Urine sodium concentrations are predictive of hypoadrenocorticism in hyponatraemic dogs: a retrospective pilot study

J Small Anim Pract. 2018 Apr;59(4):228-231. doi: 10.1111/jsap.12792. Epub 2017 Dec 20.

Abstract

Objectives: To determine if a urine sodium concentration could be used to rule out hypoadrenocorticism in hyponatraemic dogs.

Materials and methods: Medical records were reviewed for hyponatraemic dogs (serum sodium<135 mmol/L) that had recorded urine sodium concentrations. Twenty hyponatraemic dogs were included: 11 diagnosed with classical hypoadrenocorticism and nine with non-adrenal causes of hyponatraemia. A Wilcoxon rank-sum test was used to compare results between groups.

Results: No dog with hypoadrenocorticism had a urine sodium concentration less than 30 mmol/L. Urine sodium concentration in dogs with hypoadrenocorticism was significantly higher (median 103 mmol/L, range: 41 to 225) than in dogs with non-adrenal illness (median 10 mmol/L, range: 2 to 86) (P<0·0005). Serum sodium concentrations were not significantly different between dogs with hypoadrenocorticism and dogs with non-adrenal illness.

Clinical significance: These results suggest that urine sodium concentrations can be used to prioritise a differential diagnosis of hypoadrenocorticism in hyponatraemic dogs. A urine sodium concentration less than 30 mmol/L in a hyponatraemic dog makes classical hypoadrenocorticism an unlikely cause of the hyponatraemia. Nevertheless, because of the small sample size our results should be interpreted with caution and a larger follow-up study would be valuable.

MeSH terms

  • Adrenal Insufficiency / complications
  • Adrenal Insufficiency / diagnosis
  • Adrenal Insufficiency / urine
  • Adrenal Insufficiency / veterinary*
  • Animals
  • Diagnosis, Differential
  • Dog Diseases / diagnosis
  • Dog Diseases / urine*
  • Dogs
  • Hyponatremia / etiology
  • Hyponatremia / urine
  • Hyponatremia / veterinary*
  • Pilot Projects
  • Predictive Value of Tests
  • Retrospective Studies
  • Sodium / urine*

Substances

  • Sodium