How accurate is the ACTH stimulation test in dogs?
Forty-one dogs had illnesses attributable to a cause other than disease of the adrenal glands. Sensitivity of ACTH stimulation and LDDS tests were 95 and 96%, respectively. Specificity for the ACTH stimulation test was higher (91%) than that of the LDDS test (70%).
Can Addison’s disease in dogs be misdiagnosed?
Addisonians may be misdiagnosed with gastrointestinal disease, dehydration, kidney disease, pancreatitis, a ruptured bladder, or certain types of poisonings. The only way to definitively diagnose Addison’s disease is through an ACTH stimulation test.
Is ACTH high or low in Addison’s disease?
People with Addison disease (underactive or damaged adrenal glands) produce a high level of ACTH but no cortisol. People with secondary adrenal insufficiency have absent or delayed ACTH responses.
What does a low ACTH test mean?
Decreased or normal. An increased ACTH result can mean that a person has Cushing disease, Addison disease, overactive, tumor-forming endocrine glands (multiple endocrine neoplasia), or ectopic ACTH-producing tumors. A decreased ACTH result can be due to an adrenal tumor, steroid medication, or hypopituitarism.
What does ACTH stimulation test for?
The ACTH stimulation test may be used to investigate a low cortisol test result. It may be used to help diagnose primary adrenal insufficiency (Addison disease) if your healthcare practitioner suspects that your adrenal glands may not be producing enough cortisol.
Do dogs need to be starved for ACTH Stim test?
Preparing for the ACTH stimulation test: Does the animal need to be fasted? The dog or cat does not have to be fasted overnight, and lipemia does not appear to “clinically’ affect serum cortisol values.
What mimics Addison’s disease?
Other causes include congenital adrenal hyperplasia, congenital lipoid adrenal hyperplasia, X-linked adrenoleukodystrophy, familial glucocorticoid deficiency. Various syndromes associated with Addison’s disease include Triple A syndrome, Smith-Lemli-Opitz syndrome, Kearns-Sayre syndrome.
What are the symptoms of high ACTH?
Symptoms
- Weight gain and fatty tissue deposits, particularly around the midsection and upper back, in the face (moon face), and between the shoulders (buffalo hump)
- Pink or purple stretch marks (striae) on the skin of the abdomen, thighs, breasts and arms.
- Thinning, fragile skin that bruises easily.
What happens if your ACTH is low?
A decline in the concentration of ACTH in the blood leads to a reduction in the secretion of adrenal hormones, resulting in adrenal insufficiency (hypoadrenalism). Adrenal insufficiency leads to weight loss, lack of appetite (anorexia), weakness, nausea, vomiting, and low blood pressure (hypotension).
What can trigger ACTH to be released?
The adrenal cortex secretes glucocorticoids from the zona fasciculata and androgens from the zona reticularis. The secretion of glucocorticoids provides a negative feedback loop for inhibiting the release of CRH and ACTH from the hypothalamus and anterior pituitary, respectively. Stress stimulates the release of ACTH.
How does the ACTH stimulation test work for Addisons disease?
As the blood level of cortisol increases, it causes the pituitary gland to decrease its production of ACTH, which results in a lowering of the cortisol level. The ACTH stimulation test mimics this natural stimulatory pathway and demonstrates the ability of the pet’s adrenal glands to produce cortisol in response to an injection of synthetic ACTH.
When to do ACTH STIM for a dog with Cushings disease?
Typically one starts at the low end of the dose (1-2mg/kg SID to BID) and works up from there. After about a week or two of therapy, the 1-hour ACTH stim is done to assess if the dog’s cortisol levels are appropriate. The owner is also questioned to see if the clinical signs have improved or resolved.
What kind of health problems does a pug have?
Pugs are brachycephalic dogs (flat-faced) meaning, they are prone to health problems than other breeds are not. They are susceptible to skin problems, breathing issues, luxating patella, dental problems and etc.
How does Addison’s disease affect the pituitary gland?
Addison’s disease may also result from decreased stimulation of the glands by the pituitary hormone ACTH (called secondary hypoadrenocorticism). Secondary Addison’s disease is rare, and may be related to trauma, inflammation, or tumors near the pituitary gland.
As the blood level of cortisol increases, it causes the pituitary gland to decrease its production of ACTH, which results in a lowering of the cortisol level. The ACTH stimulation test mimics this natural stimulatory pathway and demonstrates the ability of the pet’s adrenal glands to produce cortisol in response to an injection of synthetic ACTH.
What to do if the ACTH stimulation test is not clear?
If the results of the ACTH stimulation test aren’t clear or your doctor suspects a problem in the pituitary, you may have an insulin tolerance test (ITT). A health care professional will give you an IV injection of the hormone insulin, which lowers your levels of blood glucose.
When did they start testing dogs for Addison’s disease?
Dr. J. Catharine Scott-Moncrieff lectured at the 2008 American College of Veterinary Internal Medicine Forum on diagnostic testing for canine hypoadrenocorticism. Here are some relevant points from that lecture:
Can a blood test tell if you have Addison’s disease?
Blood tests can find out if your cortisol levels are too low. The normal response after an ACTH injection is a rise in blood cortisol levels. People with Addison’s disease and most people who have had secondary adrenal insufficiency for a long time have little or no increase in cortisol levels.