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Re-evaluation of the low-dose dexamethasone suppression test in dogs.

L Lim¹, S E Hulsebosch², C Gilor³

¹Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, USA.

The Journal of Small Animal Practice

|September 11, 2022

Summary

This study re-evaluates the low-dose dexamethasone suppression test for diagnosing canine hypercortisolism. An 8-hour cortisol cut-point of >39 nmol/L is proposed, offering high specificity for accurate diagnosis.

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Area of Science:

Veterinary endocrinology
Canine diagnostics

Background:

Hypercortisolism is a common endocrine disorder in dogs.
Accurate diagnosis relies on reliable biochemical tests like the low-dose dexamethasone suppression test (LDDST).
The current 8-hour post-dexamethasone cortisol cut-point requires re-evaluation with advanced immunoassay techniques.

Purpose of the Study:

To re-evaluate the 8-hour cortisol cut-point of the LDDST for diagnosing hypercortisolism in dogs.
To determine the optimal cut-point using a solid-phase, competitive chemiluminescent enzyme immunoassay.

Main Methods:

Prospective study involving 27 client-owned dogs with naturally occurring hypercortisolism and 30 healthy controls.
Assessment of LDDST performance using sensitivity, specificity, and receiver operating characteristic (ROC) curve analysis.
Comparison of test results with clinical diagnosis and treatment response.

Main Results:

The study identified an optimal 8-hour post-dexamethasone cortisol cut-point of >39 nmol/L.
This cut-point demonstrated high diagnostic performance with 85.2% sensitivity and 100% specificity.
The area under the ROC curve was 0.963, indicating excellent discriminatory power.

Conclusions:

The proposed 8-hour cortisol cut-point of >39 nmol/L is effective for diagnosing canine hypercortisolism using the specified immunoassay.
This finding supports the use of an adjusted cut-point for improved diagnostic accuracy in veterinary endocrinology.