Endocrine Flashcards
What is diabetes mellitus in dogs?
Type one response genetic reduction in the number and size of pancreatic cells
What is diabetes mellitus in cats?
More likely to be type 2 and transient
Can correct with diet
Insulin resistance
What should be considered when advising a diabetic client?
Dosing of lente insulin can take a long time to get right
Strict diet and exercise regime
Know the signs of hypoglycaemia
Have a diary as to when to give insulin must be given at the same time each day
What is the standard dose of lente insulin used for dogs?
0.25-0.5mg/kg Iv/sc
How regularly should check ups be made?
Once a month initially then one every three months then once every 6 months glucose curve is run to determine insulin effectiveness
What are the clinical signs of hypoglycemia?
Lethargy weakness seizures coma ataxia give maple syrup
What is a somogi over swing?
When insulin dose is too high will cause the release of glucagon and epinephrine creates hyperglycaemia
What is canine hypothyroidism and what are the clinical signs?
Lack of production of the thyroid hormones T4(thyroxine) and T3 (triiodothyronine) Alopecia Pyoderma Lethargy Weight gain Cold intolerance Hypercholesterolomia
What are the tests that can be used to test from hypothyroidism?
Total T4 usually high
CTSH high loss of negative feedback
Free T4 low
Treatment for hypothyroidism?
Sodium levothryoxine
Therapeutic monitoring 6-8 weeks after initial dose
Evaluate clinical response(further tests)
What is thyrotoxicosis
Excess production of the thyroid hormones Clinical signs include Panting Anxiety Aggression PUPD Stupor Coma
What is hyperthyroidism?
Over production of the thyroid hormones Clinical signs include Weight loss Aggression PUPD Goitre Increased metabolic rate (HR BP GI motility CNS activity) Secondary hypertrophy
What diagnositics should be used to look at the hyperthyroid cat?
Full health screen heam, biochem, urinalysis, look for any concurrent disease
Total T4 low free T4 high cTSH low
What treatment options are there for hyperthyroidism?
Medical management
Low iodine diet, anti-thyroid drugs (flemizole, vidalta)
Surgical management
Removal of the thyroid gland
Stabilise prior to surgery (tachycardia, renal insufficiency)
Preserve paraythyroid tissue
Possible recurrence monitor for hypocalcemia
Radioactive iodine expensive but curative
What is hyperadrenocortisim and what are the three types?
Cushings excessive production of cortisol
Pituitary
Excessive production ACTH stimulates excessive cortisol production
Adrenal
Excessive production of cortisol suppresses ACTH
Iatrogenic
Excessive use of glucocorticoids suppresses ACTH and CRH
What are the clinical features of hyperadrenocortism?
Pot bellied Alopecia Median age Exercise intolerance Polyphagia Panting
What are the diagnostic tests used?
Biochem increased ALP, ALT and cholesterol
Urinalysis
Glycosuria
ACTH
Measure serum cortisol one hour before and after administration cortisol levels above 600nmol is abnormal after injection
Low dose dexmethasone
Measure serum cortisol before at 3 and 8 hours normal is a prolonged suppression of cortisol
What treatment options are suited for cushings?
Tilostane once daily with food
Surgery
Delayed healing, pulmonary thromboembolism, risk of haemorrhage
Will get hypocortisism post surgery steroid supplementation monitor electrolytes
Hypoadrenocortisim what is it and what are the clinical signs?
Lack of production of cortisol and minearlcoticoid production Loss aldersterone Clinical signs Middle age females Lethargy Anorexia PUPD Vomiting D++ Muscle cramps
What is addisons crisis?
Hypovolaemia
Pre-renal azotemia
Cardiac arrhythmia (Brady)
Low levels of cortisol
What test is used to diagnose addisons?
ACTH stim test
Both below 20nmol do not give glucocorticoids before test as they react with cortisol
What are the treatment options?
Iv fluids for shock
Hydrocortisone or dexmethasone every 6 hours
Dextrose if hypoglycaemic
Iv calcium gluconate stabilise myocardial cells
What is phaeochromocytoma?
Tumour of the adrenal medulla
Produces catecholamines
What are the clinical signs of phaeochromocytoma?
Generalise weakness Collapse Panting Tachycardia Muscle waste Hypertension
What are the treatment options for phaeochromocytoma?
Medical
Phenoxybenzamine 2-3 weeks prior to surgery if persistent tachycardia give popanolol
Surgery
Surges of catecholamines, hypertension, arrhythmia, arrest
What do parathyroid tumours cause?
Secrete PTH to increase calcium seen in older dogs
Increase calcium and decreased renal function
What are the clinical signs associated with parathyroid tumours?
Hypercalcemia
PUPD
Mass on u/s
What are the treatment options for a parathyroid tumour?
Surgery
Diuresis for high calcium ivft saline surgical removal
Postop
Hypocalcemia (Muscle twitching, seizures, facial prurutis)
Monitor renal function
5-7days risk hypocalcemia
What is and insulinoma?
A tumour of the pancreas aggressive secretes insulin hypoglycaemia
What are the clinical signs of and insulinoma?
Weakness Muscle tremors Ataxia Seizures Coma
How do you diagnose and insulinoma?
Hypoglycemia Wipples triad (Clinical signs, fasting blood glucose below 2.2mmol/l improvement in signs following feeding) Increased serum insulin U/s CT for metastasis
How do you treat and insulinoma?
Medical
Frequent meals, glucocorticoids, prednisalone, diazoxide
Surgical
Removal of nodule partial pancreatmoty monitor glucose pre-op 5% dextrose infusion
