Serum cortisol concentration and force plate analysis in the assessment of pain associated with sodium urate–induced acute synovitis in dogs

Judith D. Feldsien Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

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Vicki L. Wilke Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

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Richard B. Evans Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Mike G. Conzemius Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

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Abstract

Objective—To determine the relationship between serum cortisol concentration and pain severity as measured by force platform gait analysis in dogs with experimentally induced synovitis of the stifle joint.

Animals—10 healthy hound-type dogs.

Procedures—Dogs underwent 2 study phases. In the first phase, serum cortisol concentration, systolic arterial blood pressure, heart rate, and gait data were obtained at 0 (first sample), 2.5, 5, 7.5, and 10 hours. In the second phase, the same data were gathered immediately before (0 hours) and 2.5, 5, 7.5, and 10 hours after induction of acute urate synovitis in the left stifle joint. Data were statistically evaluated to compare changes in variable values over time and to determine the accuracy of serum cortisol measurements for diagnosis of acute orthopedic pain.

Results—Following induction of synovitis, ground reaction forces were significantly decreased relative to preinduction values at 2.5, 5.0, 7.5, and 10.0 hours and serum cortisol concentration was significantly increased at 2.5 hours. A cortisol concentration of ≥ 1.6 μg/dL indicated pain with a 91% sensitivity and 35% specificity.

Conclusions and Clinical Relevance—In this model, cortisol concentration may be useful for diagnosing pain in dogs. Although, with a cutoff of ≥ 1.6 μg/dL, pain would be detected in most dogs with pain, some pain-free dogs would also be identified as having pain. Conversely, dogs with a serum cortisol of < 1.6 μg/dL would be unlikely to have pain. Validation of this diagnostic test in a large, heterogeneous group of clinical patients is necessary.

Abstract

Objective—To determine the relationship between serum cortisol concentration and pain severity as measured by force platform gait analysis in dogs with experimentally induced synovitis of the stifle joint.

Animals—10 healthy hound-type dogs.

Procedures—Dogs underwent 2 study phases. In the first phase, serum cortisol concentration, systolic arterial blood pressure, heart rate, and gait data were obtained at 0 (first sample), 2.5, 5, 7.5, and 10 hours. In the second phase, the same data were gathered immediately before (0 hours) and 2.5, 5, 7.5, and 10 hours after induction of acute urate synovitis in the left stifle joint. Data were statistically evaluated to compare changes in variable values over time and to determine the accuracy of serum cortisol measurements for diagnosis of acute orthopedic pain.

Results—Following induction of synovitis, ground reaction forces were significantly decreased relative to preinduction values at 2.5, 5.0, 7.5, and 10.0 hours and serum cortisol concentration was significantly increased at 2.5 hours. A cortisol concentration of ≥ 1.6 μg/dL indicated pain with a 91% sensitivity and 35% specificity.

Conclusions and Clinical Relevance—In this model, cortisol concentration may be useful for diagnosing pain in dogs. Although, with a cutoff of ≥ 1.6 μg/dL, pain would be detected in most dogs with pain, some pain-free dogs would also be identified as having pain. Conversely, dogs with a serum cortisol of < 1.6 μg/dL would be unlikely to have pain. Validation of this diagnostic test in a large, heterogeneous group of clinical patients is necessary.

Contributor Notes

Dr. Feldsien's present address is Katonah Bedford Veterinary Center, 546 N Bedford Rd, Bedford Hills, NY 10507.

Supported by the University of Minnesota Small Animal Comparative Research Laboratory and Solace Pharmaceuticals.

Presented in abstract form at the Veterinary Orthopedic Society Annual Conference, Steamboat Springs, Colo, February–March 2009.

Address correspondence to Dr. Feldsien (jfeldsien@kbvetcenter.com).
  • 1.

    Conzemius MGHill CMSammarco JL, et al.Correlation between subjective and objective measures used to determine severity of postoperative pain in dogs. J Am Vet Med Assoc 1997;210:16191622.

    • Search Google Scholar
    • Export Citation
  • 2.

