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 journalArticleAcademicpeer-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 languageEnglish
Pages (from-to)173-183
Number of pages11
JournalJournal of Veterinary Internal Medicine
Volume37
Issue number1
DOIs
Publication statusPublished - 1 Jan 2023

Keywords

  • adrenal tumor
  • canine
  • catecholamines
  • normetanephrine

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