1
|
Menard M, Kurtz M, Duclos A, Vial J, Maurey C, Canonne-Guibert M, Fabrès V, Rosenberg D, Coyne M, Murphy R, Trumel C, Lavoué R, Benchekroun G. Description of serum symmetric dimethylarginine concentration and of urinary SDS-AGE pattern in dogs with ACTH dependent hyperadrenocorticism. Vet J 2024; 305:106108. [PMID: 38580156 DOI: 10.1016/j.tvjl.2024.106108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/30/2024] [Accepted: 04/02/2024] [Indexed: 04/07/2024]
Abstract
Serum symmetric dimethylarginine (SDMA) and patterns of urinary protein separated by sodium dodecyl sulfate agarose gel electrophoresis (SDS-AGE) have not been investigated as biomarkers in dogs with ACTH-dependent hyperadrenocorticism (ADHAC). This exploratory prospective study aimed to evaluate SDMA, serum creatinine (sCR), and SDS-AGE in dogs with ADHAC with and without proteinuria (ADHAC-P and ADHAC-nP, respectively). Thirty-five pet dogs classified as ADHAC-P (n=16), ADHAC-nP (n=6) and healthy (n=13) were included. Renal biomarkers were evaluated in all dogs at diagnosis. Baseline concentration of SDMA was not significantly different between the three groups (P = 0.15) whereas sCr was significantly lower in dogs in ADHAC dogs compared to healthy dogs (88.0 µmol/L [70.4-132.6; 79.2-114.4]) whether they had proteinuria or not (P = 0.014 and 0.002, respectively). However, baseline concentrations of sCr and SDMA were not significantly different between dogs with ADHAC-P dogs (SDMA, 8 µg/dL [5-12; 7-9]; sCr, 57.2 µmol/L [35.2-212.2; 52.8-92.4]) and ADHAC-nP dogs (SDMA, 8.5 µg/dL [7-13; 8-10]; sCr, 70.4 µmol/L [61.6-79.2; 61.6-70.4]) (P = 0.35 and P = 0.41, respectively). Proteinuria in dogs with ADHAC-P was mainly of glomerular origin (SDS-AGE pattern: glomerular in 10/16 dogs; mixed glomerular/tubular in four dogs). In our study, SDMA was neither significantly different in dogs with ADHAC whether they were proteinuric or not, nor between ADHAC and healthy dogs. Urinary electrophoresis provides additional information to the UPC and further investigations are needed to determine whether it may help identify dogs with ADHAC-P requiring specific antiproteinuric treatment.
Collapse
Affiliation(s)
- M Menard
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - M Kurtz
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - A Duclos
- IRSD, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - J Vial
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - C Maurey
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - M Canonne-Guibert
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France; Ecole Nationale Vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, Maisons-Alfort 94700, France
| | - V Fabrès
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France
| | - D Rosenberg
- Department of Internal Medicine, Micen Vet, Créteil, France
| | - M Coyne
- IDEXX Laboratories, Inc., Westbrook, ME, United States
| | - R Murphy
- IDEXX Laboratories, Inc., Westbrook, ME, United States
| | - C Trumel
- CREFRE, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - R Lavoué
- IRSD, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - G Benchekroun
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort F-94700, France; Ecole Nationale Vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, Maisons-Alfort 94700, France.
| |
Collapse
|
2
|
García San José P, Pérez-Alenza MD, Alonso-Miguel D, González Sanz S, Arenas Bermejo C. Prevalence of Systemic Hypertension and Control of Systolic Blood Pressure in a Cohort of 14 Dogs with Adrenal-Dependent Hypercortisolism during the First Year of Trilostane Treatment or after Adrenalectomy. Animals (Basel) 2024; 14:511. [PMID: 38338154 PMCID: PMC10854962 DOI: 10.3390/ani14030511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Hypercortisolism in dogs is frequently associated with systemic hypertension (SH). However, there are no studies evaluating the changes in systolic blood pressure (SBP) in dogs with adrenal-dependent hypercortisolism (ADH) during trilostane treatment or after adrenalectomy and their response to antihypertensive treatments. For this reason, the objectives of this study were to evaluate the changes in SBP in dogs with ADH during the first year of trilostane treatment or after adrenalectomy, the relation with clinical control of hypercortisolism and certain laboratory parameters, and the response to antihypertensive drugs. Fourteen dogs newly diagnosed with ADH were prospectively included and evaluated at diagnosis (T0) and 1, 3, 6, and 12 months after (T1, T3, T6, and T12, respectively). Dogs were classified as hypertensive (HT; SBP ≥ 160 mmHg) and non-hypertensive. In HT dogs, benazepril was considered as the first-line drug, and, if necessary, amlodipine was prescribed. The prevalence of SH at T0 was 79%, and it was reduced to 25% at T12. Blood pressure (BP) was not associated with disease control or selected laboratory parameters at any endpoint. Only 22% of dogs with SH needed more than one drug to normalize their SBP. In all dogs surgically treated that were HT at T0, BP normalized at T3.
