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This study evaluates an oral low-dose approach at home using the urinary corticoid-to-creatinine ratio measured at baseline and 8 hours after dexamethasone administration. In 168 client-owned dogs, ROC analysis shows significantly higher baseline and 8h urinary ratios in Cushing’s cases versus controls, with strong diagnostic performance. The oral test is also preferred by most owners and offers a minimally invasive diagnostic option.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/urinary-corticoid-to-creatinine-ratio-8-hours-after-low-dose-oral-dexamethasone-for-the-diagnosis-of-cushings-syndrome-in-dogs/460969/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/urinary-corticoid-to-creatinine-ratio-8-hours-after-low-dose-oral-dexamethasone-for-the-diagnosis-of-cushings-syndrome-in-dogs/460969.png","ImageObject",300,407,{"name":92,"@type":93},"Quinn Holloway","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What diagnostic problem does the study address for canine Cushing’s syndrome?","Question",{"text":112,"@type":113},"The study targets the stress and time burden of the intravenous low-dose dexamethasone suppression test, which requires multiple clinic visits and venipunctures.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How is the oral test performed and what samples are measured?",{"text":117,"@type":113},"Oral dexamethasone is administered at a low dose, and the urinary corticoid-to-creatinine ratio is measured at baseline and again 8 hours after administration.",{"name":119,"@type":110,"acceptedAnswer":120},"What diagnostic accuracy did the 8-hour urinary measurement achieve?",{"text":121,"@type":113},"The 8h urinary corticoid-to-creatinine ratio showed high diagnostic performance in dogs with Cushing’s syndrome, including reported sensitivity and specificity values derived from ROC analysis.",{"name":123,"@type":110,"acceptedAnswer":124},"Can the oral approach distinguish pituitary-dependent from adrenal-dependent Cushing’s syndrome?",{"text":125,"@type":113},"The study reports that the oral LDDST did not distinguish pituitary-from adrenal-dependent Cushing’s syndrome.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},460969,1791369310,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149,"preview_page_count":4},2336474466712,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Article  \nUrinary Corticoid-to-Creatinine Ratio 8 Hours After Low-Dose Oral Dexamethasone for the Diagnosis of Cushing’s Syndrome in Dogs  \nElber Alberto Soler Arias 1,2, * and Hans S. Kooistra 3  \nAcademic Editor: Juan Carlos Illeradel Portal  \nReceived: 7 December 2025  \nRevised: 26 December 2025  \nAccepted: 26 December 2025  \nPublished: 28 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Unidad de Endocrinología, Hospital Escuela de Veterinaria, Universidad de Buenos Aires, Ciudad Autónomade Buenos Aires, Av. San Martín 4351, Buenos Aires C1427CWO, Argentina  \n2 Endovett, Servicio de Endocrinología Veterinaria, Ciudad Autónoma de Buenos Aires, Buenos Aires C1427CWO, Argentina  \n3 Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands; [h.s.kooistra@uu.nl](h.s.kooistra@uu.nl)  \n* Correspondence: [endovett@gmail.com](endovett@gmail.com); Tel.: +54-1138231967  \nSimple Summary  \nThe lack of suppression of serum cortisol 8 h after a low dose of intravenous dexamethasone is the most accurate test for diagnosing Cushing’s syndrome in dogs, but its performance may cause stress for both the dog and owner because it requires several venipunctures. To reduce this problem, the test was evaluated in a home setting by administering a low dose of dexamethasone orally and measuring the urinary corticoid-to-creatinine ratio before and 8 h after administration. In 168 dogs (86 with Cushing’s syndrome), the 8 h sample showed high diagnostic accuracy for Cushing’s syndrome, with a sensitivity of 95% and specificity of 93% . In addition, its preference by 86% of owners over the intravenous version supports the oral method as a valid and clinically useful diagnostic option.  \nAbstract  \nThe intravenous low-dose dexamethasone suppression test (IV-LDDST) is considered the most accurate method for diagnosing Cushing’s syndrome (CS) in dogs, but its intravenous administration and repeated hospital sampling are stressful and time-consuming for both dogs and owners. This study evaluated an oral LDDST (O-LDDST) as a minimally invasive alternative. The approach is based on the urinary corticoid-to-creatinine ratio (uCC) measured in urine samples collected at home at baseline (B-uCC) and 8 h after administering a low oral dose of dexamethasone (0.01 mg/kg; 8h-uCC) . A total of 168 client-owned dogs were prospectively recruited: 42 healthy dogs (HD), 40 dogs with disease mimicking CS (DMCS), and 86 dogs with confirmed CS. An ROC curve analysis showed that dogs with CS had significantly higher B-uCC and 8h-uCC and a lower suppression percentage (%S) compared with HD and DMCS (all p \u003C 0.0001) . Optimal cut-offs were B-uCC > 14.2 × 10−6, 8h-uCC > 6.7 × 10−6, and %S \u003C 48.6%, yielding sensitivity/specificity of 82.9%/83.3%, 95.3%/92.6%, and 86.0%/85.3%, respectively. O-LDDST was preferred by 85.9% of owners, although it did not distinguish pituitary-from adrenal-dependent CS. The O-LDDST proved to be a reliable, accurate, and minimally invasive diagnostic option for CS in dogs, with 8h-uCC providing the highest accuracy.  \nKeywords: hyperadrenocorticism; hypercortisolism; oral dexamethasone; at-home diagnostic test; urinary cortisol; dexamethasone suppression test  \n1. Introduction  \nSpontaneous Cushing’s syndrome (CS), or hypercortisolism, is a clinical syndrome caused by chronic excessive endogenous glucocorticoid activity [1] . Although CS is among the most common endocrine disorders in dogs, its diagnosis still requires the integration of clinical symptoms, physical examination findings, hematological and serum biochemical abnormalities, and specific hormonal tests, as no single test provides 100% sensitivity and specificity [2] .  \nHormonal confirmation of CS relies on demonstrating cortisol excess due to im","cbCairR9SylAOsuc","https://ap.wps.com/l/cbCairR9SylAOsuc","pdf",1362775,13,"English","# Introduction\n## Study objective and rationale\n## Comparison with existing diagnostic tests\n## Method based on urinary corticoid-to-creatinine ratio\n## Diagnostic accuracy targets and interpretation criteria","[{\"question\":\"What diagnostic problem does the study address for canine Cushing’s syndrome?\",\"answer\":\"The study targets the stress and time burden of the intravenous low-dose dexamethasone suppression test, which requires multiple clinic visits and venipunctures.\"},{\"question\":\"How is the oral test performed and what samples are measured?\",\"answer\":\"Oral dexamethasone is administered at a low dose, and the urinary corticoid-to-creatinine ratio is measured at baseline and again 8 hours after administration.\"},{\"question\":\"What diagnostic accuracy did the 8-hour urinary measurement achieve?\",\"answer\":\"The 8h urinary corticoid-to-creatinine ratio showed high diagnostic performance in dogs with Cushing’s syndrome, including reported sensitivity and specificity values derived from ROC analysis.\"},{\"question\":\"Can the oral approach distinguish pituitary-dependent from adrenal-dependent Cushing’s syndrome?\",\"answer\":\"The study reports that the oral LDDST did not distinguish pituitary-from adrenal-dependent Cushing’s syndrome.\"}]","Urinary Corticoid-to-Creatinine Ratio 8 Hours After Low-Dose Oral Dexamethasone for the Diagnosis of Cushing’s Syndrome in Dogs | PDF",1790760203,33]