• 1.

    Burkitt JMHaskins SCNelson RW, et al. Relative adrenal insufficiency in dogs with sepsis. J Vet Intern Med 2007; 21:226231.

  • 2.

    Martin LGGroman RPFletcher DJ, et al. Pituitary-adrenal function in dogs with acute critical illness. J Am Vet Med Assoc 2008; 233:8795.

  • 3.

    Rivers EPGaspari MSaad GA, et al. Adrenal insufficiency in high-risk surgical ICU patients. Chest 2001; 119:889896.

  • 4.

    Marik PEZaloga GP. Adrenal insufficiency during septic shock. Crit Care Med 2003; 31:141145.

  • 5.

    Annane DSebille VCharpentier C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288:862871.

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

    Beishuizen AThijs LG. Relative adrenal failure in intensive care: an identifiable problem requiring treatment? Best Pract Res Clin Endocrinol Metab 2001; 15:513531.

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

    Soni APepper GMWyrwinski PM, et al. Adrenal insufficiency occurring during septic shock: incidence, outcome, and relationship to peripheral cytokine levels. Am J Med 1995; 98:266271.

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

    Moran JLChapman MJO'Fathartaigh MS, et al. Hypocortisolaemia and adrenocortical responsiveness at onset of septic shock. Intensive Care Med 1994; 20:489495.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Feldman ENelson R. Canine and feline endocrinology and reproduction. 3rd ed. St Louis: Elsevier, 2004.

  • 10.

    Cohn LADeclue AECohen RL, et al. Effects of fluticasone propionate dosage in an experimental model of feline asthma. J Feline Med Surg 2010; 12:9196.

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

    Peterson MEGreco DSOrth DN. Primary hypoadrenocorticism in ten cats. J Vet Intern Med 1989; 3:5558.

  • 12.

    Reinero CRBrownlee LDecile KC, et al. Inhaled flunisolide suppresses the hypothalamic-pituitary-adrenocortical axis, but has minimal systemic immune effects in healthy cats. J Vet Intern Med 2006; 20:5764.

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

    Millard RPPickens EHWells KL. Excessive production of sex hormones in a cat with an adrenocortical tumor. J Am Vet Med Assoc 2009; 234:505508.

  • 14.

    DeClue AEBreshears LAPardo ID, et al. Hyperaldosteronism and hyperprogesteronism in a cat with an adrenal cortical carcinoma. J Vet Intern Med 2005; 19:355358.

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

    Boag AKNeiger RChurch DB. Trilostane treatment of bilateral adrenal enlargement and excessive sex steroid hormone production in a cat. J Small Anim Pract 2004; 45:263266.

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

    Rossmeisl JH JrScott-Moncrieff JCSiems J, et al. Hyper-adrenocorticism and hyperprogesteronemia in a cat with an adrenocortical adenocarcinoma. J Am Anim Hosp Assoc 2000; 36:512517.

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

    Boord MGriffin C. Progesterone secreting adrenal mass in a cat with clinical signs of hyperadrenocorticism. J Am Vet Med Assoc 1999; 214:666669.

    • Search Google Scholar
    • Export Citation
  • 18.

    Zimmer CHorauf AReusch C. Ultrasonographic examination of the adrenal gland and evaluation of the hypophyseal-adrenal axis in 20 cats. J Small Anim Pract 2000; 41:156160.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Graves TKSchall WDRefsal K, et al. Basal and ACTH-stimulated plasma aldosterone concentrations are normal or increased in dogs with trichuriasis-associated pseudohypoadre-nocorticism. J Vet Intern Med 1994; 8:287289.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Golden DLLothrop CD Jr. A retrospective study of aldosterone secretion in normal and adrenopathic dogs. J Vet Intern Med 1988; 2:121125.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Willard MDRefsal KThacker E. Evaluation of plasma aldosterone concentrations before and after ACTH administration in clinically normal dogs and in dogs with various diseases (Erratum published in Am J Vet Res 1988; 49:283). Am J Vet Res 1987; 48:1713–1718.

