endocrine Flashcards
endocrine
– cells respond to
factors (hormones) produced
by distant cells
thyroid anatomy
-pared organ, bilateral, connected at bottom
-1/4 width of trachea
-lots of collagen
parathryoid: partially embedded in thyroid gland, parathyroid is ontop of the thyroid gland. esp. cats
hormone synthesis in thyroid follicular cells
-iodine is being brought across, T3 and T4 are brought back through and released.
-cell needs AA, Carbs, regular amount iodine which are needed to synthesize thyroglobulin.
-T3/T4 have a negative feedback look with the hypothalamus, if you have an adenoma it can disrupt this. have TRH hypothalamus–> TSH anterior pituitary–> T3/T4
effects of thyroid hormones
Effect on many tissues
Normal development (brain) and growth
Increase metabolic rate
Increase lipid metabolism (lipylysis)
Increase glucose metabolism (glycolysis, glucose absorption)
Heart: Rate, output, vasodilatation
Brain: Alter mental state
Reproductive system
-T3/T4 amps up metabolism
reverse T3
-useless T3 (biologically inactive) in the body, converts t4-> T3 in states of
-protein starvation**
-liver and kidney disease
-febrile illness
congenital thyroid anomaly
Aplasia or Hypoplasia: Rare
Accessory thyroid tissue or
ectopic thyroid tissue***
Common in dogs from the Larynx to diaphragm but 50 % around intrapericardial aorta around base of heart, can become neoplastic
Differential diagnosis aortic base
tumors
Thyroglossal duct cysts: Ventral neck midline cervical region dog, can become neoplastic
- Parathyroid cysts: Bilaterally along trachea in cat.
incidental seline changes of the thyroid
-minerlization, lipofuscinosis, copora amyloidosis,
-horses: thyroid cysts normal
hypothyroidism
One of the MOST COMMON endocrinopathies in DOGS, but is rare in cats and uncommon in other species.
Affected dogs are usually between 4 and 10 years of age.
Mid to large breeds»_space;» Toy and miniature breeds
No sex predilection
thyroid gland lesions with hypothyroidism
Small thyroid gland:
Gland is destroyed or was never there. So no functional thyrocytes
Thyroiditis
Idiopathic follicular atrophy
Agenesis
Big:
Gland is continuously stimulated (hyperplastic and hypertrophic thyrocytes) by TSH because hormones not produced
Iodine deficiency/excess
Goitrogenic compounds
Defect in biosynthesis of hormones
-goiter thyroid in neonate from pregnant mother with low iodine.
clinical signs of hypothyroidism
Metabolic changes:
- Weight gain
- Cold intolerance**
- Lethargy
Skin:**
-Bilateral symmetrical thinning of hair
coat
- Scaliness of coat
- Hyperpigmentation of skin
- Secondary pyoderma
- Myxedema
-hair follicles are the targets of T3/T4 hormones
Reproductive:
- Anestrus**, lack of libido
- Joint Pain
Hypercholesterolemia:
- Atherosclerosis
- Lipid infiltration in liver, kidney and
cornea
Anemia
common causes hypothyroidism
Lymphocytic thyroiditis: Inflammatory
Idiopathic thyroid atrophy: degenerative
-75% tissue lost before clinical signs
Goiters (rare) from:
Iodine deficiency
Iodine excess
Goitrogenic compounds
Genetic
lymphocytic thyroiditis
Seen mostly in dogs
may or may not develop clinical hypothyroidism.
-antibodies to Thyroglobulin, Thyroperoxidase, TSH receptor
Similar to Hashimoto’s disease of humans
Gross appearance:
Slightly enlarged, normal size or smaller, pale, micro: lymphocytes
idiopathic follicular atrophy
Idiopathic: arising spontaneously or from an obscure or unknown cause
Primary degenerative disease of the thyrocytes
Replacement of the gland by adipose tissue
Not associated with inflammation
Distinct from the follicular atrophy due to decrease in TSH stimulation.
Thyroid follicles undergo involution
hyperplasia= goiter thyroid
-most common sheep, goats at birth: abortion with slow growth rate, lethargy and abnormal mentation.
