Plasma adrenocorticotropin (ACTH) concentrations and clinical response in horses treated for equine Cushing’s disease with cyproheptadine or pergolide.
Abstract: Plasma ACTH levels have been variable in horses with a positive clinical response for therapy for equine Cushing's Disease (ECD). Therefore, our purpose was to determine the value of monitoring plasma adrenocorticotropin (ACTH) levels during treatment of equine Cushing's disease (ECD) with either cyproheptadine (n = 32) or pergolide (n = 10). First, we validated the chemiluminescent ACTH assay (specificity, precision, accuracy, intra-assay and interassay variations) and tested methods of handling the whole blood from the time of collection to when the ACTH was assayed. The sensitivity and specificity of high plasma ACTH levels for detecting ECD was determined in a retrospective study on hospitalised horses (n = 68). Surveys were sent to veterinarians who submitted equine ACTH levels that were high initially and had at least 2 ACTH samples to determine the value of monitoring ACTH levels during therapy of ECD. The ACTH chemiluminescent assay was valid. The ACTH was stable when whole blood was collected and held in plastic tubes for 8 h before separating the plasma. The sensitivity and specificity of plasma ACTH levels for detecting ECD were 84% (n = 19,95% CI 60,97) and 78% (n = 49,95% CI 63,88), respectively. Treated horses generally showed a decrease in plasma ACTH. Plasma ACTH levels may be helpful when monitoring therapy of ECD, although improvement in clinical signs should be considered most important. There were no differences between cyproheptadine and pergolide in terms of improvements in any of the clinical signs.
Publication Date: 2002-11-29 PubMed ID: 12455838DOI: 10.2746/042516402776250333Google Scholar: Lookup
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- Journal Article
- Validation Study
- Adrenocorticotropic Hormone (ACTH)
- Blood Analysis
- Clinical Pathology
- Clinical Signs
- Clinical Study
- Cortisol
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Disease Treatment
- Equine Diseases
- Equine Health
- Hormones
- Horses
- Pharmacology
- Pituitary Pars Intermedia Dysfunction
- Plasma
- Retrospective Study
- Veterinary Medicine
- Veterinary Research
Summary
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The research is aimed at assessing the effectiveness of plasma ACTH levels in monitoring the treatment of equine Cushing’s disease, using two specific drugs, cyproheptadine and pergolide. The research confirmed that ACTH levels can assist in monitoring the treatment of the disease, however, observing improvements in clinical signs were deemed more crucial.
Objective and Methodology
- The research was centered on examining the effectiveness of monitoring plasma adrenocorticotropin (ACTH) levels during the treatment of equine Cushing’s disease (ECD) with two specific drugs, namely, cyproheptadine and pergolide.
- To attain this, the researchers first verified the chemiluminescent ACTH assay in terms of its specificity, precision, accuracy, and intra-assay and interassay variations and looked into the different methods of handling whole blood from the time it’s collected till when the ACTH was assayed.
- Finally, they tested the sensitivity and specificity of high plasma ACTH levels for detecting ECD in a retrospective study on hospitalised horses.
Findings and Conclusion
- The research found that the ACTH chemiluminescent assay was valid and the ACTH remained stable when the whole blood was stored in plastic tubes for 8 hours before separating the plasma.
- The sensitivity and specificity of plasma ACTH levels for detecting ECD were established to be 84% and 78% respectively, leading to the conclusion that plasma ACTH levels can be effective when monitoring the therapy of ECD.
- However, it was noted that more emphasis should be given to the improvement in actual clinical signs rather than just focusing on the ACTH levels.
- Lastly, the research found that in terms of improving the clinical signs, there were no discernible differences between the effects of cyproheptadine and pergolide.
Implications
- This study could potentially help veterinarians in making better treatment decisions by not only focusing on plasma ACTH levels but also considering the improvement in clinical signs.
- The results of the research provide valuable insights into the efficacy of using cyproheptadine and pergolide for treating equine Cushing’s disease.
Cite This Article
APA
Perkins GA, Lamb S, Erb HN, Schanbacher B, Nydam DV, Divers TJ.
(2002).
Plasma adrenocorticotropin (ACTH) concentrations and clinical response in horses treated for equine Cushing’s disease with cyproheptadine or pergolide.
Equine Vet J, 34(7), 679-685.
https://doi.org/10.2746/042516402776250333 Publication
Researcher Affiliations
- Department of Clinical Sciences, New York State College of Veterinary Medicine, Cornell University, Ithaca 14853, USA.
MeSH Terms
- Adrenocorticotropic Hormone / blood
- Animals
- Cushing Syndrome / blood
- Cushing Syndrome / diagnosis
- Cushing Syndrome / drug therapy
- Cushing Syndrome / veterinary
- Cyproheptadine / therapeutic use
- Drug Monitoring / veterinary
- Female
- Horse Diseases / blood
- Horse Diseases / diagnosis
- Horse Diseases / drug therapy
- Horses
- Luminescent Measurements
- Male
- Pergolide / therapeutic use
- Retrospective Studies
- Sensitivity and Specificity
Citations
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