    • Search Google Scholar
    • Export Citation
  • 22.

    Goy-Thollot IDecosne-Junot CBonnet JM. Influence of aging on adrenal responsiveness in a population of eleven healthy beagles. Res Vet Sci 2007; 82:195201.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Peterson MEKemppainen RJ. Dose-response relation between plasma concentrations of corticotropin and cortisol after administration of incremental doses of cosyntropin for corticotropin stimulation testing in cats. Am J Vet Res 1993; 54:300304.

    • Search Google Scholar
    • Export Citation
  • 24.

    Frank LAOliver JW. Comparison of serum cortisol concentrations in clinically normal dogs after administration of freshly reconstituted versus reconstituted and stored frozen cosyntropin. J Am Vet Med Assoc 1998; 212:15691571.

    • Search Google Scholar
    • Export Citation
  • 25.

    Kemppainen RMansfield PSartin J. Endocrine responses of normal cats to TSH and synthetic ACTH administration. J Am Anim Hosp Assoc 1984; 20:737740.

    • Search Google Scholar
    • Export Citation
  • 26.

    Yu SMorris JG. Plasma aldosterone concentration of cats. Vet J 1998; 155:6368.

  • 27.

    Schoeman JPEvans HJChilds D, et al. Cortisol response to two different doses of intravenous synthetic ACTH (tetracosactrin) in overweight cats. J Small Anim Pract 2000; 41:552557.

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

    Tordjman KJaffe ATrostanetsky Y, et al. Low-dose (1 microgram) adrenocorticotrophin (ACTH) stimulation as a screening test for impaired hypothalamo-pituitary-adrenal axis function: sensitivity, specificity and accuracy in comparison with the high-dose (250 microgram) test. Clin Endocrinol (Oxf) 2000; 52:633640.

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

    Zaloga GPMarik P. Hypothalamic-pituitary-adrenal insufficiency. Crit Care Clin 2001; 17:2541.

  • 30.

    Peterson MEKemppainen RJ. Comparison of intravenous and intramuscular routes of administering cosyntropin for corticotropin stimulation testing in cats. Am J Vet Res 1992; 53:13921395.

    • Search Google Scholar
    • Export Citation
  • 31.

    Peterson MEKemppainen RJ. Comparison of the immunoreactive plasma corticotropin and cortisol responses to two synthetic corticotropin preparations (tetracosactrin and cosyntropin) in healthy cats. Am J Vet Res 1992; 53:17521755.

    • Search Google Scholar
    • Export Citation
  • 32.

    Pessina PFernández-Foren ACueto E, et al. Cortisol secretion after adrenocorticotrophin (ACTH) and dexamethasone tests in healthy female and male dogs. Acta Vet Scand 2009; 51:33.

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

    van Lier EPerez-Clariget RForsberg M. Sex differences in cortisol secretion after administration of an ACTH analogue in sheep during the breeding and non-breeding season. Anim Reprod Sci 2003; 79:8192.

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

    Javadi SSlingerland LIvan de Beek MG, et al. Plasma renin activity and plasma concentrations of aldosterone, cortisol, adrenocorticotropic hormone, and alpha-melanocyte-stimulating hormone in healthy cats. J Vet Intern Med 2004; 18:625631.

    • Search Google Scholar
    • Export Citation
  • 35.

    Willemse TVroom MWMol JA, et al. Changes in plasma cortisol, corticotropin, and α-melanocyte-stimulating hormone concentrations in cats before and after physical restraint and intradermal testing. Am J Vet Res 1993; 54:6972.

