PMID- 30334283
OWN - NLM
STAT- MEDLINE
DCOM- 20190117
LR  - 20210109
IS  - 1939-1676 (Electronic)
IS  - 0891-6640 (Print)
IS  - 0891-6640 (Linking)
VI  - 32
IP  - 6
DP  - 2018 Nov
TI  - The interpretive contribution of the baseline serum cortisol concentration of the 
      ACTH stimulation test in the diagnosis of pituitary dependent 
      hyperadrenocorticism in dogs.
PG  - 1897-1902
LID - 10.1111/jvim.15330 [doi]
AB  - BACKGROUND: Current recommendation for performing the ACTH stimulation test 
      (ACTHST) for diagnosis of hyperadrenocorticism (HAC) advocates the collection of 
      baseline serum cortisol concentration (BC), but no references for interpretation 
      of its results exist. OBJECTIVE: Evaluate the contribution of BC of the ACTHST to 
      the diagnosis of HAC. ANIMALS: Fifty-four dogs were evaluated for suspected HAC 
      at a referral hospital. METHODS: Records of dogs that had been evaluated by 
      ACTHST for suspected HAC were reviewed. Receiver operator characteristics (ROC) 
      analyses were used to assess the performance of BC, post-stimulation serum 
      cortisol concentrations (PC), post-to-baseline cortisol concentration difference 
      (DeltaC) and quotient (RatioC) for the diagnosis of HAC by comparing the area 
      under the ROC curve (AUC) of PC to each of the other tests. RESULTS: The AUC of 
      PC (95% confidence interval [CI]: 0.92; 95% CI, 0.81-0.98) was significantly 
      higher than AUCs of BC (0.70; 95% CI, 0.56-0.82; P = .01) and RatioC (0.55; 95% 
      CI, 0.41-0.69; P < .001), and was not significantly different from AUC of DeltaC 
      (0.86; 95% CI, 0.74-0.94; P = .09). An optimal cutoff value of 683 nmol/L (24.8 
      mug/dL) for PC yielded a sensitivity of 86% and a specificity of 94%, 
      respectively, and a cutoff value of 718 nmol/L (26.0 mug/dL) yielded a specificity 
      of 100% with of 81% sensitivity for the diagnosis of pituitary-dependent HAC. 
      CONCLUSION AND CLINICAL IMPORTANCE: The PC had good discriminatory ability for 
      the diagnosis of HAC. It was comparable to DeltaC, whereas BC and RatioC were 
      ineffective. Current recommendations to collect samples for BC appear redundant.
CI  - (c) 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley 
      Periodicals, Inc. on behalf of the American College of Veterinary Internal 
      Medicine.
FAU - Nivy, Ran
AU  - Nivy R
AUID- ORCID: 0000-0002-5523-6411
AD  - Department of Small Animal Internal Medicine, The Hebrew University Veterinary 
      Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of 
      Jerusalem, Rehovot, Israel.
FAU - Refsal, Kent R
AU  - Refsal KR
AD  - Michigan State University Veterinary Diagnostic Laboratory, College of Veterinary 
      Medicine, Medicine, Michigan State University, East Lansing, Michigan, USA.
FAU - Ariel, Ella
AU  - Ariel E
AD  - Department of Small Animal Internal Medicine, The Hebrew University Veterinary 
      Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of 
      Jerusalem, Rehovot, Israel.
FAU - Kuzi, Sharon
AU  - Kuzi S
AD  - Department of Small Animal Internal Medicine, The Hebrew University Veterinary 
      Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of 
      Jerusalem, Rehovot, Israel.
FAU - Yas-Natan, Einat
AU  - Yas-Natan E
AD  - Department of Small Animal Internal Medicine, The Hebrew University Veterinary 
      Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of 
      Jerusalem, Rehovot, Israel.
FAU - Mazaki-Tovi, Michal
AU  - Mazaki-Tovi M
AUID- ORCID: 0000-0002-6193-5817
AD  - Department of Small Animal Internal Medicine, The Hebrew University Veterinary 
      Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of 
      Jerusalem, Rehovot, Israel.
LA  - eng
PT  - Journal Article
DEP - 20181018
PL  - United States
TA  - J Vet Intern Med
JT  - Journal of veterinary internal medicine
JID - 8708660
RN  - 9002-60-2 (Adrenocorticotropic Hormone)
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Adrenocortical Hyperfunction/blood/diagnosis/metabolism/*veterinary
MH  - Adrenocorticotropic Hormone/*pharmacology
MH  - Animals
MH  - Dog Diseases/blood/*diagnosis/metabolism
MH  - Dogs
MH  - Hydrocortisone/*blood
MH  - Reference Values
PMC - PMC6271305
OTO - NOTNLM
OT  - Cushing's
OT  - added-value
OT  - basal
OT  - post-stimulation
EDAT- 2018/10/20 06:00
MHDA- 2019/01/18 06:00
PMCR- 2018/11/01
CRDT- 2018/10/19 06:00
PHST- 2018/06/18 00:00 [received]
PHST- 2018/08/23 00:00 [accepted]
PHST- 2018/10/20 06:00 [pubmed]
PHST- 2019/01/18 06:00 [medline]
PHST- 2018/10/19 06:00 [entrez]
PHST- 2018/11/01 00:00 [pmc-release]
AID - JVIM15330 [pii]
AID - 10.1111/jvim.15330 [doi]
PST - ppublish
SO  - J Vet Intern Med. 2018 Nov;32(6):1897-1902. doi: 10.1111/jvim.15330. Epub 2018 
      Oct 18.