Collapse
Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | - María Dolores Pérez-Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | - Daniel Alonso-Miguel
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | | | - Carolina Arenas Bermejo
- AniCura Hospital Veterinario Valencia Sur, 46460 Valencia, Spain;
- VetCT Teleconsulting, Cambridge CB3 0FA, UK
| |
Collapse
|
3
|
Vila BDCP, Vanhoni MS, Sousa MG. QT interval instability and variability in dogs with naturally-occurring hypercortisolism. Vet Res Commun 2023; 47:121-130. [PMID: 35575953 DOI: 10.1007/s11259-022-09936-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/04/2022] [Indexed: 01/27/2023]
Abstract
Hypercortisolism is one of the most common endocrine diseases in dogs. In humans, it is clearly associated with a higher risk of cardiovascular events, but studies in dogs are scarce. To investigate the arrhythmogenic risk of dogs with naturally-occurring hypercortisolism (NOHC), indices of variability and instability of the QT interval were retrospectively studied in 38 dogs with NOHC and prospectively studied in 12 healthy dogs: variance (QTv), total instability (TI), short-term (STI) and long-term (LTI), and mean (QTm). Except for QTm, all parameters studied were higher in the NOHC group than in the control group. In addition, STI and QTv showed moderate positive correlation with left ventricle wall thickness. The NOHC group was subdivided according to cortisol suppression pattern in the low-dose dexamethasone suppression test. All electrocardiographic indices of partial and absent suppression patterns were numerically higher than healthy dogs. QTv and TI were lower in the control group than in both NOHC subgroups. LTI and STI were lower in the CG than in the group with the partial suppression pattern. There was no statistical difference between sex groups in any of the electrocardiographic parameters studied. This result might indicate that the etiology of NOHC, and its consequent influence on hypothalamus-pituitary-adrenal axis could interfere on the heterogeneity of ventricular repolarization parameters in different ways, especially in the short-term and the long-term stability; however further studies are necessary to understand the role of cortisol on electrical instability in dogs.
Collapse
Affiliation(s)
- Beatriz de Carvalho Pato Vila
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil.
| | - Marcela Sigolo Vanhoni
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil
| | - Marlos Gonçalves Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários, 1540, Curitiba, PR, 80035-050, Brazil
| |
Collapse
|
4
|
Soares FAC, Filho NAK, Beretta BFS, Linden TS, Pöppl AG, González FHD. Thiobarbituric acid reactive substances in dogs with spontaneous hypercortisolism. Domest Anim Endocrinol 2021; 77:106634. [PMID: 34126587 DOI: 10.1016/j.domaniend.2021.106634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/25/2021] [Accepted: 04/27/2021] [Indexed: 11/18/2022]
Abstract
Thiobarbituric acid reactive substances (TBARS) are laboratory markers of oxidative stress, which can be used to evaluate the lipid peroxidation that characterizes cell membrane damage caused by excess free radicals. This prospective study aimed to assess TBARS as a parameter of lipid peroxidation in dogs with spontaneous hypercortisolism (HC) at the time of diagnosis, and after trilostane treatment. Furthermore, it aimed to investigate the correlations between TBARS levels, and laboratory and cardiovascular parameters. Sixteen dogs with HC were evaluated at 3 different time points: At diagnosis (T0), 6 mo after treatment (T1), and 12 mo after trilostane treatment (T2). A control group (n = 20) of dogs with a demographic profile similar to the HC group, but considered healthy was selected and evaluated. There was a significant difference (P < 0.001) in TBARS levels between the HC group at diagnosis (4.38 ± 1.16 nmoles MDA/mg protein) and the control group (2.15 ± 0.45 nmoles MDA/mg protein). Dogs in the HC group exhibited a significant reduction (P < 0.001) in TBARS levels after treatment. There was no significant difference in TBARS levels between the control group and the HC group at T1 and T2 evaluation. TBARS positively correlated with left atrial dimensions and hematocrit. The study demonstrates that lipid peroxidation is increased in canine HC and suggests that control of the disease is beneficial to normalize the state of oxidative stress.
