{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:50:51Z","timestamp":1788511851918,"version":"build-2803163510"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":764,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dogs with eunatremic, eukalemic hypoadrenocorticism (EEH) typically show signs of chronic gastrointestinal disease (CGD). Previous glucocorticoid administration (PGA) can give false-positive results on the ACTH stimulation test (ACTHst).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis\/Objectives<\/jats:title>\n                    <jats:p>To determine the prevalence of EEH in dogs with signs of CGD, and to identify clinical and clinicopathological features for EEH and PGA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>One hundred twelve dogs with CGD (101 non-PGA and 11 PGA), 20 dogs with EEH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multicenter prospective cohort study. Basal serum cortisol (BSC) concentration was measured in dogs with signs of CGD. When BSC was &amp;lt;2\u2009\u03bcg\/dL and in PGA dogs, ACTHst plus measurement of endogenous ACTH (eACTH) were performed. Records of dogs with EEH from 2009 to 2021 were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The BSC concentration was &amp;lt;2\u2009\u03bcg\/dL in 48\/101 (47.5%) non-PGA and in 9\/11 (82%) PGA dogs. EEH was diagnosed in 1\/112 dog (prevalence 0.9%; 95% CI, 0.1%-4.8%); the ACTHst provided false-positive results in 2\/11 PGA dogs. PGA dogs showed lower C-reactive protein-to-haptoglobin ratio (median 0.01, range 0.003-0.08; P\u2009=\u2009.01), and higher haptoglobin (140, 26-285\u2009mg\/dL; P\u2009=\u2009.002) than non-PGA dogs (0.04, 0.007-1.5; 38.5, 1-246\u2009mg\/dL, respectively). eACTH was higher (P\u2009=\u2009.03) in EEH (396, 5-&amp;gt;1250\u2009pg\/mL) than in non-PGA dogs (13.5, 7.3-46.6\u2009pg\/mL). Cortisol-to-ACTH ratio was lower (P\u2009&amp;lt;\u2009.0001 and P\u2009=\u2009.01, respectively) in EEH (0.002, 0.0002-0.2) than in non-PGA (0.1, 0.02-0.2) and PGA dogs (0.1, 0.02-0.2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Clinical Importance<\/jats:title>\n                    <jats:p>The prevalence of EEH in dogs with signs of CGD was lower than previously reported. The clinical and clinicopathological features herein identified could increase the index of suspicion for EEH or PGA in dogs with an unclear history of glucocorticoid administration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jvim.16921","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T03:59:07Z","timestamp":1701835147000},"page":"93-101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence of eunatremic, eukalemic hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease and risk of misdiagnosis after previous glucocorticoid administration"],"prefix":"10.1093","volume":"38","author":[{"given":"Antonio Maria","family":"Tardo","sequence":"first","affiliation":[{"name":"University of Bologna, Ozzano dell'Emilia Department of Veterinary Medical Sciences, , Bologna,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5577-0657","authenticated-orcid":false,"given":"Francesca","family":"Del Baldo","sequence":"additional","affiliation":[{"name":"University of Bologna, Ozzano dell'Emilia Department of Veterinary Medical Sciences, , Bologna,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2463-4062","authenticated-orcid":false,"given":"Rodolfo Oliveira","family":"Leal","sequence":"additional","affiliation":[{"name":"CIISA \u2013 Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon , Lisbon,","place":["Portugal"]},{"name":"Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS) , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Galiazzo","sequence":"additional","affiliation":[{"name":"University of Bologna, Ozzano dell'Emilia Department of Veterinary Medical Sciences, , Bologna,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4431-0791","authenticated-orcid":false,"given":"Marco","family":"Pietra","sequence":"additional","affiliation":[{"name":"University of Bologna, Ozzano dell'Emilia Department of Veterinary Medical Sciences, , Bologna,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Gaspardo","sequence":"additional","affiliation":[{"name":"University of Bologna, Ozzano dell'Emilia Department of Veterinary Medical Sciences, , Bologna,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3121-2199","authenticated-orcid":false,"given":"Federico","family":"Fracassi","sequence":"additional","affiliation":[{"name":"University of Bologna, Ozzano dell'Emilia Department of Veterinary Medical Sciences, , Bologna,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,1]]},"reference":[{"key":"2026020304060998800_jvim16921-bib-0001","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/jvim.13815","article-title":"Naturally occurring adrenocortical insufficiency\u2014an epidemiological study based on a swedish-insured dog population of 525,028 dogs","volume":"30","author":"Hanson","year":"2016","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0002","first-page":"213","article-title":"Canine and Feline Endocrinology","author":"Scott-Moncrieff","year":"2015","edition":"4th ed."