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Objective—To evaluate serum 17-hydroxyprogesterone (17-OHP) concentration measurement after administration of ACTH for use in the diagnosis of hyperadrenocorticism in dogs.
Procedure—Serum 17-OHP concentrations were measured before and after ACTH stimulation in 53 healthy dogs to establish reference values for this study. Affected dogs had pituitary-dependent (n = 40) or adrenal tumor–associated (12) hyperadrenocorticism or potentially had atypical hyperadrenocorticism (5; diagnosis confirmed in 1 dog). In affected dogs, frequency interval and borderline and abnormal serum 17-OHP concentrations after ACTH stimulation were determined. Serum cortisol concentrations were assessed via low-dose dexamethasone suppression and ACTH stimulation tests.
Results—In healthy dogs, serum 17-OHP concentration frequency intervals were grouped by sex and reproductive status (defined as < 95th percentile). Frequency intervals of serum 17-OHP concentrations after ACTH stimulation were < 7.7, < 2.0, < 3.2, and < 3.4 ng/mL (< 23.3, < 6.1, < 9.7, and < 10.3 nmol/L) for sexually intact and neutered females and sexually intact and neutered males, respectively. In 53 dogs with confirmed hyperadrenocorticism, serum cortisol concentrations after ACTH stimulation and 8 hours after administration of dexamethasone and serum 17- OHP concentrations after ACTH stimulation were considered borderline or abnormal in 79%, 93%, and 69% of dogs, respectively. Two of 5 dogs considered to have atypical hyperadrenocorticism had abnormal serum 17-OHP concentrations after ACTH stimulation.
Conclusions and Clinical Relevance—Serum 17-OHP concentration measurement after ACTH stimulation may be useful in the diagnosis of hyperadrenocorticism in dogs when other test results are equivocal. (J Am Vet Med Assoc 2005;227:1095–1101)
Objective—To evaluate the clinical features and heritability of naturally occurring hypoadrenocorticism in Nova Scotia Duck Tolling Retrievers (NSDTRs).
Design—Retrospective case series.
Animals—25 NSDTRs with hypoadrenocorticism.
Procedures—Questionnaires completed by owners of NSDTRs with hypoadrenocorticism and medical records from veterinarians were reviewed for information regarding diagnosis, age at diagnosis, concurrent diseases, age at death, and cause of death. Pedigrees were analyzed for heritability and mode of inheritance of hypoadrenocorticism (including complex segregation analysis of pedigrees of 1,515 dogs).
Results—On the basis of results of ACTH stimulation testing, hypoadrenocorticism was diagnosed in 16 female and 9 male NSDTRs (including 6 full siblings). Median age at diagnosis was 2.6 years; the diagnosis was made prior to 2 years of age in 11 dogs. Seventeen dogs had hyponatremia, hyperkalemia, or both, and serum electrolyte concentrations were within reference ranges for 8 dogs at the time of diagnosis. Median survival time after diagnosis for 4 dogs that died or were euthanized as a result of medical causes was 1.6 years. Heritability was calculated at 0.98 with no sex effect, and complex segregation analysis fit a major gene model with an autosomal recessive mode of inheritance.
Conclusions and Clinical Relevance—In NSDTRs, hypoadrenocorticism was diagnosed at an earlier age, compared with published reports of age at diagnosis among the general dog population. Among the study dogs, 32% had no serum electrolyte abnormalities at the time of diagnosis, and the disease appeared to have an autosomal recessive mode of inheritance in the breed.
Objective—To evaluate the effects of twice-daily oral administration of a low-dose of trilostane treatment and assess the duration of effects after once-daily trilostane administration in dogs with naturally occurring hyperadrenocorticism (NOH).
Animals—28 dogs with NOH.
Procedures—22 dogs received 0.5 to 2.5 mg of trilostane/kg (0.23 to 1.14 mg/lb) orally every 12 hours initially. At intervals, dogs were reevaluated; owner assessment of treatment response was recorded. To assess drug effect duration, 16 of the 22 dogs and 6 additional dogs underwent 2 ACTH stimulation tests 3 to 4 hours and 8 to 9 hours after once-daily trilostane administration.
Results—After 1 to 2 weeks, mean trilostane dosage was 1.4 mg/kg (0.64 mg/lb) every 12 hours (n = 22 dogs; good response [resolution of signs], 8; poor response, 14). Four to 8 weeks later, mean dosage was 1.8 mg/kg (0.82 mg/lb) every 12 or 8 hours (n = 21 and 1 dogs, respectively; good response, 15; poor response, 5; 2 dogs were ill). Eight to 16 weeks after the second reevaluation, remaining dogs had good responses (mean dosages, 1.9 mg/kg [0.86 mg/lb], q 12 h [n = 13 dogs] and 1.3 mg/kg [0.59 mg/lb], q 8 h ). At 3 to 4 hours and 8 to 9 hours after once-daily dosing, mean post-ACTH stimulation serum cortisol concentrations were 2.60 and 8.09 μg/dL, respectively.
