Objective—To evaluate and compare characteristics of a commercially manufactured protamine zinc insulin (PZI) product and PZI products obtained from various compounding pharmacies.
Sample—112 vials of PZI (16 vials of the commercially manufactured product and 8 vials from each of 12 compounding pharmacies) purchased over an 8-month period.
Procedures—Validated methods were used to analyze 2 vials of each product at 4 time points. Appearance, endotoxin concentration, crystal size, insulin concentration in the supernatant, pH, total insulin and zinc concentrations, and species of insulin origin were evaluated.
Results—All 16 vials of commercially manufactured PZI met United States Pharmacopeia (USP) specifications. Of 96 vials of compounded PZI, 1 (1 %) contained a concentration of endotoxin > 32 endotoxin U/mL, 23 (24%) had concentrations of insulin in the supernatant > 1.0 U/mL, and 45 (47%) had pH values < 7.1 or > 7.4; all of these values were outside of specifications. Several vials of compounded PZI (52/96 [54%]) did not meet specifications for zinc concentration (0.06 to 0.1 mg/mL for 40 U of insulin/mL, 0.075 to 0.12 mg/mL for 50 U of insulin/mL, and 0.15 to 0.25 mg/mL for 100 U of insulin/mL), and total insulin concentration in 36 [38%] vials was < 90% of the labeled concentration.
Conclusions and Clinical Relevance—Only 1 of 12 compounded PZI products met all USP specifications in all vials tested. Use of compounded PZI insulin products could potentially lead to serious problems with glycemic control in veterinary patients.
Objective—To determine the effect of natural exposure to domoic acid (DA) on eosinophil counts and adrenal gland function in California sea lions (Zalophus californianus).
Design—Cross-sectional prospective study.
Animals—39 California sea lions.
Procedures—Adult female sea lions admitted to a rehabilitation hospital during 2009 were classified into 1 of 3 groups (acute DA toxicosis, chronic DA toxicosis, or no DA exposure) on the basis of clinical signs, DA concentration in urine or feces, and hippocampal morphology. Endoparasite burden, eosinophil count, and serum cortisol and plasma ACTH concentrations were determined for each sea lion. For a subset of 8 sea lions, fecal glucocorticoid concentration after IM administration of cosyntropin was determined.
Results—Sea lions exposed to DA (acute DA toxicosis, n = 11; chronic DA toxicosis, 19) had higher eosinophil counts and lower serum cortisol concentrations, compared with values for sea lions with no DA exposure (9). Eosinophil count was not associated with endoparasite burden. Serum cortisol concentration was associated with plasma ACTH concentrations in sea lions from the no DA exposure group but not in sea lions in the acute or chronic DA toxicosis groups. Following cosyntropin injection, fecal glucocorticoid concentrations increased in all sea lions evaluated except 1.
Conclusions and Clinical Relevance—In adult sea lions, eosinophilia may be a cost-effective biomarker for DA exposure and may reflect alterations in hypothalamic, pituitary gland, or adrenal gland function. Domoic acid exposure may have subtle health effects on marine animals in addition to induction of neurologic signs.
Objective—To evaluate adrenal sex hormone concentrations
in response to ACTH stimulation in healthy
dogs, dogs with adrenal tumors, and dogs with pituitary-
dependent hyperadrenocorticism (PDH).
Animals—11 healthy control dogs, 9 dogs with
adrenal-dependent hyperadrenocorticism (adenocarcinoma
[ACA] or other tumor); 11 dogs with PDH, and
6 dogs with noncortisol-secreting adrenal tumors
Procedure—Hyperadrenocorticism was diagnosed on
the basis of clinical signs; physical examination findings;
and results of ACTH stimulation test, low-dose
dexamethasone suppression test, or both. Dogs with
noncortisol-secreting ATs did not have hyperadrenocorticism
but had ultrasonographic evidence of an AT.
Concentrations of cortisol, androstenedione, estradiol,
progesterone, testosterone, and 17-hydroxyprogesterone
were measured before and 1 hour after IM
administration of 0.25 mg of synthetic ACTH.
Results—All dogs with ACA, 10 dogs with PDH, and
4 dogs with ATs had 1 or more sex hormone concentrations
greater than the reference range after ACTH
stimulation. The absolute difference for progesterone,
17-hydroxyprogesterone, and testosterone concentrations
(value obtained after ACTH administration minus
value obtained before ACTH administration) was significantly
greater for dogs with ACA, compared with
the other 3 groups. The absolute difference for
androstenedione was significantly greater for dogs
with ACA, compared with dogs with AT and healthy
Conclusions and Clinical Relevance—Dogs with
ACA secrete increased concentrations of adrenal sex
hormones, compared with dogs with PDH, noncortisol-secreting ATs, and healthy dogs. Dogs with noncortisol-secreting ATs also have increased concentrations of sex hormones. There is great interdog variability
in sex hormone concentrations in dogs with ACA
after stimulation with ACTH. (J Am Vet Med Assoc