year-old dog with pituitary-dependent hypercortisolism (Cushing's disease) was treated with a medication called trilostane to manage its symptoms. While the urinary corticoid to creatinine ratio (UCCR) was initially high, indicating excessive cortisol levels, it did not drop below normal ranges for most dogs after treatment. The study found that the UCCR is not a reliable way to determine the correct dose of trilostane, but it could help identify dogs at risk of having low cortisol levels (hypocortisolism) during treatment. The dog continued to be monitored to ensure the trilostane was effective.
People also search for: dog Cushing's disease treatment · trilostane dosage for dogs · high cortisol levels in dogs
Abstract
BACKGROUND: The adrenocorticotropic hormone (ACTH) stimulation test is used to evaluate trilostane treatment in dogs with hypercortisolism. HYPOTHESIS: The urinary corticoid : creatinine ratio (UCCR) is a good alternative to the ACTH stimulation test to determine optimal trilostane dose. ANIMALS: Eighteen dogs with pituitary-dependent hypercortisolism. METHODS: In this prospective study, the dose of trilostane was judged to be optimal on the basis of resolution of clinical signs of hypercortisolism and results of an ACTH stimulation test. The owners collected urine for determination of UCCR at 2-week intervals for at least 8 weeks after achieving the optimal trilostane dose. RESULTS: The UCCRs were significantly higher before treatment (11.5-202.0 x 10(-6); median, 42.0 x 10(-6)) than at rechecks 2 months after optimal dosing, but they did not decrease below the upper limit of the reference range in the majority of dogs. The UCCRs of 11 dogs that initially were dosed insufficiently (range, 7.5-79.0 x 10(-6); median, 31.0 x 10(-6)) did not differ significantly from UCCRs when the dosage was optimal (8.2-72.0 x 10(-6); median, 33.0 x 10(-6)). Post-ACTH cortisol concentrations did not correlate significantly with UCCRs at rechecks during trilostane treatment. Long-term follow-up indicated that the decrease in UCCR below the upper limit of the reference was associated with hypocortisolism. CONCLUSION AND CLINICAL IMPORTANCE: The UCCR cannot be used as an alternative to the ACTH stimulation test to determine the optimal dose of trilostane, but might be helpful in detecting dogs at risk for developing hypocortisolism during trilostane treatment.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/19709356/