Conclusions and Clinical Relevance—In dogs with NOH, administration of trilostane at low doses every 12 hours was effective, although 2 dogs became ill during treatment. Drug effects diminished within 8 to 9 hours. Because of potential adverse effects, lower doses should be evaluated.
Objective—To evaluate effect of acarbose on control of glycemia in dogs with diabetes mellitus.
Design—Prospective randomized crossover controlled trial.
Animals—5 dogs with naturally acquired diabetes mellitus.
Procedure—Dogs were treated with acarbose and placebo for 2 months each: in 1 of 2 randomly assigned treatment sequences. Dogs that weighed ≤ 10 kg (22 lb; n = 3) or > 10 kg (2) were given 25 or 50 mg of acarbose, respectively, at each meal for 2 weeks, then 50 or 100 mg of acarbose, respectively, at each meal for 6 weeks, with a 1-month interval between treatments. Caloric intake, type of insulin, and frequency of insulin administration were kept constant, and insulin dosage was adjusted as needed to maintain control of glycemia. Serum glucose concentrations, blood glycosylated hemoglobin concentration, and serum fructosamine concentration were determined.
Results—Significant differences in mean body weight and daily insulin dosage among dogs treated with acarbose and placebo were not found. Mean preprandial serum glucose concentration, 8-hour mean serum glucose concentration, and blood glycosylated hemoglobin concentration were significantly lower in dogs treated with insulin and acarbose, compared with insulin and placebo. Semisoft to watery feces developed in 3 dogs treated with acarbose.
Conclusions and Clinical Relevance—Acarbose may be useful as an adjunctive treatment in diabetic dogs in which cause for poor glycemic control cannot be identified, and insulin treatment alone is ineffective. (J Am Vet Med Assoc 2000;216:1265–1269)
Objective—To evaluate pretreatment clinical and laboratory findings in dogs with naturally occurring primary hyperparathyroidism.
Animals—210 dogs with primary hyperparathyroidism and 200 randomly selected, age-matched control dogs that did not have primary hyperparathyroidism.
Procedure—Medical records for dogs with primary hyperparathyroidism were reviewed for signalment; clinical features; and results of clinicopathologic testing, serum parathyroid hormone assays, and diagnostic imaging.
Results—Mean age of the dogs with primary hyperparathyroidism was 11.2 years (range, 6 to 17 years). The most common clinical signs were attributable to urolithiasis or urinary tract infection (ie, straining to urinate, increased frequency of urination, and hematuria). Most dogs (149 [71%]) did not have any observable abnormalities on physical examination. All dogs had hypercalcemia, and most (136 [65%]) had hypophosphatemia. Overall, 200 of the 210 (95%) dogs had BUN and serum creatinine concentrations within or less than the reference range, and serum parathyroid hormone concentration was within reference limits in 135 of 185 (73%) dogs in which it was measured. Urolithiasis was identified in 65 (31%) dogs, and urinary tract infection was diagnosed in 61 (29%). Mean serum total calcium concentration for the control dogs was significantly lower than mean concentration for the dogs with primary hyperparathyroidism, but mean BUN and serum creatinine concentrations for the control dogs were both significantly higher than concentrations for the dogs with primary hyperparathyroidism.
Conclusions and Clinical Relevance—Results suggest that urolithiasis and urinary tract infection may be associated with hypercalcemia in dogs with primary hyperparathyroidism, but that development of renal insufficiency is uncommon. (J Am Vet Med Assoc 2005;227: 756–761)
Objective—To determine the efficacy and safety of percutaneous ethanol injection (PEI) for the treatment of hyperthyroidism caused by bilateral hyperplastic thyroid nodules in cats.
Procedure—Hyperthyroidism was diagnosed on the basis of clinical signs and increased serum total thyroxine (TT4) concentrations. The presence of 2 cervical thyroid nodules was confirmed by use of ultrasonography and technetium Tc 99m albumin thyroid scans. After the death of 1 cat that received PEI in both thyroid nodules at the same time, the protocol was changed to injecting ethanol into 1 nodule at a time, with at least 1 month between injections. Clinical signs, serum TT4 concentrations, serum ionized calcium concentrations, laryngeal function, findings on ultrasonographic examinations of the ventral cervical region, and results of thyroid scans were monitored.
Results—Serum TT4 concentrations transiently decreased in all 6 cats (into the reference range in 5 of 6 cats) within 4 days of the first staged ethanol injection. Each subsequent injection resulted in a transient decrease in serum TT4 concentration. The longest period of euthyroidism was 27 weeks. Adverse effects included Horner's syndrome, dysphonia, and laryngeal paralysis. One cat died of unrelated causes. One cat underwent bilateral thyroidectomy, 2 cats were treated with methimazole, and 2 cats that had increased serum TT4 concentrations were not treated further, because they remained clinically normal.
