Disorders of vasopressin production

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This chapter focuses on primary disorders of vasopressin production but, as primary polydipsia is closely related, a brief description is included.

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3.1 Relations between plasma osmolality (pOsm), plasma arginine vasopressin concentration (PAVP), urine osmolality (UOsm) and urine volume (U Volume/24 h). Small changes in plasma osmolality are associated with relatively large increases in plasma AVP concentration. Urine osmolality is increased proportional to the plasma AVP concentration, until maximal urine concentrating ability is reached (plateau). The height of this plateau is dependent upon the renal medullary concentration gradient. Urine volume rapidly decreases in response to increases in plasma AVP concentration. The shaded area represents the reference interval for PAVP in healthy dogs. (Reproduced from with permission from the publisher. © Elsevier)
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3.4 Modified water deprivation test.
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3.5 T2-weighted MRI saggital and transverse images from a 4-year-old male Golden Retriever with marked PU/PD. A 2 cm mass was visible in the sella turcica with a hyperintense rim and extension into the brain stem and displacement of the third ventricle dorsally. Modified water deprivation testing and response to desmopressin was consistent with central diabetes insipidus. Post-mortem examination confirmed a pituitary carcinoma with dorsal extension and associated compression of the hypothalamus.
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