Influence of topical dexamethasone applications on insulin, glucose, thyroid hormone and cortisol levels in dogs

The influence of two topical dexamethasone applications (dermal and ototopical) on plasma insulin, glucose, thyroid hormone and cortisol levels was investigated in beagle dogs. Both treatments significantly decreased basal cortisol values, associated with exaggerated rise in insulin (∼50%), together with unchanged serum glucose levels. Dermal dexamethasone quickly decreased plasma thyroxin (T 4) levels; whereas dexamethasone in ear drops gradually inhibited time-dependently T 4 release (18–50%). Both formulations blunted plasma triiodothyronine (T 3) levels but the response induced by dermal dexamethasone was stronger than by dexamethasone ear drops. Upon drug withdrawal, insulin secretion returned to baseline a week after treatment cessation, while cortisol, T 4 and T 3 levels did not reach baseline values. These results suggest that topical glucocorticoids unexpectedly trigger secondary hypothyroidism with concomitant suppression of hypothalamic–pituitary–adrenal axis but sensitize the endocrine pancreas, thus, their application needs careful evaluation for surprisingly different effects on endocrine stress axis activity.