Reference intervals for plasma, urinary, and salivary concentrations of free metanephrines in dogs: Relevance to the diagnosis of pheochromocytoma

Marit F. van den Berg; Hans S. Kooistra; Guy C. M. Grinwis; Sebastiaan A. van Nimwegen; Martijn van Faassen; Ido P. Kema; Erik Teske; Sara Galac

doi:10.1111/jvim.16624

Reference intervals for plasma, urinary, and salivary concentrations of free metanephrines in dogs: Relevance to the diagnosis of pheochromocytoma

Marit F. van den Berg^*, Hans S. Kooistra, Guy C. M. Grinwis, Sebastiaan A. van Nimwegen, Martijn van Faassen, Ido P. Kema, Erik Teske, Sara Galac

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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 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.

Original language	English
Pages (from-to)	173-183
Number of pages	11
Journal	Journal of Veterinary Internal Medicine
Volume	37
Issue number	1
DOIs	https://doi.org/10.1111/jvim.16624
Publication status	Published - 1 Jan 2023

Bibliographical note

Funding Information:
This study was supported by donations from Stichting D.O.G, Stichting Dierenziekenhuis Maria Naundorf van Gorkum, Stichting Abri voor Dieren and the named fund Vrienden Diergeneeskunde. The authors thank Jorieke Salij, Maria de Nijs and Stijn van Opstal for sampling and data collection.

Publisher Copyright:
© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.

Funding

This study was supported by donations from Stichting D.O.G, Stichting Dierenziekenhuis Maria Naundorf van Gorkum, Stichting Abri voor Dieren and the named fund Vrienden Diergeneeskunde. The authors thank Jorieke Salij, Maria de Nijs and Stijn van Opstal for sampling and data collection.

Funders	Funder number
Stichting Abri voor Dieren

Keywords

adrenal tumor
canine
catecholamines
normetanephrine

Access to Document

10.1111/jvim.16624Licence: CC BY-NC-ND

Veterinary Internal Medicne - 2023 - Berg - Reference intervals for plasma urinary and salivary concentrations of freeFinal published version, 1.13 MBLicence: CC BY-NC-ND

Cite this

Berg, M. F. V. D., Kooistra, H. S., Grinwis, G. C. M., Nimwegen, S. A. V., Faassen, M. V., Kema, I. P., Teske, E., & Galac, S. (2023). Reference intervals for plasma, urinary, and salivary concentrations of free metanephrines in dogs: Relevance to the diagnosis of pheochromocytoma. Journal of Veterinary Internal Medicine, 37(1), 173-183. https://doi.org/10.1111/jvim.16624

@article{e1eb25b3476a4e1694d6b0a8b138c583,

title = "Reference intervals for plasma, urinary, and salivary concentrations of free metanephrines in dogs: Relevance to the diagnosis of pheochromocytoma",

abstract = "BackgroundMeasurement of free metanephrines is recommended for screening of pheochromocytoma (PCC) but requires appropriate reference intervals (RIs).Hypothesis/ObjectivesTo 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).AnimalsEighty healthy dogs, 11 PCC dogs, 25 HC dogs, 6 NAI dogs.MethodsPlasma, 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.ResultsThe RIs for free metanephrines in plasma, urine and saliva are reported. Dogs with PCC had significantly higher pNMN than dogs with HC (P 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 ImportanceWith 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.",

keywords = "adrenal tumor, canine, catecholamines, normetanephrine",

author = "Berg, {Marit F. van den} and Kooistra, {Hans S.} and Grinwis, {Guy C. M.} and Nimwegen, {Sebastiaan A. van} and Faassen, {Martijn van} and Kema, {Ido P.} and Erik Teske and Sara Galac",

note = "Funding Information: This study was supported by donations from Stichting D.O.G, Stichting Dierenziekenhuis Maria Naundorf van Gorkum, Stichting Abri voor Dieren and the named fund Vrienden Diergeneeskunde. The authors thank Jorieke Salij, Maria de Nijs and Stijn van Opstal for sampling and data collection. Publisher Copyright: {\textcopyright} 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.",

year = "2023",

month = jan,

day = "1",

doi = "10.1111/jvim.16624",

language = "English",

volume = "37",

pages = "173--183",

journal = "Journal of Veterinary Internal Medicine",

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Reference intervals for plasma, urinary, and salivary concentrations of free metanephrines in dogs: Relevance to the diagnosis of pheochromocytoma. / Berg, Marit F. van den ; Kooistra, Hans S.; Grinwis, Guy C. M. et al.
In: Journal of Veterinary Internal Medicine, Vol. 37, No. 1, 01.01.2023, p. 173-183.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Reference intervals for plasma, urinary, and salivary concentrations of free metanephrines in dogs

T2 - Relevance to the diagnosis of pheochromocytoma

AU - Berg, Marit F. van den

AU - Kooistra, Hans S.

AU - Grinwis, Guy C. M.

AU - Nimwegen, Sebastiaan A. van

AU - Faassen, Martijn van

AU - Kema, Ido P.

AU - Teske, Erik

AU - Galac, Sara

N1 - Funding Information: This study was supported by donations from Stichting D.O.G, Stichting Dierenziekenhuis Maria Naundorf van Gorkum, Stichting Abri voor Dieren and the named fund Vrienden Diergeneeskunde. The authors thank Jorieke Salij, Maria de Nijs and Stijn van Opstal for sampling and data collection. 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 - 2023/1/1

Y1 - 2023/1/1

N2 - BackgroundMeasurement of free metanephrines is recommended for screening of pheochromocytoma (PCC) but requires appropriate reference intervals (RIs).Hypothesis/ObjectivesTo 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).AnimalsEighty healthy dogs, 11 PCC dogs, 25 HC dogs, 6 NAI dogs.MethodsPlasma, 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.ResultsThe RIs for free metanephrines in plasma, urine and saliva are reported. Dogs with PCC had significantly higher pNMN than dogs with HC (P 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 ImportanceWith 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 - BackgroundMeasurement of free metanephrines is recommended for screening of pheochromocytoma (PCC) but requires appropriate reference intervals (RIs).Hypothesis/ObjectivesTo 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).AnimalsEighty healthy dogs, 11 PCC dogs, 25 HC dogs, 6 NAI dogs.MethodsPlasma, 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.ResultsThe RIs for free metanephrines in plasma, urine and saliva are reported. Dogs with PCC had significantly higher pNMN than dogs with HC (P 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 ImportanceWith 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

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U2 - 10.1111/jvim.16624

DO - 10.1111/jvim.16624

M3 - Article

C2 - 36637037

SN - 0891-6640

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JO - Journal of Veterinary Internal Medicine

JF - Journal of Veterinary Internal Medicine

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Reference intervals for plasma, urinary, and salivary concentrations of free metanephrines in dogs: Relevance to the diagnosis of pheochromocytoma

Abstract

Bibliographical note

Funding

Keywords

Access to Document

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