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Elevations in Sex Hormones in Dogs with SARDs

September 8th, 2009 Leave a comment Go to comments

The Journal of American Animal Hospital Association (AAHA) recently published an article titled “Elevations in Sex Hormones in Dogs with Sudden Acquired Retinal Degeneration Syndrome (SARDS)“, authored by the following doctors:

  • Renee T. Carder, DVM, Diplomate ACVO
  • Jack W. Oliver, DVM, PhD
  • Rebecca L. Stepien, DVM, MS, Diplomate ACVIM (Cardiology)
  • Ellison Bently, DVM, Diplomate ACVO

The abstract of the article is below:

Dogs diagnosed with sudden acquired retinal degeneration syndrome (SARDS) commonly are
presented with concurrent clinical, physical, and historical findings consistent with hyperadrenocorticism
(HAC) at the time of vision loss. Thirteen dogs diagnosed with SARDS on the basis of
complete ophthalmic examination and extinguished bright-flash electroretinogram were evaluated
for steroid hormonal abnormalities. Signalment, case history, physical examination, and clinicopathological
findings were recorded. Serum cortisol and sex-hormone concentrations were
measured before and after adrenocorticotropic hormone (ACTH) stimulation. Clinical signs of
HAC, systemic hypertension, and proteinuria were commonly found in dogs with SARDS.
Elevations in one or more sex hormones were found in 11 (85%) of 13 dogs (95% confidence
interval [CI] 65% to 100%); cortisol was elevated in nine (69%) of 13 dogs (95% CI 44% to
94%). A minority of dogs (three [23%] of 13; 95% CI 0.2% to 46%) exhibited only an increase in
adrenal sex hormones. Only one dog had completely normal ACTH stimulation test results.
Symptoms of HAC were associated with abnormal ACTH stimulation results. Routine ACTH
stimulation testing to evaluate cortisol and sex hormones, blood pressure screening, and
urinalysis are recommended in these animals. J Am Anim Hosp Assoc 2009;45:207-214.

Dogs diagnosed with sudden acquired retinal degeneration syndrome (SARDS) commonly are presented with concurrent clinical, physical, and historical findings consistent with hyperadrenocorticism (HAC) at the time of vision loss. Thirteen dogs diagnosed with SARDS on the basis of complete ophthalmic examination and extinguished bright-flash electroretinogram were evaluated for steroid hormonal abnormalities. Signalment, case history, physical examination, and clinicopathological findings were recorded. Serum cortisol and sex-hormone concentrations were measured before and after adrenocorticotropic hormone (ACTH) stimulation. Clinical signs of HAC, systemic hypertension, and proteinuria were commonly found in dogs with SARDS.  Elevations in one or more sex hormones were found in 11 (85%) of 13 dogs (95% confidence interval [CI] 65% to 100%); cortisol was elevated in nine (69%) of 13 dogs (95% CI 44% to 94%). A minority of dogs (three [23%] of 13; 95% CI 0.2% to 46%) exhibited only an increase in adrenal sex hormones. Only one dog had completely normal ACTH stimulation test results.  Symptoms of HAC were associated with abnormal ACTH stimulation results.  Routine ACTH stimulation testing to evaluate cortisol and sex hormones, blood pressure screening, and urinalysis are recommended in these animals. J Am Anim Hosp Assoc 2009;45:207-214.

The article describes a series of research tests performed on thirteen (13) dogs:

  • Spayed Females (9)
  • Neutered Males (2)
  • Males (2)

The age range of dogs was 6 years to 11.5 years, with a median age of 9 years at the time of diagnosis.

The breeds were as follows:

  • Brittany Spaniels (2)
  • Cairn Terrier (1)
  • Chow Chow (1)
  • Dachshund (1)
  • German Shepherd (1)
  • Lhasa Apso (1)
  • Miniature Schnauzer (2)
  • Mixed Breed Dog (1)
  • Pomeranian (1)
  • Welsh Springer Spaniel (1)
  • West Highland White Terrier (1)

We found the following excerpt to be quite interesting, particularly based on the surveys that we take online here at SARDSAwareness.org:

Any breed may be affected; however, a breed predilection for dachshunds, miniature schnauzers, and Brittany spaniels has been previously reported.

We have found that nearly 40 percent of the surveys included dachshunds.  We’ll revisit our surveys and come up with a better breakdown for our next posting.

Based on our recent experience with Oscar, we also found the following to be of interest:

  • Urinalysis information was available for 10 of 13 dogs. Of these 10, seven had proteinuria.
  • Blood pressure evaluations were available for 10 of 13 dogs. Four of 10 dogs were considered to be hypertensive based on average systolic values ranging from 185 to 250 mm Hg.

Oscar’s recent urinalysis has shown excessive protein in the urine (proteinuria) and elevated proteim:creatinine ratio.  As a result, he is currently on a prescription of enalapril and we are seeking a specialized renal diet from the UC Davis Veterinary School of Medicine — Nutrition Services Department.

For an informative read on proteinuria, and the effect of blood pressure on kidney (renal) function, visit the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) page on “The Kidneys and How They Work.

The above are all interesting, but I don’t want to digress too much from the intent of the paper, which can be summarized by this excerpt:

The majority (11 of 13) of SARDS cases were found to have elevations in one or more sex hormones. Of these elevations, the most common were in 17-OH progesterone and progesterone. Additionally, cortisol was elevated in nine of 13 dogs. All of the dogs with increased cortisol had increased poststimulation values. Importantly, stimulated values (basal versus feedback) give the most information in regard to adrenal activity.23 The majority (nine of 11) of dogs demonstrated an increase in both cortisol and sex hormones. A minority (three of 13) of dogs exhibited only an increase in adrenal sex hormones, and these dogs would not be identified on routine HAC screening. Clinical signs of HAC were associated with abnormal stimulation values in 92% of cases. Only one dog was found to have clinical signs of HAC with normal ACTH stimulation results.

If you’re interested in this paper, and would like to have a further read, please visit the link at the beginning of this posting.  The article is available as a download for $5.00 USD.

You may want to share the information with your own veterinarian.

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  1. Suzanne & Jay
    September 8th, 2009 at 22:30 | #1

    Apparently, this article is not as “new” as it seems. Dr. Grozdanic at ISU stated that it had been presented at the ACVO (veterinary ophthalmology conference) about 4 or 5 years ago.

    Per Dr. Grozdanic, “In our clinical experience, proteinuria and systemic hypertension are important clinical parameters to check for due to relationship with kidney disease. We are more concerned about hypothyroidism and potential pancreas abnormalities, rather than clinical sign of hyperadrenocroticism, since in majority of patients, clinical signs of Cushing’s disease spontaneously resolve on their own.”

    The most recent references in the paper are dated 2005.

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