Urine cortisol:creatinine ratio as a screening test for hyperadrenocorticism in dogs.

A urine cortisol:creatinine (c:c) ratio, determined from a free-catch morning sample, was evaluated in each of 83 dogs as a screening test for hyper-adrenocorticism. The dogs evaluated were allotted to 3 groups, including 20 healthy dogs, 40 dogs with confirmed hyperadrenocorticism (HAC), and 23 dogs with polyuria and polydipsia not attributable to HAC (polyuria/polydipsia group; PU/PD). Overlap in the urine c:c ratios (mean +/- SEM), comparing results from the healthy dogs (5.7 x 10(-6) +/- 0.9) with those from the HAC dogs (337.7 x 10(-6) +/- 72.0) was not found. However, 11 (64%) of the 18 values from the PU/PD dogs (42.6 x 10(-6) +/- 9.4) were above the lowest ratio in the HAC group and 50% of the HAC group had a urine c:c ratio below the highest value in the PU/PD group. When the mean urine c:c ratio (+/- 2 SD) for the group of healthy dogs was used as a reference range, 100% of the HAC dogs and 18 (77%) of 23 dogs in the PU/PD group had abnormal urine c:c ratios. The sensitivity of the urine c:c ratio to discriminate dogs with HAC was 100%. The specificity of the urine c:c ratio was 22% and its diagnostic accuracy was 76%. On the basis of our findings, a urine c:c ratio within the reference range provides strong evidence to rule out HAC. However, abnormal urine c:c ratios are obtained from dogs with clinical diseases other than HAC. Therefore, measurement of a urine c:c ratio should not be used as the sole screening test to confirm a diagnosis of HAC.

Comparison of two low-dose dexamethasone suppression protocols as screening and discrimination tests in dogs with hyperadrenocorticism.

Two low-dose dexamethasone suppression test protocols were evaluated in 18 dogs with hyperadrenocorticism (14 dogs with pituitary-dependent hyperadrenocorticism [PDH] and 4 dogs with adrenocortical tumor) and in 5 healthy control dogs. Blood was obtained immediately before and 2, 4, 6, and 8 hours after IV administration of either 0.01 mg of dexamethasone sodium phosphate/kg of body weight or 0.015 mg of dexamethasone polyethylene glycol/kg. At 8 hours after dexamethasone administration, 18 of 18 (100%) dogs with hyperadrenocorticism given the sodium phosphate preparation and 16 of 18 (89%) affected dogs given the polyethylene glycol preparation failed to have suppression of plasma cortisol concentration (less than 1.4 micrograms/dl). Plasma cortisol concentration was suppressed to less than 1.4 micrograms/dl at 2, 4, and/or 6 hours after administration of either dexamethasone preparation in 5 of 14 dogs with PDH and to less than 50% of baseline cortisol concentration in 10 of 14 dogs with PDH. Suppression, as identified by these 2 criteria, was not observed at 2, 4, 6, or 8 hours after administration of either dexamethasone preparation in dogs with adrenocortical tumor. For both protocols, the 8-hour plasma cortisol concentration was suppressed to less than 1.4 micrograms/dl and to less than 50% of baseline in the 5 control dogs. Both protocols were comparable for use as screening tests in establishing a diagnosis of hyperadrenocorticism. Suppression of plasma cortisol concentration to less than 50% of baseline (or less than 1.4 micrograms/dl) during the test was consistent with diagnosis of PDH. Failure to have such suppression, however, was observed in dogs with PDH as well as in those with adrenocortical tumor.

The effect of pentobarbital on lidocaine toxicity and brainstem concentration.

The effect of pretreatment with 20 mg/kg sodium pentobarbital on the acute intravenous toxicity of 2% lidocaine was determined in rats. Pretreatment increased the LD(50) of lidocaine from 20.2 mg/kg to 26.9 mg/kg (p<0.05). This 25% decrease in lethality was accompanied by similar decreases in the concentrations of lidocaine (relative to the injected dose) in serum and brainstem samples collected immediately after death. Under the conditions of this study, pentobarbital apparently protects against lidocaine lethality by increasing the relative distribution of local anesthetic to tissues outside of the central nervous system.

Effect of chronic lithium treatment on hypothalamic-pituitary regulation of thyroid function.

We have previously observed that chronic treatment with Li causes a decrease in the goitrogenic response to iodine deficiency in rats. Since this is likely to be mediated by an alteration of thyrotropin (TSH) secretion, we have investigated the hypothalamic and pituitary function of rats fed an iodine deficient Li supplemented diet for 16 weeks. The Li group had lower thyroid and pituitary weights than the corresponding control group. Plasma thyroxine (T4) and 3,5,3'-triiodothyronine (T3) were low and comparable in both groups but plasma TSH was significantly lower in the Li group. There was no difference in the TSH content of pituitaries in the two groups. TSH release from the pituitaries in vitro was similar in both groups in the basal state as well as upon stimulation by thyrotropin releasing hormone (TRH). We conclude that chronic treatment with Li blunts the TSH response to iodine deficiency. The data also provide indirect evidence that the effect of Li is exerted at the hypothalamic rather than at the pituitary level.

Decreased thyroidal response to thyrotropin in diabetic mice.

