1
|
Rebelo N, Dias MJ, Englar R, Mateus L, Leal RO. Frequency of low-dose dexamethasone suppression test (LDDST) response patterns and their correlation with clinicopathologic signs in dogs suspected of having Cushing's syndrome: A retrospective study. Res Vet Sci 2024; 175:105318. [PMID: 38851053 DOI: 10.1016/j.rvsc.2024.105318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/17/2024] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
A retrospective cross-sectional study was conducted to assess the frequency of low-dose dexamethasone suppression test (LDDST) patterns in canine patients that had clinicopathologic signs consistent with Cushing's syndrome (CS). Medical records for patients of interest (N = 128) were reviewed between January 2014 and December 2020 to analyse and classify LDDST results based upon the following patterns: lack of suppression, partial suppression, complete suppression, escape, or inverse. Complete suppression, lack of suppression, partial suppression, escape, and inverse patterns were identified in 39.1%, 31.2%, 14.1%, 10.1% and 5.5% of cases respectively. LDDST results were also evaluated with respect to clinical signs, serum alkaline phosphatase (ALP) activity, urine specific gravity (USG) and adrenal ultrasonographic findings. There was no association between LDDST patterns and clinical signs (p = 0.11), increased ALP (p = 0.32), USG (p = 0.33) or adrenal ultrasonographic findings (p = 0.19). In all dogs that demonstrated complete suppression or an inverse pattern, CS was excluded by the attending clinician. The diagnosis of CS was also excluded without further exploration in 23.1%, 7.5% and 5.6% of dogs that demonstrated an escape pattern, lack of suppression and partial suppression pattern, respectively. These results suggest that the clinical significance of LDDST patterns, particularly escape and inverse patterns, are misunderstood by some clinicians, leading them to prematurely exclude the diagnosis of CS.
Collapse
Affiliation(s)
- Nádia Rebelo
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine - University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Maria Joana Dias
- Veterinary Teaching Hospital, CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS; Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Ryane Englar
- College of Veterinary Medicine, University of Arizona, Oro Valley, AZ 85737, USA
| | - Luísa Mateus
- Veterinary Teaching Hospital, CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS; Av. Universidade Técnica, 1300-477 Lisbon, Portugal
| | - Rodolfo Oliveira Leal
- Veterinary Teaching Hospital, CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS; Av. Universidade Técnica, 1300-477 Lisbon, Portugal.
| |
Collapse
|
2
|
Hunt A, Olin S, Whittemore JC, Esteller-Vico A, Springer C, Giori L. The effects of selected sedatives on basal and stimulated serum cortisol concentrations in healthy dogs. PeerJ 2024; 12:e16955. [PMID: 38406286 PMCID: PMC10885794 DOI: 10.7717/peerj.16955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
Background Hormone assessment is typically recommended for awake, unsedated dogs. However, one of the most commonly asked questions from veterinary practitioners to the endocrinology laboratory is how sedation impacts cortisol concentrations and the adrenocorticotropic hormone (ACTH) stimulation test. Butorphanol, dexmedetomidine, and trazodone are common sedatives for dogs, but their impact on the hypothalamic-pituitary-adrenal axis (HPA) is unknown. The objective of this study was to evaluate the effects of butorphanol, dexmedetomidine, and trazodone on serum cortisol concentrations. Methods Twelve healthy beagles were included in a prospective, randomized, four-period crossover design study with a 7-day washout. ACTH stimulation test results were determined after saline (0.5 mL IV), butorphanol (0.3 mg/kg IV), dexmedetomidine (4 µg/kg IV), and trazodone (3-5 mg/kg PO) administration. Results Compared to saline, butorphanol increased basal (median 11.75 µg/dL (range 2.50-23.00) (324.13 nmol/L; range 68.97-634.48) vs 1.27 µg/dL (0.74-2.10) (35.03 nmol/L; 20.41-57.93); P < 0.0001) and post-ACTH cortisol concentrations (17.05 µg/dL (12.40-26.00) (470.34 nmol/L; 342.07-717.24) vs 13.75 µg/dL (10.00-18.90) (379.31 nmol/L; 275.96-521.38); P ≤ 0.0001). Dexmedetomidine and trazodone did not significantly affect basal (1.55 µg/dL (range 0.75-1.55) (42.76 nmol/L; 20.69-42.76); P = 0.33 and 0.79 µg/dL (range 0.69-1.89) (21.79 nmol/L; 19.03-52.14); P = 0.13, respectively, vs saline 1.27 (0.74-2.10) (35.03 nmol/L; 20.41-57.93)) or post-ACTH cortisol concentrations (14.35 µg/dL (range 10.70-18.00) (395.86 nmol/L; 295.17-496.55); (P = 0.98 and 12.90 µg/dL (range 8.94-17.40) (355.86 nmol/L; 246.62-480); P = 0.65), respectively, vs saline 13.75 µg/dL (10.00-18.60) (379.31 nmol/L; 275.86-513.10). Conclusion Butorphanol administration should be avoided prior to ACTH stimulation testing in dogs. Further evaluation of dexmedetomidine and trazodone's effects on adrenocortical hormone testing in dogs suspected of HPA derangements is warranted to confirm they do not impact clinical diagnosis.
