Endocrine Diseases Flashcards
Hypothyroidism
thyroid gland dysfunction
Thyroid function will not return 🡪 daily life-long medication
Hypothyroidism commonly in
dogs
▪ Seen in cats treated for hyperthyroidism
Hypothyroidism acquired
hypothalamus or pituitary dysfunction
Hypothyroidism clinical signs
▪ Weight gain w/ no diet change
▪ Bilaterally symmetric alopecia; “rat tail”
▪ Cold intolerance
▪ Recurrent skin infections
▪ Reproduction problems
Hypothyroidism dx
▪ Thyroid ultrasound
▪ Thyroid biopsy
Hypothyroidism tx
Life-long supplementation w/ thyroid replacement
hormone
▪ Reevaluate 4-8 weeks after the start of therapy to evaluate levels
Hyperthyroidism
▪ Result of a functional thyroid adenoma (>70%) or thyroid carcinoma (1-2%)
Hyperthyroidism common in
cats ▪ Rare in dogs (neoplasia)
Hyperthyroidism clinical signs
▪ Middle-aged 🡪 older cat
▪ Polyphagia, V, weight loss
▪ Tachycardia +/- murmur, ↑ systolic BP
▪ Palpable enlarged thyroid
▪ Aggressive behavior, hyperactivity
▪ Blindness w/ retinal detachment
Hyperthyroidism dx
▪ Palpation
▪ ↑ Thyroid hormone levels
▪ CBC/chem – r/o other organ system failures
▪ Nuclear scintigraphy – 1-2 glands
Hyperthyroidism tx
Surgery – curative, preserve parathyroid
▪ Radioactive Iodine-131
▪ Antithyroid drug therapy
Antithyroid drug therapy
inhibit the synthesis of thyroid hormone by disrupting the incorporation of iodine
Diabetes Mellitus
Β-cells in pancreas stop producing insulin in adequate amounts or the cells in specific body tissues become resistant to action of insulin
Diabetes Mellitus occurs
Insulin facilitates the entry of glucose into the cell 🡪 glycolysis
Diabetes Mellitus type 1
100% of dogs, 50% of cats 🡪 insulin therapy
Insulin dependent
Diabetes Mellitus type 2
Noninsulin dependent 50% of cats
Insulin
▪ Protein molecule: damaged by heat, rough
handling, chemicals
▪ Refrigerate, mix gently, use new syringe (Vetsulin)
Diabetes Mellitus types
Nonketotic diabetes
Ketotic diabetes
Diabetes Mellitus Nonketonic diabetes signs
▪ PU/PD, dehydration
▪ Weight loss (especially in cats)
▪ Polyphagia
▪ Sudden cataract formation
Diabetes Mellitus signs
▪ All of the above +
▪ Depression, weakness
▪ Tachypnea
▪ Vomiting
PU/PD, dehydration
▪ Weight loss (especially in cats)
▪ Polyphagia
▪ Sudden cataract formation
▪ Odor of acetone on breath
Diabetes Mellitus dx
Evaluate clinical signs
Urine glycosuria
CBC/chem: r/o other concurrent disease
BG curve
Diabetes Mellitus types of tx
Dietary
Insulin therapy
Excercise regulation
Diabetes Mellitus dietary tx
High fiber w/ complex carbs
Diabetes Mellitus insulin therapy tx
Human or animal based
▪ Intermediate or long-acting
▪ SID or BID
▪ Monitor clinical signs, BG levels, and BG curves to adjust insulin levels as therapy progresses
Diabetes Mellitus excercise regulation tx
Normalize routines (diet and exercise)
▪ Excessive exercise may warrant a decrease in insulin for the day
Primary hypoadrenocorticism
Atrophy of the adrenal cortex 🡪 decreased production of glucocorticoids and mineralocorticoids
Secondary hypoadrenocorticism
Lack of adrenocorticotropic hormone (ACTH) – less common
hypoadrenocorticism causes
Trauma, fungal infection, neoplasm, and hereditary tendencies
Hypoadrenocorticism clinical signs
▪ Depression, lethargy, weakness, anorexia, weight loss
▪ V/D
▪ PU/PD
▪ Symptoms frequently wax and wane over time
Hypoadrenocorticism dx serum chem
Serum chemistry
▪ Low Na:K ratio
▪ ↑ BUN, creatinine, Ca, K
▪ ↓glucose and albumin, Na
Hypoadrenocorticism dx Adrenocorticotropic Hormone Stimulation test (ACTH stim)
Low resting cortisol [ ], which remains essentially unchanged after administration of ACTH
▪ Definitive diagnosis
Hypoadrenocorticism tx acute
Fluid replacement w/ normal saline
▪ Drug therapy: replace and balance steroid levels
Hypoadrenocorticism chronic tx
Oral steroid replacement therapy – daily
▪ DOCP injection every 25-30 days
▪ Monitor for clinical signs of crisis
▪ Periodic bloodwork: electrolytes, BUN, creatinine
Hyperadrenocorticism
Any disease state that results in hypersecretion of cortisol
Hyperadrenocorticism leads to
Pituitary lesion (excess ACTH)
▪ Abnormal pituitary cells secrete excessive amounts of ACTH 🡪 adrenal gland hyperplasia 🡪 oversecretion of cortisol
Adrenal tumor (excess cortisol)
Hyperadrenocorticism common in
dogs <20 kg
Hyperadrenocorticism clinical signs
Dogs >6 years old
▪ PU/PD
▪ Polyphagia, abdominal enlargement, obesity
▪ Excessive panting
▪ Muscle weakness, lethargy, lameness
▪ Bilateral symmetrical alopecia, pruritis, pyoderma
Hyperadrenocorticism dx serum chem
▪ ↑ ALP, ALT, cholesterol, glucose
▪ ↓BUN
▪ Lipemia
Urine cortisol:creatinine ratio ↑
▪ ACTH stimulation test
Hyperadrenocorticism dx Dexamethasone suppression test
Low dose
▪ PHD: no change in cortisol [ ] 8 hrs post
injection (remains high)
▪ Adrenal tumor: no change in cortisol
Tx Hyperadrenocorticism
▪ ▪
Surgical removal of one or both adrenal glands
Medical management
▪ Drug therapy to decrease adrenal gland function (trilostane/mitotane)
▪ Life-long