The effect of diabetes mellitus on the synthesis and secretion of thyroid hormone ws investigated in mice with streptozotocin-induced diabetes. Thyroid glands were labeled in vivo with 131I for 2 h. In control animals, TSH stimulated the synthesis of PB127I and 131I-labeled iodothyronines and simultaneously decreased the proportion of 131I-. These effects of TSH were not observed in diabetic animals but were demonstrable in diabetic animals treated with insulin. For studies of hormone secretion, labeled thyroid glands were cultured in vitro in medium containing 1 mM mononitrotyrosine. The rate of the hydrolysis of labeled thyroglobulin was measured as the proportion of 131I-labeled iodotyrosines and 131I-labeled iodothyronines recovered at the end of culture and was used as an index of thyroid secretion. TSH in vivo stimulated the rate of thyroglobulin hydrolysis for 6 h, with a peak occurring after 2 h. The diabetic mice had a diminished response to TSH, which improved on treatment with insulin. The addition of TSH and insulin to the culture medium significantly increased the rate of thyroglobulin hydrolysis in glands of diabetic mice over that resulting from the addition of dibutyryl cAMP alone. The generation of thyroidal cAMP in response to TSH was higher in diabetic mice than in controls. The rise in plasma T4 and T3 2 h after the administration of TSH was less in diabetic mice than in control mice or diabetic mice treated with insulin. Our studies, therefore, indicate that the thyroidal response to TSH is decreased in diabetes mellitus. The defect appears to be at a step beyond the generation of cAMP.

Role of the heterogeneity of thyroglobulin in the secretion of thyroid hormone in mice.

The rates of thyroglobulin hydrolysis and iodothyroine release from mouse thyroid glands were studied in vitro. Recently iodinated thyroglobulin ('new pool') had been labelled during life by injection of 131I 3 h before removal of the thyroid, 'old pool' thyroglobulin had been labelled by the administration of 125I in the drinking water for 1 week starting 3 weeks earlier. Chromatogrphic analysis of pronase digests of the thyroid glands showed that the iodothyronine content of the old and new pools were 19.5 and 7.4 per cent respectively. In the basal state the rate of thyroglobulin hydrolysis was lower from the old pool but the rate of hormone secretion was similar from both pools. Thyrotrophin (TSH) increased the rate of thyroglobulin hydrolysis and hormone release from both pools by up to four to six times the basal rate, the effect being maximal 2 h after administration of TSH and lasting for 6-8 h. The rate of thyroglobulin hydrolysis after TSH was similar in both pools but the rate of release of labelled iodothyronines was significantly higher from from the old pool. These studies have indicated that although hydrolysis of thyroglobulin paroceeds faster in the new pool than in the old ('last come, first served' hypothesis) neverrtheless there is no difference in the rate of hormone secretion from the two pools, and hydrolysis in both pools is affected by TSH.

Pre-precipitated and solid-phase second antibody compared in radioimmunoassay.

We describe simple methods for preparing and determining the titer of pre-precipitated second antibody. We compared the performance of this type of insolubilized second antibody with that of a commercially available solid-phase second antibody (DASP) for separation of reverse triiodothyronine (rT3) and for thyrotropin radioimmunoassays. Equilibrium time for both reagents was about 30 min, considerably briefer than for the usual second-antibody procedure. Within-assay precision was improved and percentages of nonspecific binding (mean and SD) were lower if pre-precipitated second antibody was used in both assays [rT3 pre-precipitate = 1.48 (SD 0.16), rT3 DASP = 3.76 (SD 0.22); thyrotropin pre-precipitate = 1.45 (SD 0.18), thyrotropin DASP = 3.45 (SD 0.26)]. The cost of DASP was three to 10 times that of pre-precipitated second antibody prepared with commercially available products.

Effect of inorganic iodide on thyroglobulin hydrolysis in cultured thyroid glands.

The process of thyroglobulin hydrolysis in mouse thyroid glands labelled in vitro was studied from 2-24 h after they had been maintained in tissue culture. The culture medium was supplemented with mononitrotyrosine to prevent deiodination of iodotyrosines. Hydrolysis of labelled thyroglobulin, under these conditions, led to the release of labelled iodotyrosines and iodothyronines. The rate of formation of these compounds was measured as an index of thyroglobulin hydrolysis (TH). TH was markedly stimulated by TSH. NaI inhibited TSH stimulation of TH at a concentration of 10(-5)M or greater. NaI, at similar concentrations,also markedly diminished or abolished the incorporation of 131I into thyroidal proteins from radioiodide-supplemented media. The addition of various inhibitors of iodination effectively blocked the effect of iodide on TH. In experiments where radioimmunossay was used to measure medium hormone concentrations, the release of unlabelled thyroxine (T4) and triiodothyronine (T3) induced by TSH was found to be significantly decreased in the presence of 10(-4)M NaI. These studies demonstrate that iodide inhibits the hydrolysis of thyroglobulin at or near concentrations which also inhibit iodination of thyroidal proteins. The present data suggest that formation of an iodinated compound is necessary for the effect of iodide. In addition, these studies demonstrate the utility of this in vitro system for the investigation of thyroid physiology.