Endocrine Flashcards
Based on Fenn. et. al what is the reported XX of cats undergoing hypophysectomy for treatment of acromegaly?
a. post-operative mortality
b. improvement in glycaeic control of survivors
c. % achieving remission
d. Median time to remission
e. recurrence rate of DM in cats that initially achieved remission?
a. 15%
b. 95%
c. 71%
d. 9 days
e. 12%
https://paperpile.com/app/p/26ddffb2-9bae-0694-88ba-3c16c39ad6a2
What percentage of analysed compounded trilostane packets contained an acceptable strength of trilostane in Korea?
40.9%
Incidence of hypoA in dogs?
2.3 cases per 10,000 dog years
https://paperpile.com/app/p/9a9096be-d2fe-0335-9571-5b219eb3f024
RR of hypoA in female dogs
1.85
https://paperpile.com/app/p/9a9096be-d2fe-0335-9571-5b219eb3f024
RR of death in dogs with hypoA compared to other dogs?
1.9
What percentage of cats achieved remission in a trial of exenatide ER formulation?
40%, the authors extrapolated rates may be more like 20% in larger studies
https://paperpile.com/app/p/dd7a38d2-a3a4-04ce-abc7-b07104127fad
What is the relationship between hyperTH in cats and hypocobalaminaemia, what should you do if you document low B12 in a hyperthyroid cat?
- 13% of hyperthyroid cats had reduced B12 concentration pre-treatment
- This normalised in 2/5 of these cases following treatment
- None of the cats had increased MMA concentration
- No correlation of B12 with T4 or clinical scores of hyperthyroidism. Therefore no treatment is required.
Essentially it is worth considering whether GI disease is present if you have a hyperthyroid cat with hypocobalaminaemia as it only occurs in a very low percentage of cases. It is also not something that requires treatment.
What breeds had the highest:
1. ET-1 concentration
2. PRA
3. Cortisol
Newfoundlands had the highest ET-1 concentration (3x higher than other breeds)
- Dacshunds had the highest PRA (2x higher than Newfoundland and Boxers)
- Cortisol highest in Finnish Lapphunds (3x higher than Boxers)
n.b. only 9 breeds studied
https://paperpile.com/app/p/47b2f75a-bfee-0787-88fc-4c98811b1dc0
What metabolic derrangements are known to occur in overweight dogs following a high-fat meal?
Overweight dogs had increased TG response and higher fasting cortisol/creatinine ratio to lean dogs
https://paperpile.com/app/p/17bbae0b-1ba5-0533-9172-6c047e70b8ac
What is the relationship in breed variation between Greyhounds, eicosanoid metabolites, SPB and albuminuria?
- Hydroxyeicosatetraenoic acid (HETE) isomers higher in grehyounds than non-greyhounds.
- Dihydroxyeicosatrienoic acid (DHET) isomers also higher in greyhounds
- Albuminuria correlated to total DHET
- SBP correlated to 11,12 EET and 20(S) DHET
- SBP and 8,9 EET were inversely correlated
What is the relationship in breed variation between Greyhounds, eicosanoid metabolites, SPB and albuminuria?
- Hydroxyeicosatetraenoic acid (HETE) isomers higher in grehyounds than non-greyhounds.
- Dihydroxyeicosatrienoic acid (DHET) isomers also higher in greyhounds
- Albuminuria correlated to total DHET
- SBP correlated to 11,12 EET and 20(S) DHET
- SBP and 8,9 EET were inversely correlated
https://paperpile.com/app/p/69937740-70fc-0006-b845-8b7642a8df39
In what conditions, other than diabetes mellitus is ketosis expected in cats?
Hepatic lipidosis particularly (73% of cases), CKD (21% cats) and hyperthyroidism (20% cats).
https://paperpile.com/app/p/fd9304b5-6751-0bba-8188-cff268ae6569
Which enzyme is responsible for the synthesis of aldosterone in the adrenal cortex, where is this expressed and what enzyme is likely responsible for the differential production of cortisol/aldosterone between these zones?
CYP11B2 (aldosteone synthase)
Expression is in the zona glomerulosa and zona fasciculata
CYP17 expression is higher in the zona fasciculata which may be why this zone produces cortisol
https://paperpile.com/app/p/10e74817-6f04-04c7-b29d-7cd66790027b
Which steroidogenic enzyme is responsible for the production of cortisol in the adrenal cortex?
