To evaluate the urine cortisol-to-creatinine ratio (UCCR) for the diagnosis of hypoadrenocorticism (HA) in dogs and to determine whether the method of urine cortisol measurement affects results.
41 dogs with naturally occurring HA and 107 dogs with nonadrenal illness.
Urine samples were prospectively collected from dogs undergoing testing for HA. Urine cortisol concentrations were measured at a veterinary diagnostic laboratory using either a radioimmunoassay (RIA) or a chemiluminescent immunoassay (CLIA). Receiver operating characteristic (ROC) curves were constructed to assess UCCR performance by both methods for HA diagnosis. Sensitivities, specificities, accuracies, and predictive values were calculated for various cutpoints.
The areas under the ROC curves for UCCR diagnosis of HA were 0.99 (95% CI, 0.98 to 1.00) and 1.00 (95% CI, 1.00 to 1.00) when urine cortisol was determined by RIA and CLIA, respectively. An RIA UCCR of ≤ 2 was 97.2% sensitive, 93.6% specific, and 94.7% accurate for HA diagnosis, whereas a CLIA UCCR of ≤ 10 was 100% sensitive, specific, and accurate. An RIA UCCR > 4 and a CLIA UCCR of > 10 had negative predictive values of 100%.
The UCCR was an accurate diagnostic test for HA in this study population, although equivocal results are possible. Case characteristics, method of cortisol measurement, and laboratory-specific cutpoints must be considered when interpreting results.
Objective—To evaluate the effects of deracoxib and aspirin on serum concentrations of thyroxine (T4), 3,5,3′-triiodothyronine (T3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) in healthy dogs.
Procedure—Dogs were allocated to 1 of 3 groups of 8 dogs each. Dogs received the vehicle used for deracoxib tablets (PO, q 8 h; placebo), aspirin (23 to 25 mg/kg, PO, q 8 h), or deracoxib (1.25 to 1.8 mg/kg, PO, q 24 h) and placebo (PO, q 8 h) for 28 days. Measurement of serum concentrations of T4, T3, fT4, and TSH were performed 7 days before treatment (day −7), on days 14 and 28 of treatment, and 14 days after treatment was discontinued. Plasma total protein, albumin, and globulin concentrations were measured on days −7 and 28.
Results—Mean serum T4, fT4, and T3 concentrations decreased significantly from baseline on days 14 and 28 of treatment in dogs receiving aspirin, compared with those receiving placebo. Mean plasma total protein, albumin, and globulin concentrations on day 28 decreased significantly in dogs receiving aspirin, compared with those receiving placebo. Fourteen days after administration of aspirin was stopped, differences in hormone concentrations were no longer significant. Differences in serum TSH or the free fraction of T4 were not detected at any time. No significant difference in any of the analytes was detected at any time in dogs treated with deracoxib.
Conclusions and Clinical Relevance—Aspirin had substantial suppressive effects on thyroid hormone concentrations in dogs. Treatment with high dosages of aspirin, but not deracoxib, should be discontinued prior to evaluation of thyroid function.
Objective—To determine prevalence of thyroid hormone
autoantibodies (THAA) in serum of dogs with
clinical signs of hypothyroidism.
Sample Population—287,948 serum samples from
dogs with clinical signs consistent with hypothyroidism.
Procedure—Serum THAA were detected by use of a
radiometric assay. Correlation and X2 analyses were
used to determine whether prevalence varied with
breed, age, sex, or body weight. Only breeds for
which ≥ 50 samples had been submitted were used
for analysis of breed prevalence.
Results—Thyroid hormone autoantibodies were
detected in 18,135 (6.3%) samples. The 10 breeds
with the highest prevalence of THAA were the
Pointer, English Setter, English Pointer, Skye Terrier,
German Wirehaired Pointer, Old English Sheepdog,
Boxer, Maltese, Kuvasz, and Petit Basset Griffon
Vendeen. Prevalence was significantly correlated
with body weight and was highest in dogs between 2
and 4 years old. Females were significantly more likely
to have THAA than were males.
Conclusions and Clinical Relevance—Thyroid hormone
autoantibodies may falsely increase measured
triiodothyronine (T3) and thyroxine (T4) concentrations
in dogs; results suggest that T3 concentration may be
falsely increased in approximately 57 of 1,000 dogs
with hypothyroidism and that T4 concentration may
be falsely increased in approximately 17 of 1,000
dogs with hypothyroidism. Results also suggested
that dogs of certain breeds were significantly more or
less likely to have THAA than were dogs in general.
(J Am Vet Med Assoc 2002;220:466–471)
CASE DESCRIPTION A 7-year-old castrated male Havanese was evaluated at a veterinary teaching hospital because of a 12-week history of hyperactivity, aggression, and progressive weight loss despite a healthy appetite.
CLINICAL FINDINGS Tachycardia was the only remarkable finding during physical examination. Serum 3,5,3′-triiodothyronine (T3) and free T3 concentrations were markedly increased, and thyroxine (T4), free T4, and thyroid-stimulating hormone concentrations were at or decreased from the respective reference ranges. Thyroid scintigraphy revealed suppressed uptake of sodium pertechnetate Tc 99m by the thyroid gland but no ectopic thyroid tissue, which was indicative of thyrotoxicosis induced by an exogenous source of T3.