    Waxman ASRobinson DAEvans RB, et al.Relationship between objective and subjective assessment of limb function in normal dogs with an experimentally induced lameness. Vet Surg 2008;37:241246.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Quinn MMKeuler NSLu Y, et al.Evaluation of agreement between numerical rating scales, visual analogue scoring scales, and force plate gait analysis in dogs. Vet Surg 2007;36:360367.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Mastrocinque SFantoni DT. A comparison of preoperative tramadol and morphine for the control of early postoperative pain in canine ovariohysterectomy. Vet Anaesth Analg 2003;30:220228.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Almeida TFFantoni DTMastrocinque S, et al.Epidural anesthesia with bupivacaine, bupivacaine and fentanyl, or bupivacaine and sufentanil during intravenous administration of propofol for ovariohysterectomy in dogs. J Am Vet Med Assoc 2007;230:4551.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Sammarco JLConzemius MGPerkowski SZ, et al.Postoperative analgesia for stifle surgery: a comparison of intra-articular bupivacaine, morphine, or saline. Vet Surg 1996;25:5969.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Conzemius MGBrockman DJKing LG, et al.Analgesia in dogs after intercostal thoracotomy: a clinical trial comparing intravenous buprenorphine and interpleural bupivacaine. Vet Surg 1994;23:291298.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Molony VKent JE. Assessment of acute pain in farm animals using behavioral and physiological measurements. J Anim Sci 1997;75:266272.

  • 9.

    Moberg GPMench JA. The biology of animal stress: basic principles and implications for animal welfare. Wallingford, Oxfordshire, England: CABI Publications, 2000.

    • Search Google Scholar
    • Export Citation
  • 10.

    Fox SMMellor DJLawoko CR, et al.Changes in plasma cortisol concentrations in bitches in response to different combinations of halothane and butorphanol, with or without ovariohysterectomy. Res Vet Sci 1998;65:125133.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Karnik PSJohnston SWard D, et al.The effects of epidural deracoxib on the ground reaction forces in an acute stifle synovitis model. Vet Surg 2006;35:3442.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Borer LRPeel JESeewald W, et al.Effect of carprofen, etodolac, meloxicam, or butorphanol in dogs with induced acute synovitis. Am J Vet Res 2003;64:14291437.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Schumacher HRPhelps PAgudelo CA. Urate crystal induced inflammation in dog joints: sequence of synovial changes. J Rheumatol 1974;1:102113.

    • Search Google Scholar
    • Export Citation
  • 14.

    Punke JPSpeas ALReynolds LR, et al.Kinetic gait and subjective analysis of the effects of a tachykinin receptor antagonist in dogs with sodium urate-induced synovitis. Am J Vet Res 2007;68:704708.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Hazewinkel HAvan den Brom WETheyse LF, et al.Comparison of the effects of firocoxib, carprofen and vedaprofen in a sodium urate crystal induced synovitis model of arthritis in dogs. Res Vet Sci 2008;84:7479.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    McCann MEAndersen DRZhang D, et al.In vitro effects and in vivo efficacy of a novel cyclooxygenase-2 inhibitor in dogs with experimentally induced synovitis. Am J Vet Res 2004;65:503512.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Millis DLWeigel JPMoyers T, et al.Effect of deracoxib, a new COX-2 inhibitor, on the prevention of lameness induced by chemical synovitis in dogs. Vet Ther 2002;3:453464.

    • Search Google Scholar
    • Export Citation
  • 18.

    Cross ARBudsberg SCKeefe TJ. Kinetic gait analysis assessment of meloxicam efficacy in a sodium urate-induced synovitis model in dogs. Am J Vet Res 1997;58:626631.

    • Search Google Scholar
    • Export Citation
  • 19.

    Rumph PFKincaid SABaird DK, et al.Vertical ground reaction force distribution during experimentally induced acute synovitis in dogs. Am J Vet Res 1993;54:365369.

    • Search Google Scholar
    • Export Citation
  • 20.

    Drag MKunkle BNRomano D, et al.Firocoxib efficacy preventing urate-induced synovitis, pain, and inflammation in dogs. Vet Ther 2007;8:4150.

    • Search Google Scholar
    • Export Citation
  • 21.

    Singh AKJiang YWhite T, et al.Validation of nonradioactive chemiluminescent immunoassay methods for the analysis of thyroxine and cortisol in blood samples obtained from dogs, cats, and horses. J Vet Diagn Invest 1997;9:261268.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Greiner MPfeiffer DSmith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med 2000;45234541.

    • Search Google Scholar
    • Export Citation
  • 23.