Collapse
Affiliation(s)
- Adam Hunt
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, TN, United States of America
| | - Shelly Olin
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, TN, United States of America
| | | | - Alejandro Esteller-Vico
- University of Tennessee, College of Veterinary Medicine, Department of Biomedical and Diagnostic Sciences, TN, United States of America
| | - Cary Springer
- Research Computing Support, Office of Information Technology, University of Tennessee–Knoxville, Knoxville, TN, United States of America
| | - Luca Giori
- University of Tennessee, College of Veterinary Medicine, Department of Biomedical and Diagnostic Sciences, TN, United States of America
| |
Collapse
|
3
|
García San José P, Pérez-Alenza MD, Alonso-Miguel D, González Sanz S, Arenas Bermejo C. Prevalence of Systemic Hypertension and Control of Systolic Blood Pressure in a Cohort of 14 Dogs with Adrenal-Dependent Hypercortisolism during the First Year of Trilostane Treatment or after Adrenalectomy. Animals (Basel) 2024; 14:511. [PMID: 38338154 PMCID: PMC10854962 DOI: 10.3390/ani14030511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Hypercortisolism in dogs is frequently associated with systemic hypertension (SH). However, there are no studies evaluating the changes in systolic blood pressure (SBP) in dogs with adrenal-dependent hypercortisolism (ADH) during trilostane treatment or after adrenalectomy and their response to antihypertensive treatments. For this reason, the objectives of this study were to evaluate the changes in SBP in dogs with ADH during the first year of trilostane treatment or after adrenalectomy, the relation with clinical control of hypercortisolism and certain laboratory parameters, and the response to antihypertensive drugs. Fourteen dogs newly diagnosed with ADH were prospectively included and evaluated at diagnosis (T0) and 1, 3, 6, and 12 months after (T1, T3, T6, and T12, respectively). Dogs were classified as hypertensive (HT; SBP ≥ 160 mmHg) and non-hypertensive. In HT dogs, benazepril was considered as the first-line drug, and, if necessary, amlodipine was prescribed. The prevalence of SH at T0 was 79%, and it was reduced to 25% at T12. Blood pressure (BP) was not associated with disease control or selected laboratory parameters at any endpoint. Only 22% of dogs with SH needed more than one drug to normalize their SBP. In all dogs surgically treated that were HT at T0, BP normalized at T3.
Collapse
Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | - María Dolores Pérez-Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | - Daniel Alonso-Miguel
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | | | - Carolina Arenas Bermejo
- AniCura Hospital Veterinario Valencia Sur, 46460 Valencia, Spain;
- VetCT Teleconsulting, Cambridge CB3 0FA, UK
| |
Collapse
|
4
|
Tanaka S, Suzuki S, Soeta S, Kaneda T, Hara AY. Mechanism of long-term high-dose prednisolone administration producing myocardial fibrosis in beagle dogs. Open Vet J 2023; 13:1708-1717. [PMID: 38292726 PMCID: PMC10824093 DOI: 10.5455/ovj.2023.v13.i12.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/06/2023] [Indexed: 02/01/2024] Open
Abstract
Background We previously reported that myocardial fibrosis may be one of the causes of left ventricular hypertrophy and cardiac dysfunction in dogs with hyperglucocorticism (HGC). The detailed mechanism by which myocardial fibrosis of the left ventricle occurs in dogs with HGC remains unclear. Aim Th is study investigated the mechanism by which HGC causes fibrosis of the left ventricle. Methods The impa cts of HGC on the heart by comparing samples obtained from high-dose glucocorticoid (GC)-treated (P) and untreated (C) dogs. The P group included healthy Beagle dogs (n = 6) treated with prednisolone (2 mg/kg, bid, po) for 84 days, and the C group included healthy Beagle dogs (n = 6) euthanized for unrelated reasons. In three of the P group dogs, serum was collected before the start of administration (Day 0) and on Day 84 to measure angiotensin II concentrations and oxidative stress markers (8-hydroxy-2'-deoxyguanosine (8OHdG), NADPH oxidase, and superoxide levels). Samples of the left ventricular free wall (LVFW), right ventricular free wall (RVFW), interventricular septum (IVS), and aortic root were harvested from both groups (n = 6 for each group). Using these tissue samples, angiotensin II type 1 receptor (AT1R), 8OHdG, and transforming growth factor β1 (TGFβ1) immunohistochemical stains were performed. Results The blood N ADPH oxidase concentration was significantly higher (p = 0.027) in the P group 84 days after initiation of the medication compared to that before prednisolone treatment. By contrast, there was no significant difference in serum angiotensin II (p = 0.450), 8OHdG (p = 0.068), and superoxide (p = 0.057) concentrations. The positive staining rates of AT1R, 8OHdG, and TGFβ1 in the heart (LVFW, RVFW, IVS, and aortic root) were significantly higher in the P group than those in the C group. Conclusion Angiotensin II and oxidative stress in HGC may cause left ventricular fibrosis in dogs.
Collapse
Affiliation(s)
- Sachiyo Tanaka
- Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Shuji Suzuki
- Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Satoshi Soeta
- Division of Veterinary Anatomy, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Takeharu Kaneda
- Division of Veterinary Pharmacology, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - and Yasushi Hara
- Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| |
Collapse
|
5
|
Ruijter BEW, Bik CA, Schofield I, Niessen SJM. External validation of a United Kingdom primary-care Cushing's prediction tool in a population of referred Dutch dogs. J Vet Intern Med 2023; 37:2052-2063. [PMID: 37665189 PMCID: PMC10658492 DOI: 10.1111/jvim.16848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND A prediction tool was developed and internally validated to aid the diagnosis of Cushing's syndrome in dogs attending UK primary-care practices. External validation is an important part of model validation to assess model performance when used in different populations. OBJECTIVES To assess the original prediction model's transportability, applicability, and diagnostic performance in a secondary-care practice in the Netherlands. ANIMALS Two hundred thirty client-owned dogs. METHODS Retrospective observational study. Medical records of dogs under investigation of Cushing's syndrome between 2011 and 2020 were reviewed. Dogs diagnosed with Cushing's syndrome by the attending internists and fulfilling ALIVE criteria were defined as cases, others as non-cases. All dogs were scored using the aforementioned prediction tool. Dog characteristics and predictor-outcome effects in development and validation data sets were compared to assess model transportability. Calibration and discrimination were examined to assess model performance. RESULTS Eighty of 230 dogs were defined as cases. Significant differences in dog characteristics were found between UK primary-care and Dutch secondary-care populations. Not all predictors from the original model were confirmed to be significant predictors in the validation sample. The model systematically overestimated the probability of having Cushing's syndrome (a = -1.10, P < .001). Calibration slope was 1.35 and discrimination proved excellent (area under the receiver operating curve = 0.83). CONCLUSIONS AND CLINICAL IMPORTANCE The prediction model had moderate transportability, excellent discriminatory ability, and overall overestimated probability of having Cushing's syndrome. This study confirms its utility, though emphasizes that ongoing validation efforts of disease prediction tools are a worthwhile effort.