11 b-hydroxylase cytochrome P450 (CYP11B1)
https://paperpile.com/app/p/10e74817-6f04-04c7-b29d-7cd66790027b
What is the relationship between BHB in dogs with acute pancreatitis vs. sick dogs without acute pancreatitis, and fasted dogs?
Highest in AP then sick then fasted dogs
https://paperpile.com/app/p/c01a4428-5b44-0f7e-ab98-15c1c194c642
% of dogs with DKA that have increased cPLI? What other marker did cPLI correlate with?
73%, increased cPLI was associated with lower CO2
https://paperpile.com/app/p/58dd8a27-4acc-0867-92a5-badbf1963d83
Period prevalence of felineDM in the UK
0.58%
https://paperpile.com/app/p/0e653787-de9b-0569-a88a-86034ba312a2
Risk factors for feline DM in the UK?
Age > 6 years
Bodyweight when > 4kg
Breed: tonkinese, Norweigan Forest, Burmese
https://paperpile.com/app/p/0e653787-de9b-0569-a88a-86034ba312a2
What marker may be used to assess soft tissue proliferation in cats with acromegaly?
N-Terminal Type III Procolagen Propeptide
https://paperpile.com/app/p/9c0a496b-affc-0c06-91ef-bf2696d3a5a2
To what degree do flash glucose measurements differ from reference laboratory glucose concentrations in dogs?
2.3mg/dL (0.1mmol/l). less accurate at lower glucose concentrations where the FSL tends to read lower
https://paperpile.com/app/p/3445f29f-a1d6-0577-b8c8-d255a9a05f57
What is the relationship of pituitary size to survival and DFI in dogs with HAC undergoing hypoP?
Bigger pituitart and P/B ratio associated with shorter DFI and survival
https://paperpile.com/app/p/5e2a1f28-b7be-0c3c-9c6f-697ca30e6d59
Which of the following is associated with a increased chance of reccurance of HAC in dogs following HypoP?
a - LDDST result
b - eACTH
c - UCCR
d - ACTH stimulation test results?
c
https://paperpile.com/app/p/5e2a1f28-b7be-0c3c-9c6f-697ca30e6d59
What dose of cosynotropin may be used for diagnosis of HAC compared to monitoring of HAC treatment?
Use 5ug/kg for diagnosis but a dose of 1ug/kg can be used for monitoring
https://paperpile.com/app/p/b10b7580-4396-0f8b-9179-f8c4898a477b
What proportion of cats with hyperthyroidism are underweight at the time of diagnosis and how does this change with treatment?
1/3 cats are underweight at diagnosis and the majority gain weight and BCS but around 45% of not completely regain their muscle mass. The majority of weight loss seems to be associated with muscle loss.
https://paperpile.com/app/p/c61d823c-0d3d-00b2-ab65-203af860ddad
Why do we use the cut-off of 55nmol/L basal cortisol for the exclusion of hypoA?
It has better sensitivity (99.4%) compared to the lower cutoff of 22nmol/L (sensitivity 96.9%).
https://paperpile.com/app/p/d9b8ba39-9ebc-0133-b233-2804ed312d29
What is the association of treatment of dogs with trilostane for PDH and no treatment on survival, any other factors significant in MV?
Treated dogs did not reach their MST whereas the MST for untreated dogs was 506 days. Treatement was the only significant factor in MV analysis.
https://paperpile.com/app/p/596957f1-8333-076f-89fe-b1a9107b079d
Environmental risk factors for DM in cats
Indoor cat
Obesity
Being a greedy eater
Feeding dry food (if normal weight)
https://paperpile.com/app/p/ce6e3572-285b-0ce7-a7af-dc0bab71ef27
What is the relationship between dose of I131 therapy and the incidence of treatment failure vs. azotaemia?
Low dose (2mCi) did not have an increase in treatment failure compared to standard dose (4mCi).
No difference between doses in the incidence of azotaemia but creatinine did trend higher in the standard dose group.
https://paperpile.com/app/p/ce2e42c4-f257-0e2f-a0cf-9499389b56af
What is the relationship between diagnostics at diagnosis and trilostane doses in dogs with PDH and GBM/cholestasis compared to dogs with PDH without evidence of cholestatic disease?
