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Why Are My Dog's Dexamethasone Suppression Test Result Abnormal ?

Why Are My Cat's Dexamethasone Suppression Test Result Abnormal ?

To see what normal blood and urine values are for your pet, go here

For an explanation of causes of most abnormal blood and urine tests go here

To see how tests are often grouped, go here

Ron Hines DVM PhD

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The Dexamethasone Suppression Test

Low and High Dose Methods = LDDST, HDDST

When your veterinarian sees symptoms in your pet (generally a dog but occasionally a cat) that could be due to overactive adrenal glands (Cushing's disease), the vet may suggest a dexamethasone suppression test. That test requires that your pet stay at the animal hospital for a time. The vet will take a blood sample prior to the test to determine its resting (baseline) blood cortisol level and then administer a dose of a corticosteroid compound called dexamethasone. That compound is quite similar to cortisol. In normal dogs, the low dose of dexamethasone given will suppress blood levels of cortisol in your pet. Your vet will take two more blood samples, one 4 hours and one 8 hours after the dexamethasone injection. In normal dogs, cortisol levels will be lower after the dexamethasone injection. In Cushing’s disease (hyperadrenalcorticism = HC) no decrease will occur.

Overactive adrenal glands can be due to a tumor within one or both adrenal glands that produces cortisol or a tumor within the pet’s pituitary gland (PDH) that produces ACTH hormone that stimulates the adrenal glands to produce cortisol. In an attempt to tell whether the tumor is in the pituitary or in the adrenal gland, the vet may attempt a high dose dexamethasone suppression test (about 80% of Cushing's dogs have the tumor in their pituitary gland). In that test, a substantial decrease in blood cortisol after the dexamethasone is administered point to the problem being in the pet’s pituitary gland. The test, however, is not foolproof as some cases of PDH fail to suppress cortisol in this test.

Test Interferences: icterus (jaundice) , recent corticosteroid administration

An alternative diagnostic approach is to perform an ACTH stimulation test. That is the test of choice when under active adrenal glands are suspected (Addison’s disease).

Complementary Tests :

CBC/WBC, blood chemistry panel including AP, electrolytes, urinalysis, abdominal ultrasound, plasma ACTH level. When Dexamethasone suppression results do not indicate adrenal problems, tests for diabetes, liver disease and hypothyroidism are appropriate.

.................... DxMe