},{"key":"2026020304060998800_jvim16921-bib-0003","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.2460\/javma.230.8.1190","article-title":"Comparison of classic hypoadrenocorticism with glucocorticoid-deficient hypoadrenocorticism in dogs: 46 cases (1985\u20132005)","volume":"230","author":"Thompson","year":"2007","journal-title":"J Am Vet Med Assoc"},{"key":"2026020304060998800_jvim16921-bib-0004","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1136\/vr.163.1.25","article-title":"Total and ionised calcium concentrations in dogs with hypoadrenocorticism","volume":"163","author":"Adamantos","year":"2008","journal-title":"Vet Rec"},{"key":"2026020304060998800_jvim16921-bib-0005","article-title":"Prevalence of \u2018Atypical\u2019 Addison's disease among a population of dogs diagnosed with hypoadrenocorticism","author":"Kelly"},{"key":"2026020304060998800_jvim16921-bib-0006","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2460\/javma.1981.179.02.155","article-title":"Atypical hypoadrenocorticism in three dogs","volume":"179","author":"Rogers","year":"1981","journal-title":"J Am Vet Med Assoc"},{"key":"2026020304060998800_jvim16921-bib-0007","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/jvim.12243","article-title":"Evaluation of aldosterone concentrations in dogs with hypoadrenocorticism","volume":"28","author":"Baumstark","year":"2014","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0008","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/jsap.12535","article-title":"Polyglandular endocrinopathy type II (Schmidt's syndrome) in a Dobermann pinscher","volume":"57","author":"Cartwright","year":"2016","journal-title":"J Small Anim Pract"},{"key":"2026020304060998800_jvim16921-bib-0009","first-page":"198","article-title":"Containing cost of ACTH-stimulation test","volume":"224","author":"Peterson","year":"2004","journal-title":"J Am Vet Med Assoc"},{"key":"2026020304060998800_jvim16921-bib-0010","doi-asserted-by":"crossref","first-page":"368","DOI":"10.5326\/0410368","article-title":"Use of compounded adrenocorticotropic hormone (ACTH) for adrenal function testing in dogs","volume":"41","author":"Kemppainen","year":"2005","journal-title":"J Am Anim Hosp Assoc"},{"key":"2026020304060998800_jvim16921-bib-0011","doi-asserted-by":"crossref","first-page":"413","DOI":"10.2460\/javma.231.3.413","article-title":"Use of basal serum or plasma cortisol concentrations to rule out a diagnosis of hypoadrenocorticism in dogs: 123 cases (2000\u20132005)","volume":"231","author":"Lennon","year":"2007","journal-title":"J Am Vet Med Assoc"},{"key":"2026020304060998800_jvim16921-bib-0012","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1111\/jvim.12415","article-title":"Basal serum cortisol concentration as a screening test for hypoadrenocorticism in dogs","volume":"28","author":"Bovens","year":"2014","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0013","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1111\/jvim.14589","article-title":"Evaluation of basal serum or plasma cortisol concentrations for the diagnosis of hypoadrenocorticism in dogs","volume":"30","author":"Gold","year":"2016","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0014","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1111\/jvim.13593","article-title":"Evaluation of the cortisol-to-ACTH ratio in dogs with hypoadrenocorticism, dogs with diseases mimicking hypoadrenocorticism and in healthy dogs","volume":"29","author":"Boretti","year":"2015","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0015","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1111\/jvim.15752","article-title":"Prevalence and characterization of hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease: a multicenter study","volume":"34","author":"Hauck","year":"2020","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0016","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/jvim.16365","article-title":"Evaluation of resting cortisol concentration testing in dogs with