Blog

Monitoring canine hyperadrenocorticism using pre-pill cortisol instead of an ACTH stimulation test

This stems from a recent article by Macfarlane and others published in the Vet Record 2016:

http://veterinaryrecord.bmj.com/content/179/23/597

Which looks set to become a seminal paper on managing canine hyperadrenocorticism.  You can read it yourselves in open access full text.  However, the crux is that, for the first time the authors correlated clinical status in turn with each of three measurable parameters:

• pre-pill cortisol
• 3 hour post-pill cortisol
• post ACTH cortisol

And found that pre-pill cortisol was a better predictor of clinical status.

This is great! It now looks a reasonable choice to monitor Vetoryl treatment using a simple pre-pill cortisol rather than having to go through the hassle and expense of an ACTH stim test.

The authors have subsequently developed an algorithm for decision-making when using this approach. Having spent the last hour scouring the internet for a copy I can report that it’s surprisingly difficult to find.  However, here it is: