{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T19:02:41Z","timestamp":1773687761303,"version":"3.50.1"},"reference-count":35,"publisher":"American Veterinary Medical Association (AVMA)","license":[{"start":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T00:00:00Z","timestamp":1686355200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2023,6,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec id=\"sc_a1\">\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To determine if urine electrolyte assessments can be used to monitor the adequacy of mineralocorticoid therapy in dogs with hypoadrenocorticism (HA).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a2\">\n<jats:title>ANIMALS<\/jats:title>\n<jats:p>29 dogs with naturally occurring glucocorticoid- and mineralocorticoid-deficient HA.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a3\">\n<jats:title>PROCEDURES<\/jats:title>\n<jats:p>Urine sodium and potassium concentrations, sodium-to-potassium ratios, sodium-to-creatinine ratios, and potassium-to-creatinine (K:Cr) ratios were evaluated in dogs with newly diagnosed HA that were treated with desoxycorticosterone pivalate (DOCP). Dogs underwent measurements of urine and serum sodium, potassium, and creatinine concentrations and plasma renin activities twice monthly for up to 3 months. Regression analyses and calculation of coefficients of determination (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>) were performed to investigate potential associations between urine and serum variables. Urine variables also were compared between dogs considered to be undertreated or overtreated based on plasma renin activities.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a4\">\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Urine K:Cr ratios were significantly associated with serum potassium concentrations 10 to 14 days (<jats:italic>P<\/jats:italic> = .002) and 30 days (<jats:italic>P<\/jats:italic> = .027) after the initial DOCP injection, but <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> values were only 0.35 and 0.17, respectively. Urine K:Cr ratios (median [IQR]) also were higher in dogs that were overtreated with DOCP (1.3 [0.7 to 2.3]) as compared to those dogs that were undertreated with DOCP (0.8 [0.5 to 0.9]) at 10 to 14 days after the initial DOCP injection (<jats:italic>P<\/jats:italic> = .039) but not at 30 days after the initial injection. Other urine variables were not significantly different between undertreated and overtreated dogs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a5\">\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>Measures of urine electrolytes were not useful for assessing the adequacy of mineralocorticoid therapy in HA dogs that were treated with DOCP.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/ajvr.23.02.0042","type":"journal-article","created":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T18:36:54Z","timestamp":1686076614000},"page":"1-7","source":"Crossref","is-referenced-by-count":1,"title":["Urine electrolytes do not predict desoxycorticosterone pivalate efficacy in dogs with hypoadrenocorticism"],"prefix":"10.2460","author":[{"given":"Daniel K.","family":"Langlois","sequence":"first","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Casey A.","family":"Dropkin","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Kruger","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"key":"B1","series-title":"BSAVA Manual of Canine and Feline Endocrinology","first-page":"156","article-title":"Canine hypoadrenocorticism","author":"Church DB","year":"2012","unstructured":"Church DB. Canine hypoadrenocorticism. In: Mooney CT, Peterson ME, eds. BSAVA Manual of Canine and Feline Endocrinology. 4th ed. British Small Animal Veterinary Association; 2012;156\u2013167."