    Holton LLScott EMNolan AM, et al.Relationship between physiological factors and clinical pain in dogs scored using a numerical rating scale. J Small Anim Pract 1998;39:469474.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Reese CJTrotter EJShort CE, et al.Assessing the efficacy of perioperative carprofen administration in dogs undergoing surgical repair of a ruptured cranial cruciate ligament. J Am Anim Hosp Assoc 2000;36:448455.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Bergmann HMNolte IKramer S. Comparison of analgesic efficacy of preoperative or postoperative carprofen with or without preincisional mepivacaine epidural anesthesia in canine pelvic or femoral fracture repair. Vet Surg 2007;36:623632.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Egger CMGlerum LMichelle Haag K. Efficacy and cost-effectiveness of transdermal fentanyl patches for the relief of post-operative pain in dogs after anterior cruciate ligament and pelvic limb repair. Vet Anaesth Analg 2007;34:200208.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Slingsby LSMurison PJGoossens L, et al.A comparison between pre-operative carprofen and a long-acting sufentanil formulation for analgesia after ovariohysterectomy in dogs. Vet Anaesth Analg 2006;33:313327.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Sibanda SHughes JMPawson PE, et al.The effects of preoperative extradural bupivacaine and morphine on the stress response in dogs undergoing femorotibial joint surgery. Vet Anaesth Analg 2006;33:246257.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Inoue TKo JCMandsager RE, et al.Efficacy and safety of preoperative etodolac and butorphanol administration in dogs undergoing ovariohysterectomy. J Am Anim Hosp Assoc 2006;42:178188.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Leibetseder ENMosing MJones RS. A comparison of extradural and intravenous methadone on intraoperative isoflurane and postoperative analgesia requirements in dogs. Vet Anaesth Analg 2006;33:128136.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Radlinsky MGMason DERoush JK, et al.Use of a continuous, local infusion of bupivacaine for postoperative analgesia in dogs undergoing total ear canal ablation. J Am Vet Med Assoc 2005;227:414419.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Budsberg SCCross ARQuandt JE, et al.Evaluation of intravenous administration of meloxicam for perioperative pain management following stifle joint surgery in dogs. Am J Vet Res 2002;63:15571563.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Ko JCMandsager RELange DN, et al.Cardiorespiratory responses and plasma cortisol concentrations in dogs treated with medetomidine before undergoing ovariohysterectomy. J Am Vet Med Assoc 2000;217:509514.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Kyles AEHardie EMHansen BD, et al.Comparison of transdermal fentanyl and intramuscular oxymorphone on post-op-erative behaviour after ovariohysterectomy in dogs. Res Vet Sci 1998;65:245251.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Krieger DT. Rhythms of ACTH and corticosteroid secretion in health and disease, and their experimental modification. J Steroid Biochem 1975;6:785791.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Quabbe HJGregor MBumke-Vogt C, et al.Pattern of plasma cortisol during the 24-hour sleep/wake cycle in the rhesus monkey. Endocrinology 1982;110:16411646.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Fulkerson WJTang BY. Ultradian and circadian rhythms in the plasma concentration of cortisol in sheep. J Endocrinol 1979;81:135141.

  • 38.

    Thun REggenberger EZerobin K, et al.Twenty-four-hour secretory pattern of cortisol in the bull: evidence of episodic secretion and circadian rhythm. Endocrinology 1981;109:22082212.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Richkind MEdqvist LE. Peripheral plasma levels of corticosteroids in normal beagles and greyhounds measured by a rapid competitive protein binding technique. Acta Vet Scand 1973;14:745757.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Kemppainen RJSartin JL. Evidence for episodic but not circadian activity in plasma concentrations of adrenocorticotrophin, cortisol and thyroxine in dogs. J Endocrinol 1984;103:219226.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Johnston SDMather EC. Canine plasma cortisol (hydrocortisone) measured by radioimmunoassay: clinical absence of diurnal variation and results of ACTH stimulation and dexamethasone suppression tests. Am J Vet Res 1978;39:17661770.

    • Search Google Scholar
    • Export Citation
  • 42.

    Takahashi YEbihara SNakamura Y, et al.A model of human sleep-related growth hormone secretion in dogs: effects of 3, 6, and 12 hours of forced wakefulness on plasma growth hormone, cortisol, and sleep stages. Endocrinology 1981;109:262272.

    • Crossref
    • Search Google Scholar
    • Export Citation

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