Plasma adrenocorticotropin (ACTH) concentrations and clinical response in horses treated for equine Cushing's disease with cyproheptadine or pergolide

Summary 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 (E...

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Bibliographic Details
Published in:Equine veterinary journal 2002-11, Vol.34 (7), p.679-685
Main Authors: PERKINS, G. A., LAMB, S., ERB, H. N., SCHANBACHER, B., NYDAM, D. V., DIVERS, T. J.
Format: Article
Language:English
Subjects:
Adrenocorticotropic Hormone - blood
Animals
Cushing Syndrome - blood
Cushing Syndrome - diagnosis
Cushing Syndrome - drug therapy
Cushing Syndrome - veterinary
cyproheptadine
Cyproheptadine - therapeutic use
Drug Monitoring - veterinary
equine Cushing's disease
Female
horse
Horse Diseases - blood
Horse Diseases - diagnosis
Horse Diseases - drug therapy
Horses
Luminescent Measurements
Male
pars intermedia
pergolide
Pergolide - therapeutic use
pituitary adenoma
pituitary hyperplasia
Retrospective Studies
Sensitivity and Specificity
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Summary:Summary 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 8h 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.
ISSN:0425-1644
2042-3306
DOI:10.2746/042516402776250333