Collapse
Affiliation(s)
| | - Céline Anne Bik
- MCD‐AniCura – Internal Medicine, Isolatorweg 45Amsterdam 1014ASThe Netherlands
| | - Imogen Schofield
- Royal Veterinary College, Hawkshead LaneHatfield AL9 7TAUnited Kingdom
| | - Stijn Johannes Maria Niessen
- Royal Veterinary College – Veterinary Clinical Sciences, North MimmsHertsUnited Kingdom
- Veterinary Specialist ConsultationsHilversumThe Netherlands
| |
Collapse
|
6
|
Fleeman L, Barrett R. Cushing Syndrome and Other Causes of Insulin Resistance in Dogs. Vet Clin North Am Small Anim Pract 2023; 53:711-730. [PMID: 36898861 DOI: 10.1016/j.cvsm.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
The most common causes of insulin resistance in diabetic dogs are Cushing syndrome, diestrus, and obesity. Cushing-associated effects include insulin resistance, excessive postprandial hyperglycemia, perceived short duration of insulin action, and/or substantial within-day and/or day-to-day glycemic variability. Successful strategies to manage excessive glycemic variability include basal insulin monotherapy and combined basal-bolus insulin treatment. Ovariohysterectomy and insulin treatment can achieve diabetic remission in about 10% of cases of diestrus diabetes. Different causes of insulin resistance have an additive effect on insulin requirements and the risk of progression to clinical diabetes in dogs.
Collapse
Affiliation(s)
- Linda Fleeman
- Animal Diabetes Australia, 5 Hood Street, Collingwood, Victoria 3066, Australia.
| | - Renea Barrett
- Animal Diabetes Australia, 5 Hood Street, Collingwood, Victoria 3066, Australia
| |
Collapse
|
7
|
Golinelli S, Fracassi F, Bianchi E, Pöppl ÁG, Miceli DD, Benedicenti L, De Marco V, Cook AK, Espada Castro L, Ramsey I, Seo KW, Cantile C, Gandini G, Hulsebosch SE, Feldman EC. Clinical features of muscle stiffness in 37 dogs with concurrent naturally occurring hypercortisolism. J Vet Intern Med 2023; 37:578-585. [PMID: 36798032 DOI: 10.1111/jvim.16620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 12/14/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Severe muscle stiffness (SMS) in dogs with hypercortisolism (HC) is uncommon. OBJECTIVES To evaluate signalment, presentation, treatments, and long-term outcomes of dogs with concurrent HC and SMS. ANIMALS Thirty-seven dogs. METHODS Medical records of dogs with HC and concurrent SMS were recruited from 10 institutions. Clinical information, test results, therapeutic responses, and survival times were reviewed. RESULTS All 37 dogs with HC and SMS had pituitary-dependent hypercortisolism (PDH); 36/37 weighed <20 kg. Signs and test results were typical of PDH aside from SMS, initially diagnosed in all 4 limbs in 9, pelvic limbs of 22, and thoracic limbs of 6 dogs. Hypercortisolism and SMS were diagnosed together in 3 dogs; HC 1-36 months before SMS in 23; SMS 1-12 months before HC in 11. Mitotane or trilostane, given to control HC in 36/37 dogs, improved or resolved HC signs in 28; SMS did not resolve, remaining static or worsening in 31/36 dogs, mildly improving in 5/19 dogs given additional therapies. Progression of SMS included additional limbs in 10 dogs and the masticatory muscles of 2. The median survival time from diagnosis of SMS was 965 days (range, 8-1188). CONCLUSIONS AND CLINICAL IMPORTANCE Concurrent SMS and HC is uncommon, possibly affecting only dogs with PDH. Development of SMS might occur before or after diagnosis of HC. Apart from SMS, the clinical picture and survival time of these dogs seem indistinguishable from those of dogs with HC in general. However, while muscle weakness usually resolves with HC treatment SMS does not.
Collapse
Affiliation(s)
- Stefania Golinelli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Federico Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Ezio Bianchi
- Department of Veterinary Medical Sciences, University of Parma, Parma, Italy
| | - Álan Gomes Pöppl
- Department of Animal Medicine, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Diego Daniel Miceli
- Endocrinology Unit, School of Veterinary Medicine, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina
| | - Leontine Benedicenti
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | | | - Ian Ramsey
- School of Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - Kyoung Won Seo
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Carlo Cantile
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Gualtiero Gandini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Sean E Hulsebosch
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Edward C Feldman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| |
Collapse
|
8
|
Tanaka S, Suzuki S, Teshima T, Yamashita R, Hamamoto Y, Hara Y. Regression of venous thrombus after trans-sphenoidal hypophysectomy for pituitary-dependent hyperadrenocorticism in a dog. J Small Anim Pract 2023; 64:111-117. [PMID: 36335913 DOI: 10.1111/jsap.13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 11/08/2022]
Abstract
An 8.0-kg 8-year-old male dachshund was presented for surgical treatment of suspected pituitary-dependent hyperadrenocorticism with portal vein thrombosis. Advanced diagnostic imaging revealed a thrombus in the splenic and portal veins. For the portal vein thrombus, CT angiography showed an enhanced timing delay in the lateral right and caudate liver lobes. Blood tests showed a marked increase in the liver panel, including total bile acid. Brain MRI revealed a pituitary mass, suggesting pituitary-dependent hyperadrenocorticism. The mass was completely resected. The preoperative antithrombotic therapy of rivaroxaban (0.66 mg/kg, PO, once per day) and clopidogrel sulphate (1.66 mg/kg, PO, once per day) was continued postoperatively. Six months after resection of the pituitary mass, the thrombus had disappeared. Further studies are required to prove a causal association between the disappearance of the thrombus and the treatments provided.
