Advertisement

Laboratory Diagnosis of Thyroid and Adrenal Disease

Published:October 18, 2022DOI:https://doi.org/10.1016/j.cvsm.2022.08.005

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Veterinary Clinics: Small Animal Practice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Scott-Moncrieff J.C.
        Hypothyroidism.
        in: Feldman E.C. Nelson R.W. Reusch C.E. Canine and feline endocrinology. 4th edition. Elsevier Inc, St. Louis2015: 77-135
        • Panciera D.L.
        Hypothyroidism in dogs: 66 cases (1987-1992).
        J Am Vet Med Assoc. 1994; 204: 1987-1992
        • Lobetti R.G.
        Hypercalcaemia in a dog with primary hypothyroidism.
        J S Afr Vet Assoc. 2011; 82: 242-243
        • Di Paola A.
        • Carotenuto G.
        • Dondi F.
        • et al.
        Symmetric dimethylarginine concentrations in dogs with hypothyroidism before and after treatement with levothyroxine.
        J Small Anim Pract. 2021; 62: 89-96
        • Dixon R.M.
        • Mooney C.T.
        Evaluation of serum free thyroxine and thyrotropin concentrations in the diagnosis of canine hypothyroidism.
        J Small Anim Pract. 1999; 40: 72-78
        • Kantrowitz L.B.
        • Peterson M.E.
        • Melián C.
        • et al.
        Serum total thyroxine, total triiodothyronine, free thyroxine, and thyrotropin concentrations in dogs with nonthyroidal disease.
        J Am Vet Med Assoc. 2001; 219: 765-769
        • Lawler D.F.
        • Ballam J.M.
        • Meadows R.
        • et al.
        Influence of lifetime food restriction on physiological variables in Labrador retriever dogs.
        Exp Gerontol. 2007; 42: 204-214
        • Shiel R.E.
        • Brennan S.F.
        • Omodo-Eluk A.J.
        • et al.
        Thyroid hormone concentrations in young, healthy, pretraining greyhounds.
        Vet Rec. 2007; 161: 616-619
        • Panciera D.L.
        • Hinchcliff K.W.
        • Olson J.
        • et al.
        Plasma Thyroid Hormone Concentrations in Dogs Competing in a Long-Distance Sled Dog Race.
        J Vet Intern Med. 2003; 17: 593-596
        • Lavoué R.
        • Geffré A.
        • Braun J.P.
        • et al.
        Breed-specific hematologic reference intervals in healthy adult Dogues de Bordeaux.
        Vet Clin Pathol. 2014; 43: 352-361
        • Daminet S.
        • Ferguson D.C.
        Influence of Drugs on Thyroid Function in Dogs.
        J Vet Intern Med. 2003; 17: 463-472
        • Nachreiner R.F.
        • Refsal K.R.
        • Graham P.A.
        • et al.
        Prevalence of serum thyroid hormone autoantibodies in dogs with clinical signs of hypothyroidism.
        J Am Vet Med Assoc. 2002; 220: 466-471
        • Nelson R.W.
        • Ihle S.L.
        • Feldman E.C.
        • et al.
        Serum free thyroxine concentration in healthy dogs, dogs with hypothyroidism, and euthyroid dogs with concurrent illness.
        J Am Vet Med Assoc. 1991; 198: 1401-1407
        • Peterson M.E.
        • Melián C.
        • Nichols R.
        Measurement of serum total thyroxine, triiodothyronine, free thyroxine, and thyrotropin concentrations for diagnosis of hypothyroidism in dogs.
        J Am Vet Med Assoc. 1997; 211: 1396-1402
        • Robertson J.
        Current concepts on diagnosing and managing thyroid disease in dogs & cats.
        Clin Br. 2010; : 1-12
        • Scott-Moncrieff J.C.R.
        • Nelson R.W.
        • Campbell K.L.
        • et al.
        Accuracy of serum free thyroxine concentrations determined by a new veterinary chemiluminescent immunoassay in euthyroid and hypothyroid dogs.
        J Vet Intern Med. 2011; 25: 1493
        • Rasmussen S.H.
        • Andersen H.H.
        • Kjelgaard-Hansen M.
        Combined assessment of serum free and total T4 in a general clinical setting seemingly has limited potential in improving diagnostic accuracy of thyroid dysfunction in dogs and cats.
        Vet Clin Pathol. 2014; 43: 1-3
        • Randolph J.F.
        • Lamb S.V.
        • Cheraskin J.L.
        • et al.
        Free Thyroxine Concentrations by Equilibrium Dialysis and Chemiluminescent Immunoassays in 13 Hypothyroid Dogs Positive for Thyroglobulin Antibody.
        J Vet Intern Med. 2015; 29: 877-881
        • Bennaim M.
        • Shiel R.E.
        • Evans H.
        • et al.
        Free thyroxine measurement by analogue immunoassay and equilibrium dialysis in dogs with non-thyroidal illness.
        Res Vet Sci. 2022; 147: 37-43
        • Miller A.B.
        • Nelson R.W.
        • Scott-Moncrieff J.C.
        • et al.
        Serial thyroid hormone concentrations in healthy euthyroid dogs, dogs with hypothyroidism, and euthyroid dogs with atopic dermatitis.
        Br Vet J. 1992; 148: 451-458
        • Scott-Moncrieff J.C.R.
        • Nelson R.W.
        • Bruner J.M.
        • et al.
        Comparison of serum concentrations of thyroid-stimulating hormone in healthy dogs, hypothyroid dogs, and euthyroid dogs with concurrent disease.
        J Am Vet Med Assoc. 1998; 212: 387-391
        • Dixon R.M.
        • Reid S.W.J.
        • Mooney C.T.
        Treatment and therapeutic monitoring of canine hypothyroidism.
        J Small Anim Pract. 2002; 43: 334-340
        • Graham P.A.
        • Refsal K.R.
        • Nachreiner R.F.
        Etiopathologic Findings of Canine Hypothyroidism.
        Vet Clin North Am - Small Anim Pract. 2007; 37: 617-631
        • Graham P.A.
        • Nachreiner R.F.
        • Refsal K.R.
        • et al.
        Lymphocytic thyroiditis.
        Vet Clin North Am Small Anim Pract. 2001; 31: 915-933
        • Corsini A.
        • Faroni E.
        • Lunetta F.
        • et al.
        Recombinant human thyrotropin stimulation test in 114 dogs with suspected hypothyroidism: a cross-sectional study.
        J Small Anim Pract. 2021; 62: 257-264
        • Peterson M.E.
        Hyperthyroidism in Cats: What’s causing this epidemic of thyroid disease and can we prevent it?.
        J Feline Med Surg. 2012; 14: 804-818
        • Sassnau R.
        Epidemiological investigation on the prevalence of feline hyperthyroidism in an urban population in Germany | Epidemiologische untersuchung zur prävalenz der felinen hyperthyreose in einem deutschen Großstadtbereich.
        Tierarztl Prax Ausgabe K Kleintiere - Heimtiere. 2006; 34: 450-457
        • McLean J.L.
        • Lobetti R.G.
        • Mooney C.T.
        • et al.
        Prevalence of and risk factors for feline hyperthyroidism in South Africa.
        J Feline Med Surg. 2017; 19: 1103-1109
        • Peterson M.E.
        • Kintzer P.P.
        • Cavanagh P.G.
        • et al.
        Feline hyperthyroidism: pretreatment clinical and laboratory evaluation of 131 cases.
        J Am Vet Med Assoc. 1983; 183: 103-110
        • Foster D.J.
        • Thoday K.L.
        Tissue sources of serum alkaline phosphatase in 34 hyperthyroid cats: A qualitative and quantitative study.
        Res Vet Sci. 2000; 68: 89-94
        • Campbell J.
        • Chapman P.
        • Klag A.
        The Prevalence, Magnitude, and Reversibility of Elevated Liver Enzyme Activities in Hyperthyroid Cats Presenting for Iodine-131 Treatment.
        Front Vet Sci. 2022; 9: 1-7
        • Berent A.C.
        • Drobatz K.J.
        • Ziemer L.
        • et al.
        Liver function in cats with hyperthyroidism before and after 131I therapy.
        J Vet Intern Med. 2007; 21: 1217-1223
        • Williams T.L.
        • Peak K.J.
        • Brodbelt D.
        • et al.
        Survival and the Development of Azotemia after Treatment of Hyperthyroid Cats.
        J Vet Intern Med. 2010; 24: 863-869
        • DeMonaco S.M.
        • Panciera D.L.
        • Morre W.A.
        • et al.
        Symmetric dimethylarginine in hyperthyroid cats before and after treatment with radioactive iodine.
        J Feline Med Surg. 2020; 22: 531-538
        • Peterson M.E.
        • Varela F.V.
        • Rishniw M.
        • et al.
        Evaluation of Serum Symmetric Dimethylarginine Concentration as a Marker for Masked Chronic Kidney Disease in Cats With Hyperthyroidism.
        J Vet Intern Med. 2018; 32: 295-304
        • Buresova E.
        • Stock E.
        • Paepe D.
        • et al.
        Assessment of symmetric dimethylarginine as a biomarker of renal function in hyperthyroid cats treated with radioiodine.
        J Vet Intern Med. 2019; 33: 516-522
        • Mayer-Roenne B.
        • Goldstein R.E.
        • Erb H.N.
        Urinary tract infections in cats with hyperthyroidism, diabetes mellitus and chronic kidney disease.
        J Feline Med Surg. 2007; 9: 124-132
        • Bailiff N.L.
        • Westropp J.L.
        • Nelson R.W.
        • et al.
        Evaluation of urine specific gravity and urine sediment as risk factors for urinary tract infections in cats.
        Vet Clin Pathol. 2008; 37: 317-322
        • Keebaugh A.E.
        • DeMonaco S.M.
        • Grant D.C.
        • et al.
        Prevalence of, and factors associated with, positive urine cultures in hyperthyroid cats presenting for radioiodine therapy.
        J Feline Med Surg. 2021; 23: 74-78
        • Broussard J.D.
        • Peterson M.E.
        • Fox P.R.
        Changes in clinical and laboratory findings in cats with hyperthyroidism from 1983 to 1993.
        J Am Vet Med Assoc. 1995; 206: 302-305
        • Gil-Morales C.
        • Costa M.
        • Tennant K.
        • et al.
        Incidence of microcytosis in hyperthyroid cats referred for radioiodine treatment.
        J Feline Med Surg. 2021; 23: 928-935
        • Carney H.C.
        • Ward C.R.
        • Bailey S.J.
        • et al.
        2016 AAFP Guidelines for the Management of Feline Hyperthyroidism.
        J Feline Med Surg. 2016; 18: 400-416
        • Peterson M.E.
        • Guterl J.N.
        • Nichols R.
        • et al.
        Evaluation of Serum Thyroid-Stimulating Hormone Concentration as a Diagnostic Test for Hyperthyroidism in Cats.
        J Vet Intern Med. 2015; 29: 1327-1334
        • Urbanschitz T.
        • Burgener I.A.
        • Zeugswetter F.K.
        Nutzen eines caninen TSH-Assays zur Diagnose und Therapieüberwachung der felinen Hyperthyreose | Utility of a canine TSH assay for diagnosis and monitoring of feline hyperthyroidism.
        Tierarztl Prax Ausg K Kleintiere Heimtiere. 2022; 50: 93-100
        • Peterson M.E.
        • Graves T.K.
        • Gamble D.A.
        Triiodothyronine (T3) Suppression Test: An Aid in the Diagnosis of Mild Hyperthyroidism in Cats.
        J Vet Intern Med. 1990; 4: 233-238
        • Scott-Moncrieff J.C.
        Canine Thyroid Tumors and Hyperthyroidism.
        in: Feldman E.C. Nelson R.W. Reusch C.E. Canine and feline endocrinology. 4th edition. Elsevier Inc., St. Louis2015: 196-212
      1. Endocrinology ES of V. Project agreeing language in veterinary endocrinology (ALIVE). Project ALIVE.
        (Available at:) (Accessed May 14, 2022)
        • Frank C.B.
        • Valentin S.Y.
        • Scott-Moncrieff J.C.R.
        • et al.
        Correlation of inflammation with adrenocortical atrophy in canine adrenalitis.
        J Comp Pathol. 2013; 149: 268-279
        • Thompson A.L.
        • Scott-Moncrieff J.C.
        • Anderson J.D.
        Comparison of classic hypoadrenocorticism with glucocorticoid-deficient hypoadrenocorticism in dogs: 46 Cases (1985-2005).
        J Am Vet Med Assoc. 2007; 230: 1190-1194
        • Baumstark M.E.
        • Sieber-Ruckstuhl N.S.
        • Müller C.
        • et al.
        Evaluation of aldosterone concentrations in dogs with hypoadrenocorticism.
        J Vet Intern Med. 2014; 28: 154-159
        • Lobetti R.G.
        Hyperreninaemic hypoaldosteronism in a dog.
        J S Afr Vet Assoc. 1998; 69: 33-35
        • McGonigle K.M.
        • Randolph J.F.
        • Center S.A.
        • et al.
        Mineralocorticoid before glucocorticoid deficiency in a dog with primary hypoadrenocorticism and hypothyroidism.
        J Am Anim Hosp Assoc. 2013; 49: 54-57
        • Lathan P.
        • Thompson A.
        Management of hypoadrenocorticism (Addison’s disease) in dogs.
        Vet Med Res Rep. 2018; 9: 1-10
        • Peterson M.E.
        • Kintzer P.P.
        • Kass P.H.
        Pretreatment clinical and laboratory findings in dogs with hypoadrenocorticism: 225 cases (1979-1993).
        J Am Vet Med Assoc. 1996; 208: 85-91
        • Vincent A.M.
        • Okonkowski L.K.
        • Brudvig J.M.
        • et al.
        Low-dose desoxycorticosterone pivalate treatment of hypoadrenocorticism in dogs: A randomized controlled clinical trial.
        J Vet Intern Med. 2021; 35: 1720-1728
        • Melián C.
        • Peterson M.E.
        Diagnosis and treatment of naturally occurring hypoadrenocorticism in 42 dogs.
        J Small Anim Pract. 1996; 37: 268-275
        • Adler J.A.
        • Drobatz K.J.
        • Hess R.S.
        Abnormalities of serum electrolyte concentrations in dogs with hypoadrenocorticism.
        J Vet Intern Med. 2007; 21: 1168-1173
        • Seth M.
        • Drobatz K.J.
        • Church D.B.
        • et al.
        White Blood Cell Count and the Sodium to Potassium Ratio to Screen for Hypoadrenocorticism in Dogs.
        J Vet Intern Med. 2011; 25: 1351-1356
        • Graves T.K.
        • Schall W.D.
        • Refsal K.
        • et al.
        Basal and ACTH-Stimulated Plasma Aldosterone Concentrations are Normal or Increased in Dogs With Trichuriasis-Associated Pseudohypoadrenocorticism.
        J Vet Intern Med. 1994; 8: 287-289
        • DiBartola S.P.
        • Johnson S.E.
        • Davenport D.J.
        • et al.
        Clinicopathologic findings resembling hypoadrenocorticism in dogs with primary gastrointestinal disease.
        J Am Vet Med Assoc. 1985; 187: 60-63
        • Dropkin C.A.
        • Kruger J.M.
        • Langlois D.K.
        Evaluation of urine electrolytes for the diagnosis of hypoadrenocorticism in dogs.
        Vet Clin Pathol. 2021; 50: 507-514
        • Lennon E.M.
        • Hummel J.B.
        • Vaden S.L.
        Urine sodium concentrations are predictive of hypoadrenocorticism in hyponatraemic dogs: a retrospective pilot study.
        J Small Anim Pract. 2018; 59: 228-231
        • Scott-Moncrieff J.C.
        Hypoadrenocorticism.
        in: Feldman E.C. Nelson R.W. Reusch C.E. Canine and feline endocrinology. 4th edition. Elsevier Inc., St. Louis2015: 485-520
        • Peterson M.E.
        • Feinman J.M.