TREATMENT AND OUTCOME The dog was hospitalized for 24 hours, and its diet was changed, after which the clinical signs rapidly resolved and serum T3 and free T3 concentrations returned to within the respective reference ranges. This raised suspicion of an exogenous source of T3 in the dog's home environment. Analysis of the commercial beef-based canned food the dog was being fed revealed a high concentration of T3 (1.39 μg/g) and an iodine (82.44 μg/g) concentration that exceeded industry recommendations. No other source of T3 was identified in the dog's environment.
CLINICAL RELEVANCE To our knowledge, this is the first report of clinical thyrotoxicosis in a dog induced by exogenous T3, although the source of exogenous T3 was not identified. This case highlights the importance of measuring serum T3 and thyroid-stimulating hormone concentrations in addition to T4 and free T4 concentrations when there is incongruity between clinical findings and thyroid function test results.
Objective—To determine the effects of levothyroxine
sodium (L-T4) on serum concentrations of thyroid
gland hormones and responses to injections of thyrotropin-releasing hormone (TRH) in euthyroid horses.
Animals—12 healthy adult mares.
Procedure—8 horses received an incrementally
increasing dosage of L-T4 (24, 48, 72, or 96 mg of
L-T4/d) for weeks 1 to 8. Each dose was provided for
2 weeks. Four additional horses remained untreated.
Serum concentrations of total triiodothyronine (tT3),
total thyroxine (tT4), free T3 (fT3), free T4 (fT4), and thyroid-
stimulating hormone (TSH) were measured in
samples obtained at weeks 0, 2, 4, 6, and 8; 1.2 mg
of TRH was then administered IV, and serum concentrations
of thyroid gland hormones were measured 2
and 4 hours after injection. Serum reverse T3 (rT3) concentration
was also measured in the samples collected
at weeks 0 and 8.
Results—Treated horses lost a significant amount of
weight (median, 19 kg). Significant treatment-by-time
effects were detected for serum tT3, tT4, fT3, fT4, and
TSH concentrations, and serum tT4 concentrations
were positively correlated ( r, 0.95) with time (and
therefore dosage) in treated horses. Mean ± SD
serum rT3 concentration significantly increased in
treated horses (3.06 ± 0.51 nmol/L for week 8 vs 0.74
± 0.22 nmol/L for week 0). Serum tT3, tT4, fT3, and TSH
concentrations in response to TRH injections differed
significantly between treated and untreated horses.
Conclusions and Clinical Relevance—Administration
of levothyroxine sodium increased serum tT4 concentrations
and blunted responses to TRH injection in healthy
euthyroid horses. (Am J Vet Res 2005;66:1025–1031)
Objective—To evaluate the effect of a soy-based diet on general health and adrenocortical and thyroid gland function in dogs.
Animals—20 healthy privately owned adult dogs.
Procedures—In a randomized controlled clinical trial, dogs were fed a soy-based diet with high (HID; n = 10) or low (LID; 10) isoflavones content. General health of dogs, clinicopathologic variables, and serum concentrations of adrenal gland and thyroid gland hormones were assessed before treatment was initiated and up to 1 year later. Differences between groups with respect to changes in the values of variables after treatment were assessed by means of a Student t test (2 time points) and repeated-measures ANOVA (3 time points).
Results—No differences were detected between the 2 groups with respect to body condition and results of hematologic, serum biochemical, and urine analyses. Most serum concentrations of hormones did not change significantly after treatment, nor were they affected by diet. However, the mean change in serum concentration of total thyroxine was higher in the HID group (15.7 pmol/L) than that in the LID group (–1.9 pmol/L). The mean change in estradiol concentration after ACTH stimulation at 1 year after diets began was also higher in the HID group (19.0 pg/mL) than that in the LID group (–5.6 pg/mL).
Conclusions and Clinical Relevance—Phytoestrogens may influence endocrine function in dogs. Feeding soy to dogs on a long-term basis may influence results of studies in which endocrine function is evaluated, although larger studies are needed to confirm this supposition.
Objective—To determine the effects of hypothyroidism on insulin sensitivity, glucose tolerance, and concentrations of hormones counter-regulatory to insulin in dogs.
Animals—8 anestrous mixed-breed bitches with experimentally induced hypothyroidism and 8 euthyroid control dogs.
Procedures—The insulin-modified frequently sampled IV glucose tolerance test and minimal model analysis were used to determine basal plasma insulin and glucose concentrations, acute insulin response to glucose, insulin sensitivity, glucose effectiveness, and disposition index. Growth hormone response was assessed by stimulation and suppression tests. Additionally, basal serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) concentrations and urine cortisol-to-creatinine concentration ratios were measured and dual energy x-ray absorptiometry was performed to evaluate body composition.
Results—Insulin sensitivity was lower in the hypothyroid group than in the euthyroid group, whereas acute insulin response to glucose was higher. Glucose effectiveness and disposition index were not different between groups. Basal serum GH and IGF-1 concentrations as well as abdominal fat content were high in hypothyroid dogs, but urine cortisol-to-creatinine concentration ratios were unchanged.
Conclusions and Clinical Relevance—Hypothyroidism appeared to negatively affect glucose homeostasis by inducing insulin resistance, but overall glucose tolerance was maintained by increased insulin secretion in hypothyroid dogs. Possible factors affecting insulin sensitivity are high serum GH and IGF-1 concentrations and an increase in abdominal fat. In dogs with diseases involving impaired insulin secretion such as diabetes mellitus, concurrent hypothyroidism can have important clinical implications.