Dose-response relation between plasma concentrations of corticotropin and cortisol after administration of incremental doses of cosyntropin for corticotropin stimulation testing in cats

We compared the plasma cortisol and immunoreactive corticotropin (IR-ACTH) responses to incremental doses (1.25, 12.5 and 125 micrograms) of synthetic ACTH (cosyntropin) administered IV to 6 clinically normal cats. Mean plasma cortisol concentration increased significantly (P < 0.0001) after administration of all 3 doses of cosyntropin. After administration of the 1.25- and 12.5-microgram doses, plasma cortisol concentration peaked at 30 minutes, then decreased to values not significantly different from baseline concentration by 90 and 120 minutes, respectively. In contrast, after administration of the 125-microgram dose, mean cortisol concentration peaked at 60 minutes and remained significantly (P < 0.05) higher than baseline values at 120 minutes. Compared with the 1.25- and 12.5-microgram doses, administration of the 125-microgram dose of cosyntropin induced significantly (P < 0.05) higher cortisol responses at 60, 90, and 120 minutes. Although individual cat's peak plasma cortisol concentration after administration of the 125-microgram dose was higher than the peak value determined after administration of the 2 lower doses of cosyntropin, these differences were not statistically significant. Mean plasma IR-ACTH concentration increased significantly (P < 0.0001) and reached a maximal value at 30 minutes after administration of all 3 doses of cosyntropin. After administration of the 1.25- and 12.5-microgram doses, plasma IR-ACTH concentration decreased to values not significantly different from baseline concentration by 60 and 120 minutes, respectively, whereas mean IR-ACTH concentration remained significantly (P < 0.05) higher than baseline values 120 minutes after administration of the 125-microgram dose. Mean peak plasma IR-ACTH concentration attained after administration of the 125-microgram dose of cosyntropin was significantly higher than that attained after administration of the 2 lower doses. Peak plasma IR-ACTH concentration attained after administration of the 12.5-microgram dose of cosyntropin was significantly higher than that attained after administration of 1.25 micrograms of cosyntropin. Results of the study indicate that IV administration of cosyntropin at doses ranging from 1.25 to 125 micrograms induces similar peak plasma cortisol responses in clinically normal cats, indicating that all of the doses may maximally stimulate the adrenal cortex. Administration of the higher cosyntropin doses did, however, result in more prolonged adrenocortical response.