9. HORMONES

Question 1

treatment of canine hypothyroidism

Answer 1

-LEVOTHYROXINE
synthetic form of thyroxine T4: life long T4 supplement

Question 2

levothyroxine: goal

Answer 2

no clinical signs of disease

Question 3

levothyroxine monitoring

Answer 3

clinical response + peak TT4 concentration

Question 4

levothyroxine improvement

Answer 4

can take weeks to months

Question 5

levothyroxine overdose

Answer 5

dogs are resistant to thyrotoxic effects of excessive T4 supplement
-up to 20x standard dosage
-clinical thyrotoxicosis over 90 nmol/l: panting, weight loss, hyperactivity, tachycardia, hyperthermia
>most signs resolve within few days of withdrawing therapy

Question 6

levothyroxine gradual introduction

Answer 6

with concurrent illness : cardiac, hypoadrenocorticism, DM
>25-50% of starting dose

Question 7

treatment of feline hyperthyroidism

Answer 7

anti-thyroid drugs: METHIMAZOLE

Question 8

methimazole if too much

Answer 8

T4

Question 9

methimazole anti-thyroid drug decrease production of

Answer 9

thyroid hormone, decrease circulating concentrations of thyroid hormone, reverse thyrotoxicosis

Question 10

methimazole dose must be

Answer 10

titrated to individual needs

Question 11

methimazole …. within 2-3 weeks

Answer 11

euthyroidism

Question 12

methimazole doses adjusted to achieve

Answer 12

basal serumm tT4 concentration that is at or below middle of reference range for tT4
>trandermal

Question 13

methimazole adverse effects within… and life threatining adverse effects

Answer 13

first 3 month
> life–threatining adverse effects: agranulocytosis, thrombocytopenia, severe hepatopathy

Question 14

methimazole common and mild adverse effects

Answer 14

-GI signs: nausea, vomiting, lethargy, diarrhea
-leukopenia
-eosinophilia
-lymphocytosis>usually resolve despite continuing treatment

Question 15

methimazole … therapy

Answer 15

life long

Question 16

….tends to advance despite treatment with anti-thyroid drugs, thus commonly necessitates increases in drug dosage over time > in order to maintain euthyroidism

Answer 16

feline hyperthyroidism

Question 17

…. regulates glucose metabolism

Answer 17

insulin

Question 18

increases glucose uptake in peripheral tissues, increases glucose storage in liver, inhibits gluconeogenesis

Answer 18

insulin

Question 19

insulin, treatment of

Answer 19

diabetes mellitus

Question 20

insulin goal

Answer 20

control blood glucose below renal threshold as much of 24h period as possible > improve clinical signs > avoid clinically significant hypoglycemia

Question 21

feline insulin

Answer 21

glargine insulin: long acting

Question 22

canine insulin

Answer 22

porcine insulin zinc: intermediate acting

Question 23

insulin dosage based on

Answer 23

patients estimated ideal body weight

Question 24

insulin dosage should not be

Answer 24

increased more than q1-2w

Question 25

insulin pharmacokinetics

Answer 25

vary depending on: insulin type, product formulation and individual patient’s response

Question 26

insulin … window on each side of dosing interval

Answer 26

12 +/- 2h

Question 27

…inactivated insulin

Answer 27

freezing/heating

Question 28

insulin dosing

Answer 28

pens

Question 29

treatment for canine pituitary dependent hyperadrenocorticism=CUSHING SYNDROME

Answer 29

trilostane

Question 30

trilostane inhibit

Answer 30

synthesis of adrenocortical hormones cortisol and aldosterone

Question 31

cushing syndrome, trilostane, goal

Answer 31

control of cortisol secretion

Question 32

trilostane administer

Answer 32

with food q12h

Question 33

trilostane monitoring

Answer 33

-frequent monitoring : clinical signs > ACTHST

Question 34

trilostane adverse effects

Answer 34

-well tolerated
-lethargy
-mild electrolyte abnormalities
-GI signs: vomiting, diarrhea, inappetence

Question 35

treatment of canine hypoadrenocorticism: ADDISON’S DISEASE

Answer 35

glucocorticoids

Question 36

canine hypoadrenocorticism: ADDISON’S DISEASE has … deficiency

Answer 36

glucocorticoid (+mineralcorticoid)

Question 37

chronic treatment of glucocorticoids

Answer 37

predisolone PO
-life-long supplementation

Question 38

treatment of typical hypoadrenocorticism in addition to glucocorticoid

Answer 38

mineralcorticoids
:deoxycorticosterone pilavate (DOCP)/fludrocortisone
>electrolyte monitorin; Na ja K

Question 39

fludrocortisone

Answer 39

mineralcorticoids
-dose adjusted by assessing serum Na and K conc > increase until Na:K is >28