Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicine

Although arginine vasopressin (AVP) deficiency, AVP resistance, and primary polydipsia are important causes of polyuria and polydipsia (PUPD), measurement of AVP has never been implemented as a routine diagnostic test for patient care in either human or veterinary medicine, due to significant challe...

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Main Authors: Mathieu Victor Paulin, Thomas Schermerhorn, Suraj Unniappan, Elisabeth C. R. Snead
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Veterinary Science
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Online Access:https://www.frontiersin.org/articles/10.3389/fvets.2025.1528008/full
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author Mathieu Victor Paulin
Thomas Schermerhorn
Suraj Unniappan
Elisabeth C. R. Snead
author_facet Mathieu Victor Paulin
Thomas Schermerhorn
Suraj Unniappan
Elisabeth C. R. Snead
author_sort Mathieu Victor Paulin
collection DOAJ
description Although arginine vasopressin (AVP) deficiency, AVP resistance, and primary polydipsia are important causes of polyuria and polydipsia (PUPD), measurement of AVP has never been implemented as a routine diagnostic test for patient care in either human or veterinary medicine, due to significant challenges with the methodologic reliability of laboratory assays for measuring AVP. Responses to a modified water deprivation test and/or a desmopressin acetate trial have been used as indirect markers of AVP deficiency or resistance. However, interpretations of these tests can be especially challenging in cases of partial AVP deficiency or resistance. Over the past decade, plasma copeptin (CoP), a glycopeptide comprising the C-terminal part of the AVP preprohormone, has mostly replaced AVP measurement in humans. When combined with CoP-based stimulation tests, such as hypertonic saline and arginine stimulation tests, plasma CoP measurement offers excellent diagnostic accuracy for the diagnosis and differentiation of cases of central diabetes insipidus (DI), nephrogenic DI, and primary polydipsia in humans. In dogs, CoP has recently been measured in saliva and serum using canine or human enzyme-linked immunosorbent assays. This review will provide an update on the physiologic regulation of AVP production and secretion, the limitations of its measurement in human and veterinary medicine, as well as a summary of the indications and performance of CoP measurement in human and veterinary medicine to date. This is with a purpose to encourage validation and implementation of CoP measurement in veterinary medicine.
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spelling doaj-art-75e01f7e36e04ca3acbe7fcafd7c9f212025-08-20T02:52:59ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692025-03-011210.3389/fvets.2025.15280081528008Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicineMathieu Victor Paulin0Thomas Schermerhorn1Suraj Unniappan2Elisabeth C. R. Snead3Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, CanadaDepartment of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, United StatesDepartment of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, CanadaDepartment of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, CanadaAlthough arginine vasopressin (AVP) deficiency, AVP resistance, and primary polydipsia are important causes of polyuria and polydipsia (PUPD), measurement of AVP has never been implemented as a routine diagnostic test for patient care in either human or veterinary medicine, due to significant challenges with the methodologic reliability of laboratory assays for measuring AVP. Responses to a modified water deprivation test and/or a desmopressin acetate trial have been used as indirect markers of AVP deficiency or resistance. However, interpretations of these tests can be especially challenging in cases of partial AVP deficiency or resistance. Over the past decade, plasma copeptin (CoP), a glycopeptide comprising the C-terminal part of the AVP preprohormone, has mostly replaced AVP measurement in humans. When combined with CoP-based stimulation tests, such as hypertonic saline and arginine stimulation tests, plasma CoP measurement offers excellent diagnostic accuracy for the diagnosis and differentiation of cases of central diabetes insipidus (DI), nephrogenic DI, and primary polydipsia in humans. In dogs, CoP has recently been measured in saliva and serum using canine or human enzyme-linked immunosorbent assays. This review will provide an update on the physiologic regulation of AVP production and secretion, the limitations of its measurement in human and veterinary medicine, as well as a summary of the indications and performance of CoP measurement in human and veterinary medicine to date. This is with a purpose to encourage validation and implementation of CoP measurement in veterinary medicine.https://www.frontiersin.org/articles/10.3389/fvets.2025.1528008/fullADHAVPdesmopressinwater metabolismPUPD
spellingShingle Mathieu Victor Paulin
Thomas Schermerhorn
Suraj Unniappan
Elisabeth C. R. Snead
Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicine
Frontiers in Veterinary Science
ADH
AVP
desmopressin
water metabolism
PUPD
title Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicine
title_full Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicine
title_fullStr Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicine
title_full_unstemmed Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicine
title_short Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicine
title_sort arginine vasopressin and copeptin comparative review and perspective in veterinary medicine
topic ADH
AVP
desmopressin
water metabolism
PUPD
url https://www.frontiersin.org/articles/10.3389/fvets.2025.1528008/full
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AT elisabethcrsnead argininevasopressinandcopeptincomparativereviewandperspectiveinveterinarymedicine