chronic gastrointestinal signs","volume":"36","author":"Gallego","year":"2022","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0017","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1111\/jvim.12392","article-title":"Use of the cortisol-to-ACTH ratio for diagnosis of primary hypoadrenocorticism in dogs","volume":"28","author":"Lathan","year":"2014","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0018","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1111\/jvim.16358","article-title":"Urinary cortisol-creatinine ratio in dogs with hypoadrenocorticism","volume":"36","author":"Del Baldo","year":"2022","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0019","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.2460\/javma.21.12.0538","article-title":"Investigation of the urine cortisol to creatinine ratio for the diagnosis of hypoadrenocorticism in dogs","volume":"260","author":"Moya","year":"2022","journal-title":"J Am Vet Med Assoc"},{"key":"2026020304060998800_jvim16921-bib-0020","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1177\/104063879700900307","article-title":"Validation of nonradioactive chemiluminescent immunoassay methods for the analysis of thyroxine and cortisol in blood samples obtained from dogs, cats, and horses","volume":"9","author":"Singh","year":"1997","journal-title":"J Vet Diagn Invest"},{"key":"2026020304060998800_jvim16921-bib-0021","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.1939-165X.2003.tb00333.x","article-title":"Validation of a chemiluminescent enzyme immunometric assay for plasma adrenocorticotropic hormone in the dog","volume":"32","author":"Scott-Moncrieff","year":"2003","journal-title":"Vet Clin Pathol"},{"key":"2026020304060998800_jvim16921-bib-0022","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.2460\/javma.242.11.1549","article-title":"Prevalence of inherited disorders among mixed-breed and purebred dogs: 27,254 cases (1995-2010)","volume":"242","author":"Bellumori","year":"2013","journal-title":"J Am Vet Med Assoc"},{"key":"2026020304060998800_jvim16921-bib-0023","article-title":"Canine Hypoadrenocorticism (Canine Addison's Disease): History, Contemporary Diagnosis by Practicing Veterinarians, and Epidemiology","author":"Kelch","year":"1996"},{"key":"2026020304060998800_jvim16921-bib-0024","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1111\/jsap.13285","article-title":"Hypoadrenocorticism in dogs under UK primary veterinary care: frequency, clinical approaches and risk factors","volume":"1\u20138","author":"Schofield","year":"2021","journal-title":"J Small Anim Pract"},{"key":"2026020304060998800_jvim16921-bib-0025","first-page":"555","article-title":"Canine and Feline Endocrinology","author":"Reusch","year":"2015","edition":"4th ed."},{"key":"2026020304060998800_jvim16921-bib-0026","doi-asserted-by":"crossref","first-page":"1947","DOI":"10.1111\/jvim.16564","article-title":"Characterization of clinicopathologic and abdominal ultrasound findings in dogs with glucocorticoid deficient hypoadrenocorticism","volume":"36","author":"Reagan","year":"2022","journal-title":"J Vet Intern Med"},{"key":"2026020304060998800_jvim16921-bib-0027","first-page":"151","article-title":"Canine and Feline Gastroenterology","author":"Polzin","year":"2012","edition":"1st ed."},{"key":"2026020304060998800_jvim16921-bib-0028","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1136\/vr.154.26.814","article-title":"Effects of different glucocorticoid treatments on serum acute phase proteins in dogs","volume":"154","author":"Martinez-Subiela","year":"2004","journal-title":"Vet Rec"},{"key":"2026020304060998800_jvim16921-bib-0029","first-page":"123","article-title":"BSAVA Manual of Canine and Feline Clinical Pathology","author":"McGrotty","year":"2016","edition":"3rd ed."}],"container-title":["Journal of Veterinary Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/38\/1\/93\/66662914\/jvim16921.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/38\/1\/93\/66662914\/jvim16921.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T09:06:14Z","timestamp":1770109574000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jvim\/article\/38\/1\/93\/8448629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,1]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1,1]]}},"URL":"https:\/\/doi.org\/10.1111\/jvim.16921","relation":{},"ISSN":["1939-1676"],"issn-type":[{"value":"1939-1676","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1]]},"published":{"date-parts":[[2024,1,1]]},"assertion":[{"value":"2023-01-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}