Endo Endo endooooooo

Question 1

just giz everything you can remember about Addisons

Answer 1

Hypoadrenocorticism
* Patho: Lack of cortisol. Can be iatrogenic (overuse of steroids and sudden stop), or primary (idiopathic adrenal destruction)
* Signalment: 4-5 year old dogs, often female
* CS: the great pretender, signs wax and wane, PUPD, lethargy, V/D
o Low cortisol = lethargy, GI bleeds (low albumin), anaemic, hypoglycaemia
o Low aldosterone = poor renal function, low sodium in blood, water loss, azotaemia
* Dx: ACTH stimulation test = flatline, no effect on cortisol due to atrophy of cortex
o Bloods = No stress leukogram, high K, low Na/Cl, low glucose
* Tx : desoxycortone pivalate DOCP (monthly injection)

Question 2

what about cushings

Answer 2

Hyperadrenocorticism
* Patho: Excess glucocorticoids (iatrogenic, pituitary dependent (High ACTH too) or adrenal dependent)
* Signalment: Middle aged terriers
* CS: PUPD, polyphagia, pot belly, muscle wastage, thin skin (veins), hepatomegaly, bilateral flank alopecia
* Dx: ACTH stimulation = exaggerated cortisol response
o Low dose dexamethasone: failure of cortisol suppression
o Bloods: High stress leukogram, high ALP, ALT, high glucose
* Tx: Adrenalectomy, or Trilostane

Question 3

hypothyroidismmm

Answer 3

• Patho: Acquired (idiopathic atrophy) or iatrogenic (thyroidectomy/ goitrogens ) leads to high TSH and low T4 in primary
• Signalment: Middle aged dogs. Dobermans, golden retrievers, cocker spaniels
• CS: Dullness, lethargy, obesity (increased metabolism), cold intolerance, bradycardia
  o Skin changes: Bilateral symmetrical alopecia, sad facial expression
• Dx: Low total T4 and high TSH
  o Bloods: Hypercholesterolaemia, Anaemia, mildly increased ALT/ALP
• Tx: T4 replacement (Levothyroxine)

Question 4

hyperT

Answer 4

• Patho: Usually bilateral adenomatous hyperplasia
• Signalment: Older cats. Skinny crazy kitties!
• CS: Goitre. Increased metabolic rate = weight loss, polyphagia, V/D (due to increased motility and malabsorption).
  o Tachycardia, hyperactivity, reduced stress tolerance, PUPD
• Dx: High T4, TSH low
  o Free, unbound T4 unaffected by other systems
• Tx: Thyroidectomy, methimazole, thiamazole