Bonadio C M, Feldman E C, Cohen T A, Kass P H
Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA.
J Vet Intern Med. 2014 Jul-Aug;28(4):1239-43. doi: 10.1111/jvim.12357. Epub 2014 May 26.
Trilostane medical treatment of naturally occurring hyperadrenocorticism (NOH) in dogs is common, as is use of the adrenocorticotropic hormone (ACTH) stimulation test (ACTHst) in monitoring response to treatment. There is uncertainty regarding when the ACTHst should be started relative to time of trilostane administration.
To compare ACTHst results in dogs being treated for NOH with trilostane when the test is begun 2 versus 4 hours after trilostane administration.
Twenty-one privately owned dogs with NOH, each treated with trilostane for at least 30 days.
Each dog had 2 ACTHst completed, 1 started 2 hours and the other 4 hours after trilostane administration. The second test was started no sooner than 46 hours and no later than 74 hours after the first.
For all 21 dogs, the mean post-ACTH serum cortisol concentration from tests started 2 hours after trilostane administration (5.4 ± 3.7 μg/dL) was significantly lower (P = .03) as compared with results from the tests started 4 hours after administration (6.5 ± 4.5 μg/dL).
Results of ACTHst started at different times yield significantly different results. Dogs with NOH, treated with trilostane, and monitored with ACTHst results should have all of their subsequent ACTHst tests begun at or about the same time after trilostane administration.
曲洛司坦用于治疗犬自发性肾上腺皮质功能亢进(NOH)很常见,促肾上腺皮质激素(ACTH)刺激试验(ACTHst)用于监测治疗反应也很常见。关于ACTHst应在曲洛司坦给药后何时开始,目前尚不确定。
比较在曲洛司坦给药后2小时和4小时开始进行ACTHst的犬自发性肾上腺皮质功能亢进治疗效果。
21只 privately owned患有NOH的犬,每只均用曲洛司坦治疗至少30天。
每只犬完成2次ACTHst,1次在曲洛司坦给药后2小时开始,另1次在给药后4小时开始。第二次试验在第一次试验后不早于46小时且不晚于74小时开始。
对于所有21只犬,曲洛司坦给药后2小时开始的试验中,ACTH刺激后血清皮质醇平均浓度(5.4±3.7μg/dL)显著低于给药后4小时开始的试验结果(6.5±4.5μg/dL)(P = 0.03)。
在不同时间开始的ACTHst结果有显著差异。用曲洛司坦治疗并通过ACTHst结果监测的NOH犬,其所有后续ACTHst试验应在曲洛司坦给药后大致相同时间开始。