- PDH dogs with GBM were deemed to have more severe clinical signs, higher cholesterol concentrations and higher post-ACTH corstisol at the time of diagnosis
- Dogs with GBM had higher 2.5x higher trilostane doses than thoe without
- Dogs with imaging evidence of cholestasis had 1.5x higher trilostane doses than normal group
https://paperpile.com/app/p/3ebd887c-5f05-0369-bb0f-26eb262b3667
What POMC mutation has been found to NOT be associated with DM in labrador retrievers?
14 base pair deletion at exon 3, no association with DM but is associated with obesity in this breed
https://paperpile.com/app/p/eb90b48c-619b-0888-9b5a-be1a13ffa694
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873617/
What degree of ionised hypercalcaemia has been associated with a higher risk of develoment of post-treatment hypocalcaemia in dogs with primary hyperparathyroidism?
> 1.81mmol/l associated with increased risk of post-treatment iCa <1.00mmol/L
https://paperpile.com/app/p/cc173fee-5fc4-0a2e-8df9-49df72e29f00
How ot treat a HS cat with pasireotide and success of this therapy
8mg/kg LAR q1m
- Remission achieved in 3/8 (37.5%) treated cats
- Improved insulin resistance overall
- No significant decrease in frutosamine or median blood glucose
- Significant decrease in insulin doses
- Diarrhoa was frequent, followed by hypoglycaemia and worsening polyphagia.
https://paperpile.com/app/p/354a6a55-7b9a-019b-8401-fc4ce38a3b88
How long should levothyroxine be discontinued for if you want to re-assess thyroid function in. a dog that has been supplemented but that you did not suspect had hypothyroidism?
1 week, this is a valid assumption if the dog has been treated up to 16 weeks
https://paperpile.com/app/p/976fc95d-f3be-040e-9b69-27e31e5e47e4
Results of treatment of dogs withhyperlipidaemia with bezafibrate, time and success rate, effect on liver enzymes and cholesterol.
- 4 - 10mg/kg bezafibrate
- Normalisation of serum TG after 30 days in 91.3% dogs, cholesterol only decreased in 66.7% dogs
- TG decreased more in dogs with primary hyperlipidaemia than those with secondary
- ALT activitydecreased significantly after 30 days of treatment
- They did not actually measure ALP
https://paperpile.com/app/p/0b42daeb-4211-0f9c-9abf-784906ccfcce
What percentage of thyroid cysts will resolve with RAI in hyperthyroid cats?
50%
https://paperpile.com/app/p/0ac342e5-7ae0-0160-8a84-1c1f641fda36
What would be acceptable scenarios to interpret ACTH stimulation tests where tetracosactide has been known to be administered perivascularly?
Healthy dogs
Dogs with HAC that are being monitored on trilostane treatment.
https://paperpile.com/app/p/656ad8a9-fd8e-0e16-8018-f2e5c3758031
What is the relationship between breed and coat length and riskof hyperthyroidism in cats?
- DSH had increased risk of hyperthyroidism compared to pure-bred cats
- Longhaired DSH were more likely to develop hyperthyroidism.
- No association with coat colour or pattern
https://paperpile.com/app/p/d4abd7ca-0d30-065a-8f4a-341105d8432d
What is the relationship between homocysteine, folic acid and hypothyroidism?
- Hypothyroid dogs had higher homocystenie and lower folic acid than healthy dogs and this is similar to what is seen in humans.
- Homocysteine was inversely correlated to folic acid, TT4, fT4
https://paperpile.com/app/p/2847d0f0-c5f3-0fe0-917d-4fff1f8a531b
Percenatge of dogs with hypoadrenocorticism with elevated TSH and how long this takes to resolve with glucocorticoid treatment.
- Around 1/3 dogs with hypoA had increased cTSH values.
- cTSH normlaised in most of these cases withiin 2 - 4 weks but took up to 4 months after initiation of glucocorticoids.
https://paperpile.com/app/p/2f33adde-253e-0581-8a33-833a43518a79
What threshold of total calcium may be specific for diagnosis of ionsed hypercalcaemia in dogs, what condition applies to this value?
12mg/dL (2.99mmol/L) had a good PPV but poor sensitivity for ionised hypercalcaemia in non-hyperphosphataemic dogs.
What non-neutral short acting rh insulin has been shown to be effective in DKA management in cats?
Lispro - it resulted in shorter time to normoglycaemia than regular insulin in this study
What is true of the diagnostic accuracy of FGMS in dogs with DKA?
Analytical accuracy criteria are not met but results are acceptable for clinical accuracy
What is the mode of inheritance of DM in American Eskimo Dogs?
Polygnic