Comparison ofIVandIMFormulations of SyntheticACTHforACTHStimulation Tests in Healthy Dogs

Abstract

Background: Two commercially available forms of synthetic ACTH are used to diagnose and monitor hyper-and hypoadrenocorticism in dogs.Objective: To compare the biologic activity of the liquid and lyophilized forms of cosyntropin. Animals: Eighteen privately owned healthy dogs were included. Methods: Dogs were assigned to one of 2 groups of 9 dogs each. Group 1 dogs were tested with the lyophilized product first and the liquid solution 30-60 days later. The Group 2 dogs were tested with the liquid solution first and the lyophilized drug 30-60 days later. For the ACTH stimulation tests, serum samples were collected before and 1 hour after IM administration of 0.25 mg reconstituted lyophilized product or 1 hour after IV administration of 0.25 mg of liquid solution. Cortisol concentrations of all serum samples were measured by use of a commercial cortisol radioimmunoassay.Results: Serum cortisol concentrations before and after ACTH stimulation did not differ significantly between groups (P = .57). In addition, no individual dog had as much as a 20% difference in serum cortisol concentrations after administration of either ACTH formulation.Conclusions and Clinical Importance: Given the lack of significant differences of the ACTH stimulation test results, the lyophilized and liquid solution products can be used interchangeably.

Diagnosis of Spontaneous Canine Hyperadrenocorticism: 2012 ACVIM Consensus Statement (Small Animal)

“…Recently, Cosyntropin Injection was introduced for IV use only. No differences in cortisol concentrations were found in response to 250 μg Cortrosyn IM or Cosyntropin Injection IV in 18 healthy dogs . In some countries, compounded ACTH preparations are available.…”

“…No differences in cortisol concentrations were found in response to 250 lg Cortrosyn IM or Cosyntropin Injection IV in 18 healthy dogs. 52 In some countries, compounded ACTH preparations are available. In 1 study, cortisol concentrations 60 minutes after administration of compounded ACTH (2.2 U/kg IM) were no different than after Cortrosyn (5 lg/kg IV).…”

Hypoadrenocorticism

“…Not all of these products have been directly compared in dogs but they are considered interchangeable. Although there are differences in peak concentration and duration of ACTH when administered intravenously versus intramuscularly, there is no difference in peak cortisol concentration in response to cosyntropin administered either intravenously or intramuscularly (Hansen et al, 1994;Cohen and Feldman, 2012). The lowest dose shown to result in maximal cortical stimulation in dogs with suspected adrenal A B C D AA BB CC FIGURE 12-10 Serial electrocardiogram (ECG) segments obtained from two dogs with hypoadrenocorticism and hyperkalemia.…”

Uso de baixa dose de ACTH sintético no teste de estimulação da função adrenal para o diagnóstico e controle do hiperadrenocorticismo canino: avaliação da eficácia diagnóstica

“…A aplicacao deste princípio ativo pode ser realizada por via endovenosa e via intramuscular e ambas demonstraram-se eficazes para a realização do estímulo da função adrenal em animais sadios, no entanto preconiza-se a via endovenosa para evitar alteraçõescoes provenientes da absorção. Na literatura, observam-se doses entre 5ug/ kg a 250ug/animal por administração endovenosa (Cohen et al 2012) para a realização do teste, porem não relata-se dose inferior a 5ug/kg (Behrend et al 2013) para este fim. Como demostrado por Martin et al (2007), a dose de 1ugkg em animais sadios promove o máximo estimulo da adrenal, constatando que uma baixa dose de ACTH pode ser igualmente ou até mais eficaz que a utilização de uma dose muito elevada do hormônio sintético, diminuindo os custos para o proprietário e respeitando a fisiologia do animal.…”