Canis ISSN: 2398-2942

Pre-trilostane cortisol monitoring

Contributor(s): Samuel Fowlie, Ian Ramsey

Overview

  • Measurement of resting cortisol levels immediately before trilostane administration.

Sampling

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Tests

Methodologies

  • Chemiluminescent immunoassay.
  • Using a Siemens IMMULITE® - other methods may give different results and have not been validated so far.

Availability

  • Available at most commercial laboratories.
  • Ideally send to a laboratory participating in an external quality assurance scheme, eg ESVE or SCE.

Validity

  • Using a pre-trilostane cortisol of ≤138 nmol/L to distinguish dogs that had excellent control from those that were undercontrolled:

Sensitivity

  • Sensitivity of 55.4% - ie 44.6% of dogs with a pre-trilostane cortisol < 138 nmol/L will be undercontrolled.

Specificity

  • Specificity of 86.5% - ie 13.5% of dogs with excellent control will have a pre-trilostane cortisol >138 nmol/L.

Technique (intrinsic) limitations

  • Variability in cortisol assays.

Technician (extrinsic) limitations

  • Patient stress.

Result Data

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Further Reading

Publications

Refereed Papers

  • Recent references from VetMed Resource and PubMed.
  • Macfarlane L, Parkin T, Ramsey I (2016) Pre-trilostane and three-hour post-trilostane cortisol to monitor trilostane therapy in dogs Vet Rec 179, 597-605 PubMed.

Other sources of information

  • Ramsey I K, Macfarlane L, Fracassi F, Galac S & Reusch C (2016) The repeatability of various cortisol measurements in clinically stable dogs with hyperadrenocorticism being treated with Vetoryl. European College of Veterinary Internal Medicine Congress, Gotenburg (published in Journal of Veterinary Internal Medicine 17, 737 (Abstract).
  • Wehner A, Gloeckner S, Sauter C, Kruse D, Stockhaus C & Hartmann (2013) Association between ACTH stimulation tests, clinical signs, and laboratory parameters in dogs with hyperadrenocorticism treated with Vetoryl. European College of Veterinary Internal Medicine Congress, Liverpool (Abstract).
  • Sieber-Ruckstuhl N, Musella C, Burkhardt W, Riond B, Reusch C E, Boretti F S (2017) Agreement of Two Pre-Pill Cortisol Measurements in Dogs with Hypercortisolism Treated with Trilostane. European College of Veterinary Internal Medicine Congress, Malta (Abstract).

Organisation(s)

  • Dechra Veterinary Products - Technical Support team can provide additional advice about trilostane monitoring and their trilostane-containing product Vetoryl®.


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