Background Results of ACTH stimulation test (ACTHst), pre‐ and post‐trilostane serum cortisol concentrations (SCCs), urine concentration (urine‐specific gravity [USG]), and urine cortisol : creatinine ratios (UCCRs) are common variables used to monitor trilostane treatment of dogs with pituitary‐dependent hyperadrenocorticism (PDH). However, none has consistently discriminated dogs receiving an adequate dose (A) from those overdosed (O) or underdosed (U). Objectives To assess and compare recommended monitoring variables, including serial SCCs in a cohort of dogs with PDH treated with trilostane. Animals Privately owned dogs with PDH (n = 22) and 3 healthy dogs (controls). Methods Prospective, multicenter, 2‐day study. On day “a” (randomized): ACTHst was completed. Day “b” (>2 to <7 days later): SCCs were assessed −0.5 hours, immediately before, and 1, 2, 2.5, 3, 3.5, 4, 6, 8, and 12 hours after trilostane administration. On the first study day, urine collected at home was assessed for USG, UCCR and owner opinions regarding PDH were categorized as: A (clinical signs resolved), U (remains symptomatic), or ill (possible O). Results At 27 pairs of evaluations, 7 dogs were categorized as A, 19 U, and 1 possible O (excluded from the study). There was overlap in SCC results from the A and U dogs at every time point. Results of USG, UCCR, and ACTHst did not discriminate A from U dogs. Trilostane suppresses SCC within 1 hour of administration and its duration of action in most PDH dogs is <8 hours. Conclusions and Clinical Importance No single variable or group of variables reliably discriminated A dogs from U dogs during trilostane treatment for PDH.
Background: Precise reference intervals of adrenal gland thickness are required for detection of adrenomegaly in dogs with hyperadrenocorticism (HAC). Methods: Eighty‐six clinically healthy dogs were prospectively included, and 91 dogs with untreated HAC were retrospectively evaluated. Dorso‐ventral adrenal gland thickness was ultrasonographically measured on the sagittal plane. Dogs were classified into four body weight categories, and those with HAC were also ultrasonographically classified as consistent with pituitary‐dependent HAC (PDH), adrenal‐dependent HAC (FAT), equivocal adrenal asymmetry (EAA), or normal adrenal thickness. Results: The upper limits for left adrenal gland in clinically healthy dogs were 5.1 mm (≥2.5–5 kg), 5.5 mm (>5–10 kg), 6.4 mm (>10–20 kg), and 7.3 mm (>20–40 kg), and for right adrenal gland the upper limits were 5.3 mm (≥2.5–5 kg), 6.8 mm (>5–10 kg), 7.5 mm (>10–20 kg), and 8.7 mm (>20–40 kg). The sensitivity of ultrasound to detect adrenomegaly in dogs with HAC was 95.6%. Most dogs with HAC (56.0%) had ultrasound findings consistent with either PDH or FAT; however, EAA was commonly occurring in 39.6% of dogs with HAC. Conclusions: The sensitivity of ultrasonography to detect adrenomegaly in dogs with HAC is high when using four weight categories. EAA is common in dogs with HAC.
Background: In people, obesity and prediabetes mellitus might predispose to chronic kidney disease (CKD). Aims: To assess the association of overweight [Body condition score (BCS) >5] and glucose metabolism alterations, with established or potential markers of CKD. In addition, fructosamine and fasted blood glucose were compared as predictors of early abnormal glucose metabolism. Methods: 54 clinically healthy cats were included in a cross-sectional study comprising 25 neutered males and 29 (28 neutered) females aged 7.2 (5.5-9.4) years. Two potential markers of CKD, namely urinary free active transforming growth factor-b1-creatinine ratio and urinary retinol binding protein-creatinine ratio were measured along with other parameters to assess CKD. A receiver operating curve was used to identify the best sensitivity and specificity of fructosamine to identify cats with fasting glucose >6.5 mmol/L. Results: No association was found between BCS and markers of CKD. Fructosamine was greater in cats with fasting glucose >6.5 mmol/L compared to those with fasting glucose 6.5 mmol/L. A fructosamine concentration !250 mmol/L was able to detect cats with hyperglycemia with a sensitivity of 77% and a specificity of 65%. Furthermore, fructosamine was more strongly correlated with fasting glucose than albumin-corrected fructosamine (r ¼ 0.43, p ¼ 0.002 vs r ¼ 0.32, p ¼ 0.026). Cats with higher fructosamine had lower serum symmetric dimethylarginine concentrations. Conclusion: The present study does not suggest an effect of obesity on renal function in domestic cats. Clinical relevance: Fructosamine might be of value for the diagnosis of prediabetes mellitus in cats.
Objectives Adrenal gland size and its association with body weight have been rarely evaluated in cats. This study was undertaken to assess the association between feline body weight and adrenal gland thickness, and to propose reference intervals (RIs) for adrenal gland thickness in healthy cats. Methods This was a cross-sectional study in which 39 healthy cats were included. The cats were divided into two weight categories, classified as ⩽4.0 kg and >4–8 kg of ideal body weight (with 13 and 26 cats in each group, respectively), which took into consideration the body condition score of the cats. All cats underwent an ultrasound examination that was taken from a subcostal position. Maximum dorsoventral thicknesses of the left (MTL) and right (MTR) adrenal glands were measured in a sagittal plane. RIs were obtained for the maximum thickness (MT), which included the MTLs and MTRs of each cat. RIs with the 90% confidence intervals were calculated according to American Society for Veterinary Clinical Pathology guidelines on RIs. Results No statistical differences for adrenal gland thickness were observed between the left and right ( P = 0.543) adrenal glands or between male and female cats ( P = 0.943). Mean MT was significantly greater in the group of cats weighing >4–8 kg compared with the group of cats weighing ⩽4 kg (3.7 ± 0.6 vs 3.2 ± 0.4 mm; P <0.005). The lower limit of the RI for MT was 2.4 mm (range 2.2–2.6 mm) in the group weighing ⩽4 kg and 2.6 mm (range 2.4–2.8 mm) in the group weighing >4–8 kg. The upper limit of the RI for MT was 3.9 mm (range 3.7–4.1 mm) in the group of cats weighing ⩽4 kg and 4.8 mm (range 4.6–5.1 mm) in the group of cats weighing >4–8 kg. Conclusions and relevance The use of RIs based on two group sizes allows for a more accurate ultrasonographic evaluation of adrenal gland thickness in cats. The maximum normal adrenal gland thickness is lower in smaller cats (3.9 mm for those weighing ⩽4 kg and 4.8 mm for those weighing >4–8 kg).
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