Assessment of adrenocortical reserve capacity and inflammatory parameters in critically ill dogs

Abstract

Inflammatory markers and adrenocorticotropic hormone (ACTH) stimulation test results may help us recognise critically ill dogs with poor disease outcome. Systemic inflammatory response syndrome (SIRS) criteria, the fast version of the Acute Patient Physiologic and Laboratory Evaluation Score (APPLE), complete blood count, albumin and C-reactive protein (CRP) levels, baseline and stimulated cortisol levels and Δcortisol value were recorded in 50 client-owned dogs admitted to the Small Animal Hospital of the University of Veterinary Medicine Budapest with various inflammatory or neoplastic conditions. Increasing APPLE score was associated with a decreasing chance of survival (P = 0.0420). The Δcortisol value was significantly higher in SIRS dogs than in non-SIRS dogs (mean ± SD Δcortisol: 342.5 ± 273.96; mean ± SD Δcortisol: 175.3 ± 150.35; P = 0.0443). Elevated baseline or stimulated cortisol levels were associated with a higher chance of non-survival (P = 0.0135 and P = 0.0311, respectively). These data indicate that pathologically higher baseline and stimulated cortisol levels represent an exaggerated stress response in critically ill dogs, which is negatively associated with survival.

Restrained expression of canine glucocorticoid receptor splice variants α and P prognosticates fatal disease outcome in SIRS

“…Similar results were obtained by studying critically ill human and canine patients, i.e. plasma cortisol level varied in a wide range and mortality was associated with higher cortisol concentrations 46 – 49 , 55 – 58 . On the other hand, we could not find a significant relationship between the above-mentioned parameters such as serum CRP level and baseline serum total cortisol level and cGRα and cGR-P mRNA level or ratio of cGRα and cGR-P expression.…”

Pseudohypoadrenocorticism in a Siberian Husky with Trichuris vulpis Infection

“…These results are likely a response to the stress associated with the underlying disease of whipworm infection with secondary circulatory shock and dehydration. Several studies have examined the stress response in critically ill dogs and demonstrated that an exaggerated basal cortisol concentration was negatively associated with survival [14–16]. Further, the normal physiological response mounted by some patients may be insufficient for the degree of illness, and the adrenal gland may be unable to meet the demands of ongoing stress [17].…”