Collapse
Affiliation(s)
- S Tanaka
- Laboratory of Veterinary Surgery, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - S Suzuki
- Laboratory of Veterinary Surgery, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - T Teshima
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - R Yamashita
- Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - Y Hamamoto
- Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - Y Hara
- Laboratory of Veterinary Surgery, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| |
Collapse
|
9
|
Vila BDCP, Vanhoni MS, Sousa MG. QT interval instability and variability in dogs with naturally-occurring hypercortisolism. Vet Res Commun 2023; 47:121-130. [PMID: 35575953 DOI: 10.1007/s11259-022-09936-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/04/2022] [Indexed: 01/27/2023]
Abstract
Hypercortisolism is one of the most common endocrine diseases in dogs. In humans, it is clearly associated with a higher risk of cardiovascular events, but studies in dogs are scarce. To investigate the arrhythmogenic risk of dogs with naturally-occurring hypercortisolism (NOHC), indices of variability and instability of the QT interval were retrospectively studied in 38 dogs with NOHC and prospectively studied in 12 healthy dogs: variance (QTv), total instability (TI), short-term (STI) and long-term (LTI), and mean (QTm). Except for QTm, all parameters studied were higher in the NOHC group than in the control group. In addition, STI and QTv showed moderate positive correlation with left ventricle wall thickness. The NOHC group was subdivided according to cortisol suppression pattern in the low-dose dexamethasone suppression test. All electrocardiographic indices of partial and absent suppression patterns were numerically higher than healthy dogs. QTv and TI were lower in the control group than in both NOHC subgroups. LTI and STI were lower in the CG than in the group with the partial suppression pattern. There was no statistical difference between sex groups in any of the electrocardiographic parameters studied. This result might indicate that the etiology of NOHC, and its consequent influence on hypothalamus-pituitary-adrenal axis could interfere on the heterogeneity of ventricular repolarization parameters in different ways, especially in the short-term and the long-term stability; however further studies are necessary to understand the role of cortisol on electrical instability in dogs.
Collapse
Affiliation(s)
- Beatriz de Carvalho Pato Vila
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil.
| | - Marcela Sigolo Vanhoni
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil
| | - Marlos Gonçalves Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil
| |
Collapse
|
10
|
Srisowanna N, Thanaboonnipat C, Pisamai S, Komin K, Choisunirachon N. The use of ultrasonographic adrenal dimensions and the adrenal dimension-to-aorta ratio in the diagnosis of benign and malignant adrenal diseases in dogs. Vet World 2023; 16:104-110. [PMID: 36855360 PMCID: PMC9967719 DOI: 10.14202/vetworld.2023.104-110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/05/2022] [Indexed: 01/13/2023] Open
Abstract
Background and Aim Ultrasound (US) is a useful tool for detecting adrenal abnormalities. However, a definite reference range differentiating normal and diseased adrenal glands in dogs of varying body sizes is still lacking. The organ dimension-to-aorta (Ao) ratio of the dogs is correlated with their body weight (BW). Therefore, this study aimed to investigate the adrenal dimensions, including adrenal pole thickness and adrenal length, as well as the adrenal dimension-to-Ao ratio, to differentiate between dogs with normal, benign lesions such as pituitary-dependent hyperadrenocorticism (PDH) and malignant invasive adrenal tumors. Materials and Methods The medical records and US images of 39 dogs that were either normal (normal) (n = 15) or affected by PDH (n = 15) or malignant invasive adrenal tumors (tumor) (n = 9) were retrieved in this study. All the dogs had a transabdominal US on the sagittal plane. The adrenal dimensions and luminal Ao diameter at the peak of the systolic phase were recorded. The average adrenal dimensions, including the adrenal dimension-to-Ao ratio, were compared among the groups. Results Most of the dogs in each group were small-breed dogs with comparable ages, BW, and Ao values. Both adrenal dimensions and the adrenal dimension-to-Ao ratio were significantly lower in the normal group than in the PDH and tumor groups. To differentiate the PDH group from the tumor group, adrenal dimensions of pole thickness and length were more appropriate than the adrenal dimension-to-Ao ratio. Conclusion Adrenal dimensions and the adrenal dimension-to-Ao ratio can be used to diagnose adrenal diseases. However, in small-breed dogs, adrenal dimensions are suitable for differentiating PDH from tumor groups. Further research is required with a larger sample size and a wider range of canine body sizes.
Collapse
Affiliation(s)
- Naparee Srisowanna
- Small Animal Hospital, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand
| | - Chutimon Thanaboonnipat
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand
| | - Sirinun Pisamai
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand
| | - Kiatpichet Komin
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand
| | - Nan Choisunirachon
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand,Corresponding author: Nan Choisunirachon, e-mail: Co-authors: NS: , CT: , SP: , KK:
| |
Collapse
|
11
|
Oh J, Lee D, Yun T, Koo Y, Chae Y, Yang MP, Kang BT, Kim H. Inverse relationship between eosinophil profiles and serum glucose concentration in dogs with naturally occurring hypercortisolism. Domest Anim Endocrinol 2022; 80:106727. [PMID: 35417804 DOI: 10.1016/j.domaniend.2022.106727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/03/2022]
Abstract
Hyperglycemia and eosinopenia are well-known characteristics of hypercortisolism (HC) in humans, however, their association in dogs with HC has rarely been reported. This study aimed to evaluate the association between eosinophils and serum fasting glucose concentration in dogs with HC. Forty-seven dogs with HC and 43 dogs with non-adrenal illness were included. In this retrospective cohort study, the complete blood count, blood chemistry profile, and pre- and post-adrenocorticotropic hormone (ACTH) cortisol concentrations were analyzed. Significant differences were found in neutrophil, monocyte, eosinophil, and platelet counts; eosinophil percentage; neutrophil-to-lymphocyte ratio; aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase activities (P < 0.05) between the groups. In dogs with HC, the eosinophil percentage was inversely correlated with fasting blood glucose (r = -0.3515, P = 0.0154) and post-ACTH cortisol concentrations (r = -0.6509, P < 0.0001). The neutrophil-to-lymphocyte ratio was inversely correlated with the eosinophil percentage (r = -0.4573, P = 0.0012) and count (r = -0.3688, P = 0.0108), but positively correlated with the fasting blood glucose level (r = 0.3888, P = 0.0069). Such correlations were not identified in dogs with non-adrenal illness. A multivariate analysis showed that only eosinophil percentage was associated with the presence of hyperglycemia in dogs with HC (odds ratio = 2.100, 95% confidence interval = 1.051-4.199, P = 0.0360). Therefore, eosinopenia induced by excess cortisol might be associated with altered glucose metabolism in dogs with HC. A better understanding of this correlation could be valuable to predict and prevent the complications of HC.