    • Search Google Scholar
    • Export Citation

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Cortisol and aldosterone response to various doses of cosyntropin in healthy cats

Amy E. DeClue DVM, MS, DACVIM1, Linda G. Martin DVM, MS, DACVECC2, Ellen N. Behrend VMD, PhD, DACVIM3, Leah A. Cohn DVM, PhD, DACVIM4, David I. Dismukes DVM, MS, DACVS5, and Hollie P. Lee6
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  • 1 Comparative Internal Medicine Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211
  • | 2 Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849
  • | 3 Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849
  • | 4 Comparative Internal Medicine Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211
  • | 5 Comparative Internal Medicine Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211
  • | 6 Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849

Abstract

Objective—To determine the lowest dose of cosyntropin on a per body weight basis that would produce maximal cortisol and aldosterone secretion and the ideal timing of blood sample collection after ACTH stimulation in healthy cats.

Design—Randomized crossover trial.

Animals—7 adult sexually intact male purpose-bred cats.

Procedures—Each cat received saline (0.9% NaCl) solution (control) and 5 doses (125 μg/cat and 10, 5, 2.5, and 1 μg/kg [4.54, 2.27, 1.14, and 0.45 μg/lb]) of cosyntropin IV with a 2-week washout period between treatments. Blood samples were obtained before (baseline) and at 15, 30, 45, 60, 75, and 90 minutes after administration of saline solution or cosyntropin.

Results—Serum cortisol and aldosterone concentration increased significantly, compared with baseline values, after administration of all cosyntropin doses. Lower doses of cosyntropin resulted in an adrenocortical response equivalent to the traditional dose of 125 μg/cat. The lowest doses of cosyntropin that stimulated a maximal cortisol and aldosterone response were 5 and 2.5 μg/kg, respectively. Lower doses of cosyntropin resulted in a shorter interval between IV administration of cosyntropin and peak serum cortisol and aldosterone concentrations.

Conclusions and Clinical Relevance—Low-dose ACTH stimulation testing with IV administration of cosyntropin at 5 μg/kg followed by blood sample collection at 60 to 75 minutes resulted in concurrent peak serum cortisol and aldosterone concentrations that were equivalent to those achieved following administration of cosyntropin at 125 μg/cat, the standard dose currently used.

Abstract

Objective—To determine the lowest dose of cosyntropin on a per body weight basis that would produce maximal cortisol and aldosterone secretion and the ideal timing of blood sample collection after ACTH stimulation in healthy cats.

Design—Randomized crossover trial.

Animals—7 adult sexually intact male purpose-bred cats.

Procedures—Each cat received saline (0.9% NaCl) solution (control) and 5 doses (125 μg/cat and 10, 5, 2.5, and 1 μg/kg [4.54, 2.27, 1.14, and 0.45 μg/lb]) of cosyntropin IV with a 2-week washout period between treatments. Blood samples were obtained before (baseline) and at 15, 30, 45, 60, 75, and 90 minutes after administration of saline solution or cosyntropin.

Results—Serum cortisol and aldosterone concentration increased significantly, compared with baseline values, after administration of all cosyntropin doses. Lower doses of cosyntropin resulted in an adrenocortical response equivalent to the traditional dose of 125 μg/cat. The lowest doses of cosyntropin that stimulated a maximal cortisol and aldosterone response were 5 and 2.5 μg/kg, respectively. Lower doses of cosyntropin resulted in a shorter interval between IV administration of cosyntropin and peak serum cortisol and aldosterone concentrations.

Conclusions and Clinical Relevance—Low-dose ACTH stimulation testing with IV administration of cosyntropin at 5 μg/kg followed by blood sample collection at 60 to 75 minutes resulted in concurrent peak serum cortisol and aldosterone concentrations that were equivalent to those achieved following administration of cosyntropin at 125 μg/cat, the standard dose currently used.

Contributor Notes

Dr. Dismukes' present address is Alabama Veterinary Specialists, 3783 Pine Ln SE, Bessemer, AL 35022.

Supported in part by the University of Missouri.

Presented in abstract form at the 27th Annual American College of Veterinary Internal Medicine Forum, Montreal, June 2009.

The authors thank Rachael Cohen for technical assistance.

Address correspondence to Dr. DeClue (decluea@Missouri.edu).