M Seth1, K J Drobatz, D B Church, R S Hess. 1. Department of Clinical Sciences, Matthew J. Ryan Veterinary Hospital of The University of Pennsylvania, Philadelphia, PA, USA. mseth69@gmail.com
Abstract
BACKGROUND: Abnormal sodium to potassium (Na:K) ratios can raise suspicion for hypoadrenocorticism (HA). Although dogs with HA usually have normal leukograms, their white blood cell counts may be useful in screening for HA. OBJECTIVES: To examine the utility of combining the Na:K ratio with white blood cell counts to screen for HA in hospitalized dogs requiring fluid treatment administered i.v.. ANIMALS: Fifty-three dogs with confirmed HA and 110 sick dogs confirmed not to have HA. METHODS: Retrospective, case-control study. Dogs were included if they were hospitalized and administered fluids i.v., had a complete blood count and measurement of serum Na and K concentrations. HA was diagnosed using an ACTH stimulation test, or ruled out by measurement of basal serum cortisol concentration. RESULTS: The receiver operating characteristic (ROC) curve for the lymphocyte count was not significantly different from the ROC curve of the Na:K ratio (P = .55). The ROC curve for the model combining the Na:K ratio and lymphocyte count was superior for identifying dogs with HA compared to the Na:K ratio (P = .02) or lymphocyte count (P = .005) alone. At the 100% sensitivity cutoff, lymphocyte count was more specific for detection of HA than Na:K (P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: A combination of the Na:K ratio and lymphocyte count provides a better screening test for HA compared to the Na:K ratio or lymphocyte count alone. At 100% sensitivity, the lymphocyte count is a more specific test for HA than the Na:K.
BACKGROUND: Abnormal sodium to potassium (Na:K) ratios can raise suspicion for hypoadrenocorticism (HA). Although dogs with HA usually have normal leukograms, their white blood cell counts may be useful in screening for HA. OBJECTIVES: To examine the utility of combining the Na:K ratio with white blood cell counts to screen for HA in hospitalized dogs requiring fluid treatment administered i.v.. ANIMALS: Fifty-three dogs with confirmed HA and 110 sick dogs confirmed not to have HA. METHODS: Retrospective, case-control study. Dogs were included if they were hospitalized and administered fluids i.v., had a complete blood count and measurement of serum Na and K concentrations. HA was diagnosed using an ACTH stimulation test, or ruled out by measurement of basal serum cortisol concentration. RESULTS: The receiver operating characteristic (ROC) curve for the lymphocyte count was not significantly different from the ROC curve of the Na:K ratio (P = .55). The ROC curve for the model combining the Na:K ratio and lymphocyte count was superior for identifying dogs with HA compared to the Na:K ratio (P = .02) or lymphocyte count (P = .005) alone. At the 100% sensitivity cutoff, lymphocyte count was more specific for detection of HA than Na:K (P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: A combination of the Na:K ratio and lymphocyte count provides a better screening test for HA compared to the Na:K ratio or lymphocyte count alone. At 100% sensitivity, the lymphocyte count is a more specific test for HA than the Na:K.
Authors: Annabel Botsford; Ellen N Behrend; Robert J Kemppainen; Philippe R Gaillard; Frank Oprandy; Hollie P Lee Journal: J Vet Intern Med Date: 2018-09-19 Impact factor: 3.333
Authors: F S Boretti; F Meyer; W A Burkhardt; B Riond; R Hofmann-Lehmann; C E Reusch; N S Sieber-Ruckstuhl Journal: J Vet Intern Med Date: 2015-08-06 Impact factor: 3.333