Collapse
Affiliation(s)
- Jimin Oh
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - Dohee Lee
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - Taesik Yun
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - Yoonhoi Koo
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - Yeon Chae
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - Mhan-Pyo Yang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - Byeong-Teck Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea
| | - Hakhyun Kim
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, Republic of Korea.
| |
Collapse
|
12
|
Schofield I, Brodbelt DC, Niessen SJM, Church DB, Geddes RF, O'Neill DG. Frequency and risk factors for naturally occurring Cushing's syndrome in dogs attending UK primary-care practices. J Small Anim Pract 2021; 63:265-274. [PMID: 34881823 PMCID: PMC9299886 DOI: 10.1111/jsap.13450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/23/2021] [Accepted: 10/31/2021] [Indexed: 01/03/2023]
Abstract
Objectives To estimate the frequency and risk factors for Cushing's syndrome in dogs under UK primary veterinary care. Materials and Methods Dogs with Cushing's syndrome were identified by searching electronic patient records of primary‐care veterinary practices. Pre‐existing and incident cases of Cushing's syndrome during 2016 were included to estimate the 1‐year period prevalence. Incident cases were used to estimate the annual incidence and to identify demographic risk factors for the diagnosis of Cushing's syndrome in dogs, through multivariable logistic regression. Results Analysis included 970 pre‐existing and 557 incident cases of Cushing's syndrome from a population of 905,544 dogs. The estimated 1‐year period prevalence for Cushing's syndrome in dogs under veterinary care was 0.17% (95% confidence interval 0.16 to 0.18) and incidence was 0.06% (95% confidence interval 0.05 to 0.07). In multivariable logistic regression modelling, the Bichon frise (odds ratio=6.17, 95% confidence interval 4.22 to 9.00), Border terrier (5.40, 95% confidence interval 3.66 to 7.97) and Miniature schnauzer (3.05, 95% confidence interval 1.67 to 5.57) had the highest odds of Cushing's syndrome. The Golden retriever (0.24, 95% confidence interval 0.06 to 0.98) and Labrador retriever (0.30, 95% confidence interval 0.17 to 0.54) were the most protected breeds. Increasing age, bodyweight greater than the breed‐sex mean and being insured also showed increased odds of Cushing's syndrome. Clinical Significance As Cushing's syndrome is predominately diagnosed and managed in primary‐care practice, this study provides valuable new information of its epidemiology in this setting. Demographics reported are supportive of previous work and additional novel associations identified, such as the Border terrier, could enhance the index of suspicion for veterinarians.
Collapse
Affiliation(s)
- I Schofield
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts AL9 7TA, UK
| | - D C Brodbelt
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts AL9 7TA, UK
| | - S J M Niessen
- Clinical Science and Services, The Royal Veterinary College, Hatfield, Herts AL9 7TA, UK.,Veterinary Specialist Consultations, Hilversum, The Netherlands
| | - D B Church
- Clinical Science and Services, The Royal Veterinary College, Hatfield, Herts AL9 7TA, UK
| | - R F Geddes
- Clinical Science and Services, The Royal Veterinary College, Hatfield, Herts AL9 7TA, UK
| | - D G O'Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts AL9 7TA, UK
| |
Collapse
|
13
|
Cognitive dysfunction severity evaluation in dogs with naturally-occurring Cushing´s syndrome: A matched case-control study. J Vet Behav 2021. [DOI: 10.1016/j.jveb.2021.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
14
|
Ronja N, Kölle P. [Obesity in dogs - A review of underlying reasons]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:284-293. [PMID: 34425607 DOI: 10.1055/a-1548-2293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Obesity does not merely represent a human problem but is also recognized as an immense health threat in domestic animals. However, this disease is frequently not recognized by the pet owner. Current studies assume that up to 60 % of domestic dogs are overweight or significantly obese with various reasons existing for this development. Not only the feeding management contributes to the development of obesity but also genetics, age and gender as well as specific primary diseases add to the individual's weight gain. Addtionally, medical treatment and the owner-pet-relationship may increase the risk for obesity. In order to treat obesity in a qualified manner or ideally to prevent this from developing in the first place, a profound knowledge concerning the underlying causes is essential. The present article provides a review of the most important impact factors thus adding to the body of information allowing for the acquisition of such expertise.
