Endocrine And Metabolic Dissorders Flashcards
What is Hyperadrenocorticism more commonly known as?
Cushing’s disease
What species is cushings disease most common in?
Dogs
What causes cushings disease?
Excessive cortisol in the body. Either due to excessive steroid use or an over production of cortisol by the adrenal glands
What can cause over production of cortisol by the adrenal glands in cushings disease?
A tumour on the pituitary gland (pituitary dependent HAC) which over stimulates the adrenal glands to produce cortisol
Or a tumour on the adrenal gland (adrenal dependent HAC)
What is the most common form of Hyperadrenocorticism ?
Pituitary-dependent HAC
What are the clinical signs of cushings disease?
Polyuria/ polydipsia Polyphagia Pot belly Panting Bilateral Alopecia and skin changes (thin inelastic skin) Muscle atrophy and weakness
What are the diagnostics for cushings disease?
Blood tests: haematology and biochemistry
ACTH stimulation test
Low-dose dexamethasone suppression test (LDDST)
High-dose dexamethasone suppression test (HDDST)
Endogenous ACTH assay
Abdominal ultrasonography
Abdominal radiography
MRI or CT (pituitary and adrenal areas)
What tests would be used to confirm cushings disease?
ACTH stimulation
LDDST
What tests would be used to differentiate between pituitary-dependent and adrenal dependent HAC ?
HDDST
ACTH assay
How would pituitary-dependent HAC be treated?
Medically with trilostane (veterinary licensed product) or mitotane (human-licences product) if there are complications
How can adrenal- dependent HAC be treated?
Drugs or surgical removal
What are the nursing care point for a patient with cushings disease?
Monitor vital and clinical signs Assist VS with diagnostic tests Observe after blood sampling for haematoma formation and handle carefully as brushing can occur easily Provide water Clan and groom as necessary Administer meds prescribes by VS
What is Hypoadrenocorticism more commonly known as?
Addison’s disease
Shat causes Addison’s disease?
A reduction in, or failure of steroid production by the adrenals
What causes the reduction of steroid production by the adrenals in Addison’s disease?
Usually immune destruction of the adrenal gland but may also be a consequence of treating Hyperadrenocorticism
What does Addison’s diseases cause?
Electrolyte Imbalances, hyponatraemia, hyperkalaemia and dehydration
What is hyponatraemia?
Low sodium
What is hyperkalaemia?
High potassium
Which electrolyte imbalance caused by Addison’s disease can be life threatening?
Hyperkalaemia
What are the initial clinical signs of Addison’s disease?
Lethargy and inappetence but can be vague
What are the clinical signs of untreated Addison’s disease?
Anorexia Vomiting Haemorrhagic diarrhoea Hypotension Weakness Bradycardia Collapse
What are the diagnostics for Addison’s disease ?
Haematology and biochemistry Sodium:potassium ratio
ACTH stimulation test
ECG
What would the treatment be for a patient with Addison’s in an acute crisis?
Shock rate fluid therapy to reduce potassium levels and rehydrate
Intravenous corticosteroids
What is the treatment for a stable Addison’s patient?
Glucocorticoids and mineralocorticoids
Monitor treatment by measuring the sodium:potassium ratio
What is the nursing care needed for a patient with Addison’s disease?
Monitor vital and clinical signs (especially heart rate if in crisis) Assist VS with diagnostic tests Administer meds prescribed by VS fluid therapy (high in saline/low potassium) Encourage eating Provide fresh water Clean and groom as necessary Take outside frequently ECG when heart rate is low
What causes hyperthyroidism?
Overproduction of thyroxine by the thyroid gland as a result of benign neoplasia
What are the clinical signs of hyperthyroidism?
Polyphagia with weight loss Emaciation Aggression and hyperactivity Hear murmur and tachycardia Polyuria/polydipsia Vomiting and diarrhoea
What diagnostics can be used for hyperthyroidism?
Blood tests: haematology and biochemistry, total t4
What is the treatment for hyperthyroidism?
Administration of methimazole or carbimazole, radioactive iodine, or thyroidectomy.
What is the nursing care for a patient with hyperthyroidism?
Monitor vital and clinical signs
Assist veterinary surgeon with diagnostic tests
Reduce patient stress as much as possible
Feed a suitable diet
Provide water freely
Clea and goon as necessary
Administer meds prescribed by VS
provide post op nursing and observation for hypocalcaemic complications after thyroidectomy
Follow protocol for nursing after radioactive iodine treatment
What is hypothyroidism?
Decreased production of thyroxine (T4) as a result of atrophy or lymphocytic infiltration of the thyroid gland. Resulting in a decreased metabolic rate
What are the clinical signs of hypothyroidism?
Lethargy, exercise intolerance
Obesity
Bradycardia
Dermatological abnormalities: Alopecia seborrhoea, hyper pigmentation, pyoderma
What are the diagnostics for hypothyroidism?
Blood tests: haematology and biochemistry
Total T4, free T4 and thyroid stimulating hormone (TSH) assay treatment trial
What is the treatment for hypothyroidism?
Supplement thyroxine (levothyroxine)
What are the nursing care requirements for a hypothyroid patient?
Monitor vital and clinical signs Assist veterinary surgeon with diagnostics tests Feed a suitable diet Provide water freely Clean and groom patient Administer meds on VS prescriptions
What can hypercalcaemia cause?
Renal failure and death