Collapse
Affiliation(s)
- F A C Soares
- Veterinary Sciences Post-Graduation Program, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre-RS, Brazil.
| | - N A Kretzmann Filho
- REPROLAB/PPGMAE, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre-RS, Brazil
| | - B F S Beretta
- REPROLAB/PPGMAE, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre-RS, Brazil
| | - T S Linden
- PetEndocrine, Veterinary Endocrinology and Metabology, Porto Alegre-RS, Brazil
| | - A G Pöppl
- Department of Animal Medicine, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre-RS, Brazil
| | - F H D González
- Department of Veterinary Clinical Pathology, School of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre-RS, Brazil
| |
Collapse
|
5
|
García San José P, Arenas Bermejo C, Alonso-Miguel D, Clares Moral I, Cuesta-Alvaro P, Pérez Alenza MD. Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment. J Vet Intern Med 2020; 35:130-141. [PMID: 33274787 PMCID: PMC7848348 DOI: 10.1111/jvim.15978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/09/2020] [Accepted: 11/19/2020] [Indexed: 12/26/2022] Open
Abstract
Background Systemic hypertension (SH) is common in dogs and humans with hypercortisolism and can persist after treatment. Objectives To evaluate changes in prevalence of SH and systolic blood pressure (SBP) in dogs with pituitary‐dependent hyperadrenocorticism (PDH) during the first year of trilostane treatment, its relationship with disease control and selected laboratory variables, and their response to antihypertensive treatment. Animals Fifty‐one dogs with PDH treated with trilostane Q12h. Methods Prospective case series study. Dogs were evaluated at diagnosis (T0) and 1, 3, 6, and 12 months (T12). Dogs were classified as nonhypertensive (SBP < 160 mm Hg) or hypertensive (SBP≥160 mm Hg) and subclassified according to target organ damage (TOD) risk. Hypertensive dogs were treated with benazepril and, if control of SH was not achieved, amlodipine was added. Results Prevalence of SH decreased from T0 (36/51) to T12 (17/37; P = .01). Changes in SBP during the study were influenced by the risk of TOD at T0. In severely hypertensive (SBP ≥ 180 mm Hg) dogs, the decrease in SBP was more pronounced whereas in normotensive (SBP < 140 mm Hg) dogs SBP increased slightly (P = .00). Blood pressure was not associated with disease control. Antihypertensive treatment was needed in 31/51 dogs, and in 13/31 dogs additional SH control with amlodipine was required. One third of nonhypertensive dogs at T0 required treatment with benazepril because SH developed during follow‐up. Conclusions and Clinical Importance In dogs with PDH, SBP should be measured at every visit, regardless of disease control or SBP at diagnosis. More than 1 drug may be necessary to manage SH in affected dogs.
Collapse
Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | | | - Daniel Alonso-Miguel
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Irene Clares Moral
- Veterinary Teaching Hospital Complutense, Complutense University of Madrid, Madrid, Spain
| | - Pedro Cuesta-Alvaro
- Computing Services, Research Support, Complutense University of Madrid, Avda de la Complutense s/n, Madrid, Spain
| | - María Dolores Pérez Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
6
|
García San José P, Arenas Bermejo C, Clares Moral I, Cuesta Alvaro P, Pérez Alenza MD. Prevalence and risk factors associated with systemic hypertension in dogs with spontaneous hyperadrenocorticism. J Vet Intern Med 2020; 34:1768-1778. [PMID: 32614466 PMCID: PMC7517838 DOI: 10.1111/jvim.15841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 12/14/2022] Open
Abstract
Background Systemic hypertension (SH) is common in dogs with hyperadrenocorticism (HAC) however there are not many studies assessing its prevalence and risk factors. Objectives To determine the prevalence and severity of SH in dogs with HAC and its association with clinical and laboratory findings to identify potential risk factors. Animals Sixty‐six client owned dogs with spontaneous HAC. Methods Retrospective cross‐sectional study. Medical records of dogs with HAC were reviewed. Systolic blood pressure (SBP) was measured using Doppler ultrasonography. Clinical signs, physical examination findings and clinicopathologic data (CBC, serum biochemistry and electrolytes, urinalysis and urinary culture, and adrenal function tests) were reviewed for analysis. Results Prevalence of SH (≥150 mm Hg) was 82% (54/66) and prevalence of severe SH (≥180 mm Hg) was 46% (30/66). All dogs with thrombocytosis had SH (P = .002), and a platelet count ≥438 × 103/μL was 100% specific and 61.1% sensitive to predict SH (AUC = .802, P = .001). Median potassium levels were lower in hypertensive dogs (4.1 mEq/L, range 3.1‐5.4 mEq/L) than in normotensive ones (4.5 mEq/L, range 4.0‐5.0 mEq/L) (P = .007). Dogs with UPC ≥ 0.5 had higher median SBP than those without proteinuria (P = .03). Dogs with concurrent diabetes mellitus seemed to have a reduced risk of SH (OR = .118, 95%CI = .022‐.626, P = .02). Conclusions and Clinical Importance Systemic hypertension is common in dogs with HAC and is frequently severe. Blood pressure should be routinely assessed in these dogs, especially if thrombocytosis, proteinuria or low potassium concentrations are present.
Collapse
Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | | | - Irene Clares Moral
- Veterinary Teaching Hospital Complutense, Complutense University of Madrid, Madrid, Spain
| | - Pedro Cuesta Alvaro
- Data Processing Center, Department of Political and Public Administration Sciences II, Political Sciences Faculty, Complutense University of Madrid, Madrid, Spain
| | - María Dolores Pérez Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|