Comparison of ACTH response and dexamethasone suppression as screening tests in canine hyperadrenocorticism

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Abstract

Sixty-four dogs were shown to have hyperadrenocorticism. Seven dogs had an adrenal gland tumor removed at laparotomy. Twenty-six dogs were diagnosed as having pituitary-dependent hyperadrenocorticism. At necropsy, 16 of these 26 dogs had a pituitary tumor and bilateral adrenal gland hyperplasia and 10 had bilateral adrenal gland hyperplasia without evidence of a pituitary tumor. Thirty-one dogs were diagnosed as having hyperadrenocorticism after complete remission of all clinical signs following o,p'-DDD therapy. Each of the 64 dogs was tested by ACTH stimulation and by dexamethasone suppression to assess the pituitary-adrenal axis prior to surgery, necropsy, or treatment with o,p'-DDD (mitotane). The dexamethasone screening test was diagnostic more often than was the ACTH stimulation test in each of the 3 groups, ie, 100% vs 57% in the adrenal gland tumor group, 96% vs 88% in the pituitary-dependent hyperadrenocorticism group, 86% vs 84% in the dogs that responded to o,p'-DDD therapy, and 92% vs 83% in all 64 dogs. No dog with hyperadrenocorticism was normal on both endocrine tests. The response to dexamethasone administration in the adrenal gland tumor and pituitary-dependent groups of dogs with hyperadrenocorticism was similar. Significant differences were not seen in the response to ACTH stimulation in these 2 groups of dogs with hyperadrenocorticism. Either of these tests suggest hyperadrenocorticism if results are abnormal but do not provide evidence for differentiating between pituitary-dependent and adrenal gland tumor hyperadrenocorticism. Both tests were considered useful and reasonably reliable when attempting to confirm a diagnosis of hyperadrenocorticism.

Original languageEnglish (US)
Pages (from-to)506-510
Number of pages5
JournalJournal of the American Veterinary Medical Association
Volume182
Issue number5
StatePublished - 1983

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Adrenocortical Hyperfunction
hyperadrenocorticism
dexamethasone
Adrenocorticotropic Hormone
Dexamethasone
Canidae
Dogs
screening
adrenal glands
dogs
Adrenal Glands
Mitotane
DDD (pesticide)
neoplasms
Pituitary Neoplasms
hyperplasia
Hyperplasia
necropsy
mitotane
testing

ASJC Scopus subject areas

  • veterinary(all)

Cite this

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title = "Comparison of ACTH response and dexamethasone suppression as screening tests in canine hyperadrenocorticism",
abstract = "Sixty-four dogs were shown to have hyperadrenocorticism. Seven dogs had an adrenal gland tumor removed at laparotomy. Twenty-six dogs were diagnosed as having pituitary-dependent hyperadrenocorticism. At necropsy, 16 of these 26 dogs had a pituitary tumor and bilateral adrenal gland hyperplasia and 10 had bilateral adrenal gland hyperplasia without evidence of a pituitary tumor. Thirty-one dogs were diagnosed as having hyperadrenocorticism after complete remission of all clinical signs following o,p'-DDD therapy. Each of the 64 dogs was tested by ACTH stimulation and by dexamethasone suppression to assess the pituitary-adrenal axis prior to surgery, necropsy, or treatment with o,p'-DDD (mitotane). The dexamethasone screening test was diagnostic more often than was the ACTH stimulation test in each of the 3 groups, ie, 100{\%} vs 57{\%} in the adrenal gland tumor group, 96{\%} vs 88{\%} in the pituitary-dependent hyperadrenocorticism group, 86{\%} vs 84{\%} in the dogs that responded to o,p'-DDD therapy, and 92{\%} vs 83{\%} in all 64 dogs. No dog with hyperadrenocorticism was normal on both endocrine tests. The response to dexamethasone administration in the adrenal gland tumor and pituitary-dependent groups of dogs with hyperadrenocorticism was similar. Significant differences were not seen in the response to ACTH stimulation in these 2 groups of dogs with hyperadrenocorticism. Either of these tests suggest hyperadrenocorticism if results are abnormal but do not provide evidence for differentiating between pituitary-dependent and adrenal gland tumor hyperadrenocorticism. Both tests were considered useful and reasonably reliable when attempting to confirm a diagnosis of hyperadrenocorticism.",
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AB - Sixty-four dogs were shown to have hyperadrenocorticism. Seven dogs had an adrenal gland tumor removed at laparotomy. Twenty-six dogs were diagnosed as having pituitary-dependent hyperadrenocorticism. At necropsy, 16 of these 26 dogs had a pituitary tumor and bilateral adrenal gland hyperplasia and 10 had bilateral adrenal gland hyperplasia without evidence of a pituitary tumor. Thirty-one dogs were diagnosed as having hyperadrenocorticism after complete remission of all clinical signs following o,p'-DDD therapy. Each of the 64 dogs was tested by ACTH stimulation and by dexamethasone suppression to assess the pituitary-adrenal axis prior to surgery, necropsy, or treatment with o,p'-DDD (mitotane). The dexamethasone screening test was diagnostic more often than was the ACTH stimulation test in each of the 3 groups, ie, 100% vs 57% in the adrenal gland tumor group, 96% vs 88% in the pituitary-dependent hyperadrenocorticism group, 86% vs 84% in the dogs that responded to o,p'-DDD therapy, and 92% vs 83% in all 64 dogs. No dog with hyperadrenocorticism was normal on both endocrine tests. The response to dexamethasone administration in the adrenal gland tumor and pituitary-dependent groups of dogs with hyperadrenocorticism was similar. Significant differences were not seen in the response to ACTH stimulation in these 2 groups of dogs with hyperadrenocorticism. Either of these tests suggest hyperadrenocorticism if results are abnormal but do not provide evidence for differentiating between pituitary-dependent and adrenal gland tumor hyperadrenocorticism. Both tests were considered useful and reasonably reliable when attempting to confirm a diagnosis of hyperadrenocorticism.

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