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Pituitary ACTH and adrenocortical secretion in critically ill dogs

Jennifer E. Prittie DVM1, Linda J. Barton DVM, DACVECC2, Mark E. Peterson DVM, DACVIM3, Robert J. Kemppainen DVM, PhD4, Leslie G. Herr DVM, MS5, and Philip R. Fox DVM, MS, DACVIM6
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  • 1 Department of Medicine, the Bobst Hospital, The Animal Medical Center, New York, NY 10021.
  • | 2 Department of Medicine, the Bobst Hospital, The Animal Medical Center, New York, NY 10021.
  • | 3 Department of Medicine, the Bobst Hospital, The Animal Medical Center, New York, NY 10021.
  • | 4 Department of Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL 36849.
  • | 5 111 Conway Ct, Exton, PA 19341.
  • | 6 Department of Medicine, the Bobst Hospital, The Animal Medical Center, New York, NY 10021.

Abstract

Objective—To evaluate pituitary-adrenal function in a population of critically ill dogs by measuring serial plasma concentrations of basal cortisol, ACTH-stimulated cortisol, and endogenous ACTH.

Design—Prospective study.

Animals—20 critically ill dogs admitted to an intensive care unit (ICU).

Procedure—Basal plasma cortisol, ACTH-stimulated cortisol, and endogenous ACTH concentrations were measured for each dog within 24 hours of admission and daily until death, euthanasia, or discharge from the ICU. Established reference ranges for healthy dogs were used for comparison. Survival prediction index (SPI) scores were calculated for each dog within 24 hours of admission.

Results—No significant difference was found between initial concentrations of basal cortisol, ACTH-stimulated cortisol, and endogenous ACTH in 13 dogs that survived and those in 7 dogs that died. High initial basal endogenous ACTH concentrations were correlated with subsequent high values. Low basal ACTH-stimulated cortisol concentrations were predictive of higher subsequent values. All basal and ACTH-stimulated cortisol concentrations were within or above the reference range in the 52 plasma samples collected from the 20 dogs during hospitalization. The SPI scores correlated with outcome (ie, alive or dead), but none of the plasma hormone concentrations correlated with SPI score or outcome.

Conclusions and Clinical Relevance—Results indicate that none of the critically ill dogs in our study population developed adrenal insufficiency during hospitalization in the ICU. (J Am Vet Med Assoc 2002;220:615–619)

Abstract

Objective—To evaluate pituitary-adrenal function in a population of critically ill dogs by measuring serial plasma concentrations of basal cortisol, ACTH-stimulated cortisol, and endogenous ACTH.

Design—Prospective study.

Animals—20 critically ill dogs admitted to an intensive care unit (ICU).

Procedure—Basal plasma cortisol, ACTH-stimulated cortisol, and endogenous ACTH concentrations were measured for each dog within 24 hours of admission and daily until death, euthanasia, or discharge from the ICU. Established reference ranges for healthy dogs were used for comparison. Survival prediction index (SPI) scores were calculated for each dog within 24 hours of admission.

Results—No significant difference was found between initial concentrations of basal cortisol, ACTH-stimulated cortisol, and endogenous ACTH in 13 dogs that survived and those in 7 dogs that died. High initial basal endogenous ACTH concentrations were correlated with subsequent high values. Low basal ACTH-stimulated cortisol concentrations were predictive of higher subsequent values. All basal and ACTH-stimulated cortisol concentrations were within or above the reference range in the 52 plasma samples collected from the 20 dogs during hospitalization. The SPI scores correlated with outcome (ie, alive or dead), but none of the plasma hormone concentrations correlated with SPI score or outcome.

Conclusions and Clinical Relevance—Results indicate that none of the critically ill dogs in our study population developed adrenal insufficiency during hospitalization in the ICU. (J Am Vet Med Assoc 2002;220:615–619)