},{"key":"B2","series-title":"Textbook of Veterinary Internal Medicine","first-page":"1825","article-title":"Hypoadrenocorticism","volume":"Vol 2","author":"Hess RS","year":"2017","unstructured":"Hess RS. Hypoadrenocorticism. In: Ettinger S, Feldman E, Cote E, eds. Textbook of Veterinary Internal Medicine. 8th. Vol 2. Elsevier; 2017:1825\u20131832."},{"issue":"1","key":"B3","series-title":"J Am Vet Med Assoc","first-page":"59","article-title":"Canine hypoadrenocorticism: report of 37 cases and review of 39 previously reported cases","volume":"180","author":"Willard MD","year":"1982","unstructured":"Willard MD, Schall WD, McCaw DE, Nachreiner RF. Canine hypoadrenocorticism: report of 37 cases and review of 39 previously reported cases. J Am Vet Med Assoc. 1982;180(1):59\u201362."},{"issue":"4","key":"B4","series-title":"Top Companion Anim Med","first-page":"96","article-title":"A review of the genetics of hypoadrenocorticism","volume":"29","author":"Boag AM","year":"2014","unstructured":"Boag AM, Catchpole B. A review of the genetics of hypoadrenocorticism. Top Companion Anim Med. 2014;29(4):96\u2013101. doi:10.1053\/j.tcam.2015.01.001"},{"issue":"4","key":"B5","series-title":"J Vet Intern Med","first-page":"1399","article-title":"Prevalence and characterization of hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease: a multicenter study","volume":"34","author":"Hauck C","year":"2020","unstructured":"Hauck C, Schmitz SS, Burgener IA, et al. Prevalence and characterization of hypoadrenocorticism in dogs with signs of chronic gastrointestinal disease: a multicenter study. J Vet Intern Med. 2020;34(4):1399\u20131405. doi:10.1111\/jvim.15752"},{"issue":"1","key":"B6","series-title":"J Am Vet Med Assoc","first-page":"85","article-title":"Pretreatment clinical and laboratory findings in dogs with hypoadrenocorticism: 225 cases (1979\u20131993)","volume":"208","author":"Peterson ME","year":"1996","unstructured":"Peterson ME, Kintzer PP, Kass PH. Pretreatment clinical and laboratory findings in dogs with hypoadrenocorticism: 225 cases (1979\u20131993). J Am Vet Med Assoc. 1996;208(1):85\u201391."},{"issue":"1","key":"B7","series-title":"J Vet Intern Med","first-page":"154","article-title":"Evaluation of aldosterone concentrations in dogs with hypoadrenocorticism","volume":"28","author":"Baumstark ME","year":"2014","unstructured":"Baumstark ME, Sieber-Ruckstuhl NS, M\u00fcller C, Wenger M, Boretti FS, Reusch CE. Evaluation of aldosterone concentrations in dogs with hypoadrenocorticism. J Vet Intern Med. 2014;28(1):154\u2013159. doi:10.1111\/jvim.12243"},{"key":"B8","series-title":"Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice","first-page":"45","article-title":"Disorders of sodium and water: hypernatremia and hyponatremia","author":"DiBartola SP","year":"2012","unstructured":"DiBartola SP. Disorders of sodium and water: hypernatremia and hyponatremia. In: DiBartola SP, ed. Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice. 4th ed. Elsevier; 2012:45\u201379."},{"key":"B9","series-title":"Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice","first-page":"92","article-title":"Disorders of potassium: hypokalemia and hyperkalemia","author":"DiBartola SP","year":"2012","unstructured":"DiBartola SP, Autran De Morais H. Disorders of potassium: hypokalemia and hyperkalemia. In: DiBartola SP, ed. Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice. 4th ed. 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Can Vet J. 2016;57(4):387\u2013394."