Collapse
Affiliation(s)
- Nitsch Ronja
- Medizinische Kleintierklinik, Tierärztliche Fakultät der Ludwig-Maximilians-Universität München
| | - Petra Kölle
- Medizinische Kleintierklinik, Tierärztliche Fakultät der Ludwig-Maximilians-Universität München
| |
Collapse
|
15
|
Espiñeira IM, Vidal PN, Ghersevich MC, Soler Arias EA, Bosetti F, Cabrera Blatter MF, Miceli DD, Castillo VA. Adrenal cortex stimulation with hCG in spayed female dogs with Cushing's syndrome: Is the LH-dependent variant possible? Open Vet J 2021; 11:319-329. [PMID: 34307090 PMCID: PMC8288738 DOI: 10.5455/ovj.2021.v11.i2.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/23/2021] [Indexed: 11/09/2022] Open
Abstract
Background: The expression and overexpression of luteinizing hormone (LH) receptors in the canine adrenal gland cortex have been reported. Therefore, it was hypothesized that a LH-dependent form of Cushing’s syndrome (CS) could exist in dogs. Aim: To assess whether the adrenal gland post-ovariectomy (OVx) exhibits a greater response to adrenocorticotrophin (ACTH) stimulation; to evaluate whether the adrenal gland responds to human chorionic gonadotropin (hCG) stimulation by increasing the release of cortisol; and to consider whether hCG stimulus testing would be useful as a diagnosis for possible cases of LH-dependent CS. Methods: Cortisol concentrations were measured from healthy female dogs (n=16) at baseline and following ACTH stimulation before and 2 months after gonadectomy (OVx). Cortisol concentrations were also measured for female dogs with CS (n = 14) following administration of hCG (5000 IU). A post-hCG cortisol concentration greater than 140 nmol/l was used to define dogs with LH-dependent Cushing’s syndrome. Results: In normal female dogs, both pre- and post-stimulation cortisol concentrations increased following OVx (p = 0.002 and p = 0.0003, respectively). In female dogs with CS, cortisol concentrations increased following stimulation with hCG in 57% (8/14; p = 0.002). Age at the time of OVx was associated (p = 0.015) with the cortisol response to hCG [8 (5–9) years vs. 3.5 (2–6) years, p = 0.0013). Conclusion: Based on these results, an LH-dependent form of CS occurs in spayed female dogs, and that it is more likely to occur when female dogs are spayed later in life.
Collapse
Affiliation(s)
- Ignacio M Espiñeira
- Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Becario Estímulo UBACyT, Rep. Argentina
| | - Patricia N Vidal
- Hospital Escuela de Medicina Veterinaria-U. Endocrinología, Rep. Argentina.,Becaria Proyecto Estratégicos UBACyT, Rep. Argentina
| | - María C Ghersevich
- Facultad de Ciencias Agropecuarias, U. Católica de Córdoba-Argentina, Rep. Argentina
| | | | - Fernanda Bosetti
- Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Hospital Escuela de Medicina Veterinaria-U. Endocrinología, Rep. Argentina
| | - María F Cabrera Blatter
- Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Hospital Escuela de Medicina Veterinaria-U. Endocrinología, Rep. Argentina
| | - Diego D Miceli
- Hospital Escuela de Medicina Veterinaria-U. Endocrinología, Rep. Argentina.,IByME-CONICET, Rep. Argentina
| | - Víctor A Castillo
- Facultad de Ciencias Veterinarias, Cátedra de Clínica Médica de Pequeños Animales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Hospital Escuela de Medicina Veterinaria-U. Endocrinología, Rep. Argentina
| |
Collapse
|
16
|
Muñoz-Prieto A, Rubić I, Horvatic A, Rafaj RB, Cerón JJ, Tvarijonaviciute A, Mrljak V. Metabolic profiling of serum from dogs with pituitary-dependent hyperadrenocorticism. Res Vet Sci 2021; 138:161-166. [PMID: 34147706 DOI: 10.1016/j.rvsc.2021.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/09/2021] [Accepted: 06/09/2021] [Indexed: 12/17/2022]
Abstract
Hyperadrenocorticism (HAC) is one of the most common endocrine diseases in dogs characterized by excessive cortisol production caused by an adrenocorticotropic hormone (ACTH)-secreting tumor, namely pituitary-dependent HAC (PDH) or cortisol-secreting adrenal tumor. Metabolomics presents the ability to identify small molecule metabolites. Thus, the use of metabolomics techniques in canine PDH can provide information about the pathophysiology and metabolic changes in this disease. This study aimed to identify and compare differences in serum metabolites between dogs with PDH and healthy dogs. The metabolomic profile of 20 dogs diagnosed with PDH was compared with 20 healthy dogs using liquid chromatography/mass spectrometry (LC/MS), and metabolite discrimination was performed using partial least squares-discriminant analysis (PLS-DA), the variable important in projection (VIP) and fold changes (FC) group-wise comparisons. The hypergeometric test identified the significantly altered pathways. A total of 21 metabolites were found to be significantly different between the two groups. The major alterations were found in arachidonic and decanoic acid, and phospholipids related to phosphatidylcholine (PC), phosphatidylethanolamine (PE) and phosphatidylinositol (PI). These metabolites are related to insulin resistance and other complications (i.e. hypertension). Our results indicate that PDH produces changes in serum metabolites of dogs, and the knowledge of these changes can aid to better understanding of pathophysiological processes involved and contribute to potentially detect new biomarkers for this disease.
Collapse
Affiliation(s)
- Alberto Muñoz-Prieto
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb 10000, Croatia
| | - Ivana Rubić
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb 10000, Croatia
| | - Anita Horvatic
- Department of Chemistry and Biochemistry, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia
| | - Renata Baric Rafaj
- Department for Chemistry and Biochemistry, Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - José Joaquín Cerón
- Interlab-UMU, Regional Campus of International Excellence "Mare Nostrum", University of Murcia, Murcia 30100, Spain
| | - Asta Tvarijonaviciute
- Interlab-UMU, Regional Campus of International Excellence "Mare Nostrum", University of Murcia, Murcia 30100, Spain.
| | - Vladimir Mrljak
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, Zagreb 10000, Croatia
| |
Collapse
|
17
|
Machine-learning based prediction of Cushing's syndrome in dogs attending UK primary-care veterinary practice. Sci Rep 2021; 11:9035. [PMID: 33907241 PMCID: PMC8079424 DOI: 10.1038/s41598-021-88440-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/08/2021] [Indexed: 11/29/2022] Open
Abstract
Cushing’s syndrome is an endocrine disease in dogs that negatively impacts upon the quality-of-life of affected animals. Cushing’s syndrome can be a challenging diagnosis to confirm, therefore new methods to aid diagnosis are warranted. Four machine-learning algorithms were applied to predict a future diagnosis of Cushing's syndrome, using structured clinical data from the VetCompass programme in the UK. Dogs suspected of having Cushing's syndrome were included in the analysis and classified based on their final reported diagnosis within their clinical records. Demographic and clinical features available at the point of first suspicion by the attending veterinarian were included within the models. The machine-learning methods were able to classify the recorded Cushing’s syndrome diagnoses, with good predictive performance. The LASSO penalised regression model indicated the best overall performance when applied to the test set with an AUROC = 0.85 (95% CI 0.80–0.89), sensitivity = 0.71, specificity = 0.82, PPV = 0.75 and NPV = 0.78. The findings of our study indicate that machine-learning methods could predict the future diagnosis of a practicing veterinarian. New approaches using these methods could support clinical decision-making and contribute to improved diagnosis of Cushing’s syndrome in dogs.
