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J Am Vet Med Assoc. 2007 Aug 1;231(3):413-6.

Use of basal serum or plasma cortisol concentrations to rule out a diagnosis of hypoadrenocorticism in dogs: 123 cases (2000-2005).

Author information

1
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.

Abstract

OBJECTIVE:

To determine whether basal serum or plasma cortisol concentration can be used as a screening test to rule out hypoadrenocorticism in dogs.

DESIGN:

Retrospective case-control study.

ANIMALS:

110 dogs with nonadrenal gland illnesses and 13 dogs with hypoadrenocorticism.

PROCEDURES:

Sensitivity and specificity of basal serum or plasma cortisol concentrations of either <or= 1 microg/dL or <or= 2 microg/dL to detect dogs with hypoadrenocorticism were estimated by use of the ACTH stimulation test as the gold standard.

RESULTS:

Basal cortisol concentrations of <or= 1 microg/dL had excellent sensitivity (100%) and specificity (98.2%) for detecting dogs with hypoadrenocorticism. For basal cortisol concentrations of <or= 2 microg/dL, sensitivity was 100% but specificity was 78.2%.

CONCLUSIONS AND CLINICAL RELEVANCE:

On the basis of sensitivity and specificity, basal serum or plasma cortisol concentrations had high negative predictive values over a wide range of prevalence rates and can be used to rule out a diagnosis of hypoadrenocorticism. Dogs with basal cortisol concentrations > 2 microg/dL that are not receiving corticosteroids, mitotane, or ketoconazole are highly unlikely to have hypoadrenocorticism. However, if the basal cortisol concentration is <or= 2 microg/dL, little to no information regarding adrenal gland function can be obtained and an ACTH stimulation test should be performed.

PMID:
17669044
DOI:
10.2460/javma.231.3.413
[Indexed for MEDLINE]

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