-non neoplastic, non inflammatory enlargement of the thyroid gland due to increased TSH secretion resulting from inadequate thyroxine synthesis and decreased T3/T4.
hyperplasia= Goiters path causes 4
The four major pathologic mechanisms include:
1.) Iodine deficient diet**
Feed deficiency less common – born dead or weak
Can be exacerbated by goitrogenic compounds
Begins as a hyperplastic goiter -> colloid goiter with correction of diet
Excess dietary iodine**
High intake leads to inhibition of thyroid peroxidase -> decreases the
organification of iodine -> decreased thyroixine
Goitrogenic compounds interfering with thyroxinogenesis: Brassica plants
Genetic enzyme defects in hormone synthesis
goiter thyroid 3 morphological causes
1.) Diffuse Hyperplastic Goiter:
More common in young animals born to dams on iodine deficient diet or excess iodide or dams fed goitrogenic substances.
2.) Colloid goiter:
Represents involutionary phase of hyperplastic goiter (recovery following correction of the problem in diffuse hyperplastic goiter).
3.) Congenital dyshormonogenetic goiter (inherited goiter):
Autosomal recessive disorder in some breeds of sheep, goats and cattle; rare in dogs and cats (more common in children).
Result of genetic impairment of thyroglobulin synthesis; T4 & T3 levels are low even though iodine uptake and turnover are increased.
-symmetrically enlagred at birth
thyroid hyperplasia/ musculoskeletal syndrome in horses
Hyperplastic goiters
Mandibular prognathia
Flexural deformity**
Ruptured tendons of the common
digital extensor muscles
Delayed ossification of carpal bones
hyperthyroidism
-most common endocrinopathie in CATS
DISCRETE ADENOMAS or HYPERPLASTIC NODULES seen grossly
Follicles (on histo) outside the adenomas or nodular hyperplasia may be atrophied (decreased TSH due to feedback)
Carcinomas are uncommon in cats
clinical signs/ lesions with hyperthyroidism
-metabolic changes: hyperactivity, PU/PP/PD **, weight loss
-skin: rough coat, cervical swelling, coughing and dyspenia due to enlarged gland.
-heart: left ventricular hypertrophy in cats if left untreated, can get to HCM
-tachycardia/ murmor
- 10-15% of cats present with overt
congestive heart failure (dyspnea,
muffled heart sounds, ascites
multifocal nodular hyperplasia of the thyroid
-idiopathic, incidental lesion in old animals exept CATS where it may be functional
follicular cell adenoma in thyroid
-more common and may be functional in cats
-also in horses(white) dogs
hyperthyroidism in dogs
-rare Occurs in middle aged and older dogs (7-15 years)
Clinical findings can be similar to cats with hyperthyroidism
Discrete Adenomas or hyperplastic nodules (not common)
THYROID CARCINOMAS
Follicular cell adenocarcinoma
May or may not be functional
Highly aggressive and invasive, may become fixed or invade lungs, thyroid vein, lymph nodes.
parafollicular cells
C cells are found between follicles or follicular cells and are derived
from neural crest cells.
Secretory granules contain calcitonin (CT), an emergency hormone, which protects against hypercalcemia by:
Inhibiting bone resorption
Diuresis of Ca2
parathyroid feedback
PTH and CT act in concert to keep [Ca2+] in the ECF within narrow
limits
PTH level is controlled by direct feedback control system based on [Ca2+ /P] in the blood
Protects against hypocalcemia by
increasing intestinal absorption of calcium (with Vit D3)
Stimulating bone resorption of calcium
Enhances renal tubular reabsorption of calcium
hypoparathyroidism causes
Lymphocytic parathyroiditis: Believed to be immune-mediated
Parturient Paresis (Milk Fever): Occurs in cows fed a high calcium diet before parturition
Other causes include:
Destruction of the parathyroids by neoplasms, accidental removal during thyroid
surgery or long-term hypercalcemia from ingestion of calcinogenic plants like Cestrum
diurnum.
hyperparathyroidism primary vs secondary
-primary:
- parathyroid adenomas usually in older dogs (single, encapsulated, functional tumors produce excess PTH will see atrophy of para gland
-secondary:
due to nutritional imbalances
-excess dietary P, N or low Ca and vitamin D3.
-bran diets in horses
-meat diets in cats/ dogs
renal: response to hypercalcemia and progressive hyperphosphatemia due to decreased GFR, low calcium
secondary will lead to prolonged hypocalemia –> hyperplasia of cheif cells –> bilateral enlargement of parathyroid gland
-excess PTH can lead to fibrous osteodystrophy from bone resorption, bones become swollen.
hypercalcemia of malignancy
Paraneoplastic syndrome:
-caused by secretion of PTH-related protein which mimics the action of PTH
- cause hypercalcemia and hypophosphatemia.
examples:
- Adenocarcinoma of apocrine glands of anal sac (mainly in dogs)
-Lymphosarcoma (in dogs and cats).