        Hypercalcemia associated with hypoadrenocorticism in sixteen dogs.
        J Am Vet Med Assoc. 1982; 181: 802-804
        • Adamantos S.
        • Boag A.
        Total and ionised calcium concentrations in dogs with hypoadrenocorticism.
        Vet Rec. 2008; 163: 25-26
        • Goodson T.L.
        • Randell S.C.
        A challenging case: Severe hypercalcemia in a puppy with hypoadrenocorticism.
        Vet Med. 2009; 104: 126-129
        • Gow A.G.
        • Gow D.J.
        • Bell R.
        • et al.
        Calcium metabolism in eight dogs with hypoadrenocorticism.
        J Small Anim Pract. 2009; 50: 426-430
        • Langlais-Burgess L.
        • Lumsden J.H.
        • Mackin A.
        Concurrent hypoadrenocorticism and hypoalbuminemia in dogs: A retrospective study.
        J Am Anim Hosp Assoc. 1995; 31: 307-311
        • Syme H.M.
        • Scott-Moncrieff J.C.
        Chronic hypoglycaemia in a hunting dog due to secondary hypoadrenocorticism.
        J Small Anim Pract. 1998; 39: 348-351
        • Osborne L.G.
        • Burkitt-Creedon J.M.
        • Epstein S.E.
        • et al.
        Semiquantitative acid–base analysis in dogs with typical hypoadrenocorticism.
        J Vet Emerg Crit Care. 2021; 31: 99-105
        • Decôme M.
        • Biais M.C.
        Prevalence and clinical features of hypoadrenocorticism in Great Pyrenees dogs in a referred population: 11 cases.
        Can Vet J. 2017; 58: 1093-1099
        • Medinger T.L.
        • Williams D.A.
        • Bruyette D.S.
        Severe gastrointestinal tract hemorrhage in three dogs with hypoadrenocorticism.
        J Am Vet Med Assoc. 1993; 202: 1869-1872
        • Wakayama J.A.
        • Furrow E.
        • Merkel L.K.
        • et al.
        A retrospective study of dogs with atypical hypoadrenocorticism : a diagnostic cut-off or continuum.
        . 2017; 58: 365-371
        • Lyngby J.G.
        • Sellon R.K.
        Hypoadrenocorticism mimicking protein-losing enteropathy in 4 dogs.
        Can Vet J. 2016; 57: 757-760
        • Reagan K.L.
        • Reagan B.A.
        • Gilor C.
        Machine learning algorithm as a diagnostic tool for hypoadrenocorticism in dogs.
        Domest Anim Endocrinol. 2020; 72https://doi.org/10.1016/j.domaniend.2019.106396
        • Lennon E.M.
        • Boyle T.E.
        • Hutchins R.G.
        • et al.
        Use of basal serum or plasma cortisol concentrations to rule out a diagnosis of hypoadrenocorticism in dogs: 123 Cases (2000-2005).
        J Am Vet Med Assoc. 2007; 231: 413-416
        • Bovens C.
        • Tennant K.
        • Reeve J.
        • et al.
        Basal Serum Cortisol Concentration as a Screening Test for Hypoadrenocorticism in Dogs.
        J Vet Intern Med. 2014; 28: 1541-1545
        • Gold A.J.
        • Langlois D.K.
        • Refsal K.R.
        Evaluation of Basal Serum or Plasma Cortisol Concentrations for the Diagnosis of Hypoadrenocorticism in Dogs.
        J Vet Intern Med. 2016; 30: 1798-1805
        • Lathan P.
        • Moore G.E.
        • Zambon S.
        • et al.
        Use of a low-dose ACTH stimulation test for diagnosis of hypoadrenocorticism in dogs.
        J Vet Intern Med. 2008; 22: 1070-1073
        • Botsford A.
        • Behrend E.N.
        • Kemppainen R.J.
        • et al.
        Low-dose ACTH stimulation testing in dogs suspected of hypoadrenocorticism.
        J Vet Intern Med. 2018; 32: 1886-1890
        • Javadi S.
        • Galac S.
        • Boer P.
        • et al.
