TY - JOUR
T1 - Reference intervals for plasma, urinary, and salivary concentrations of free metanephrines in dogs
T2 - Relevance to the diagnosis of pheochromocytoma
AU - van den Berg, Marit F.
AU - Kooistra, Hans S.
AU - Grinwis, Guy C.M.
AU - van Nimwegen, Sebastiaan A.
AU - van Faassen, Martijn
AU - Kema, Ido P.
AU - Teske, Erik
AU - Galac, Sara
N1 - Publisher Copyright:
© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Measurement of free metanephrines is recommended for screening of pheochromocytoma (PCC) but requires appropriate reference intervals (RIs). Hypothesis/Objectives: To report RIs for plasma, urinary and salivary concentrations of free metanephrines and to determine the diagnostic performance of plasma free normetanephrine (pNMN) and metanephrine (pMN) concentrations in dogs with PCC, hypercortisolism (HC), and nonadrenal illness (NAI). Animals: Eighty healthy dogs, 11 PCC dogs, 25 HC dogs, 6 NAI dogs. Methods: Plasma, urine, and saliva were collected prospectively from healthy dogs, and free metanephrine concentrations were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition, medical records of dogs that had plasma free metanephrine concentrations measured by LC-MS/MS between 2018-2021 were studied retrospectively. Results: The RIs for free metanephrines in plasma, urine and saliva are reported. Dogs with PCC had significantly higher pNMN than dogs with HC (P <.001) and NAI (P =.002). The PCC dogs had significantly higher pMN than HC dogs (P <.001), but not higher than NAI dogs (P =.29). Using the upper reference limit, pNMN (>3.56 nmol/L) showed high sensitivity (100%, 95% confidence interval [CI]: 72-100) and specificity (94%, 95% CI: 79-99) for diagnosis of PCC, whereas pMN (>2.49 nmol/L) showed moderate sensitivity (73%, 95% CI: 39-94) and high specificity (94%, 95% CI: 79-99). Conclusions and Clinical Importance: With establishment of these RIs, biochemical testing for PCC in dogs can be substantially improved. Measurement of pNMN is superior to pMN in dogs with PCC.
AB - Background: Measurement of free metanephrines is recommended for screening of pheochromocytoma (PCC) but requires appropriate reference intervals (RIs). Hypothesis/Objectives: To report RIs for plasma, urinary and salivary concentrations of free metanephrines and to determine the diagnostic performance of plasma free normetanephrine (pNMN) and metanephrine (pMN) concentrations in dogs with PCC, hypercortisolism (HC), and nonadrenal illness (NAI). Animals: Eighty healthy dogs, 11 PCC dogs, 25 HC dogs, 6 NAI dogs. Methods: Plasma, urine, and saliva were collected prospectively from healthy dogs, and free metanephrine concentrations were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition, medical records of dogs that had plasma free metanephrine concentrations measured by LC-MS/MS between 2018-2021 were studied retrospectively. Results: The RIs for free metanephrines in plasma, urine and saliva are reported. Dogs with PCC had significantly higher pNMN than dogs with HC (P <.001) and NAI (P =.002). The PCC dogs had significantly higher pMN than HC dogs (P <.001), but not higher than NAI dogs (P =.29). Using the upper reference limit, pNMN (>3.56 nmol/L) showed high sensitivity (100%, 95% confidence interval [CI]: 72-100) and specificity (94%, 95% CI: 79-99) for diagnosis of PCC, whereas pMN (>2.49 nmol/L) showed moderate sensitivity (73%, 95% CI: 39-94) and high specificity (94%, 95% CI: 79-99). Conclusions and Clinical Importance: With establishment of these RIs, biochemical testing for PCC in dogs can be substantially improved. Measurement of pNMN is superior to pMN in dogs with PCC.
KW - adrenal tumor
KW - canine
KW - catecholamines
KW - normetanephrine
UR - http://www.scopus.com/inward/record.url?scp=85146333138&partnerID=8YFLogxK
U2 - 10.1111/jvim.16624
DO - 10.1111/jvim.16624
M3 - Article
C2 - 36637037
AN - SCOPUS:85146333138
SN - 0891-6640
VL - 37
SP - 173
EP - 183
JO - Journal of Veterinary Internal Medicine
JF - Journal of Veterinary Internal Medicine
IS - 1
ER -