},{"issue":"2","key":"B12","series-title":"J Vet Intern Med","first-page":"43","article-title":"Treatment and long-term follow-up of 205 dogs with hypoadrenocorticism","volume":"11","author":"Kintzer PP","year":"1997","unstructured":"Kintzer PP, Peterson ME. Treatment and long-term follow-up of 205 dogs with hypoadrenocorticism. J Vet Intern Med. 1997;11(2):43\u201349. doi:10.1111\/j.1939-1676.1997.tb00072.x"},{"issue":"3","key":"B13","series-title":"J Am Vet Med Assoc","first-page":"392","article-title":"Efficacy of microcrystalline desoxycorticosterone pivalate for treatment of hypoadrenocorticism in dogs","volume":"202","author":"Lynn RC","year":"1993","unstructured":"Lynn RC, Feldman EC, Nelson RW. Efficacy of microcrystalline desoxycorticosterone pivalate for treatment of hypoadrenocorticism in dogs. J Am Vet Med Assoc. 1993;202(3):392\u2013396."},{"key":"B14","series-title":"Vet Med (Auckl)","first-page":"1","article-title":"Management of hypoadrenocorticism (Addison\u2019s disease) in dogs","volume":"9","author":"Lathan P","year":"2018","unstructured":"Lathan P, Thompson AL. Management of hypoadrenocorticism (Addison\u2019s disease) in dogs. Vet Med (Auckl). 2018;9:1\u201310. doi:10.2147\/VMRR.S125617"},{"key":"B15","article-title":"Package insert for Zycortal","year":"2023","unstructured":"Dechra Veterinary Products. Package insert for Zycortal. Accessed January 2, 2023. https:\/\/www.dechra-us.com\/Files\/Files\/SupportMaterialDownloads\/US\/ZYC21001-PI-0221-Final.pdf"},{"issue":"3","key":"B16","series-title":"Aust Vet J","first-page":"77","article-title":"Lower initial dose desoxycorticosterone pivalate for treatment of canine primary hypoadrenocorticism","volume":"91","author":"Bates JA","year":"2013","unstructured":"Bates JA, Shott S, Schall WD. 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J Vet Intern Med. 2017;31(6):1649\u20131657. doi:10.1111\/jvim.14828"},{"issue":"3","key":"B18","series-title":"J Vet Intern Med","first-page":"1266","article-title":"Evaluation of a low-dose desoxycorticosterone pivalate treatment protocol for long-term management of dogs with primary hypoadrenocorticism","volume":"33","author":"Sieber-Ruckstuhl NS","year":"2019","unstructured":"Sieber-Ruckstuhl NS, Reusch CE, Hofer-Inteeworn N, et al. Evaluation of a low-dose desoxycorticosterone pivalate treatment protocol for long-term management of dogs with primary hypoadrenocorticism. J Vet Intern Med. 2019;33(3):1266\u20131271. doi:10.1111\/jvim.15475"},{"issue":"4","key":"B19","series-title":"J Vet Intern Med","first-page":"1720","article-title":"Low-dose desoxycorticosterone pivalate treatment of hypoadrenocorticism in dogs: a randomized controlled clinical trial","volume":"35","author":"Vincent AM","year":"2021","unstructured":"Vincent AM, Okonkowski LK, Brudvig JM, et al. 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Duration of pituitary and adrenocortical suppression after long-term administration of anti-inflammatory doses of prednisone in dogs. Am J Vet Res. 1992;53(5):716\u2013720."},{"issue":"4","key":"B24","series-title":"Can Vet J","first-page":"407","article-title":"Ketoconazole-induced transient hypoadrenocorticism in a dog","volume":"61","author":"Sullivant AM","year":"2020","unstructured":"Sullivant AM, Lathan P. Ketoconazole-induced transient hypoadrenocorticism in a dog. Can Vet J. 2020;61(4):407\u2013410."},{"issue":"2","key":"B25","series-title":"J Vet Intern Med","first-page":"363","article-title":"The renin-angiotensin-aldosterone system and its suppression","volume":"33","author":"Ames MK","year":"2019","unstructured":"Ames MK, Atkins CE, Pitt B. The renin-angiotensin-aldosterone system and its suppression. J Vet Intern Med. 2019;33(2):363\u2013382. doi:10.1111\/jvim.15454"},{"issue":"5","key":"B26","series-title":"J Vet Intern Med","first-page":"1471","article-title":"Use of plasma renin activity to monitor mineralocorticoid treatment in dogs with primary hypoadrenocorticism: desoxycorticosterone versus fludrocortisone","volume":"28","author":"Baumstark ME","year":"2014","unstructured":"Baumstark ME, Nussberger