Johnson C M, Kass P H, Cohen T A, Feldman E C
Department of Small Animal Internal Medicine, Animal Specialty and Emergency Center, Los Angeles, CA.
Department of Population Health and Reproduction, School of Veterinary Medicine and School of Medicine, University of California, Davis, CA.
J Vet Intern Med. 2017 May;31(3):730-733. doi: 10.1111/jvim.14708. Epub 2017 Apr 13.
Standard protocols for adrenocorticotropic hormone (ACTH) stimulation testing (ACTHst) often involve intravenous (IV) injection of corticotropin. ACTH might be unintentionally injected into the perivascular (PV) space.
To compare stimulation test results after IV and PV injections of ACTH.
Twenty privately owned dogs were studied: 10 healthy and 10 with trilostane-treated naturally occurring hyperadrenocorticism (HAC).
Prospective study. Each of 20 dogs underwent 2 ACTHst not <4 nor more than 14 days apart. Five healthy and 5 HAC dogs had an IV ACTHst first and PV second; 5 healthy and 5 HAC dogs had a PV ACTHst first and IV second. Blood samples for measurement of serum cortisol concentration were collected before and 1 hour after ACTH administration.
No significant difference in results was demonstrated when comparing serum cortisol concentrations after IV and PV ACTH administration in all 20 dogs (median μg/dL; interval μg/dL: 8.2; 1.4-17.4 versus 7.8; 0.9-16.9; P = .23). No significant difference in results was demonstrated when comparing serum cortisol concentrations after IV and PV ACTH administration in the 10 healthy dogs (median μg/dL; interval μg/dL: 10.9; 7.3-17.4 versus 10.6; 7.1-16.9; P = .54) or in the 10 HAC dogs (median μg/dL; interval μg/dL: 6.3; 1.4-8.6 versus 5.2; 0.9-8.7; P = .061).
Perivascular administration of ACTH does not significantly alter stimulation test results in healthy dogs or in dogs with HAC undergoing therapy with trilostane.
促肾上腺皮质激素（ACTH）刺激试验（ACTHst）的标准方案通常涉及静脉注射促肾上腺皮质激素。ACTH可能会意外注入血管周围（PV）间隙。
比较静脉注射和血管周围注射ACTH后的刺激试验结果。
对20只私人饲养的犬进行研究：10只健康犬和10只接受曲洛司坦治疗的自然发生的肾上腺皮质功能亢进（HAC）犬。
前瞻性研究。20只犬中的每只犬在不小于4天且不超过14天的间隔内接受2次ACTHst。5只健康犬和5只HAC犬先进行静脉ACTHst，后进行血管周围ACTHst；5只健康犬和5只HAC犬先进行血管周围ACTHst，后进行静脉ACTHst。在ACTH给药前和给药后1小时采集血样以测定血清皮质醇浓度。
在所有20只犬中，比较静脉注射和血管周围注射ACTH后的血清皮质醇浓度时，结果无显著差异（中位数μg/dL；区间μg/dL：8.2；1.4 - 17.4对7.8；0.9 - 16.9；P = 0.23）。在10只健康犬中比较静脉注射和血管周围注射ACTH后的血清皮质醇浓度时，结果无显著差异（中位数μg/dL；区间μg/dL：10.9；7.3 - 17.4对
10.6；7.1 - 16.9；P = 0.54），在10只HAC犬中比较时结果也无显著差异（中位数μg/dL；区间μg/dL：6.3；1.4 - 8.6对5.2；0.9 - 8.7；P = 0.061）。
在健康犬或接受曲洛司坦治疗的HAC犬中，血管周围注射ACTH不会显著改变刺激试验结果。