        Aldosterone-to-renin and cortisol-to-adrenocorticotropic hormone ratios in healthy dogs and dogs with primary hypoadrenocorticism.
        J Vet Intern Med. 2006; 20: 556-561
        • Lathan P.
        • Scott-Moncrieff J.C.
        • Wills R.W.
        Use of the Cortisol-to-ACTH Ratio for Diagnosis of Primary Hypoadrenocorticism in Dogs.
        J Vet Intern Med. 2014; 28: 1546-1550
        • Boretti F.S.
        • Meyer F.
        • Burkhardt W.A.
        • et al.
        Evaluation of the Cortisol-to-ACTH Ratio in Dogs with Hypoadrenocorticism, Dogs with Diseases Mimicking Hypoadrenocorticism and in Healthy Dogs.
        J Vet Intern Med. 2015; 29: 1335-1341
        • Del Baldo F.
        • Gerou Ferriani M.
        • Bertazzolo W.
        • et al.
        Urinary cortisol-creatinine ratio in dogs with hypoadrenocorticism.
        J Vet Intern Med. 2022; 36: 482-487
        • Behrend E.N.
        Canine Hyperadrenocorticism.
        in: Feldman E.C. Nelson R.W. Reusch C.E. Canine and feline endocrinology. 4th edition. Elsevier Inc., St. Louis2015: 377-451
        • Bennaim M.
        • Shiel R.E.
        • Mooney C.T.
        Diagnosis of spontaneous hyperadrenocorticism in dogs. Part 2: Adrenal function testing and differentiating tests.
        Vet J. 2019; 252: 105343
        • Behrend E.N.
        • Kooistra H.S.
        • Nelson R.
        • et al.
        Diagnosis of spontaneous canine hyperadrenocorticism: 2012 acvim consensus statement (small animal).
        J Vet Intern Med. 2013; 27: 1292-1304
        • Pace S.L.
        • Creevy K.E.
        • Krimer P.M.
        • et al.
        Assesment of Coagulation and Potential Biochemical Markers for Hypercoagulability in Canine Hyperadrenocorticism.
        J Vet Intern Med. 2013; 27: 1113-1120
        • Teske E.
        • Rothuizen J.
        • de Bruijne J.J.
        • et al.
        Corticosteroid-induced alkaline phosphatase isoenzyme in the diagnosis of canine hypercorticism.
        Vet Rec. 1989; 125: 12-14
        • Martins F.
        • Carvalho G.
        • Jesus L.
        • et al.
        Epidemiological, clinical, and laboratory aspects in a case series of canine hyperadrenocorticism: 115 cases (2010-2014).
        Pesqui Veterinária Bras. 2019; 39: 900-908
        • Ling G.V.
        • Stabenfeldt G.H.
        • Comer K.M.
        • et al.
        Canine hyperadrenocorticism: Pretreatment clinical and laboratory evaluation of 117 cases.
        J Am Vet Med Assoc. 1979; 174: 1211-1215
        • Hoffman J.M.
        • Lourenço B.N.
        • Promislow D.E.L.
        • et al.
        Canine hyperadrenocorticism associations with signalment, selected comorbidities and mortality within North American veterinary teaching hospitals.
        J Small Anim Pract. 2018; 59: 681-690
        • Forrester S.D.
        • Troy G.C.
        • Dalton M.N.
        • et al.
        Retrospective evaluation of urinary tract infection in 42 dogs with hyperadrenocorticism or diabetes mellitus or both.
        J Vet Intern Med. 1999; 13: 557-560
        • Dupont P.
        • Burkhardt W.A.
        • Boretti F.S.
        • et al.
        Urinary tract infections in dogs with spontaneous hypercortisolism – frequency, symptoms and involved pathogens.
        Schweiz Arch Tierheilkd. 2020; 162: 439-450
        • Weese J.S.
        • Blondeau J.
        • Boothe D.
        • et al.
        International Society for Companion Animal Infectious Diseases (ISCAID) guidelines for the diagnosis and management of bacterial urinary tract infections in dogs and cats.
        Vet J. 2019; 247: 8-25
        • Smiley L.E.