Conclusions and Clinical Relevance—Percutaneous ethanol ablation of bilateral thyroid nodules as a treatment for cats with hyperthyroidism is not recommended. This treatment is not as efficacious as the medical and surgical treatments presently used. (J Am Vet Med Assoc 2001;218:1293–1297)
Objective—To determine total dietary fiber (TDF) concentration and composition of commercial diets used for management of obesity, diabetes mellitus, and dietary fat-responsive disease in dogs.
Sample—Dry (n = 11) and canned (8) canine therapeutic diets.
Procedures—Insoluble and soluble dietary fiber (IDF and SDF), high-molecular-weight SDF (HMWSDF), and low-molecular-weight SDF (LMWSDF) concentrations were determined. Variables were compared among diets categorized by product guide indication, formulation (dry vs canned), and regulatory criteria for light and low-fat diets.
Results—SDF (HMWSDF and LMWSDF) comprised a median of 30.4% (range, 9.4% to 53.7%) of TDF; LMWSDF contributed a median of 11.5% (range, 2.7% to 33.8%) of TDF. Diets for diabetes management had higher concentrations of IDF and TDF with lower proportions of SDF and LMWSDF contributing to TDF, compared with diets for treatment of fat-responsive disease. Fiber concentrations varied within diet categories and between canned and dry versions of the same diet (same name and manufacturer) for all pairs evaluated. Diets classified as light contained higher TDF and IDF concentrations than did non-light diets. All canned diets were classified as low fat, despite providing up to 38% of calories as fat.
Conclusions and Clinical Relevance—Diets provided a range of TDF concentrations and compositions; veterinarians should request TDF data from manufacturers, if not otherwise available. Consistent responses to dry and canned versions of the same diet cannot necessarily be expected, and diets with the same indications may not perform similarly. Many diets may not provide adequate fat restriction for treatment of dietary fat-responsive disease.
Objective—To determine total dietary fiber (TDF) composition of feline diets used for management of obesity and diabetes mellitus.
Sample—Dry veterinary (n = 10), canned veterinary (12), and canned over-the-counter (3) feline diets.
Procedures—Percentage of TDF as insoluble dietary fiber (IDF), high-molecular-weight soluble dietary fiber (HMWSDF), and low-molecular-weight soluble dietary fiber (LMWSDF) was determined.
Results—Median measured TDF concentration was greater than reported maximum crude fiber content in dry and canned diets. Median TDF (dry-matter) concentration in dry and canned diets was 12.2% (range, 8.11% to 27.16%) and 13.8% (range, 4.7% to 27.9%), respectively. Dry and canned diets, and diets with and without a source of oligosaccharides in the ingredient list, were not different in energy density or concentrations of TDF, IDF, HMWSDF, or LMWSDF. Similarly, loaf-type (n = 11) and gravy-type (4) canned diets differed only in LMWSDF concentration. Disparities in TDF concentrations among products existed despite a lack of differences among groups. Limited differences in TDF concentration and dietary fiber composition were detected when diets were compared on the basis of carbohydrate concentration. Diets labeled for management of obesity were higher in TDF concentration and lower in energy density than diets for management of diabetes mellitus.
Conclusions and Clinical Relevance—Diets provided a range of TDF concentrations with variable concentrations of IDF, HMWSDF, and LMWSDF. Crude fiber concentration was not a reliable indicator of TDF concentration or dietary fiber composition. Because carbohydrate content is calculated as a difference, results suggested that use of crude fiber content would cause overestimation of both carbohydrate and energy content of diets.
Objective—To determine ultrasonographic characteristics of the thyroid gland in healthy small-, medium-, and large-breed dogs and evaluate the relationships of thyroid gland size and volume with body weight and body surface area (BSA).
Animals—72 dogs of small (6 Toy and 6 Miniature Poodles), medium (12 Beagles), and large breeds (12 Akitas and 36 Golden Retrievers).
Procedure—Each dog's thyroid gland was examined ultrasonographically with a 10- to 5-MHz multifrequency linear-array transducer. Size, shape, echogenicity, and homogeneity of thyroid lobes were evaluated on longitudinal and transverse images. Thyroid lobe volume was estimated by use of the equation for an ellipsoid (π/6 [length × height × width]).
Results—Thyroid lobes appeared fusiform or elliptical on longitudinal images and triangular or round to oval on transverse images. In most dogs, thyroid lobes were hyperechoic or isoechoic, compared with surrounding musculature, and had a homogeneous echogenic pattern. Mean length, width, height, and volume of thyroid lobes were significantly greater in Akitas and Golden Retrievers, compared with findings in Beagles or Poodles; mean length, width, and height were significantly greater in Beagles, compared with findings in Poodles. Total thyroid gland volume correlated with body weight (r = 0.73) and BSA (r = 0.74).
Conclusions and Clinical Relevance—Among the dog breeds examined ultrasonographically, thyroid lobe size and volume were more variable than shape, echogenicity, and homogeneity. The correlation of thyroid gland volume with BSA suggests that size of the dog, rather than breed, should be considered when assessing thyroid glands ultrasonographically.