J, Boretti FS, et al. Use of plasma renin activity to monitor mineralocorticoid treatment in dogs with primary hypoadrenocorticism: desoxycorticosterone versus fludrocortisone. J Vet Intern Med. 2014;28(5):1471\u20131478. doi:10.1111\/jvim.12426"},{"issue":"5","key":"B27","series-title":"Clin Endocrinol (Oxf)","first-page":"529","article-title":"The role of plasma renin activity in evaluating the adequacy of mineralocorticoid replacement in primary adrenal insufficiency","volume":"45","author":"Flad TM","year":"1996","unstructured":"Flad TM, Conway JD, Cunningham SK, McKenna TJ. The role of plasma renin activity in evaluating the adequacy of mineralocorticoid replacement in primary adrenal insufficiency. Clin Endocrinol (Oxf). 1996;45(5):529\u2013534. doi:10.1046\/j.1365-2265.1996.00838.x"},{"issue":"2","key":"B28","series-title":"Endocrinol Metab Clin North Am","first-page":"407","article-title":"Fine tuning for quality of life: 21st century approach to treatment of Addison\u2019s disease","volume":"38","author":"Reisch N","year":"2009","unstructured":"Reisch N, Arlt W. Fine tuning for quality of life: 21st century approach to treatment of Addison\u2019s disease. Endocrinol Metab Clin North Am. 2009;38(2):407\u2013418. doi:10.1016\/j.ecl.2009.01.008"},{"issue":"11","key":"B29","series-title":"Public Health Nutr","first-page":"2983","article-title":"Validation of salt intake measurements: comparisons of a food record checklist and spot-urine collection to 24-h urine collection","volume":"25","author":"Beer-Borst S","year":"2022","unstructured":"Beer-Borst S, Hayoz S, Gr\u00e9a Krause C, Strazzullo P. Validation of salt intake measurements: comparisons of a food record checklist and spot-urine collection to 24-h urine collection. Public Health Nutr. 2022;25(11):2983\u20132994. doi:10.1017\/S1368980022001537"},{"issue":"2","key":"B30","series-title":"Am J Nephrol","first-page":"89","article-title":"Urine electrolytes and osmolality: when and how to use them","volume":"10","author":"Kamel KS","year":"1990","unstructured":"Kamel KS, Ethier JH, Richardson RM, Bear RA, Halperin ML. Urine electrolytes and osmolality: when and how to use them. Am J Nephrol. 1990;10(2):89\u2013102. doi:10.1159\/000168062"},{"issue":"9","key":"B31","series-title":"Hypertens Res","first-page":"1129","article-title":"Urinary sodium\/potassium ratio as a screening tool for hyperaldosteronism in men with hypertension","volume":"44","author":"Segawa H","year":"2021","unstructured":"Segawa H, Higashi A, Masuda I, Yoshii K, Iwahori T, Ueshima H. Urinary sodium\/potassium ratio as a screening tool for hyperaldosteronism in men with hypertension. Hypertens Res. 2021;44(9):1129\u20131137. doi:10.1038\/s41440-021-00663-9"},{"issue":"12","key":"B32","series-title":"Hypertens Res","first-page":"1850","article-title":"Investigation of the urinary sodium-to-potassium ratio target level based on the recommended dietary intake goals for the Japanese population: the INTERMAP Japan","volume":"45","author":"Salman E","year":"2022","unstructured":"Salman E, Kadota A, Okami Y, et al. Investigation of the urinary sodium-to-potassium ratio target level based on the recommended dietary intake goals for the Japanese population: the INTERMAP Japan. Hypertens Res. 2022;45(12):1850\u20131860. doi:10.1038\/s41440-022-01007-x"},{"issue":"1","key":"B33","series-title":"Nutr J","first-page":"68","article-title":"Agreement between 24-hour urine and 24-hour food recall in measuring salt intake in primary school children in Australia","volume":"21","author":"Santos JA","year":"2022","unstructured":"Santos JA, Bolton KA, Rosewarne E, et al. Agreement between 24-hour urine and 24-hour food recall in measuring salt intake in primary school children in Australia. 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