Collapse
|
18
|
Breu D, Stieger N, Müller E. [Occurrence of uroliths - age-, breed-, and gender-specific differences in dogs from Germany]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:6-12. [PMID: 33588460 DOI: 10.1055/a-1334-0733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to assess the distribution and frequency of uroliths in dogs in Germany and to evaluate age-, gender-, and breed-specific differences. MATERIAL AND METHODS A total of 2772 uroliths from dogs in Germany that had been submitted from veterinary practices during the years 2017-2019 were analyzed by infrared spectroscopy. RESULTS Uroliths were analyzed as follows: Struvite (44.7 %), calcium oxalate monohydrate (whewellite 24.5 %), cystine (15.2 %), ammonium urate (5.3 %), calcium oxalate dihydrate (weddellite 4.4 %), calcium phosphate (1.6 %), xanthine (1.2 %), whewellite/weddellite (11 %), brushite (0.4 %) and other substances (1.7 %). The dogs' median age (in years) with regards to the urolith type amounted to: struvite 8, calcium oxalate (whewellite and weddellite) 10, cystine 5, brushite 11, xanthine 6.5, and ammonium urate 6 years. Struvite uroliths were most common in intact females (83.8 %) and neutered females (80.8 %), while cystine uroliths (36.7 %) and calcium oxalates (35.7 % whewellite and weddellite) were most common in intact males. Calcium oxalate (50 %), struvite (17.3 %), and cystine uroliths (10.5 %) were found in male neutered dogs. The most frequent breeds with struvite uroliths were Pug (75.9 %), Labrador (73.1 %), Shih Tzu (62.2 %), Dachshund (50.4 %) and Maltese (36 %). Calcium oxalates were most frequently encountered in the breeds Miniature Schnauzer (54.8 %), Jack Russell Terrier (49.5 %), and Yorkshire Terrier (48.2 %). Cystine uroliths were most frequent in the breeds French Bulldog (47.2 %), Bulldogs (44.8 %), Chihuahua (44.1 %) and Dachshund (32.8 %). CONCLUSION AND CLINICAL RELEVANCE Dogs from Germany displayed age-, gender- and breed-specific differences in the frequency of urine calculi occurrence. Knowledge of the frequent occurrence of the distinct uroliths in Germany as well as potential breed dispositions allow the veterinarian to implement an appropriate preventive treatment plan. This would involve a targeted monitoring program for the prevention and follow-up care of the patient in conjunction with the pet owner.
Collapse
|
19
|
García San José P, Arenas Bermejo C, Alonso-Miguel D, Clares Moral I, Cuesta-Alvaro P, Pérez Alenza MD. Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment. J Vet Intern Med 2020; 35:130-141. [PMID: 33274787 PMCID: PMC7848348 DOI: 10.1111/jvim.15978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/09/2020] [Accepted: 11/19/2020] [Indexed: 12/26/2022] Open
Abstract
Background Systemic hypertension (SH) is common in dogs and humans with hypercortisolism and can persist after treatment. Objectives To evaluate changes in prevalence of SH and systolic blood pressure (SBP) in dogs with pituitary‐dependent hyperadrenocorticism (PDH) during the first year of trilostane treatment, its relationship with disease control and selected laboratory variables, and their response to antihypertensive treatment. Animals Fifty‐one dogs with PDH treated with trilostane Q12h. Methods Prospective case series study. Dogs were evaluated at diagnosis (T0) and 1, 3, 6, and 12 months (T12). Dogs were classified as nonhypertensive (SBP < 160 mm Hg) or hypertensive (SBP≥160 mm Hg) and subclassified according to target organ damage (TOD) risk. Hypertensive dogs were treated with benazepril and, if control of SH was not achieved, amlodipine was added. Results Prevalence of SH decreased from T0 (36/51) to T12 (17/37; P = .01). Changes in SBP during the study were influenced by the risk of TOD at T0. In severely hypertensive (SBP ≥ 180 mm Hg) dogs, the decrease in SBP was more pronounced whereas in normotensive (SBP < 140 mm Hg) dogs SBP increased slightly (P = .00). Blood pressure was not associated with disease control. Antihypertensive treatment was needed in 31/51 dogs, and in 13/31 dogs additional SH control with amlodipine was required. One third of nonhypertensive dogs at T0 required treatment with benazepril because SH developed during follow‐up. Conclusions and Clinical Importance In dogs with PDH, SBP should be measured at every visit, regardless of disease control or SBP at diagnosis. More than 1 drug may be necessary to manage SH in affected dogs.
