Recombinant human thyrotropin stimulation test in 114 dogs with suspected hypothyroidism: a cross-sectional study.

OBJECTIVE

To evaluate the performance and define cut-offs for the interpretation of a thyroid-stimulating hormone (TSH) stimulation test with a recombinant human TSH dose of 75 μg/dog administered intravenously in dogs with suspected hypothyroidism.

MATERIALS AND METHODS

Cross-sectional study. Medical records of dogs presented for suspected hypothyroidism were retrospectively reviewed. Animals were included if a TSH stimulation test with a recombinant human TSH dose of 75 μg/dog was performed and follow-up was available. Dogs with a post-TSH serum total thyroxine (T4) level of ≥2.2 μg/dL were considered euthyroid. Dogs with a post-TSH T4 level of <2.2 μg/dL were classified as hypothyroid or euthyroid based on follow-up, including response to levothyroxine supplementation. A receiver operating characteristic curve analysis was used to define the performance of the test.

RESULTS

One hundred and fourteen dogs were included. Forty were classified as hypothyroid and 74 as euthyroid. Post-TSH T4 cut-offs of 1.3 and 1.7 μg/dL showed sensitivities of 92.5 and 100% and specificities of 97.3 and 93.2%, respectively. Post-TSH T4 levels of >1.7 μg/dL had a negative predictive value of 100%. Post-TSH T4 levels of <1.3 μg/dL showed a positive predictive value of 94.9%. Area under the ROC curve for post-TSH T4 was 0.99.

CLINICAL SIGNIFICANCE

A TSH stimulation test performed with a recombinant human TSH dose of 75 μg/dog is highly reliable to discriminate between hypothyroid and euthyroid dogs, even in cases of concurrent non-thyroidal illness or administration of medications. A post-stimulation T4 concentration of >1.7 μg/dL is suggestive of normal thyroid function.