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Endocrine > Diagnosis + Treatment of Disease- Thyroid Gland > Flashcards

Diagnosis + Treatment of Disease- Thyroid Gland Flashcards

1
Q

Where is the thyroid gland located?

A

2 lobes either side of the trachea, just below the larynx

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2
Q

With regard to dogs + cats, is the thyroid gland usually palpable?

A

No

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3
Q

Name 3 disorders of the thyroid gland

A

Hypothyroidism
Hyperthyroidism
Goitre

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4
Q

Name two methods to diagnose thyroid disease

A

Clinical signs

Blood tests

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5
Q

What blood tests can be used to detect thyroid disease?

A

Total T4
Free T4
Endogenous canine TSH
Thyroglobulin autoantibodies

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6
Q

Why can endogenous canine TSH be used to detect thyroid disease?

A

Comes from the pituitary gland + drives the production of TH

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7
Q

What results would you expect from the blood tests of an animal with HYPERthyroidism?

A

High serum T4 (total)

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8
Q

Describe two methods that could be used to treat HYPERthyroidism

A
  1. Remove thyroid tissue through surgery or radioactive iodide
  2. Reduce synthesis of thyroid hormone from existing tissue by restricting iodine + blocking synthesis with thioureylenes
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9
Q

What are the cons of thyroidectomy?

A
  • Upfront cost

- Risk of damage to parathyroid glands

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10
Q

What role does the parathyroid gland play?

A

Very important in Ca regulation

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11
Q

Describe + explain how radioactive iodide can be used to treat HYPERthyroidism

A
  • Destroys thyroid follicles
  • rapidly incorporated into thyroid follicles
  • half life 8 days + serum T3/ T4 start to normalise after 1-2 wks
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12
Q

What are the cons of using radioactive iodide to treat HYPERthyroidism?

A
  • Treated animals must be hospitalised for 1-4wks
  • Treated animals + excreta need to be handled carefully until radioactivity is gone
  • VV expensive
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13
Q

What is the main pro of radioactive iodine compared to surgical thyroidectomy to treat HYPERthyroidism?

A

less risk of hypocalcaemia

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14
Q

Describe the adverse effects that could occur after removing thyroid tissue?

A
  • HYPOthyroidism

- Bilateral disease- damaged PTH + hypocalcaemia (from bilateral thyroidectomy)

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15
Q

Name the thioureylene used in the UK

A

Carbimazole

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16
Q

Name the thioureylene used overseas

A

Thiamazole

17
Q

Describe how the UK thioreylene works to block synthesis of iodine?

A
  • Carbimazole metabolised to methimazole = inhibits synthesis of T3 + T4
  • GI absorption after oral administration, widely distributed
  • Metabolised by hepatocyte P450 enzymes followed by conjugation w/ glucuronide (classic phase 1 + 2 of liver metabolism)
18
Q

How long would you predict before free T3 + T4 decline after treating with carbimazole?

A

3 weeks

19
Q

What adverse effect may occur after treatment w/ carbimazole?

A

HYPOthyroidism

20
Q

What is the most common endocrine disorder in dogs?

A

HYPOthyroidism

21
Q

How would you test for HYPOthyroidism?

A

Total T4
Free T4
Endogenous TSH
Thyroglobulin autoantibodies

22
Q

Explain why Total T4 is not a reliable test for HYPOthyroidism

A

Breed, age + drugs can affect T4 values + sick euthyroid syndrome- if Total T4 is low, dog may not actually be hypothyroid

23
Q

What is meany by ‘sick euthyroid syndrome’`?

A

Low T4 is shown with ANY sick dog- not necessarily hypothyroidism

24
Q

What is the most common cause of HYPOthyroidism in dogs?

A

Thyroglobulin autoantibodies

25
Q

What result would you expect from endogenous canine TSH in a hypothyroid dog?

A

Increased

26
Q

What can be used to treat HYPOthyroidism?

A

Thyroid hormone replacement therapy

27
Q

Describe what is used in TH replacement therapy

A
  • oral administration (absorbed from GI tract)
  • Levothyroxine = T4
  • Liothyronine = T3
28
Q

What adverse effects may occur from thyroid hormone replacement therapy?

A
  • Signs of HYPERthyroidism
  • > BMR (calorgenic/ >heat)
  • CV stimulant = >CO, >sensitivity of heart to catecholamines

Endocrine (4 decks)

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