Collapse
Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | | | - Daniel Alonso-Miguel
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Irene Clares Moral
- Veterinary Teaching Hospital Complutense, Complutense University of Madrid, Madrid, Spain
| | - Pedro Cuesta-Alvaro
- Computing Services, Research Support, Complutense University of Madrid, Avda de la Complutense s/n, Madrid, Spain
| | - María Dolores Pérez Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
20
|
Schofield I, Brodbelt DC, Niessen SJM, Church DB, Geddes RF, Kennedy N, O'Neill DG. Development and internal validation of a prediction tool to aid the diagnosis of Cushing's syndrome in dogs attending primary-care practice. J Vet Intern Med 2020; 34:2306-2318. [PMID: 32935905 PMCID: PMC7694798 DOI: 10.1111/jvim.15851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Novel methods to aid identification of dogs with spontaneous Cushing's syndrome are warranted to optimize case selection for diagnostics, avoid unnecessary testing, and ultimately aid decision-making for veterinarians. HYPOTHESIS/OBJECTIVES To develop and internally validate a prediction tool for dogs receiving a diagnosis of Cushing's syndrome using primary-care electronic health records. ANIMALS Three hundred and ninety-eight dogs diagnosed with Cushing's syndrome and 541 noncase dogs, tested for but not diagnosed with Cushing's syndrome, from a cohort of 905 544 dogs attending VetCompass participating practices. METHODS A cross-sectional study design was performed. A prediction model was developed using multivariable binary logistic regression taking the demography, presenting clinical signs and some routine laboratory results into consideration. Predictive performance of each model was assessed and internally validated through bootstrap resampling. A novel clinical prediction tool was developed from the final model. RESULTS The final model included predictor variables sex, age, breed, polydipsia, vomiting, potbelly/hepatomegaly, alopecia, pruritus, alkaline phosphatase, and urine specific gravity. The model demonstrated good discrimination (area under the receiver operating curve [AUROC] = 0.78 [95% CI = 0.75-0.81]; optimism-adjusted AUROC = 0.76) and calibration (C-slope = 0.86). A tool was developed from the model which calculates the predicted likelihood of a dog having Cushing's syndrome from 0% (score = -13) to 96% (score = 10). CONCLUSIONS AND CLINICAL IMPORTANCE A tool to predict a diagnosis of Cushing's syndrome at the point of first suspicion in dogs was developed, with good predictive performance. This tool can be used in practice to support decision-making and increase confidence in diagnosis.
Collapse
Affiliation(s)
- Imogen Schofield
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, UK
| | - David C Brodbelt
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, UK
| | - Stijn J M Niessen
- Clinical Science and Services, The Royal Veterinary College, Hatfield, UK.,The VetCT Telemedicine Hospital, St John's Innovation Centre, Cambridge, UK
| | - David B Church
- Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - Rebecca F Geddes
- Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - Noel Kennedy
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, UK
| | - Dan G O'Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, UK
| |
Collapse
|
21
|
García San José P, Arenas Bermejo C, Clares Moral I, Cuesta Alvaro P, Pérez Alenza MD. Prevalence and risk factors associated with systemic hypertension in dogs with spontaneous hyperadrenocorticism. J Vet Intern Med 2020; 34:1768-1778. [PMID: 32614466 PMCID: PMC7517838 DOI: 10.1111/jvim.15841] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 12/14/2022] Open
Abstract
Background Systemic hypertension (SH) is common in dogs with hyperadrenocorticism (HAC) however there are not many studies assessing its prevalence and risk factors. Objectives To determine the prevalence and severity of SH in dogs with HAC and its association with clinical and laboratory findings to identify potential risk factors. Animals Sixty‐six client owned dogs with spontaneous HAC. Methods Retrospective cross‐sectional study. Medical records of dogs with HAC were reviewed. Systolic blood pressure (SBP) was measured using Doppler ultrasonography. Clinical signs, physical examination findings and clinicopathologic data (CBC, serum biochemistry and electrolytes, urinalysis and urinary culture, and adrenal function tests) were reviewed for analysis. Results Prevalence of SH (≥150 mm Hg) was 82% (54/66) and prevalence of severe SH (≥180 mm Hg) was 46% (30/66). All dogs with thrombocytosis had SH (P = .002), and a platelet count ≥438 × 103/μL was 100% specific and 61.1% sensitive to predict SH (AUC = .802, P = .001). Median potassium levels were lower in hypertensive dogs (4.1 mEq/L, range 3.1‐5.4 mEq/L) than in normotensive ones (4.5 mEq/L, range 4.0‐5.0 mEq/L) (P = .007). Dogs with UPC ≥ 0.5 had higher median SBP than those without proteinuria (P = .03). Dogs with concurrent diabetes mellitus seemed to have a reduced risk of SH (OR = .118, 95%CI = .022‐.626, P = .02). Conclusions and Clinical Importance Systemic hypertension is common in dogs with HAC and is frequently severe. Blood pressure should be routinely assessed in these dogs, especially if thrombocytosis, proteinuria or low potassium concentrations are present.
Collapse
Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | | | - Irene Clares Moral
- Veterinary Teaching Hospital Complutense, Complutense University of Madrid, Madrid, Spain
| | - Pedro Cuesta Alvaro
- Data Processing Center, Department of Political and Public Administration Sciences II, Political Sciences Faculty, Complutense University of Madrid, Madrid, Spain
| | - María Dolores Pérez Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
22
|
Bennaim M, Shiel RE, Mooney CT. Diagnosis of spontaneous hyperadrenocorticism in dogs. Part 1: Pathophysiology, aetiology, clinical and clinicopathological features. Vet J 2019; 252:105342. [PMID: 31554593 DOI: 10.1016/j.tvjl.2019.105342] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 07/15/2019] [Accepted: 07/19/2019] [Indexed: 01/26/2023]
Abstract
Hyperadrenocorticism is a relatively common endocrine disorder in dogs. It occurs as a result of a functional pituitary or adrenal tumour, although other causes have been rarely reported. Canine hyperadrenocorticism has been extensively described but diagnosing this disease remains challenging. Few studies have investigated the clinical and clinicopathological features helpful in differentiating dogs with hyperadrenocorticism from dogs in which the disease is suspected but eventually excluded. Ultimately the diagnosis is based on a combination of multiple pieces of information emanating from the signalment, history, clinical findings, and a variety of diagnostic tests. The first part of this review aims to critically appraise the available data on epidemiology, clinical and laboratory features of naturally occurring canine hyperadrenocorticism.
Collapse
Affiliation(s)
- Michael Bennaim
- Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Ireland.
| | - Robert E Shiel
- Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Ireland
| | - Carmel T Mooney
- Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Ireland
| |
Collapse
|