BackgroundDogs with hyperadrenocorticism (HAC) may be more mildly affected at the time of diagnosis today, which could influence the prevalence of associated clinical and clinicopathological abnormalities and diagnostic test performance. Different low‐dose dexamethasone suppression test (LDDST) result patterns have not been evaluated individually.ObjectivesTo assess the current features of HAC and evaluate if the diagnostic test performance of individual LDDST result patterns differ.AnimalsOne hundred and twenty‐three dogs undergoing investigation for HAC.MethodsRetrospective evaluation of dogs in which a LDDST was performed and HAC confirmed or excluded by alternative means. Cases with basal cortisol concentrations (t
0) < 1 μg/dL were excluded. Each LDDST result was classified as (a) complete suppression (t
3 and t
8 < 1 μg/dL), (b) lack of suppression (t
3 and t
8 > 1 μg/dL and both > 50% t
0), (c) partial suppression (t
3 and t
8 > 1 μg/dL but either < 50% t
0), (d) escape (t
8 > 1 μg/dL and t
3 < 1 μg/dL) or (e) inverse (t
3 > 1 μg/dL and t
8 < 1 μg/dL) pattern.ResultsFifty‐nine (48%) dogs were diagnosed with HAC and 64 (52%) with non‐adrenal illness. Hyperadrenocorticism cases had similar clinicopathological abnormalities compared to previous reports. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) (95% confidence interval [CI]) of the LDDST for diagnosing HAC were 96.6 (91.9‐100)%, 67.2 (55.7‐78.7)%, 73.1 (63.2‐82.9)%, and 95.6 (89.5‐100)%, respectively. Lack of suppression pattern had the highest PPV (93.9 [85.8‐100]%) followed by the partial suppression pattern (67.9 [50.6–85.2]%) and escape or inverse pattern (36.8 [15.1–58.5]%).Conclusions and Clinical ImportanceA lack of suppression LDDST pattern has the highest PPV for diagnosing HAC followed by a partial suppression pattern. By contrast, the escape or inverse pattern provided limited support of HAC.
OBJECTIVE To evaluate the effects of postoperative photobiomodulation therapy and physical rehabilitation on early recovery variables for dogs after hemilaminectomy for treatment of intervertebral disk disease.
ANIMALS 32 nonambulatory client-owned dogs.
PROCEDURES Dogs received standard postoperative care with photobiomodulation therapy (n = 11), physical rehabilitation with sham photobiomodulation treatment (11), or sham photobiomodulation treatment only (10) after surgery. Neurologic status at admission, diagnostic and surgical variables, duration of postoperative IV analgesic administration, and recovery grades (over 10 days after surgery) were assessed. Time to reach recovery grades B (able to support weight with some help), C (initial limb movements present), and D (ambulatory [≥ 3 steps unassisted]) was compared among groups. Factors associated with ability to ambulate on day 10 or at last follow-up were assessed.
RESULTS Time to reach recovery grades B, C, and D and duration of postoperative IV opioid administration did not differ among groups. Neurologic score at admission and surgeon experience were negatively associated with the dogs' ability to ambulate on day 10. The number of disk herniations identified by diagnostic imaging before surgery was negatively associated with ambulatory status at last follow-up. No other significant associations and no adverse treatment-related events were identified.
CONCLUSIONS AND CLINICAL RELEVANCE This study found no difference in recovery-related variables among dogs that received photobiomodulation therapy, physical rehabilitation with sham photobiomodulation treatment, or sham photobiomodulation treatment only. Larger studies are needed to better evaluate effects of these postoperative treatments on dogs treated surgically for intervertebral disk disease.
Hypoadrenocorticism is characterized by a reduction in mineralocorticoid and/or glucocorticoid production by the adrenal glands. Several subtypes have been described with different clinical and clinicopathological consequences. Most affected dogs have vague and non-specific signs that precede an eventual life-threatening crisis. This review aims to appraise classification, the available data on epidemiology and the clinical and laboratory features of naturally occurring canine hypoadrenocorticism.
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