        • Peterson M.E.
        Evaluation of a Urine Cortisol:Creatinine Ratio as a Screening Test for Hyperadrenocorticism in Dogs.
        J Vet Intern Med. 1993; 7: 163-168
        • Kaplan A.J.
        • Peterson M.E.
        • Kemppainen R.J.
        Effects of disease on the results of diagnostic tests for use in detecting hyperadrenocorticism in dogs.
        J Am Vet Med Assoc. 1995; 207: 445-451
        • Jensen A.L.
        • Iversen L.
        • Koch J.
        • et al.
        Evaluation of the urinary cortisol: Creatinine ratio in the diagnosis of hyperadrenocorticism in dogs.
        J Small Anim Pract. 1997; 38: 99-102
        • Rijnberk A.
        • van Wees A.
        • Mol J.A.
        Assessment of two tests for the diagnosis of canine hyperadrenocorticism.
        Vet Rec. 1988; 122: 178-180
        • Feldman E.C.
        Comparison of ACTH response and dexamethasone suppression as screening tests in canine hyperadrenocorticism.
        J Am Vet Med Assoc. 1983; 182: 506-510
        • Reusch C.E.
        • Feldman E.C.
        Canine Hyperadrenocorticism Due to Adrenocortical Neoplasia: Pretreatment Evaluation of 41 Dogs.
        J Vet Intern Med. 1991; 5: 3-10
        • Van Liew C.H.
        • Greco D.S.
        • Salman M.D.
        Comparison of results of adrenocorticotropic hormone stimulation and low-dose dexamethasone suppression tests with necropsy findings in dogs: 81 cases (1985-1995).
        J Am Vet Med Assoc. 1997; 211: 322-325
        • van Rijn S.J.
        • Galac S.
        • Tryfonidou M.A.
        • et al.
        The Influence of Pituitary Size on Outcome After Transsphenoidal Hypophysectomy in a Large Cohort of Dogs with Pituitary-Dependent Hypercortisolism.
        J Vet Intern Med. 2016; 30: 989-995
        • Kerl M.E.
        • Peterson M.E.
        • Wallace M.S.
        • et al.
        Evaluation of a low-dose synthetic adrenocorticotropic hormone stimulation test in clinically normal dogs and dogs with naturally developing hyperadrenocorticism.
        J Am Vet Med Assoc. 1999; 214: 1497-1501
        • Behrend E.N.
        • Kemppainen R.J.
        • Bruyette D.S.
        • et al.
        Intramuscular administration of a low dose of ACTH for ACTH stimulation testing in dogs.
        J Am Vet Med Assoc. 2006; 229: 528-530
        • Nivy R.
        • Refsal K.R.
        • Ariel E.
        • et al.
        The interpretive contribution of the baseline serum cortisol concentration of the ACTH stimulation test in the diagnosis of pituitary dependent hyperadrenocorticism in dogs.
        J Vet Intern Med. 2018; 32: 1897-1902
        • Behrend E.N.
        • Kennis R.
        Atypical Cushing’s Syndrome in Dogs: Arguments For and Against.
        Vet Clin North Am - Small Anim Pract. 2010; 40: 285-296
        • Feldman E.C.
        • Nelson R.W.
        • Feldman M.S.
        Use of low- and high-dose dexamethasone tests for distinguishing pituitary-dependent from adrenal tumor hyperadrenocorticism in dogs.
        J Am Vet Med Assoc. 1996; 209: 772-775
        • Rodríguez Piñeiro M.I.
        • Benchekroun G.
        • de Fornel-Thibaud P.
        • et al.
        Accuracy of an adrenocorticotropic hormone (ACTH) immunoluminometric assay for differentiating ACTH-dependent from ACTH-independent hyperadrenocorticism in dogs.
        J Vet Intern Med. 2009; 23: 850-855
        • Scott-Moncrieff J.C.
        • Koshko M.A.
        • Brown J.A.
        • et al.
        Validation of a Chemiluminescent Enzyme Immunometric Assay for Plasma Adrenocorticotropic Hormone in the Dog.
        Vet Clin Pathol. 2003; 32: 180-187