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Evaluation of the basal and postadrenocorticotrophic hormone serum concentrations of 17-hydroxyprogesterone for the diagnosis of hyperadrenocorticism in dogs
  1. P. S. Chapman, BVetMed, MRCVS1,
  2. J. Ede, BVetMed, MRCVS1,
  3. C. T. Mooney, MVB, MPhil, PhD, DECVIM-CA, MRCVS2,
  4. H. Evans, BSc3,
  5. J. O'Connor, MVB, MRCVS2,
  6. D. U. Pfeiffer, DrMedVet, PhD, DipTropVetSci, DipECVPH, MACVS1 and
  7. R. Neiger, DrMedVet, PhD, DECVIM-CA, DACVIM, MRCVS1
  1. 1 Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA
  2. 2 Department of Small Animal Clinical Studies, Faculty of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
  3. 3 Cambridge Specialist Laboratories, Peek House Business Centre, Dales Manor Business Park, Grove Road, Sawston, Cambridgeshire CB2 4TJ
  1. Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancy Street, Philadelphia, PA 19104, USA

Abstract

Serum concentrations of 17-hydroxyprogesterone and cortisol were measured before and after the administration of exogenous adrenocorticotrophic hormone (AcrH) to three groups of dogs: 27 healthy dogs (group 1), 19 dogs with non-adrenal illness (group 2) and 46 dogs with hyperadrenocorticism (group 3). The median (range) post-AcTH concentrations of 17-hydroxyprogesterone were 5-0 (22.2 to 16.8), 6.9 (2.0 to 36.2) and 14.4 (1.7 to 71) nmol/litre in groups 1, 2 and 3, respectively. There were no significant differences in the basal or post-Acm concentrations of cortisol or 17-hydroxyprogesterone between groups 1 and 2. The post- ACTH concentrations of 17-hydroxyprogesterone in group 3 were significantly (P<0.001) greater than those in groups 1 and 2 combined. The area under the receiver operating curve (ROC) for the post-AcrH concentration of cortisol (0.94) was significantly greater than that for the post-AcTH concentration of 17-hydroxyprogesterone (0.76). Using a two-graph ROc analysis, a cut-off of 8.5 nmol/litre was found to maximise both the sensitivity and specificity of the post-AcTH concentration of 17-hydroxyprogesterone for the diagnosis of hyperadrenocorticism at 71 per cent. With a cut-off of 4.5 nmol/litre the sensitivity increased to 90 per cent but the specificity decreased to 40 per cent; with a cut-off of 16.7 nmol/litre the specificity increased to 90 per cent but the sensitivity decreased to 47 per cent.

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